HomeMy WebLinkAboutPermit Building 2010-7-26
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Siru.ctural Permit Application
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225 Fifth Street. Spdngfie]d, OR 97477. PH(54 ])726.3753. FAX(541)726.3689
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Pennit no.:
Date: '7-
-10
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.
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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
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o Residential 0 Government Commercial
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Reference:
Name:
Address;
State: oR. lIP.
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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:
e-
CCB license no.:
Print name:
Signature:
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Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
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RRk'Nt:... ,Lot
(a) Job description: ~SUIFl FflC;E
Occupancy
Construction type: fi'ErNFo/U.EP c<!JA/c.eE7E-
Squarefeet: Il j) IlD'~ v /0 00" 50""
-;-0.
Cost per square foot: ~_
.Other information:
Type of Heat:
Energy Path:
D new D alteration
(b) Foundation-only permit?
Total valuation:
o addition
o Yes
ONo
$'S'5 a
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
$
$
$
(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): $
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(a) Seismic fee, 1% (.01 x permit fee r2a]): $
TOTAL fees and surcharges (2e+3c+4a): $
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PROJECT STATUS: Issued
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CITY oF.;:sPRINGFIELD
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Building I Commercial Permit
PERMIT NO: COM2010-00986
IVR Number:
ISSUED: 8/30/10
APPLIED: 7/26/10
225 Fifth St
Springfield,OR 97477
Phone: 541.726.3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitce nter@ci.springfield.or.us
EXPIRES: 2/25/2011
VALUE: $55,000,00
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SCOPE: PAV
-,- WORK INVOLVED: REP
TYPE OF STRUCTURE: COM
SITE ADDRESS: 402 SHELLEY ST Springfield
ASSESOR'S PARCEL NO: 1703271007900
PROJECT DESCRIPTION:
OWNER:
ADDRESS:
Contractor Type
# of Units:
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Resurface parking lot
ATTENTION: I)regon I~W I~yui,co yvu,:,v
follow rules adopted by the Oregon Utility
Notification Center, Those rules are set forth
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00[10, YO(WN:rRj;t';OR~NF6RMA'f16'Ne' .uy I
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Contractor Nam~ '. ir.:::.:"A...-;..,.:;.-;..,..:t ltilihl t\1~,I;C ~YJ.Won
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I BUILDING,INFORMATION I
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# of St('}ries:
I Height of Stru~i~re:
Type of Heat:
Water Type:
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# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
Springfield Building Perm)1
NOTICE" Range Type:
THIS PER!t\ff"'J'~\ALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENr.ED OR IS ABANDONED FOR
NY 180 ~levtr~cal-SpeJ!al1Y fode Edition:
A St;}lngm.I'c1'F!ire Code Edition:
Mechanical Specialty Code Edition:
Municipal I Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
.. '. .. Site Informa~ion
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Phone Number:
Lie No
lie Exp
Phone
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:
I
Page 1 of 3
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.U5
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: COM2010-00986
IVR Number:
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pe rmilce nter@ci,springfield.or.us
PROJECT STATUS: Issued
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ISSUED':, 8/301.10" , .
APPll'EbY iti~)1b'
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EXPIRES: 2/25/2011
VALUE: $55.000.00
SITE ADDRESS: 402 SHELLEY ST Springfield
ASSESOR'S PARCEL NO: 1703271007900
SCOPE: PAV
WORKINVOLVED:REP
TYPE OF STRUCTURE: COM
PROJECT DESCRIPTION:
Resurface parking lot
DEVELOPMENT INFORMATION I
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Paved.p~ive Reqd: ;"~'
%.Of.Lgt-Coverage: ..1.
Highest point on structure to
north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer:
Sto~m Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
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Sidewalk Type:
Downspout/Drains:
Valuation Description ~
.
Descriotion
Tvoe of Construction
Unit Amount Unit Tvpe
Unit Cost
Value
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DescriDtion ~Amount Paid Date Paid ReceiDt #
Plan Review Minor - Planning $119.00 08/30/2010 299358
Building Permit Fee.____ $489.60 08/30/2010 299358
State of Oregon Surc_harge (12% of applicable fees) $58,75 08/3012010 299358
TeChnologY fee (5% of permit total) $24.48 08/30/2010 299358
Total Amount Paid $691.83
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Springfield Building Permit
8/30/2010 11:38;03AM
Page 2 of3
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Commercial'Permit
PERMIT NO: COM.2.010-00986
.. ,.-.IVR Number;:
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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
PROJECT STATUS: Issued
ISSUED; 8/30/10
APPLIED: 7/26/10
EXPIRES: 2/25/2011
VALUE: $55,000.00
SITE ADDRESS: 402 SHELLEY ST Springfield
ASSESOR'S PARCEL NO: 1703271007900
SCOPE: PAV
WORK INVOLVED: REP
TYPE OF STRUCTURE: COM
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PROJECT DESCRIPTION:
Resurface parking lot
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Deoartment Received Due Date ComoletE(" Result Reviewer Comments
Permit Issuance 08/30/2010 08/27/2010 08/27/2010 Issued Chris Carpenter
Fire Department Review 07/27/2010 APP
Planning Review 07/29/2010 APP
Application Acceptance 07/28/2010 08/19/2010 Application Accepted
Initial Review, 07/27/2010 08/19/2010 08/19/2010 Approved
Public Works Review 08/24/2010 08/26/2010 08/24/2010 Approved
Structural Review 08/27/2010 08/19/2010 08/19/2010 Approved
No issues,
Parking Lot striping and impfi
Chris Carpef"!ter
Chris Carpenter
Clayton McEachern
Kip Kaufman
Planning and fire have signet
no sdcs
INSPECTIONS REQUIRED ~
Inspections
1055 Rough Grading for Paving
1059 Final Paving
1996 Final Inspection - Planning
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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 comP!,i~nce with ORSi 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 prope y, and the.approved.set,ofplans will remain on the site at all times during
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Page 3 of 3
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TRANSACTION RECEIPT
COM20tO-00986
402 SHELLEY ST
CITY OF SPRINGFIELD
225 Fifth 81
Springfield,OR 97477
541-726-3753
permitce nter@ci.springfield.or.us
RECEIPT NO: 20IOOOOI70
RECORD NO: COM20IO-00986
DATE: 08/30/2010
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Plan Review Minor - Planning
Building Permit Fee
State of Ore:gon Surcharge (12% of applicable fees)
I.:.E.hnology fee (5% of permit total)
$119.00
100-00000-425602 $489.60
821-00000-215004 $58.75
100-00000-425605 $24.48
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....-."..... TOTAL DUE: $691.83
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Credit Card
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jon bottensek
$691.83
$691.83
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FEE By RECORD
Case #: COM2010-00986
402 SHELLEY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Fax: 541-726-3676
permitcenler@ci.springfield.or.us
Trans
Code
Revenue
Account Number
Date Calculaled Original Amount
Calculated By Amount Due
07/29/2010 EMM 119.00 119.00
, . 489601
08/19/2010 . KKALJFMAN 489.60
08/27/2010 KKAUFMAN 58.75 58.75
08/27/2010 . Kt<AUFMA.!" . . "+;:;:1"24.48:; "t 24481
Total Due: 691.83
Description
Plan Review Minor - Planning
IBUi.ldihg . Permit Fee:,:
State of Oregon Surcharge (12% of
applicable fees)
fr-;Chi)OI09y fele{?~ofper~Tlit total)
Fee by Record
100-0000(
1002' 1 dO,00000425602
,1099 821-00000-215004 .
2099,
i1 qO:00000425605
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Print Date: 8/27/2010 8:46:31AM
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