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Home My WebLink AboutPermit Building 2010-1-10 Structural Permit Application ,!). 'i . ",.1:. '-ljf-~i1'ff.:..r' ~~''!:itf'''~'<f;0-~'''''''~lI"..;r~",,",~~"M-e~l~~~ ::::-';. ""~ ~~.... ~ , D"' '~"'S_o- --.~- . - -''<#.1"-'- ~- .1flb'''~'~ -~. ~"U !;cl:,-lj~~;,;~I;rY:QII! RB.:!Dl~flEr;Q.--:.QR~@~I~iF(t\~",~~r..':Th\'~""'- DEPARTMENT USEPNL.Y 8/1- :s: Pf(.. -ze j..s;I- Pennit no.: Z.?:3 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(54 1)726-3689 Date: This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. >t,;~~~: ::"{i~/~Q,qA~:,:':9'QY'~'~NJ~.~~It21~[&:RQYA~i::~m~t;~~{r.;~{~;1tij~~,~~f~ This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: . 0 Yes 0 No ~W:N~~~~~lc~t~GQRX1lQJtl~.~:qN,~:fRp,GztIQ~~J~~X:t4Wf!~~:;'~ o Residential D Government Commercial 1fk:f;)~\:!,:h~#9B~SIJ~LiN~9RMATri?N51A~p.ito_c:6:iT9N~;gB'f:P;'iYe~: Job site address: ~5 M Ai City: Subdivision: Reference 11{)-3 363 Le- " ',p,ROPERTYOWNER.. . Name: Address: 3 i?'2 1..- City: State: Phone: Fax: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. Sign here: teB license no.: Print name: Signature: . ii).,~,ii~;J',~iZ~~~~;$\J.~"c:0Nj"tMt:tqR.:I~F;()R.MA;j;IQN1r.~~&~,!,~~~ Name CCD License Number Phone Number Electrical Plumbing Mechanical'" ;j .;'~~;};:?~';"'::;;r\:!.F~Esi::HERU[EF:);i:'r';..;';:~"il:""';~', "'ii,"'. JTfJy~l~a.ii.~KW6fo~f.#!~:~J9"~~~~Jfrl)ii}jh~11f!;n:~:;.;~~:&j;R::i~1/i~,7j1f;;\;f-:.~~~?i~~~f:;~; - <:?-'1,M L58~~ (a) Job description: Occupancy Construction type: Square feet: Cost per square foot: Other information: Type of Heat: o addition DYes oNo (a) Permit fee (use valuation [able): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): $ $ $ $ $ (a) Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ (c) Subtotal of fees above (3a and 3b): $ (a) Seismic fee, 1 % (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ .i...- ~ -: . www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00273 IVR Number: 811176376298 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 5P~I.N..G..FIEl.~.. _ ."-- ,"'l~ 7, "'--~ OREGON permilcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/29/10 APPLIED: 9/10/10 EXPIRES: 3/28/2011 VALUE: $2,000.00 SITE ADDRESS: 1815 MAIN ASSESOR'S PARCEL NO: Springfield 1703363107401 SCOPE: Tenanllnfill WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: T.I. to Suite F OWNER: ADDRESS: KIT & KAREN CHAN FAMilY LLC 3881 MEADOW VIEW DR EUGENE OR 97408 Phone Number: Contractor Typ_e Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lic No Lic Exp Phone BUILDING INFORMATION ~ # of Units: Construction Type Occupancy Type Occupancy Comments # of Bedrooms: Hazmat: No Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: 31 Type liB B 1,650 s.f; Gym: # of Stories: Height of Structure: Type of Heat: 'I Water Type: Range Type: o Sprinkled Building: No Fire Alanns: No 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: 2007 Energy Path: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 9/29/2010 10:35:16AM Page 1 of 3 . , SPRINGFIELD ~"1. .~. ,~ . . C. OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00273 IVR Number: 811176376298 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfield.or.us pe rmitcenter@ci, springfield. or. us PROJECT STATUS: Issued . ISSUED: 9/29/10 APPLIED: 9/10/10 EXPIRES: 3/28/2011 VALUE: $2,000.00 SITE ADDRESS: 1815 MAIN ASSESOR'S PARCEL NO: Springfield 1703363107401 SCOPE: Tenant Infill WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: T.I. to Suite F DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dis!: # StreetTrees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Total: Handicapped: Compact: PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvpe of Construction Unit Amount Unit TVDe Unit Cost Value c;:; ~ :" '.:- "-::., ':';~~~"i ";:' ';::.f::;';~^:Y\:;~:~:};4ji''0'.'V-~-~''FE_~ipA,[YJ~~~~l~~f:;:.:;t{-~g2'F;'~7r::~'~c-~;.: ~,'j~ -l DescriDtion Amount Paid $58.00 $2.90 $6.96 $67.86 Date Paid 09/29/2010 09/29/2010 09/29/2010 ReceiDt # 374429 374429 374429 Building Permit Fee Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Springfield Building Permit 9/29/2010 10:3S:16AM Page 2 of3 www.ci.springfield.or.u$ CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00273 IVR Number: 811176376298 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/29/10 APPLIED: 9/10/10 EXPIRES: 3/28/2011 VALUE: $2,000.00 SITE ADDRESS: 1815 MAIN ASSESOR'S PARCEL NO: Springfield 1703363107401 SCOPE: Tenant Infill WORK INVOLVED: New TYPE OF STRUCTURE: Commercia' PROJECT DESCRIPTION: T.I. to Suite F r'~<:,.'-,; ~ :?~~ ",'.;,~~.t~~'~^,-c" ',,'. ~t~~-4:I~.:~:~':;;J'"'~;fl~~_~.yreiY~ \ ';~'~~-,~;k"'!:~~~~::7~~l:5~~':' ,",~';,,; ~::~;;':~:,;:h ;:"f:;11B 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 or 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 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 ~n the site at all times during construction. Owner or Contractor Signature Date Springfield Building Permit 9/29/2010 10:35:16AM Page 3 of 3 S~:~N....~~ L-~~ ~ORfGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00273 1815 MAIN ST CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 permilcenter@ci.springfield.or.us RECEIPT NO, 2010000422 RECORD NO, 811-SPR2010-00273 DATE, 09/29/2010 \.QFSCRIP]"ION.;~- _ Bujldin~ Permit Fee Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) "<' ~., '~o''c;'t:::-' :G_?",,~.:vt ',' ~.,' f~~J;;j~~ ;o:~~:':: . .. ~-I Y'-~<::_Q9JJN.L<::J.1QE;:.:.;2 'A0;~I'v'IOQ~n:i:?@: 100-00000-425602 $58.00 100-00000-425605 $2.90 821-00000-215004 $6.96 TOTAL DUE: $67.86 . ~ PJ.\.:.YcfR_:"~c~EiERKKALifM~N_:$'~(,,QMMEN'tS-0c~"~;---'':lJ', _'';'_::-.::;~:MO\.!tnjiAiD..,.''_'i' '; -1 r, ~PAY~rI]I;NIiYPE- Check 1180 Courtney Thurman TI $67.86 $67.86