HomeMy WebLinkAboutPermit Building 2013-6-5 r SPRINGFIELD ,_ 225 Fifth St
hit-C� CITY OF SPRINGFIELD Springfield,OR 97477
`C� Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00369
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/05/2013 EXPIRES: 12/01/2013
STATUS DATE: 06/05/2013 APPLIED: 02/21/2013
SITE ADDRESS: 126 W OLYMPIC ST,Springfield,OR 97477 SCOPE: Interior
ASSESOR'S PARCEL NO: 1703274106700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Interior alterations to one duplex unit and exterior flatwork for full wheelchair accessibility
OWNER: HOUSING AUTHORITY&URBAN Phone Number:
ADDRESS: 300 W FAIRVIEW DR
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections .-
1120 Foundation Foundation: After forms are erected but prior to concrete placement.
1220 Underfloor framing •
1260 Framing Frarpi lneion: Prior to cover and after all rough in inspections have been
ATTENTION: Oregon law r sour @§ Y I may
1410 underneoftikurturdid es adopted by the es ar
u;; aGc',Cont.! Those rules are set forth
1420 Insulationn ()p n1�-1701-0010 through OAH Yo2-001- ruUr/CE:
• a of thertl1°s by
outaln wpe' •,u0 T ..
1430 Insulation:VJaG1. YOU may I tlpn7:Prior to cover. P
to r t°r (Note: N?9� Alrrr,pen SR
1440 Insulation Ceifng Oregon Uf.''yli g I Irlaluun nO .'L°' 1ZEU S A« EXPIR
nuu�.].-r for the Ore S rt o111 tsu a ion: Prior to cover.
„n MAnr UNIT E 1p
° Is I-&cc 2 C E T F
1540 Gypsum Board/LathrDrywalS Drywall:)Prior to taping. Lath/Plaster: To,be m d*^ r� I Ba�dS�3NCD WORK
ar � h �Nrn�/,y/�
board, interior and exterior are in place, but prior WO16Ar. S AN ° "VS NnT
1999 Final Building Final Building: After all required inspections have been requested and approved84R
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.
p...4..„, 6/C120 g .
Owner or Contractor Signature Date
Springfield Building Permit 6/5/2013 1:01:36PM Page 1 of 1
' SPRINGFIELD -- CITY OF SPRINGFIELD
't, e- 225 Fifth St
; .' - � , TRANSACTION RECEIPT Springfield,OR 97477
r
1, • OREGON - 541-726-3753
811-SPR2013-00369
www.springfield-or.gov 126 W OLYMPIC ST permitcenter @springfield-or.gov
RECEIPT NO: 2013001125 RECORD NO:811-SPR2013-00369 DATE:06/05/2013
IDESCRIPTIO■� -: ACCOUNT CODE/TRANS-CODE.;'-7:1;1,--: ' .AMOUNT TDUE, ' I
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 101.71
SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 79.17
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 208.40
SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 54.35
SDC:Total Sewer Administration Fee 719-00000-426604 1175 15.51
SDC: Total Storm Administration Fee 719-00000-426604 1180 6.68
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 79.79
Structural Building Permit Fee 224-00000-425602 1002 664.92
Technology fee(5%of permit total) 100-00000-425605 2099 33.25
TOTAL DUE: 1,243.78
-- - - - • -.-AMOUNT PAID'
LPAYMENT TYPE PAYOR.� -caswER:ccaRPENTER • COMMENTS^`. -.
Check PADDOCK MASONRY 1,243.78
33166
TOTAL PAID: 1,243.78
•
SPRINGFIELD CITY OF SPRINGFIELD
hit&(:ORREGON TRANSACTION RECEIPT SpdngfieldttR97477
541-726-3753
811-SPR2013-00369
www.springfield-or.gov 126 W OLYMPIC ST permitcenter @springfeld-or.gov
RECEIPT NO: 2013000453 RECORD NO:811SPR2013-00369 DATE:03/08/2013
11114-4o3:11:A1f[o]tI _ ,r`_ i. ACCOUNT.CODEIiRANSCOpE 3: `
Structural Plan Review Fee Residential 224-00000-425602 1061 432.20
TOTAL DUE: 432.20
PAYMENTRTYFE PAYOR casNIER:K iT ON" COMMENTS AMDAINPAID
Check Housing Authority of Lane County 432.20
93193
TOTAL PAID: 432.20
•
111 Structural Permit Application DEPARTMENT USE ONLY
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CITY OF SPRINGFIELD,OREGON .' tt u Permit no.:
225 Fifth Street•Springfield,OR 97477 •PH(541)726-3753•FAX(541)726-3689
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Si 3-3�
Date:2(2. r / .3
This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of issuadce or if work is
suspended for 180 days.
LOCAL GOVERNMENT:APPROVAL+
•
This project has final land-use approval. --
Signature: Date: FEE SCHEDULE •'
This project has DEQ approval. 'I:Valuation information _ -_, ;,_
Signature: Date: (a) Job description: I PJT'CY1-iota (at&rt-t x yeti^o p s..,_`"F'
Zoning approval verified: ❑ Yes ❑No Occupancy 0_7 ytt(-_E3C \(3/L_\ T-)
Property is within flood plain: ❑Yes ❑No Construction type:(/l
• f 40.CATEGORY(nOF.CONSTRUCTION;•„� _ , Square feet:
Riesidential ❑ Government ❑ Commercial Cost per square foot:
JOB SITE INFORMATION`i•AND LOCATION Other information:
Job site address: /2 Co (N, OG Y+M PIC, Type of Heat:
City: cS'PRfNGF/GAD State: (5 E. ZIP:7'1477
Energy Path:
Subdivision: Lot no.: h
new Q4lteration ❑ addition
Reference: 703 Z7t/ Taxlot: 17-03 -Z7-ti OC.7oe,-
RAC SIN OWNER// )Foundation only permit? ❑Yes ❑No
Name: 11C`�-S� of L_Ahie `oaNTn' Total valuation: S 'f(,. ,.
=2; Building-fees ;t i
Address: 300 WEST FAIRUtcu .pR(VE- ��-(�
( (a) Permit fee(use valuation table): S Igg
City: ,5pRI,-il,Fie et, f State: OR. ZIP:(74;77
(b)Investigative fee(equal to[2a]): $
Phone-6$t-2G91 Fax:51-y C&87...-- 387 (c)Reinspection($ per hour):
E-mail: itteea J H 6 ApyC HAGS, (3 5 (number of hours x fee per hour) S
This installation is being made on residential or farm property owned by (d)Enter 12%surcharge(.12 x[2a+2b+2c]): . $$ 7
me -_ : ••_••• • n• .••Of-• • h li and is exempt from_Iicrnsin•
r., • -,,., „_ •e I . t i �C-k11roc=-T (e) Subtotal of fees above(2a through 2d): S
3`Plan review feesµ 5< t'f ._�I I 'c•'�"'te
Sign here: / / , a- _ - - /I�q L`-
(a)Plan review(65%x permit fee[2a]): $ Lt 2
CONTRA . OR STALLAT•I•N.. ,
(b)Fire and life safety(40%x permit fee[2a]) S
Business name: Fu BL t E_3- tS) T b (c) Subtotal of fees above(3a and 3b): S
Address: / F :2
4 1SdiS ellan.Ous fees,:;,5' ,i;, ',
City: State: ZIP: - -
(a) Seismic fee, 1/u(.01 x permit fee [2a]) S
Phone: - - Fax: - -
E-mail: TOTAL fees and surcharges(2e+3c+4a): S X21O/f+
CCB license no.:
•
Print name:
Signature:
?.SUB CONTRACTOR IN;FORMATION" t :;
Name I CCB License Number I Phone Number
Electrical
Plumbing
Mechanical