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HomeMy WebLinkAboutPermit Building 2013-5-22 SPRINGFIELD • 225 Fifth St CITY OF SPRINGFIELD Springfeld,OR 97477 - } Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01026 www.springfield-ocgov permitcenter©springfield-or.gav PROJECT STATUS: Issued ISSUED: 05/22/2013 EXPIRES: 11/17/2013 STATUS DATE: 05/22/2013 APPLIED: 05/22/2013 SITE ADDRESS: 565 HARLOW RD,APT#1,Springfield,OR 97477 SCOPE: ReRoof ASSESOR'S PARCEL NO: 1703271200800 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Reroof OWNER: COUNTRYSIDE LLC Phone Number: ADDRESS: 111 SW 5TH AVE STE 3690 PORTLAND OR 97204 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor CL LARGE INC COB 60147 05/24/2014 541-344-1415 INSPECTIONS REQUIRED Inspections 1620 Roofing Roofing: Prior to installing any roof covering. 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. • r-C* f-7 • Owner o•n a t. - - - ure 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 COMMENCED OR IS ABANDONED FOR In OAR 952-001-0010 obtain copies OAR 952-001- 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the teleph .c number for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 5/22/2013 1:44:08PM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD • 225 Fifth St _; TRANSACTION RECEIPT Spdngfield,OR97477• 91(Lte OREGON 541-726-3753 811-SPR2013-01026 www.springfield-or.gov 565 HARLOW RD. APT 1 permitcenter @springfield-or.gov RECEIPT NO: 2013001016 RECORD NO:611-SPR2013-01026 DATE:05/22/2013 IWiti1N141o1:� :'"L�:xk - +`'._ ' t " ACGOU VCODE/TRANS CODE.." �`. Building Permit Fee 224-00000-425602 1002 801.22 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 96.15 Technology fee(5%of permit total) 100-00000-425605 2099 40.06 TOTAL DUE: 937.43 BAYMENTaIWR PAYOR 'DAENieR`D TCSE7Y COMMENTS. ' AMO—PAIRFINP` ng Check Evergreen Roofing 937.43 1129 • TOTAL PAID: 937.43 • A. Structural Permit Application SPRINGFIELD , DEPARTMENTaUSE ONLY CITY OF SPRINGFIELD, OREGON u% Permit no "� t ORl ' 70,30L O�/ �j EGON V 225 Fifth Street•Springfield,OR 97477•PH(54I)726-3753•FAX(541)726-3689 Date: 572_a / 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. w ,�m� allt.v LOCAL`GOVERNMENT APPROVAL 111.1-, - az yyl i ,rte. + f FEE SCHEDULE'; rra 'a" -:,. This project has final land-use approval. _1'_kaluatton`mformation a r_tilv '. ,x,';iL .„m;-f.`...s Signature: Date: (a)Job description: This project has DEQ approval. � - 2�i 111.1 f— Ga-M H Signature: Date: Occupancy hi Zoning approval verified: ❑Yes ❑No Construction type:ki4, • Property is within flood plain: ❑Yes ❑No Square feet: ezirrer ya ',t . nATtoo O RYlOF*Cbl NSTRU-CiT O e - r Cost per square foot 1Z ❑Residential ❑Government 21 Commercial Other information: r EPkJOBrSITEINFORMATION"AND;LOCATIO lif t ' Type of Heat Job site address:56,6 $' ,{4(Q t9 Energy Path: cityoritrit.t.Fat State:OIL ZIPf'[1lif / 0 new 'alteration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No Reference: Taxlot: Total valuation: $ °„`., ',,sM` 'r r,, s .PROPERtiel,OWNER"L'`S scE`.w' 4vnE.= f 2.'Buildm"fees* - ' ++ "�°' : `," ' ta Name:jff/,V/ ?LOA v 7 hen r,440,2194 (a)Permit fee(use valuation table): $ Address://J 5(,fl, 5-771.- for .71.90 (b)Investigative fee(equal to[2a]): City:.g 'Jl".4 State: 0k- ZIP:q-7Z (c)Reinspection(S per hour): - Phone:'7y3 .QQ��f tPpdt�O/� Fax6-24/X2„/ y 1 (number of hours x fee per hour) E-mail:mq� I IraeIr,1Z aA21Aftr.rppdv4YtsJI Cam (d)Enter 12%surcharge(.12x[2a+2b+2c]): $ // r J I (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application 3 Plan'[¢view fees:eta ,wS4_IR5-5w. s,INit,g,;- ASIS (a)Plan review(65%x permit fee[2a]): $ Sign here:"'IV (b)Fire and life safety(40%x permit fee[2a]): $ ❑This installation is being made on residential or farm property owned by _ (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing n"et * ' I ,� vF n 3 sx°' y4 Mrscellaneous fees,fitiyct,�a+_,;;s,�s,,.,. .,,,"�`W��[xr_v,k�.,�'gn requirements under ORS 701.010. S (a) Seismic fee, 1%(.01 x permit fee[2a]): , CONTRQCTORINTALLATIOJ s f x + r $ (b)Technology fee,5%(.05 x permit fee[2a]): $ Business name: V 2.Q /249,r1,46. OQ TOTAL fees and surcharges(2e+3c+4a+4b): s13.7 r-d3 Address:2.37 W. /6r-- city: elya State:qL ZIP/7149 PhonS21/ 14/15 Fax: /-9G,a-oPn!_ E-mail:Gr, 415esVerea r,-e1 (b •PgAA . m/✓1 CCB license no.:4,0 X47 •/ Print name:9 z-_ fgey�-�'� Signature-.<47:e ; SUB-CCONTRACTOR INFORMATION _ Name CCB License# Phone Number Electrical Plumbing Mechanical