HomeMy WebLinkAboutPermit Miscellaneous 2010-7-28
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-01000
ISSUED: 07/28/2010
APPLIED: 07/27/2010
EXPIRES: 01/28/2011
VALUE: $ 1,593.00
Status
Iss u ed
225 Fifth Street, Springfield, OR
54 I -726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 498 Harlow Rd
ASSESSOR'S PARCEL NO.: 1703220002800
Springfield TYPE OF WORK: Commercial Miscellaneons
TYPE OF USE: Addition
PROJECT DESCRIPTION: Hayden Dental ~nite.~ ~ install bathroom and attic fans
Commercial
Owner:
Address:
SKYHA WK PROPERTIES LLC
32671 SKYHA WK WAY
EUGENE OR 97405
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
J COO INC
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License
169209
Expiration Date
05/06/2012
Phone
541-746-7065
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BuiLDiNG~iN'FORMA TION I
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path: . "
Sprinkled Building: .
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
! DE~E~OPMENTINFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
OVerlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
, ~'IUN: regon law \::lIUlII:;;:) VLl,
I PUBLIC IMPROVE J:'ITS les adopted by the Oregon Utility
. . ':,....;.. i:' Notification CSiiliwalk'lTypeples are set forth
. .... ,., in OAR 952-001-0010 through OAR 952-001-
0090. You m~o".l','!I!l!uJW?~@iQs:.he rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Notes: NOTICE: THE WORK
THIS PERMIT SHALL EXPIRE J: ~In
tlUTHORIL I~Utn II IOu , ~,. cOR
'OMlvlENCED OR IS ABANDONE eValuation Descri
'~.IY 180 DAY PERIOD.
Description Tvpe of Construction
$' Per Sq Ft
or multiplier
Square Footage
'of Bid Amount
Value
Date Calculated
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Page I of2
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Status
Issued
" 225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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Mechanical CII
'>;$1':00
(ifJ}:,: '
Use Bid Amount
,",
Total Value of Project
Fees Paid i
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Mechanical-Value
Minimum/Adjustment Mechanical,
Amount Paid
$9.48
$3,95
$58.00
$21.00, , "
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Total Amount Paid
$92.43 '
I Plan Reviews ~
Date Paid
.1:
P/28/10
" 7/28/10
7/28/10
7/28/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-01000
ISSUED: 07/28/2010
APPLIED: 07/27/2010
EXPIRES: 01/28/2011
VALUE: $ 1,593.00
1,593.00
$1,593.00
$1,593.00
07/27/2010
Receipt Number
3201000000000000480
3201000000000000480
3201000000000000480
3201000000000000480
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, iris~ections requested after 7:00 a.m. will be made the following
work day. ;~f~.\~:::r: f~;':'~;7 ,-
Reauired InsDections ~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that I have carefully examined "the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any an.d all work performed sball be done in accordance witb
the Ordinances oflhe City of Springfield and the Laws of the State,of()regon pertaining to the work described herein, and
that NO OCCUP ANCY will be made of any strudu're'without pennission 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 inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
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Owner or Contractors Signature
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Date
225 Fifth Stred
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000000000000480
Date: 07/28/2010
2:56:45PM
Job/Journal Number
COM2010-01000
COM2010-0JOOO
COM20 I 0-0 I 000
COM2010-01000
Payments:
Type of Payment
Check
cRcceintl
Description
Mechanical-Value
Minimum/Adjustment Mechanical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
STATEWIDE SERVICES
'.' R~C'eived By
hjm
Check Number
~atch Number
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Item Total:
Authorization
Number How Received
Amount Due
58.00
21.00
9.48
3.95
$92.43
Amount Paid
3019 randy meyer In Person
Payment Total:
$92.43
$92.43
7/28/2010