The URL can be used to link to this page

Home My WebLink AboutPermit Building 2010-6-23 Structural Permit Application iDEPARTMENTUSE ONLY" > "'," ... ,." ... . '1(- Permit no. t!/tJ- ~()(P Date: t;;. 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. 'c. >:LClCAL.GgVERNMENlj A'PPROIIA'i:" ,,> I,>'.. This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Datc: Zoning approval verified: DYes DNo Property is within flood plain: DYes DNo I:," ".> >.CATE<lqRYClF: CONSTRUCTIQN', ..,..::: D Residential I 0 Government IKI Commercial I....:..... i::UO~SITE.fNfQRMA TI9~.:AND"LOCATIQN:':] " i. Job site address: 2659 Olympic Street City: Springf ield I State: OR I ZIP 97477 Subdivision: I Lotna.: Reference: 1103 Z S Cf4 I Taxlot 0 SbCC }. .... 'i'';:: PROPERTY OWNER '. ./ : C", Name: Wal- Mart R.E. Business Trust Address: 2001 S E lOth Str""t. City: Bentonville State: AR I ZIP 72712 Phon"47 g- 204-3090 Fax479- 293-8350 E.mail:machelle. terrill@wal-mart .com This installation is being made on residential or farm property owned by me or a member afmy immediate family, and is exempt from licensing requirements under ORS 701.010. Sign here: N/A .' Ci . C.; ....... cCONTRACTORjflsTALLATIONi .. ....... '. Business name: TBD Address: City: State: I ZIP: Phone: - - Fax: . . E-mail: CCB license no.: Print name: Signature: .....cD'::1;.\!,;~;$UEl:CONTRACTClR. 1f'.!.1f9.RIVIATIClNi:!1i" ..]0; Name ceo License Number Phone Number Electrical Plumbing Mechanical .' . . FEE SCHgOULE; . . .'. ",. . 1. V'~*Hlti(m,i!lfQrfu~tion .. .. ." ... .'; '. (a) Job description: Seaf ood removal Occupancy Mercantile Construction type: VN Square feet: 540 s. f. affected area Cost per square foot: Other infonnation: .. Type of Heat: Energy Path: Dnew 129 alteration o addition (b) Foundation-only permit? DYes IKINo Total valuation: I $40,000.0 2.IMlding fees ..... '/0" .t. .,...; 'Oo 0;. :;.. c. (a) Permit fee (use valuation table): $ (b) Investigative fee (equal to [2aD: $ (c) Reinspcction ($ per hour): $ (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): $ (e) Subtotal offees above (2a through 2d): $ >;jCP1all r~v!e~fe-es ". .;. .'. . . ;. (a) Plan review (65% x pennit fee [2aD: $254.83 (b) Fire and life safety (40% x permit fee [2aD: $ (c) Subtotal offees above (3a and 3b): $ ;;4.'iMts,i;~lIa_n_eous;fe~'s-i:_:,; _c- ..; . ~;. i'd'."... ..;". .,' , (a) Seismic fee, 1% (.01 x permit fee [2aD: $ TOTAL fees and surcharges (2e+3c+4a): S 225 Fifth Street Springfield, Oregon 97477 54]-726-3759 Phone -,~ "'r'~& 1'_, 1'l.1il,'!U" "'jI'.......... ftIr,'..'.'......., ; " ." ' " " :.','. .. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 'J':'>:! 220]000000000000723 Date: 06/23/20]0 8:10:5IAM Job/Journal Number COM20 1 0-00806 Description Plan Review Commllnd/Public Payments: Type of Payment Check Paid By RAYMOND HARRIS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 254,83 $254.83 Amount Paid CJC 4262 In Person Payment Total: $254,83 $254.83 i ~. " }fk~'; ,.~~ '1: cReceintl Page I of I 6/23/20 I 0 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 www.ci.springfield.OLUS ,'.,1 ,~. 2 ;\,'" permitcenter@cLspringfield,or.us RECEIPT NO: 2010000123 RECORD NO: 'COM20 1'0'00806 DATE: 08/24/20.10. rtrEscJ~IPJI0NF>7~j'i:aiVj:~,;i?i~~;;t~;)%:.::~~~~~~~~~~jis~{.fu1~C~COnNf0C~QOE";Y~#,0!~if~~~-~;~MQU_N:r:QIJ.,~cJ,~;c; ~ ,;,~,~~\] Plan Review Comm/lnd/Public $254.83 Building Permit 224-0.0.0.0.0.-42560.2 $392.0.5 Fixture 224-0.0.0.0.0.-42560.3 $19.0.0. Minimum/Adjustment Plumbing 224-099o.o.~256o.3 ____.__.._.._ __.___.___$39~ State of Ore~on Surcharge (12% of applicable fees)____~2..1:9_9.o.o.o.-215~~__.________ $54.01 Technolo.gy fee J~/~'?!.permit total) ___ 1o.o.-o.o.o.09~256o.5 __________.______._ $22.59.. ~echa-"ical Permit!"" (based on valu~ofworkL_________._~2.4.-90o.o.O:4.~.?o.4..___.. _'.__ .'___.__..' $87.,~~ State Surcharg!i.ee Adj!'stment .-l!2.1:9.o.o.o.9:.~~59.o.4..._.,.___,___..._,_.~o..47 Tech Fee Adjustment _._.29.9:99o.o.O-"-256..o~. $4.36 TOTAL DUE: $883.47 l:';eAYMENT~'j--YF>E?j';~:f[P,AY0R~icASHTERjfrM-;'CHAbo1:.';::rc]1MME~J:.S1rC;I~~~;;--~~'ct(:;~!)';;;?AM0IjNJ'yAI(j~:::~!''''';~'~d Check PS CONTRACTING, INC. 220.3 TAYLOR CUTOFF ROAD $628.64 7234 SEQUIM WA 98382 , -.~..''', '. .t. .;..-..,....! " ._..,~.,,-".-... ,;j,:rC~)~.:, ,; 'h,.(i; .:.'1'" ~,","" ,.;: ;, -""""\' . ,;1;.'.;"1.,: ',. www.ci.springfield.OLUS CITYOF,SPRINGFIELD Building I Commercial Permit PERMIT NO: COM2010-00806 IVR Number: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 SPRIN..G..F. .~.E.~~ - '>'.~ .'..>. 'OREGON perm itcenter@ci.springfield.or,us PROJECT STATUS: Issued ISSUED: 8/24/10 APPLIED: 6/23'/10. EXPIRES: 2/19/2011 VALUE: $40,000.00 ,: \ l~ . SITE ADDRESS: 2659 OLYMPIC ST Springfield. ... ASSESOR'S PARCEL NO: 1703254403600 ,. SCOPE: COM WORK INVOLVED: AL T TYPE OF STRUCTURE: COM PROJECT DESCRIPTION: OWNER: ADDRESS: Seafood Removal Phone Number: Contractor Type Contractor Name PS CONTRACTING INC CONTRACTOR INFORMATION ~ . Lie Type CCB 'Btl/(DING INFORMATION ~ Lic No 160646 Lie Exp 07/13/2012 Phone 360-504-2586 # of Units: Construction Type Occupancy Type Occupancy Comments ;,.:;, "'\ lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy load: VB # of Stories: Height of Structure: Type of Heat: Water Type: RangeJ'ype:.., # of Bedrooms: 'H~-r. "/~t. I"' i Hazm:~::~~~ J, .:~~,;" ( '''; Sprinkled Building: Y Fire Alarms: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal! Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Struct~~al Special~ Code ,~~ition: ',:.; Site info'='J.laiio.~; '. '1 Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: ,/, ., , 'IOU to - ,. On laW leC\Uile~n IJtili\'i IE-Nil ON: Ole~eo b'l t\'le Ole~e set 10lt\'l Ai lules aoor -c\'lose (lIles n 952.001- \0110'11 C ntel. \ \'101'-" b'i Notilication ~1 .001 0 t\'l10\)9 0\ t\'le lules in Ol'-B 952-0 a'l obtain cOf\e~\'Ie teler\'lO~~n 0090, 'IoU m cente!. (NO ~ti\it'l Notilica \ ca\lin9 t~el t\'le 0le90n 332.231\1\). DUmbel 0 tel is 1 _800- cen _:f!:.;'..'::;:;: ,',;",,;'\'- NOTlCE:}\, .' THIS PERMIT SHALL EXPIRE IF THE WORW:: ,iLfii AUTHORIZED UNDER THIS PERMIT IS NOr:- -:,. , COMMENCED OR IS ABANDONED FOR ~O""t:.:.,'r02"Y PERIOD. 8/24/2010 12:29:33PM Page 1 of 3 WWoN. cl. springfield .or. u s CITY OF SPRINGFIELD Building I COlT!mer~ifll,Permit '.(,;;;,.. .,. PERMIT NO: COM2010"00806 : '''','II(R Numbli;: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 S~i~~~.E. :1. ", ~~: ~'OR'EGOH permitcenter@ci.springfiekl.or.us PROJECT STATUS: Issued ISSUED: 8/24/10 APPLIED: 6/23/10 EXPIRES: 2/19/2011 VALUE: $40.000.00 SITE ADDRESS: 2659 OLYMPIC ST Springfield ASSESOR'S PARCEL NO: 1703254403600 SCOPE: COM WORK INVOLVED: AL T TYPE OF STRUCTURE: COM . .t\;i PROJECT DESCRIPTION: Seafood Removal . r' :~<', . ';~~t\:;~~ ::~z. i 1~, DEVELOPMENT iNFORMA nON ~ 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: \ . PUBLIC IMPROVEMENTS ~ REQUIRED PARKING Total: Handicapped: Compact: .:.'{>f' ::,,' jb"': Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: .J .';"j Sidewalk Type: Downspout/Drains: T,,'," .' ./~G~D, ~,-);-,' ':~ _~~~:~:V'!iILla~ion:Description ~ """-""1-1. Descriction Tvce of Construction Unit Amount Unit Tvoe Unit Cost Value Descriotion Plan Review Commllnd/Public Building Permit Fixture ---~- Minimum/Adjustment PlumbinL~. ~tate of Oregon Surcharge (12% of applicable fees) !echnology fee (5% of permit tot~) Mechanical Permit fee (based, on value of work) State Surcharge Fee Adjustme!lt Tech Fee Adjustment . ~ {..;:,:;~' .:) Amount Paid Date Paid Receiot # $254.83 06/23/2010 13866 $392.05 08/24/2010.--"~-.'...-299305.-'. -~. $19W.. 08/24/2010 299305 . .. $3900' .".~... 0812412010......._....299305-. ,,' '.' $54-:DV.'......os72472010....----- 299305 -$2210-.-..08/247201 0'..'~".--~9305..-'. $s7':'25'-.._--..-0012472010......._-299305-- $10.47 08/24/2010 299305 $4.36 08/24/2010 299305 ._--~'-- $883.47 .1'; Total Amount Paid . Springfield Building Permit 8/24/2010 12:29:33PM Page 2 of 3 ~ .i. .~.. ,,::;~~vii..i .1;:ii:~bi1l.'1 0::l?#'1\ r_~;:'#A~".i "I ~...< www.ci.springfield.or.us ,- -' './ ,.'. CITY OF:;SPRINGFIELD .,....'",.'>.r. ,,;;;,,~(,;'~il,;,' . 6::";;'':'' Building I'Commercial Permit PERMIT NO: COM2010-00806 225 Fifth St Springfield,OR 9747.7 Phone: 541-726-3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 permitcenter@ci_springfield,or,us IVR Number: PROJECT STATUS: Issued ISSUED: 8/24/10 APPLIED: 6/23/10 EXPIRES: 2/19/2011 VALUE: $40,000,00 SITE ADDRESS: 2659 OLYMPIC ST Springfield ASSESOR'S PARCEL NO: 1703254403600 . y "" SCOPE: COM 'r, WORK INVOLVED: ALT rY~E'oF STRUCTURE: COM PROJECT DESCRIPTION: Seafood Removal 1Ii<'t.... .L^..~~~__~-..~~.'";y'<~~.""/J;,1I-;--.;'.< --;.. . _~.-_~~~.;PE<"'~I~,;l_,_('''_ ,.,~,'...,..,c~".'.....c.,'-"'0~--r-;::,,"<-'"~'.'- '-;70;Jr'~ .' = ~:i::t... _, ' -'c---iL"'~,':-:-",~4:,~~ '."t--}. ,,-,S*-, - ''''''1' 'F;,+v~Plan ReVIew. '.<,~-'.c1tr..t;$"'c-"-'-'kc". '.,;~..~.t.,"~ ,', -';'}'" _.,7.... 4,,-,cJ;'0",' . ,..,., , . -. :,!;",.;.,;,,;,",)' ~- -.... - ......~~~.,.. ~ . .- ...~ .. ,''', ~-~,.~'.._.._-'~' -~". ,. ,,,,,-,_@4;"-i<',,,,,"-~__~."".___~~ Deoartment Fire Department Review Planning Review Public Works Review Structural Review Application Acceptance Initial Review Energy Code Review Structural Review Permit Issuance Received 07/01/2010 06/26/2010 07/16/2010 07/14/2010 06/23/2010 06/23/2010 08/13/2010 08/16/2010 08/24/2010 Due Date 08/16/2010 08/16/2010 08/16/2010 08/16/2010 08/16/2010 Comolete Result APP APP APP .J!,::': .WI, ....r-, .~~pl!c:atjon Accepted 08/16f20JO~;:' ','ApproVed' 'j:_:",,~ , "''-.:0.,,)' 08/16/.tH12,~~:;: ;f;p.we~~~. 08/16/~O{9 i ' Ap~roved 08/16/2010 Issued INSPECTIONS REQUIRED ~ Reviewer Comments Plans Review: seafood depal No new SDC's Plan review complete- waitin! Chris Carpenter Chris Carpenter Jack Foster Chris Carpenter Nancy Machado Result entered by CJC 8/16/: See workflow history Inspections 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 Ihe Stata or Oregon pe~aini;'g to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the ~_pni,m'unity'Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with'0~S-701.005 will be used on this project. I further agree to ensure that all required inspections are requested at,the propertime,V{at each address is readable from the street, that the ~M1I'~"'r~~.'~";~i_"::=::'~'''~''"'""' Owner or Contractor Signature Date . i;.-", ~y10'~ .~'j!),?{.. .;'I'!'~ . _ '\:,~' Ii' Springfield Building Permit I,'i ~. .. I!i~~~';- .'.1;'" p8lZ4/Z010 ,;~2:.29:33PM Page 3 of 3