HomeMy WebLinkAboutPermit Building 2004-3-17
1;
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00225
ISSUED: 03/17/2004
APPLIED: 02/26/2004
EXPIRES: 09/17/2004
VALUE: $ 10,375.00
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 525 MILL ST
ASSESSOR'S PARCEL NO.: 1703352304500
Springfield TYPE OF WORK: Office
TYPE OF USE: Alteration Public
PROJECT DESCRIPTION: Remodel of person ell office, separate from EMC AC alterations (coolin'g for computer
room). OK to final remodel prior to EMC completion~
Owner: SCHOOL DISTRICT #19
Address: 525 MILL ST SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
General
Mechanical
Contractor
OWNER
COMFORT FLOW
License
Expiration Date Phone
tc.
'I"~
460
BUILDING INFORMATION I
06/27/2004 541-726-0100
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# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
c~~ of Heat: Sq Ft 2nd Floor:
~~~Type: Sq Ft Basement:
,\Y::-~ '~Jle Type: ,0 Sq Ft Garage/Carport
~ ~ ~~gy Path: ~o~ ~~\k~t Other:
~:~ <:(~~~~ ~0C;) ~..::s fltlPffVious Surface Area:
..~, Co. ('"..... .~ .() r_0 C') ,
~ ~ '\.~I~E\rELOPMENT INFORMATJON.Jf-J rz}0 OJ?jV.s.0C;) 0
. SETBACKS.,( ,-:>~....SJ<<; c.. ~'f.J ~,.;".;:s-- ..siZlC;)O~~0 ~ ~O~~QUlRED PARKING
.' ~. ~" ~"... ,\:.1 S). 0 ~ ~ ~ ~ "\: 0~. ~ .
Frontyard Setback: ~~ k,~ ~<v ~<<:- ~'S Overlay Dist: ~0($l>'O 0C::J0 :::,($ c:, 0 ,el- ~,v Total:
Side 1 Setback: ~~ '2><< ~~'\; ~<S> -:A <<<<; # Street Tree~~Ii1tt:~ ,,'\:' ~O R,0..:s-0 ~O ~. Handicapped:
Side 2 Setback: '\.~ ~~ L~~ <v~ Paved Dr~~qsl~ ".0"f::J~\j.~ cP 0,0' -# 0f?:~ Compact:
~ ~~' CO~ . /.~ 0CJ 0~ ~ ~ ~ ..::s ()"r .
Rearyard Setback: ~'S ~ ~ % okK~t qo~er.fge~~ ~-..;J 0" 0<::- ~o:-"
Solar Setbacks: . ~ ~ ~O~ ~O a:~ -;?;\ ~ '!o.0($ r;~
...~ ...r~ rb ~ r~ _0 .X
I PUBLIC Ilw~J{,~viME~~~',~~c~'P .
., ~_ ~" :\.. .r
. . \j~ vq} ~'O0 (" r Sidewalk Type:
<;::.:s Downspouts/Drains:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
B
VN
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Pal!e 1 of 3
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Status . Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax '
541-726-3769 Inspection Line
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2004-00225
ISSUED: 03/17/2004
APPLIED: 02/26/2004
EXPIRES: 09/17/2004
VALUE: $ 10,375.00
I Valuation Descriotion ,
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
10,375.00
Value
Date Calculated
Description
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Total Value of Project
$10,375.00
$10,375.00
02/26/2004
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To Request an inspection call the 24 hour recording at 726-3769. All inspection 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
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5 Framing Inspection: . Prio~ to cover and after all rough in inspections have been approved~
3 Drywall: Prior to taping.
2 Ceiling Grid: After drywall approval but prior to cover.
4 Final Fire Department. After all requirements of the Fire Department have been met.
1 Final Building: After all required inspections have been requested and approved and the building is complete.
6 Rough Mechanical: Prior to Cover
7 Final Mechanical: When all mechanical work is complete.
Pal!e 2 of 3
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00225
ISSUED: 03/17/2004
APPLIED: 02/26/2004
EXPIRES: 09/17/2004
VALUE: $ 10,375.00
JI
225 Fifth Street, Springfield, OR
541-726-3753 PhOne
541-726-3676 Fax
541-726-3769 Inspection Line
'\'j.;
8 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
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 and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without 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 requi . p-ections are equested at the proper time, that each address is readable from the
street, that the permit card is I ed at the fr9 f the roperty, and the approved set of plans will remain on the site at all
times during construction.
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Owner or Contrac . ure'
3~7 /J
Date / /
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Pal!:e 3 of3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00225
COM2004-00225
COM2004-00225
Payments:
Type of Payment
CreditCard
Receipt #: 1200400000000000334
Description
Building Permit
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
STEPHEN L. ANDERSON
Received By
Check Number
Batch Number Authorization Number
Jmp
000326 017669
City of Springfield Offi(ial Receipt
Development Services Department
Public Works Department
Date: 03/17/2004
8:27:58AM
Amount Paid
Item Total:
115.20
8.06
11.52
$134.78
How Received
In Person
Payment Total:
Amount Paid
$134.78
$134.78-
A IT ACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGb JRKSHEET
JOURNAL OR JOB NUMBER COM2004-00225
NAME OR COMPANY: SPRINGFIELD SCHOOL DISTRICT
LOCATION: 525 MILL ST
MAP & TAX LOT NUMBER: 17 03 35 23 04500
DEVELOPMENT TYPE: OFFICE REMODEL
NEW DEVELOPED AREA (S.F.): ITE:
EXISTING DEVELOPED AREA (S.F.): ITE:
TOTAL IMPERVIOUS SURFACE (S.F.): LOT SIZE (S.F.): 0
1. STORM DRAINAGE
IMPERVIOUS SQ. FT
x
$ 0.290 PER SF
TOTAL STORM DRAINAGE SDC:j $
1070
2. SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's 0
B. IMPROVEMENT COST:
NUMBER OF DFU's 0
(SEE REVERSE SIDE)
x $ 22.64 PER DFU 1$
x $ 17.21 PER DFU , $
TOTAL LOCAL WASTEWATER SDC:' $
3. TRANSPORTATION:
BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
0.000 x 0 x $ 17.23 PER TRIP x 0 NTF 1$
B. IMPROVEMENT COST:
0.000 x 0 x $ 76.01 PER TRIP x 0 NTF 1$
EXISTING
A. REIMBURSEMENT COST:
0.00 x 0 x $ 17.23 PER TRIP x 0 NTF 1$
B. IMPROVEMENT COST:
0.00 x 0 x $ 76.01 PER TRIP x 0 NTF 1$
TOTAL TRANSPORTATION REIMBURSEMENT SDC: $
TOTAL TRANSPORTATION IMPROVEMENT SDC: $
TOTAL TRANSPORTATION SDC:I $
4. SANITARY SEWER - MWMC
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$
EXISTING:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
I
I
$
TOTAL MWMC REIMBURSEMENT FEE: $
TOTAL MWMC IMPROVEMENT FEE: $
MWMC ADMINISTRATIVE FEE: $
TOTAL MWMC SDC:I $
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
1$
5. ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE)
$
x 5% $
TOTAL TRANSPORTATION ADMINISTRATION FEE:
TOTAL SEWER ADMINISTRATION FEE:
#DIV/O!
#DIV/O!
1078
1079
stevelll- W. B.eCluc!r1:j B.Clrlll-es
1S\l?~E~J~&!glko03.xIS
3/2/04
DATE
TOTAL SDC CHARGES
I NONE
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