HomeMy WebLinkAboutPermit Miscellaneous 2013-4- • SPRINGFIELD 225 Fifth St
' CITY OF SPRINGFIELD Springfield,OR 97477
".:C b4/ Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00790
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/19/2013 EXPIRES: 10/16/2013
STATUS DATE: 04/19/2013 APPLIED: 04/19/2013
SITE ADDRESS: 1650 CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1703253403900 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Insulation support framing
OWNER: MERCURY DIME,LLC Phone Number:
ADDRESS: PO BOX 26125
EUGENE OR 97402
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor RICHARD AIELLO CCB 82355 05/01/2014 541-342-3007
L. INSPECTIONS REQUIRED
Inspections
•
1440 Insulation Ceiling Ceiling Insulation: Prior to cover.
1999 Final Building Final Building: After all required inspections have been requested and approved and
the building is complete.
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.
/7m4•.l• . G i. iy, 2c =3
Owner or Contractor Signature Date
•
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth
OMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
1R0 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•
Springfield Building Permit 4/19/2013 8:50:13AM Page 1 of 1
• SPRINGFIELD CITY OF SPRINGFIELD
d 225 Fifth St
TRANSACTION RECEIPT Spdngfeld,OR97477
OREGON 541-726-3753
811-SPR2013-00790
www.spdngfield-or.gov 1650 CENTENNIAL BLVD permitcenter@springfield-or.gov
RECEIPT NO: 2013000782 RECORD NO:811-SPR2013-00790 DATE:04/19/2013
Jo14_14i3L fl!1∎1:.) ._s a ?.L-.,1_a., i F_.. 'k' ,'ACCOUNT CODEITRAN
Building Permit Fee 224-00000-425602 1002 276.19
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 33.14
Technology fee(5%of permit total) 100-00000-425605 2099 13.81
TOTAL DUE: 323.14
PA Y OR CASHIER:JLARSON., S_C_GOMMENTS g__. _. X .f:.:: A.M._OUNTSPAIDkr<Is "
Credit `#vL'kd
Card RICHARD AIELLO 323.14
149562
TOTAL PAID: 323.14
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF SPRINGFIELD. OREGON Permit no.: gt ( ZCA 3Oc37 YO
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON
Date: 4 y //3
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.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
This project has final land-use approval. 1.Valuation information
Signature: Date: (a)Job description: 2,)C 6 egos f/ .4.i a �6 ,c 4.
This project has DEQ approval.
Signature:
Date: Occupancy Afar, oac 0j3 S*co 447.70.,,
Zoning approval verified: ❑Yes ❑No
Construction type: S - 16
Property is within flood plain: ❑Yes ❑No Square feet: V 3, a as
CATEGORY OF CONSTRUCTION Cost per square foot:
❑Residential ❑Government ❑Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat: «eC! fNeil
Job site address: /1 SD C FN rersium L 82 u p Energy Path:
City: f' .404'ir2A I State: p/L ZIP:17r77 ❑new ®glteration ❑addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: Taxlot: Total valuation: $Zi,Oa0
PROPERTY OWNER 2.Building fees
Name: /y orifro4v z»ri1E C C (a)Permit fee(use valuation table): $
Address: P o ea 26 1 Zf (b)Investigative fee(equal to[2a]): $
City: erect 6wo State:D2 I ZIP97f44 (c)Reinspection($ per hour):
Phone:SW• 34/4. 67 4! Fax: - - (number of hours x fee per hour)
E-mail: 5 TEi6/v S f',E y err7t Cep (d)Enter 12%surcharge(.12 x[2a+26+2c1): $
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: 3.Plan review fees
(a)Plan review(65%x permit fee[20): S
Sign here: (b)Fire and life safety(40%x permit fee[2a]): S
❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3W: $
me or a member of my immediate family,and is exempt from licensing 4.Miscellaneous fees
requirements under ORS 701.010. °
(a)Seismic fee, I%(.01 x permit fee[2a]): S
CONTRACTOR INSTALLATION (b)Technology fee,5%(.05 x permit fee[2a]): $
Business name: rC U co, drip... I
TOTAL fees and surcharges(2e+3c+4a+ 5
4b): $ 1-1
Address: /7 Q t [:CA- ra ,a.-.n-f.q ^it o D
City: S _ tt eGO State:eta . Z1P:Q7f/77
Phone: fr., fa 1 01,4/ Fax: 15 917°V ad di"
E-mail: 2 Co Z eo
CC6 license no.: 72 3 vs"
Print name: .?AG,µv"IA _4Ar1 td
Signature: #.44.,4 elate
SUB-CONTRACTOR INFORMATION .
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical
C.ENCENNIAL BLVD.
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