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Home My WebLink AboutPermit Building 2010-8-12 /. :..~. www.cLspringfield.or.us PROJECT STATUS: Issued ~ .. :...'~ "t'. ',:;-, .... ~ . Ih ('!:, ;..,t. CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: COM2010-00933 IVR Number: ISSUED: 8/12/10 APPLIED: 7/13/10 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.or.us EXPIRES: 2/7/2011 VALUE: $31.068,00 SITE ADDRESS: 2669 Cloverleaf Lp S Springfield ASSESOR'S PARCEL NO: 1703224300800 SCOPE: CF WORK INVOLVED: ADD TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Sunroom Addition; 192 s.f. Unconditioned Space , r Phone Number: OWNER: ADDRESS: CLOVERLEAF ASSISTED LIVING LLC 184 E 11TH AVE STE 210 EUGENE OR 97401 Contractor Type # of Units: 0 Construction Type Occupancy Type Occupancy Comments CONTRACTOR INFORMATION ~ Contractor Name _..~~:::':.,.._.,,...\:"'__. ~ .,.:.. Lic Type CHAMPION WINDOW CO OF PORTLAND.lLC' CCB BUIEDlNCfiNFORMA liON ~ J~ VA SR-2 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: . # of Bedrooms: Sprinkled Building: y Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit Electrical Specialty"Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code'Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: ".:,~~ Site I~formation.' _. ,,.l~~......,. ,.:........ ..~__....,' ?~~F,. ~i:ri~.GY... -. rp?, r~~:r-7'1i~ ."= 'J!....DiM ,;.,PI.H <<: '~'.~'rJ ;' . ," f",:.'r-'1< 'h' ATTENTION: Oregon law requIres you 10 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center" (Note: the telephone number for the Oregon Utility Notification' Center is 1-800-332-2344): ' _1,'ch''~;8i1212010 r1:2~:01AM ., --'. .. Lic No 180343 Lic Exp 02/0112012 Phone 503-624-2678 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 192 Occupancy Load: 13 *- ~\)<<-'~ / '\--<-'-<- f> ~\) S~ -#\\)~ ~~ 'X\-\\-'V 'vY:- ~S ~<:) , '~-X-~ ~"\ ~ N~. -# C;)'0~'V<<:-f? ~ ~,~'\~ "1.,-<-<<-' 0v\-'V \)~ ~\)'V' ~,\~\--<-\)~~~,,\-} "1.<<:- . ~ "-~~ CO\) 'V ,,\J ~ '\ '0-~ Page 1 of 7 . "r. S.r,IUN. G F.IE~ ~"';\'l'-' ','-" ." ~ ; rlil ~. OREGON . 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726-3769 Fax: 541'726-3676 www.ci.springfield.or.us CITY OF SPRINGFIELD Building 'gommercial Permit . ...'....." ....t. .'._.. .' . ~, . ,. . .. ~..~,.,.. --~'~,. '~~'--. .... . PERMIT NO: 'C'OM2Mo'~00933 ...-..,,"', -""".<.-' ,r:'iVRi'Nulrifikf: ,.~~"";',' "., permilcenter@ci,springfield.or.us PROJECT STATUS: Issued ISSUED: 8/12/10 APPLIED: 7/13/10 EXPIRES: 2/7/2011 VALUE: $31,068.00 SITE ADDRESS: 2669 Cloverleaf lp S Springfield ASSESOR'S PARCEL NO: 1703224300800 SCOPE: CF WORK INVOLVED: ADD lYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Sunroom Addition; 192 s.f..Unconditioned Space DEVELOPMENT INFORMATION ~ , ;;.r;~' : :: :,; , REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Total: Handicapped: Compact: Street Improvements: Storm Sewer: . Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: PUIl!:lC'.IMPRPVEMENTS, ~ ~(5t~~\ ""[ffty.(, . :,;~-'l. ~ji~:/;~} <- i~~~~ :: E:::~':':; Sidewalk Type: Downspout/Drains: Valuation -Description ~ "11)4" ',"~..\ '" ,,",~'1'.\'.. Descriotion Tvee of Construction';~' ;::.., i . Unit Amount Unit Tvee Unit Cost Value .:',. ..1' ~l0,:~::~c-..;~~.t.,:~,_ Descriotion Plan Review Comm/lnd/Public Building Permit ~ 5% Technology Fee + 12% State Surcharge Plan Review Fire & Ufe Safety ~~,::~~"'~0E~SI!AIP .' Amount Paid $216.77 $333.49 ,;,-1~.~~.1~:?? ; '~:,~ '~~:':~~92 ','~;,. ' ,~t:~'~33:~O . . . Total Amount Paid 1~1~",~t;~~' !~$740:35 ,,:'~" " '",,:..~~-;:;........, ~ <, ',. ""',-",, ',1, I Date Paid 07113/2010 08/12/2010 08/12/2010 08(12/2010 08/12/2010 Receipt # 153978 224424 224424 224424 224424 Springfield Building Permit 8/12/2010 11:26:01AM Page 2 of7 ....' . ""''':';;'''' ]I; li.~; ~j i: ,I '",:..,f ,].f~~i~ " ,.tlr; CITY OF"SPRING.FIELD 'lit. 'd. : 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541.726-3676 Building:1~ommercial Permit PERMIT NO: COM2010-00933 www.cLspringfield.or.U5 IVR Number: PROJECT STATUS: Issued ISSUED: 8/12/10 APPLIED: 7/13/10 "t.-, EXPIRES: 2/7/2011 VALUE: $31,068.00 perm itcenler@ci,springfield.Of.US . "(<1",'" .,.. "~,,. ., ,,:~"';'ty.ll',t .,~lt~'l :r,;,-, ,..~".. ,'" SITE ADDRESS: 2669 Cloverleaf Lp S Springfield .""'1, '\'<V~," ,t, S~OPE: CF ,..."" {,....",..C, WORK INVOLVED: ADD ASSES OR'S PARCEL NO: 1703224300800 ,~,,-~,. ".-- :'. '!,,',.;.,. .."tYPE OF STRUCTURE: COM d, "i PROJECT DESCRIPTION: Sunroom Addition; 192 sj. Unconditioned Space f:~,~::7'~-~f -' ';:f~_' '~~~- -';-~-~-~ '~~~2:Pl~;-~Yll!W -, " Oeoartment Received Due Date ComDlete .Bmill.!! Fire Department Review 08/02/2010 APP OK to Issue 08/06/2010 10 Planning Review 07/19/2010 APP Public Works Review 08/06/2010 DONE Structural Review 08/06/2010 APP Structural Review 08/03/2010 WI '1' .;'.~'jil' :,' ," 'j,!' ,l'''';\J ,'J r Initial Review 08/09/2010 08/09/2010 08/09~201'Q .~, Over the .Gaunter Electrical Review 08/09/2010 08/09/2010 08(P?/~0,,1.9 ~ Overl~h.~:Counter Mechanical Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Plumbing Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Planning Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Fire Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Public Works Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Energy Code Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Traffic Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Structural Review 08/09/2010 08/09/2010 08/09/2010"; Over. the Counter !..,{.:~. ...." :'~--' ", . .,. ,. Application Acceptance 08/09/2010 08/09/2010 n:-f~i-~~. ".~~e~~e~~ounter. Permit Issuance 08/12/2010 08/09/2010 08/09/2D.1Q}i .tsS~~d~ ~. INSPE~,TIONS REqUIRED Inspections 1110 Footing 1150 Slab/Flatwork <> --;.--,-.- .:-h.' , ~', "~~'~M~~~__ \::~.:::::..::..::~~~~,_ .~: ~~_ ~l~:r~;'- .~~~ Reviewer Comments Plans Review: addition of an Provide signed electrical pen Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter C:hris Carpenter Chris Carpenter Chris Carpenter 'Chris Carpenter David Bowlsby ~ no sdc's on this, no new dwel Provide signed electrical perr Public Works Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit See workflow history 1260 Framing 1710 Fire Sprinklers 1734 Fire Alarm Rough 1740 Fire Alarm Final ::' i' t.,;, ~ 1999 Final Building .J . '.! ',.! I, ,_,(~ . 'I .;;.'-')n_I.1 , '.i: .',' OWNER: ADDRESS: CLOVERLEAF ASSISTED LIVING LLC 184 E 11TH AVE STE 210 EUGENE OR 97401 , ". I ~~ r: Phone ~umber: Contractor Type CONTRACTOR INFORMATION ~ Lic No 180343 Springfield Building Permit Contractor Name CHAMPION WINDOW eo OF PORTLAND LLC ~,;;~,.,:, . :(,,\;:.~'''''' 6.;,~L~I,\f,"';., l. ~ f :V"l',,(".J,l, ~,' I"{.'" t. ,:.~:..,.,l,:..,'~.'~,~~:. ~:' "..',~". ." I Ef:8t121201H',.t7*1~2S:01AM ~ ,,:;:rr;"",:.\' Lie Type CCB Lic Exp 02/01/2012 Phone 503-624-2678 Page 3 of7 .f.pg:..; ~l!'f!j.1f':J-".. .._.._.'~, .,...... .- "_,c,__".-,_,,.. .~""'" 't~Ct~f, ..~, ..ji;~Fil j'l ~i ~<;.\'rv' ,. www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit. PERMIT NO: COM2010-00933 IVR Number: 225 Fifth:St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitcenter@ci,springfield.or.us PROJECT STATUS: Issued ISSUED: 8/12/10f .". " APRI:JED: 7/13/10. , " "', ". EXPIRES: 2/7/2011 VALUE: $31.068.00 SITE ADDRESS: 2669 CLOVERLEAF S Springfield ASSESOR'S PARCEL NO: 1703224300800 SCOPE: CF WORK INVOLVED: ADD TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Sunroom Addition; 192 s.f. Unconditioned Space I BUILDING INFORMATION ~ # of Units: 0 Construction Type Occupancy Type Occupancy Comments VA SR-2 ,-,-!:~~ "~!~'.\:P\~;.~ # of Stot~es: Heig ht:6f'Str,ucllJre :" t,'""" s~~~. ,,~"j;l'~. Type oJiH~at: . Water Type: Range Type: Hazmat: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 192 Occupancy Load: 13 # of Bedrooms: Sprinkled Building: Y Energy Path: Electrical Specialty Code Edition: Springfield Fire Code,Edition: Mecha~.ic~I.$Ptl!ci_aJt(C~de ,Edition: ,'i' ." . ,I' .1.-.. ',.-'i.L. Municipal I Development Code: FlIu'Mtifng Specially'Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Fire Alarms: Site Infonnation ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: d.l' "',,.-'1; ',..:,~ -~tr,,{;,"i.. .,' ,.,',..,;;l:- ;;;f(jrlU~ ... ..,. DEVELO"MENT INFORMATION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: ' L, ",.l.. . 11,1', <> I .j; 'i 'ICY::ll;.r;,\' I' ,lln!" riJ't;;~"r~h,~: 'liYl ,1..<;1 Springfield Building Permit 8/12/2010 11:26:01AM Page 4 017 www.ci.springfield.OLuS CITY OF SPRINGFIELD Building rCom~ercial Permit ~i:,<~;!"" ',' f"" : PERMIT NO: ,.COM2010-00933 1_;,:'1.0(1;; , 'r ~;., " 'IVR: Number: 225 Fifth ,St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541-726.3676 permitcenter@ci.springfield,or,us PROJECT STATUS: Issued ISSUED: 8/12/10 APPLIED: 7/13/10 EXPIRES: 2/7/2011 VALUE: $31.068.00 SITE ADDRESS: 2669 CLOVERLEAF S Springfield ASSESOR'S PARCEL NO: 1703224300800 SCOPE: CF WORK INVOLVED: ADD TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Sunroom Addition; 192 s.f. Un<<?onditi,<?ne,d ~pace :~ p,UB,L1C IMPROVEMENTS I ;", Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: ~'<- .-. 1;[''''0 .,' ,.'\.,;.I(:.lHTljl>X;.\., \' L 'I.:: ;-tt~: . " , . ,'-;G~'.?)r' ;~~G'1'-H <~ '~~Lo-i~'f ',rr ;,',", ." "1"'" . : Valuation Description ~ Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value , n~ '0' i; "':i,J" .::'0ie>"., ~ ,~"" . ?~,'}t~EES~~~ID~';.2~j~'~-"':~-~,':i r,. _.,.;~,-"-~~~:~,~:z~~. '~.::.:, _.:"~;~~-~~~ ""'--":"';: ,',',"""".', ,,,,,,",,"--;, DescriDtion Plan Review Commllnd/Public Building Permit + 5% Technology Fee + 12% State Surcharge Plan Review Fire & life Safety Amount Paid ~"l $216.71" ' ., ',' $~.3~~il~ , , ,.,b!~L:~~ ",.~,,. $16i97; ,C' ~l,:;:'.W'{' $40:02 $133.40 Total Amount Paid $740,35 Date Pa id 07/13/2010 08/12/2010 08/12/2010. 08/12/2010 08/12/2010 ReceiDt # 153978 224424 224424 224424 224424 C~t :,t'i{l'l~,1'",:. ',..! 'f'~,~t, :~:~jJtgt~( :,~ 'J;~>,:;' :.. ',::,-C1;". " ..~ '''l , .' ::::~i t, Springfield Building Permit 8/1212010 11:26:01AM~": Page 5 of 7' ., ~~ ~!; ~~ ,,~'j.'~~~}~ :';~~,~~~:L. \ ,,'- ":,:110T:"'. ,';- f' -i. ,<,' S)~lt~~EL~ ilfr:!EGON www.c1.springfiefd.or.us " '" :lft.':'.- '. -: ' 7'"~"ri~.' CITY0F"SPRINGFIELD '. 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Building I Commercial Permit PERMIT NO: COM2010-00933 IVR Number: Due Date 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 permifce~ter@ci,springfieJd,or. us PROJECT STATUS: Issued ISSUED:,8/12/,10 ~.,f ' ~ ..'_ ,.,..., APPL.lED: ii13ho' EXPIRES: 2/7/2011 VALUE: $31,068.00 , ~';':~~"')' " SITE ADDRESS: 2669 CLOVERLEAF S Springfi-~i~'~': " ~;"~" " ASSESOR'S PARCEL NO: 1703224300800 " PROJECT DESCRIPTION: ~,,_,c':: . '.' Deoartment Fire Department Review OK to Issue Planning Review Pubffc Works Review Structural Review Structural Review Initial Review Electrical Review Mechanical Review Plumbing Review Planning Review Fire Review Public Works Review Energy Code Review Traffic Review Structural Review Application Acceptance Permit Issuance Inspections 1110 Footing \;~:t.- SCOPE:CF WORK INVOLVED: ADD TYPE OF STRUCTURE: COM Sunroom Addition; 192 s.f. Unconditioned Space , ~c ".1' :':'::'~~. -~0'\~:--,~~c~!." <~,::: . :ill~:~f_~~i-i~y.;~," ;:' .' e, --'.:..~~~~~~~~'_:,~~~~~~~;~- -~; ~'s~,* ' ::~~~;t~~~~"":-1f~ Rece ived 08/02/2010 08/06/2010 07/19/2010 08/06/2010 08/06/2010 08/03/2010 08/09/2010 08/09/2010 08/09/2010 08/0912010 08109/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/09/2010 08/12/2010 Comolete Result APP 10 APP .._ DON~;. -.." APP' ,'"i"".' "I -fi;~{~:i WI .: .,,'r 08/09/2010' Over the Counter 08/09/2010 Over the Counter 08/09/2010 Over the Counter 0810912010 Over the Counter 08/09/2010 Over the Counter 08/09/2010 Over the Counter 08/09/2010 Over the Counter 08/09/2~~~ l.. _R.v,~f.~he, Counter. 08/09/.29,tO:-, ;9,y-~rl- .!~~ Counter 08/09/20%)' 'b~er th'e Counter ;:~~~~~" ~,Ov~~the~Counter 08/09/2q,fo Issued INSPECTIONS REQUIRED I Reviewer Comments Plans Review: addition of an Provide signed electrical perr Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter David Bowlsby no sdc's on this, no new dwel Provide signed electrical perr Public Works Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit Over the counter permit See workflow history 1150 Slab/Flatwork 1260 Framing 1710 Fire Sprinklers 1734 Fire Alarm Rough' 1740 Fire Alarm Final ,: 1~,;~' /. '1.' , , " 1999 Final Buildin9 ",- .r Springfield Building Permit ." " ,. ",!';'''' . ~!.IAt9~~ "!'d'"rtr; ,',.'I, ,..':r.D~.}+,~'''; i ,'t'" '!v".V/ (d'~'" ( "r'},~aft;'L .~, ~b~"~ 8/12/2010 11:26:01AM Page 6 of 7 :li.I.I.-- vi:""" www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial'Permit PERMIT NO: COM2010-00933 IVR Number: 225 Fifth: St Springfie'rd,OR 97477 Phone: 541-726.3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 S~R,' ING,F,I EL~,D" " ' _i c, , .... .~ .'. .... :w..... . OREGON perm itcenler@ci.springfield.or.us PROJECT STATUS: Issued ,. '{>' ..~. ISSUED: 8/12/10 APPLIED: 7/13/10 EXPIRES: 2/7/2011 VALUE: $31,068.00 SITE ADDRESS: 2669 CLOVERLEAF S Springfield ASSESOR'S PARCEL NO: 1703224300800 SCOPE: CF WORK INVOLVED: ADD TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Sunroom Addition; 192 s.!.'yncon~itioned Space . J,nH~;< ::)~: 'iii'"., ,; '" By signature, I state and agree, that I have carefully eXarl.1l~~~d the-:c9rnplet~d application and do hereby certify that all information hereon is true and correct, and I further certify thafany,andiall work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the,State' or Or~ego~ pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without perm'i~5ion of the Community Services Division, Building Sa:fety, 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. 'I :.: -:=- .J-f ~ Owner or Contractor Signature . 'c?~;?hC)/o I " , ,D~te'~, J. :\,1,< :'-" ;1;,lrr:' /, "[::.1' ..}J .,1.,1 '. :!:~.{ :-::.,'\,:;,;,'S,~~.~';",,~ :1, ;~,'" "_iIW2}! , _"." :} th'c\j ",]': Aff~J' ~Si:8tc , 't,.:.'. ~ ", . .r' r'~. t: ' ,;...;.....i'.. Springfield B~ilding Permit 8/12/2010 11:26:01AM Page 7 of 7 ,f,j. ..'.,' , 61~/ ':;;"':;:l"d ; " ~'" ':; '/.\'. .~' ,,::.,:",r;":, , Ii 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone SI?"'!'. '!I;I....... :di...... .. ~. II .. --........... -. ~._.,.__a.M~ .... ..,," City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000819 Date: 07/1:3/2010 IO:59:15AM Job/Journal Number COM2010-00933 Payments: Type of Payment Check cReccintl Description Plan Review CommlIndlPublic Paid By CHAMPION WINDOW CO OF PORTLAND -" ~ \ -."Check Number Rec:eived-BY":I' Batch Number . '(jjb U", ! " : I, \ 11,~: .~ 1; .-- ~..- _.~,-. .......... '""-'" ~- .-( . \- . :,,-,'':.ch'''! i:,y'/~, "."dT , c' I ,,~ ,\."j .... "' . '.',...:. , _.,.".........t' I" . ;;"~';,:'.'i~' , .':,., ) ";-;.::" OJ Page 1 of 1 Item Total: Authorization Number How ~eceived Amount Due 216.77 $216.77 Amount Paid 14464 $216.77 In Person Payment Total: $216.77 , 7/13/2010 . " .:~ \ :,~" . S':~~NG.~IE~ iIi,'>a... .. ~.. ~\..:~~. ,-, OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.ci.springfietd.or.us permitce nter@ci.springfield,or.us .. .. '.-' , -, .' ~" , , RECEIPT NO: 2010000045 RECORDNO:C0M2010-00933 . ~riESCRi&TldN~5"*,ii~~,~~-~7,j'.'.j""'-'i'Y~1:~.4?~;~',~~,f'v'.A:CC.OXINTE,CQDE, Plan Review Comm/lnd/Public Building Permit .~ 5% Technology Fee + 12% State Surcharge Plan Review Fire & Life Safety DATE: 08/12/2010 "'~ii.A:MQ(JNT.:l[)_(JE c $21677 $333.49 $1667 $40.02 --- $133.40 ._-~_.. ----,-,,--,--- ,-~- TOTAL DUE: $740.35 L;;JPAVMEN'f'fYP.Ec,j pAYbR~;';r';:iCASH_I1:iR_'-_D'''OiNlSBY;:;LCOMMENTS ."'_ ." -,,> ,-'"f _ft : ":AMOUNT.PAiD .'_ ~ -,~!i4_~ '_ ---'_--- _.", '" ___~-,,,,_,,______,,,,,,__'~_~,,,"__'<-~____-',^-,,~",,---,'d'_'__,_,,__,_,,,,, '" Check CHAMPION WINDOW CO OF $523,58 PORTLAND LLC 224-00000-425602 100-00000-425605 821-00000-215004 224-00000-425602 14566 . '., ",~.,. ~\'I .,:' ,-,:;,,,:,;,: '.;'.. \::': ..:. '7" . ~'(;':E~) '~~:~(}l;;;'~(~!){" j' , ~:,'~'~',.,~ ~~ " . j ;~. - < '~..: . . ~- " '.:~fn "--,"""" 1,'.l',/ , ] ;. ;, J