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Home My WebLink AboutPermit Miscellaneous 2010-11-5 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: COM2010-00126 IVR Number: 811000053311 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 11/05/2010 01/29/2010 Issued 11/05/2010 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilce nter@ci. springfield. or. us EXPIRES: VALUE: 05/04/2011 $10,000.00 SITE ADDRESS: 2300 HENDERSON AVE, Eugene ASSESOR'S PARCEL NO: 1803032000600 SCOPE: CELL WORK INVOLVED: ALT TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: OWNER: ADDRESS: Replacement of cell antennas on existing tower Phone Number: Contractor Type CONTRACTOR INFORMATION ~ Lie Type CCB BUILDING INFORMATION ~ # of Stories: Contractor Name Bel CONTRACTING INC # of Units: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: 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: Lie No 133466 Lie Exp 02/05/2011 Phone 503-806.0606 lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy load: Site Information ~ Enginee~ed Fill: Fill Volume: Flood Hazard Area: Land Hazard Ar9\llTENTION' Oregon law . Retaining Wall~ollow rules ~dopted by threoqUlres YOuu,to . e regon lllty Salls Rep?rt ~lWl~tion 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). . . ~..;, ~:.:",;: > , NOTICE: IRE IF1HE WOR\( . THIS PERM\T SHALL ;x~S PERMIT IS NOT.. AUTHORIZED UNDE: ABANDONED FOR" . COMMENCED OR \ ANY 180 DAY PERIOD. Springfield Building Permit 11/5/2010 11:49:13AM Page 1 of 4 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: COM2010-00126 IVR Number: 811000053311 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 11/05/2010 01/29/2010 EXPIRES: VALUE: 05/04/2011 $10,000.00 11/05/2010 SITE ADDRESS: 2300 HENDERSON AVE, Eugene ASSESOR'S PARCEL NO: 1803032000600 SCOPE: CEll WORK INVOLVED: AlT TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setbac~: Rearyard Setback: Solar Setback: Replacement of cell antennas on existing tower DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion Tvoe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Description Plan Review Comm/lnd/Public Building Permit + 5% Technology Fee + 12% State Surcharge Total Amount Paid Amount Paid $88.40 $136.00 $6.80 $16.32 $247.52 Date Paid 01/29/2010 11/05/2010 11/05/2010 11/05/2010 Receipt # 23166 ~-~.~ 374817 374817 374817 Springfield Building Permit 11/5/2010 11:49:13AM Page 2 of4 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: COM2010-00126 IVR Number: 811000053311 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 11/05/2010 11/05/2010 01/29/2010 ISSUED: APPLIED: 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: VALUE: 05/04/2011 $10,000,00 SITE ADDRESS: 2300 HENDERSON AVE, Eugene ASSES OR'S PARCEL NO: 1803032000600 SCOPE: CELL WORK INVOLVED: AL T TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: Replacement of cell antennas on existing tower Plan Review ~ Deoartment Received Due Date Plumbing Review 08/09/2010 08/09/2010 Comments: Over the counter permit Comoleted 08/09/2010 Result Over the Counter 08109/2010 08/09/2010 08/09/2010 Over the Counter Traffic Review Comments: Over the counter permit lr;~~~~ Code R:vlew ,,::';;c~- ;<"'_v?~/9~/2010' O~1091?O~':. 08/0_~201~.~' overth~?o.~n1e~ ! 'f,Comments: Over~the counter permit""'"" ~"7 . -::- ,,~-" ~ -. .'?i ~ _~ ~<0"" !':w:;;i _..,\, ->'/,,1" r___ ~ ~ ~ "" '''L-~~_~~........... . Initial Review 08/09/2010 081Q9f2010 0810912010 Over the Counter Comments: Over the counter permit El~cti'lca.LReview C<;>minents;. Mechanical Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Comments: Over the counter permit Reviewer Chris Carpenter Chris Carpenter ,Ch.l:isC?!p~rjtert ." "- ",: ~" ' .' 4" ,".~ ,,, ',,, ,,' . . ." - -. Chris Carpenter ."'.''','' ~~~ 'Ii';"'" Chris Carpenter Over the Counter Planning Review 08/09/2010 08/09/2010 08/09/2010 Comments: Over the counter permit Public Works Review 08/09/2010 08/09/2010 08/09/2010 Over the Counter Comments: Over the counter permit Structural Review Comments: As submitted 02/01/2010 APP Chris Carpenter Chris Carpenter . ' - .~ \... Chris Ca!p~n!~:.:~~~."'- " ' " '" .. "..- .. ~ ..~, 6;"-; .;,:.~ CJC "', Initial Review 02101/2010 APP LLH INSPECTIONS REQUIRED ~ Inspections Springfield Building Permit 11fS/2010 11:49:13AM Page 3 of4 S,P~IH, G,f,IE"l:i] .{" -;;':;~, /,L ""........ ..-z', 'OREGON CITY OF SPRINGFIELD 225 fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: COM2010-00126 IVR Number: 811000053311 permitcenler@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Issued 11/05/2010 ISSUED: APPLIED: 11/05/2010 01/29/2010 EXPIRES: VALUE: 05/04/2011 $10,000,00 SITE ADDRESS: 2300 HENDERSON AVE, Eugene ASSESOR'S PARCEL NO:. 1803032000600 SCOPE: CELL WORK INVOLVED: AL T TYPE Of STRUCTURE: COM PROJECT DESCRIPTION: Replacement of cell antennas on existing tower 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 t~is 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. c~c ~ /---- Owner or ontractor Signature /~/~//7) D te Springfield Building Permit 11/5/2010 11:49:13AM Page 4 of 4 . Structural Permit Application . DEPARTMENT USE ONLY CITY OF SPRINGFIELD. OREGON C~~ 4'1 -..__ Permitno.{j/O - i;2(/ 225 Fifth Street. Springfield, OR 97477 . PH(541 )726-3753 . FAX(541 )726-3689 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days 0 suspended for 180 days. lOCAL GOVERNMENT APPROVAL This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval veri fled: DYes DNo Property is within flood plain: DYes DNo CATEGORY OF CONSTRUCTION o Residential I 0 Government llZl Commercial JOB SITE INFORMATION AND lOCATION Job site address: 2300 Henderson Ave City: Sprinofield State: OR I ZIP:97403 Subdivision: I lot no.: Reference: I Taxlot: 18-03-03-13-00500 PROPERTY OWNER Name: ClealWire clo RealCom Associates Address: 621 SW Alder St, Suite 300 City: Portland State: OR I ZIP: 97205 Phone: 503-241-0279 ext 23 Fax: 503-241-2204 E-mail: pslotemaker@realcomassoc.com This installation is being made on residential or fann property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. Sign here: CONTRACTOR INSTALLATION Business name: TBD Address: City: State: ., ZIP: Phone: . . Fax: . - E-mail: CCS license no.: Print name: Signature: SUB-CONTRACTOR INFORMATION Name CCB License Number Phone Number Electrical Plumbing Mechanical FEE SCHEDULE 1. Valnation information (a) Job description: Install new & replacement antennas on an Occupancy eXlstmg tower Construction type: Square feet: Cost per square foot: Other infonnation: Type of Heat: Energy Path: Dnew tKJ alteration D addition (b) Foundation-only pennit? DYes DNo Total valuation: $10,000.00 2. Building fees (a) Permit fee (use valuation table): $ (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): $ 3. Plan review fees (a) Plan review (65% x pennit fee [2a]): $ 5iZ' 'J,.!J-- (b) Fire and life safety (40% x pennit fee [2a]): $ (e) Subtotal offees above (3a and 3b): $ 4. Miscellaneous fees (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ \)s0300\~ oosoU SP:~N.~"L~ .t~~ lif'~"x OREGON www.ci.springfield.or.us TRANSACTION RECEIPT COM2010-00126 2300 HENDERSON AVE CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 permitcenler@ci.springfield.or.us RECEIPT NO: 2010000771 RECORD NO: COM2010-00126 DATE: 11/05/2010 IllESc:RIPTION"'".'.....4. 1i..!:!.E:~"^., ""- Building Permit + 5% Technology Fee + 12% State Surcharge .. ~. ^''r~'___ . "'" _ :_~w;_ ?::~.":7~:; :",;:];;;;"", +....,*,,_ wr",' ,:r-'~,";:C~ -, /,;:i#",". "" 'v, A(;_c:.6.iJ.~TiC_Q!:!l;ii,i~4[,~"".~ 224-00000-425602 1 00-00000-425605 821-00000-215004 TOTAL DUE: I" PAYM.E1'IT'T_y~.e.e,Y_Q8.''? 1 CASHIER. D8iJw(S8YL2:;c.QMIV!EN:rS'.":1.~, ; '.'" $"" ". .; , A~Q.uilJ~p-'lUo .. .' . 1 $136.00 $6.80 $16.32 $159.12 'AM.OU/':lJ)~~IIi:~--=_~ Credit Card 114512 tracy webster $159.12 $159.12