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HomeMy WebLinkAboutPermit Building 2011-4-29 , ,-.J r' .-' . Sh .IcturalPermit Application .-:=:;J .~. - .. ,'. '"';' ; ,-' ..,~- -) - ., ,,~ .,' ,"',". '~~~. -: ~:.~.~;+:> '. . ;,'.;- ....- ".._,' '''. ClfY 01- ,s1.Rl~GF.lELD;..OJ{E9QN .,c'.,''', ':',. '" . .:: ~,,'" Pate: This'permit is issued uuder OAR 918-460-0030. Permits expire if work is not started within 180 days 0 suspended for 180 days. ,~:.;, ;.; ,j..;:,I), !(j'ffitiillb :''''i;!\7CDNM' E~;r.,",..""FiFl"'dlt;!\:i1i"''',;"":;o,,,~,";W...,,; ;R", ..'~ ,,,';I,,"J.? ..\>>._'I'I"~., .... ..~'...f!''''J\~~'. "., :'-'l,:,:,!a~". .!~.....,. .HW or ~';~;r.r~.;r.;.':'JiJ This project has finall,,!,d-use approval. Signature: Date: 1'lirsproject h~1JEQ approv.... Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No ''''''''''\i!l.~A:'~tf''S'':I.,...''''^'1;''''''''''=e'''''''','S''''i'.{;'''C''''''Ii.W,'>1i;;;.'''''' .~kl"'cii'''''' ~1'.'~~~'\'f~~~~",}~~.!-?~\:J~iftWtt8~"H.P.I ~.~..:_J';,'2~~~~k<lJ,~\f%i1'~' >f.."'~~~:~i~~~B')S~m~0k~~~~~~~~Jl:,;~~'~~m. ....''''..., ..,~> ,.~ .U".... .n J\'l'<'\Ii!.. ._.c...._ ....'<..... ,,,_"..~. ..~""l- Job site address: 2.'llat:> b/tl"~"",lI.'" ~l City:SPfU~t.C1Cl..b State: crR- IZIP:q'1<1't Subdivision: I Lotno.: Reference: 1 =-11. ~Taxlot: B':z.~' .<. . ;.,.' ~:, p'fi0p.Emj:toNN$'t',".:';::'\'./(>:):": Name: I!. A-7'''' "loLl< Y~?()e:i..S Address: j/ () }?, ~ 6/71cJ 5 City: /' .A,,., A<../1 State: IL I ZIP: 'M6/ Phone: . -" Fax: - - 225 Fifth Street. Springfield. OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 E-mail: ,~, me OT'~ Sign here: .d /~~, ~ ~_. " .,.j/I.(J!'l:r,AA91i\0~A '.~Ai::Ll\ir,16fu:.,\:;;;>':': 'i:";;"S:"c 'Bu~ne~n~~: t,Dl'''' 7i;/~~'" ..' Add,e,,: / 7/> " I: I~./..i! ,/",,';" ,... /..; City: ~... State: 0("" I ZIP: <J7IP2,... Phone~ _ - .2Jr1'Fax; . . E-mail: .CCB license no.: Print name: Signature: : .~~","'l; '~. ''":" ",8,':"";';/t6.,€:T""RliOi'FIDli 8"''"':'''''' ";, ,~ ~,'-/.: ,~.,.~C ~R." .,' "'_'''r.,~\\..''''P~I_.!.:~_., ~~",~'_"-d~I'~~.. ~L. Name CCB License Number Phone Number Electrical Plumbing Mechanical , , ;~r.<; ~:~~'~~~~:g,?~;;I:':J~~~~r.1E~l;:~~H~iI~r;'i4::;:;~S'i!t?~:1~..j..~.:~~'~)' t~\~M~!~:~~~~n1~i!t9mi~Q9~~~~~f~~~:JJtfi~it~~ '(a)Jobdescription::rN~!.. f'3) C~~". Occupancy <if _ . ~IL. &'-, II!:: .a Construction ~pe: IB:- Square feet: u ~ A Cost .per square itat: Other infonnation: Type of Heat, by Energy Path: ~new 0 alteration: 0 addition (b) Foundation-only pennil? 0 Yes 0 No Total valuation: I sL2. C;~ r 5 ."'....'''il..a. '''''''''''d.''~~'},l;",,,, >~,.. .1" "-!\j'~.l';;';' ",1"'" "' ';~'.,:' ,.". ft~i1R,!I. ,..m,g;J.,em'-t~~"l .. > ~ ;jo/tH.~~?~Y\..:.:.1jji-k1t(gB:}ti'!;;~~~:~ (a) Pennit'fee (use valuation table): $ (b) Investigativefee (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 offeas above (1a through 2d): 5 ~""'''''l ,:!!Ill ~, .",,,,,w"""'f",\w.;!l'm')1j;\\"'~~." '. '5Jj "'~t~ ~ ~~W:~~R~Yjti\Y:~~>>_~~~~~knf;~&1.~.~rili::~#.i~Nl~1k!if~i~~4? (a) Plan review (65% x pennit fee [28]): $ (b) Fire and'life silfe1y (40% x permit fee [2a]): $ (e) Subtotal offee. above (3. and 3b): 5 ~f~i'~'eI'"it.:~~6'ifiia~i1fji~A~~,":i;~~J~?~~~:;i'i6.!.~~:t.f;;~~.~!:',:~~:~~;' \;o;'.~ ....,........' ~... -- _ ~. _,..__, dnl~~....~~I...'Y..l~-j.-"Q?ii~i..Yf'''',:t~t"..,.~~'(>;O ,~.f"'-', :~~....~.\....;;.J-. (a) Seismic fee. 1% (.01 x pennit fee [2a]): 5 TOTAL f~as Qnd sorehQrgas (1e+30+4a): sIt"'. ,a S' , JocDe J?L ~/ed~&. ;//eell/vY 717- 57'!- '/.777 /#,L?&55:/>/ / #/ IA/aI-#3JO /2tJD. Chtf/al,u ;cd ~)')/Je5/JW t:A. 3/)/~f' S~~I~~:EL~. .!~ .-",''!Jh'OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00711 2800 GATEWAY ST permltcenter@ci.springfield.or.us ~'.'!, \"-'?"~7~i~,m'?"~>~"_h,f;Y8'::~~]~~~~::ACd0i.fNT~C,ODE~~,:"~~;'+'" ...::~~AivloUNT~DUE~ 224-00000-425602 528.56 821-00000-215004 6343 224-00000-425602 343.56 100-00000-425605 2643 TOTAL DUE: 961.98 I; 'PAXMEflTiirYeI:'7"'feAYOR-,_:'''CASHfE'';;K~YFMAN'' .ij,;;'!7'~(LQi.jM~I~I~;;:i":.--' . "c:b, ;'AMOUNTPAID ,'.' Credit Card Joe De Poto 961.98 RECEIPT NO: 2011000841 1DESCRI~TION.. _ . ~:.'.. Building Permit Fee State of Oregon Surcharge (12% of applica~le fees) Structural Plan Review Fee Commercial Technology fee (5% of permit total) RECORD NO: 811-SPR2011-00711 DATE: 04/29/2011 %.__i.,,~..::..1 - oJ 379862 TOTAL PAID: 961.98