HomeMy WebLinkAboutPermit Building 2010-4-15
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00462
ISSUED: 04115/2010
APPLIED: 04/14/2010
EXPIRES: 10/15/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3530 GAME FARM RD SPACE 25 Springfield TYPE OF WORK: Miscellaneous
ASSESSOR'S PARCEL NO.: 1703154003100
TYPE OF USE: Alteration
PROJECT D,ESCRIPTlON: Revision to MH space to accommodate RV placement
Residential
Owner: URBAN TRANSITIONS LLC
Address: 840 BEL TLlNE RD STE 202 .
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Plumbing
Contractor _. .. License Expiration Date
BEAR MOUNTAIN ELEGfRIC LLC . 136298 08/12/2011
RELIABLE PLUMBING'&'MECHANICAL 182964 ll/O l/20 11
BUILDING INFORMATION ~. VOl!. \0
la'll feqU\Ies \)\\\\\'1 .
# of S&,fi' '. Olego" '0 \he Olegon se\ ~ize:
p/tl~i1\i ~l!uct\il~h~se lU\es ~ 952~'" 1st Floor:
1Ci\fl!'lL ~ f'ell,,\el. 0I"IOU9" 0 \he tu\!in ~2nd Floor:
NWi\ OO~-OO~ '" COpieS at ~epl\lilrAft Basement:
\ ''IlIa'l O'o~ \NO\e: ~e~o\~Garage/carport
OOi\Hiiil\. ~ce,,\e ;ego" \)\I\iI'I 4). Sq Ft Other:.
S~~ijl1blilBlh~ ~_8oo-33~-,2..34 Occupant Load:
nu es....tP.{\
I DEVELOPMENT INFORMATION ~
Phone
541-741-8844
541-689-4235
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Constrnction Type
Secondary Constrnction Type:
# of Bedrooms:
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS ~
. ; ",~, 'j I ( :"
1';"
.~~~" . '
. ~ ,
'"d.,;:">;
. Sidewalk Type: .' .."'....,..~O?\<.
Downspo~~\i 1~J \$ ~01
~01\C~~\1I~ $~~\\ 1\\\S i'~~~~ fO\\
\\-\\~JQ~\l~tl \)~~ \S ~t.l\tlO .,.'
~\.lQ\III\III~\\C~~ ~~?\Otl.
fI,\\'i "\ \)0 0
,..'.:.
Notes:
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p'aee 1 of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'.;..li..
:':/;I*" 'i:."
'J.';
I Valuation Description I
Description
Tvpe of Constrnction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
.~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Fixture
Sanitary Sewer - 1st 100 Feet
Water Line - 1st 100'
Amount Paid
Date Paid
$27.84
$11.60
$55.00
$6.00
$19.00
$76.00
$76.00
~u
. .,,'
,,:~~, ~i ,
4/15/10
4/1 5/1 0
4/1 5/1 0
4/15/10
4/15/10
4/15/10
4/15/10
"
Total Amount Paid
.
$271.44,,, .
I Plan Reviews I
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00462
ISSUED: 04/15/2010
APPLIED: 04/14/2010
EXPIRES: 10/15/2010
VALUE:
Value
Date Calcnlated
Receipt Number
1201000000000000344
1201000000000000344
1201000000000000344
1201000000000000344
1201000000000000344
1201000000000000344
1201000000000000344
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
~ellHiredJnsnections ~
Sanitary Sewer Line: Prior to filling trench and including required testing.
Water Line: Prior to filling trench and including required testing.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
Rough Plumbing: Prior to cover and includi,,:g:requir~d testing,
'. -c". " 'to..
Final Plumbing: When all plumbing work is complete.
Pedestal: Prior to cover,
Pa2e 2 of 3
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00462
ISSUED: 04/15/2010
APPLIED: 04/14/2010
EXPIRES: 10/15/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springlield and the L~'1's, of ,th,e State, of Oregon pertaining to the wOrk described herein, and
that NO OCCUPANCY will be made of any structu're;>yithoi,-j 'permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspection's are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front o(the property, and the approved set of pl~ns will remain on the site at all
1i~ 1}/;5/;1)
Owner or Contractors Signature Date
:, :\
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Pace 3 of 3
,,:' .
225 Fifth Street+Springfield, OR 97477 t PH(541)726-3753t FAX(541)726-3689
SPRINQFIELO -':'''''-.hi!~O:",",~
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DEPARTMENT USE ONLY
COW' zalO- 00 /.(b L
Permit no.:
I Date L{-/5' - /0
I
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
First branch circuit (2) I S 55.00 I
Each ~dditional branch circuit I S 6.00
;\liscella:neous fees: service or feeder not included
Each pu~p or irrigation circle (2) S 63.00 \ 5)
Each sig~ or outline lighting (2) S 63.00 $
Signal circuit or a limite, d-e, ne.rg~~~;PJ?tlel:' " I S 63.00
alleratio~, or extensi{;m.,(2)~.~;"Y..' ."
Each ad:ditiona~in;pect'''' ~O\, k
,.L. .' ,~SE:'
~()\\' ~~I~ ~ ~'fIitJii;.\J \' _ .
'W,\'o .~W\l: ~~~i~\~58.00)'
f\\)'\' ~i;&~~\Hl ~,()~e (.12 x [AD
'CG~ ;~'\)'a!\\!logy Fee (5% of [AD
f\~ TOT A~ fees and surcharges (A through C):
LOCAL- GOVERNMENT APPROVAL
Zoning approval verified" 0 Yes 0 No
CATEGORY OF .CONSTRUCTION
-erResidential I 0 Government 0 Commercial
'",JOB SITE INFORMATION. AND LOCATION '-'-
Job site address: '35]. 0 6-r\~ E FA t?-w\ -r+.::r ~
City: Sf>Ph I State:04- I ZIP 97'177
Reference: 17031540 I Taxlot.: 03100
DESCRIPTION OF WORK
R.. V ~E:::i)f!' ~ r-.4-L
PROPERTY OWNER
Name c..A Q..~ TM...JSft, T (e_5' I /" I
Address: <gL(O 'j?~ rL.{,\i(!' f2.-) S7e> ZoZ
$.l'P D T State oL- I ZIP: 9 7V77
,s>o/
A..\\g.(J
~S'Q.~
\}..I\
440-2584-J (9/08/COM)
FEE SCHEDULE
Number of inspections per item () Qty.
.- ,
Cost
ea.
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) 5134.00 .5
Each additional 500 sq. fl. or portion I I 5 25.00 S
th.:reof
Limited energy (2) I 5 32,00 I s
Each manufactured home or modular 5 63.00 I s
dwelling service or feeder (2)
Services or feeders: inslQl!mion, alteration, relocation
200 amps or less (2)
5 81.00 S'
20110400 amps (2)
40 I to 600 amps (2)
601 to 1.000 amps (2)
Over 1,000 al1'.l?s or volts (2)
Each branch circuit
S 6.00
5
.b. Fee for branch circuits without purchase of a service or feeder fee:
5 5S'1
s /..,
I S
558.00 I S
S b(
S -;~L
S .:3 O~
s 7/31
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
~~Q~~
~
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000344
Date: 04/15/2010
9:05:34AM
Job/Journal Number
COM20 1 0-00462
COM20 1 0-00462
COM20 I 0-00462
COM20 I 0-00462
COM20 1 0-00462
COM20 1 0-00462
COM20 1 0-00462
Payments:
Type of Payment
Check
cReceintl
Description
Sanitary Sewer - 1st 100 Feet
Water Line - 151 100'
Fixture
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
WHITNEY BOSS
Received By
djb
".
, ,
Page I of 1
Check Number
I
Batch Numberl
1280
Item Total:
Authorization
Number How Received
Amount Due
76,00
76,00
\9,00
55,00
6,00
27.84
11,60
$271.44
Amount Paid
In Person
Payment Total:
$271.44
$271.44
4/15/2010