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Home My WebLink AboutPermit Miscellaneous 2011-7-8 S~:I;:-. IE~ ~~.~ ~OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00153 IVR Number: 811184011695 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perrnitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/08/2011 ISSUED: APPLIED: 07/08/2011 02/01/2011 EXPIRES: VALUE: 01/03/2012 $5,000.00 SITE ADDRESS: 1701 CENTENNIAL BLVD, Springfield, OR 97477.3365 ASSESOR'S PARCEL NO: 1703253404502 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Cell Tower - Communication Tower Alteration Commercial PROJECT DESCRIPTION: Cell tower - replace 6 of 12 antennas with new models Phone Number: OWNER: ADDRESS: ORDER OF ELKS LODGE #2145 1701 CENTENNIAL BLVD SPRINGFIELD OR 97477 Contractor Type Contractor Name CONTRACTOR INFORMA TION ~ Lic Type Lie No Lie Exp Phone # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heal: Waler Type: Range Type: Hazmat: o Construction Type Occupancy Type Occupancy Comments Type liB U Replace antennas # 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: Lot Size: Sq Fl1 sl Floor: Sq FI 2nd Floor: Sq Ft Basement: Sq FI Garage: Sq FI Carport: Sq FIOlher: 0 Occupancy Load: 2008 2010 Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining wa~TTENTION: Oregon law re ' Soils Report R~l\UWeij:rles adopted by the gUJres you to NotifICation Center Th I regon Utility in OAR 952-001-001 0 t~r~~ruh es are set forth 0090, You ma b' ,9 OAR 952-001_ calling the c~~e;am(NcootPI,etshof the rules by nu b I ,e, e telephone m erC or the Oregon Utility Notilication . enter IS 1-800-332-2344), NOTICE: . ,-,' THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 7/8/2011 11 :37:05AM Page 10f4 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: 811-SPR2011-00153 IVR Number: 811184011695 permitcenter@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Iss ued 071081Z011 ISSUED: APPLIED: 07/08/2011 02/01/2011 EXPIRES: VALUE: 01/03/2012 $5,000.00 SITE ADDRESS: 1701 CENTENNIAL BLVD, Springfield, OR 97477-3365 ASSESOR'S PARCEL NO: 1703253404502 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Cell Tower M Communication Tower Alteration Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Cell tower ~ replace 6 of 12 antennas with new models 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 ~ Descrietion Bid Tvoe of Construction NA Unit Amount Unit Tvee 5,000.00 Bid Unit Cost 1.00 Value 5,000.00 5,000.00 FEES PAID ~ Descriotion Planning ~ Minor Review - City 5o/~~!echnology Fee Structural Plan Review Fee Commercial Structural Plan Review Fee Commercial Building Permit Fee Fire, Life, Safety Plan Re.view Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount Paid $119.00 $5.95 ___,,,,,_,,_,,."_,,_,..._0 $51.05 $5.66 $87.25 $34.90 $4.36 $10.47 $318.64 Date Paid Reciot # 02/01/2011 2011000201 02/01/2011 2011000201 ."._.._...__._-.~_._-_...._-_.".__.""-- 02/01/2011 2011000201 07/08/2011 2011001931 07/08/2011 2011001931 07/08/2011 2011001931 07/08/2011 2011001931 07/08/2011 2011001931 Springfield Building Permit 7/8/2011 11 :37:05AM Page 2 of 4 . S:A~~::EL~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00153 IVR Number: 811184011695 WWN.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@Ci,springfie!d.or.us PROJECT STATUS: STATUS DATE: Issued 07/08/2011 ISSUED: APPLIED: 07/08/2011 02/01/2011 EXPIRES: VALUE: 01/03/2012 $5,000.00 SITE ADDRESS: 1701 CENTENNIAL BLVD, Springfield, OR 97477-3365 ASSESOR'S PARCEL NO: 1703253404502 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Cell Tower. Communication Tower Alteration Commercial PROJECT DESCRIPTION: Cell tower - replace 6 of 12 antennas with new models Plan Review DeDartment Received Structural Review 02/02/2011 Comments: Planning and Public Works ComDleted 02/02/2011 Due Date 02/0212011 Result Waiting internal ~ Reviewer Kip Kaufman Initfal Review 02102/2011 0210212011 0210212011 Approved , .;. J ApP,ilg.tioh Aceeptane,;":,'.';, - 02/0.11201\ ..6210.112.911,: .92102120,11 .._~'--:';~2--~_~'j::~~'~'~ '~:'~-w:'" .~'~f~4>';:'f::~~('?~ .'~ " ,",,; David Bowlsby A~pplicatjon 'Acceptedti':~: ~. 'Da^'"vi(fBbwI5by~,;,~ !>~"'>~ ',' ' ".:-' . " .' ;':e,.','. :" '~S" ";J'i' ~," .~".c~,'..., ""~,~'L;'~~: '.~',. -'--,.. Planning Review 02/02/2011 02/02/2011 02/03/2011 Approved Liz Miller Comments: See attached document regarding existing tower in the MUC zone. ~--:--'-'-~'-"~'---'~~~, """"-'. ,..'~'-~--'~ .;>>" - iFire Review ,t. ._,";, 021021201)., 02/0g12011 02103/201.1, . Approved . Gilbert Gordon'. . i,_:',d~minents: ;Pla(l~~ FE!vfeJ:,:ppgrad~lrePI_a.c~,~er~t)t6 o.f _12 'a~t~~B:~es'oneXi;tin~, 9~!l"~2,we(J9,b.#SP~011 '-Oq1,53~ occ~pa.~'c~" t~- Classifi9i3JlqLr..:..l,L;;.c;_q!l~!!lJction TYR?dl:J?~J!l}--,-!pp-ear,to\m~L9.9de,re~~~ill~!Jt.~~_ Public Works Review 02/02/2011 02/0212011 02/1712011 Approved T McEachern Permit Issuance 0211712011 0211712011 07/0812011 Issued David Bowlsby INSPECTIONS REQUIRED ~ Inspections 1260 Framing -'~1 i I ....::.:.:..J .. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. 1999 Final Building Springfield Building Permit 7/8f2011 11 :37:05AM Page 3 of 4 SPRIN ..G.FIE~LD. . .- .;." ;l>.&. ~~, I.W ."""\OREGON www.ci.springfield.or.uS CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00153 IVR Number: 811184011695 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci. springfield. or. us PROJECT STATUS: STATUS DATE: 155 ued 07/08/2011 ISSUED: APPLIED: 07/08/2011 02/01/2011 EXPIRES: VALUE: 01/03/2012 $5,000.00 SITE ADDRESS: 1701 CENTENNIAL BLVD, Springfield, OR 97477-3365 ASSESOR'S PARCEL NO: 1703253404502 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Cell Tower - Communication Tower Alteration Commercial PROJECT DESCRIPTION: Cell tower - replace 6 of 12 antennas with new models 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 on the site at all times during construction. .... l~ Date Springfield Building Permit 7/8/2011 11 :37:05AM Page 4 of4 Structural Permit Application 1;,,;.i;@im@1l~(onult\toflil; .' 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(54 [)726-3689 J ~ ,/ .t"'.! j'~' ~_:, . - .....?\"r"....;,;,_".., I~ DEPARTMENT USE ONLY S ZCI -00 ISJ. Permit no.: Date: Z - ( - Zu/ I This permit is issued under OAR 918~460~0030. Permits expire if work is not started within 180 days of issuance or if WOI"k is suspended for I KO days. LOCAL GOVERNMENT APPROVAL This project has fillalland-use approval. Signature: Date: ---- This project has DEQ approval. Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within !load plain: 0 Yes 0 No CATEGORY OF CONSTRUCTION o Residential 0 Government KJ Commercial JOB SITE INFORMATION AND LOCATION Job site address: 1701 Centennial Blvd City: S ringfield State: OR Subdivision: Reference: Applicant IIftOP'f:fl"T I 6"lJUER Name: Verizon Wireless (VAW) LLC c/o Land Services NW Address: ATTN: Ed Fournier PO Box 302 City: Bend State: OR Phone: - 541.728.3328 FIlX: E-mail: Ed@LandServicesNW.com ZIP: 97709 206-350.1223 This installation is being made on residential or farm property owned by me or a member army immediate family, and ~exempt from r ensing requirements under ORS 701.010. Sign here: Business nnme: Address: City: Phone: E-mail: cell license no.: Print name: State: ZIP: Fax: Signature: SUB.CONTRACTOR INFORMA nON Name Cell Ucense Number Phone Number Electrical rlumbing Mechanical FEE SCHEDULE 1. Valuation inrormation (a) Job description: replace 6 of 12 antennas with new mod I Occupancy unmanned telecom Construction type: modular telecom Square feet: no change Cost per square fool: Other in formation: Type of Heat: Energy Path: o new . 1ZI alteration o addition (b) Foundation-only penn it'! DYes I1Q No Total valuation: S 5 000.00 2. Building fees (a) Pennil fee (use valuation table): S (b) Investigative fee (equal to [2u]): S (c) Reinspection ($ per hour): $ (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): S (c) Subtotal of fees above (2a through 2d): $ 3. Plan review fees (3) Plan review (65%x permit fee [2a)): S c::,b~- (b) Fire and life safety (40% x pennil fee [2a]): $ (e) Subtotal of fees above (3a nnd 3b): $ 4. Miscellaneous fees (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3C+4a): S s . SP;~~~=L~ L~~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.U5 811-SPR2011-00153 1701 CENTENNIAL BLVD pe rmitcenter@ci.springfleld.or,us RECEIPT NO: 2011001931 tDESCRll1.tI6,.t'F<',,~j :,,'0." ' Building Permit Fee Fire, Life, Safety Plan Review State of Oregon Surcha!ge (12% of applicable fees) Structural Plan Review Fee Commercial ---~-- ,_, Techn2-I-",9Y fee ~~of ~ermit total) RECORD NO: 811,SPR2011,00153 DATE: 07/08/2011 , . ~, ';;~1\''''\ ' , -:.;.',it~+;;,\*i''';~:''ACt.OUNT~C,6DEI'''-" " ;'7;~',p':MOUNf;DliE':, j,'.' ."", I 224,00000-425602 87.25 224,00000-425602 34.90 821,00000,215004 10.47 224,00000,425602 5,66 100,00000,425605 4.36 '. '-""-'--""'-- TOTAL DUE: 142,64 't j0!:'~"tAM6UNT'!f'AID",:""-!!+>-' .' $142,64 '. ~}"PA YMENm;YPE' .' :- PAYOR, . cAsH~R::6BoWLs~",,';;i';c6MMENfs/, '~.. Credit Card T3 construction lie 318043 TOTAL PAID: $142.64 S~~I.N.G..FIEL~ .- ....(~ :' o-e" OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00153 1701 CENTENNIAL BLVD CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541~726-3753 permilcenter@ci.springfield,or.us RECEIPT NO: 2011000201 lOESCRIP..TION 5% Technology Fee Planning - Minor Review - City Structural Plan Review Fee Commercial RECORD NO: 811-SPR2011-00153 ,j~ ,.,.t .~ " :' ~y ACCQUNLCOOE. . 100-00000-425605 100-00000.425002 224-00000-425602 TOTAL DUE: DATE: 02/01/2011 ~~AMOUNLOUE~::') 5.95 119.00 51.05 176.00 AMOUNT pAID:. 176.00 'F L...i~r1LEJ:lTJYJ'E . Check 1320 PAYOR CASHIER:'DBOWLSBY; CO.I"!II'v1E.N:r.~! urban wireless inc TOTAL PAID: 176.00