HomeMy WebLinkAboutPermit Building 2013-6-4 •
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SPRINGFIELD 225 Fifth St
` CITY OF SPRINGFIELD Springfield,OR 97477
ht
Phone: 541-726-3753
OREGON
Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01067
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/04/2013 EXPIRES: 11/30/2013
STATUS DATE: 06/04/2013 APPLIED: 05/28/2013
SITE ADDRESS: 38 KREMONT AVE,Springfield,OR 97477 SCOPE: Deck
ASSESOR'S PARCEL NO: 1803023304700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Elevated deck for manufactured home
OWNER: SHAVER JAY D&SHIRLEY A Phone Number:
ADDRESS: 926 ANDERSON LN APT 9
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
1020 Zoning Setbacks
1110 Footing Footing: After trenches are excavated.
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved. •
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 loc he front of the property, and the approved set of plans will remain on the site at all times during
constr on.
4 Al & _ y , 13
Irw
Contractor Signature Date
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"dQTICE:
ATTENTION: Oregon law requires you to 'HIS PERMIT SHALL EXPIRE IF THE WORK
follow rules adopted by the Oregon Utility iJ"(110RIZED 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- tNY 180 DAY PERIOD.
0090. You may obtain copies of the rules by •
calling the center. (Note: the telepl....try.
),pr . 'C! '1ilr., ^ . i Ntilifie in •
Springfield Building Permit 6/4/2013 1:22:49PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
OREGON TRANSACTION RECEIPT 54 gzfil3,oR97477.
811-S PR2013-01067
www.springfield-ar.gov 38 KREMONT AVE permitcenter @springfield-or.gov
RECEIPT NO: 2013001107 RECORD NO: 811-SPR2013-01067 DATE:06/04/2013
DESCRIPTION..,.''- ,,.-__*__._ r >_ ,,,. ,, , ;, ,,,, r.;ACCOUNTCODE/TRANS.CODE
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.84
Structural Building Permit Fee 224-00000-425602 1002 90,33
Structural Plan Review Fee Residential 224-00000-425602 1061 58.71
Technology fee(5%of permit total) 100-00000-425605 2099 4.52
• TOTAL DUE: 164.40
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'=,PAYMENT:TYPE � PAYOR , caseleR� iLn' RSON x .ms s.i.COMMENTS .� `" - ,,, !` a AMOUNT , . „ ;
Check SHAVER JAY D& SHIRLEY A 164.40
2061
TOTAL PAID: 164.40
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Structural Permit Application SPRINGFIELD
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„,: ,"`,...,-,- ;.• :; ,...- 7.3.1:,:r 7
.,V)ITY-43FtPRINCIFIEED--IOREGON -; - .--; .,,---yr-:tc,:--.1 - : es
Permit no.: 5 1 3 - o i 0 67
it•••
225 Fifth Street•Springfield OR 97477•PH(541)726-3753•FAX(54l)726-3689 OREGON
Date: 5/2'z/-3
This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of issuane or if work is
suspended for 180 days.
ww:iefiwycercaa-avairpatitr,a-miovgitgrafit: M.,?:117eXtrifESSell-Tiolialltrihitli-..!%:-
This project has final land use approval. WilaiitArirfalattltIer,41'','r-zt...yla.,,mscreo f..47'.:,'ti.:
Signature: Date: (a)Job description: zere...v.._
This project has DEQ approval.
Occupancy v1/4,_
Signature: Date: .
Zoning approval verified: 0 Yes 0 No Construction type: Vi3
Property is within flood plain: 0 Yes 0 No Square feet:
Sii,:t.'7.-1:AWATtatrii;;;;5!IC:WiigirallietieiFiElaggait, Cost per square foot: •
X Residential 0 Government 0 Commercial Other information:
r7,7.WASTS5-67§1,1grl WF7616A-Arf rOwN1,115.cirdaTra31-1, v,1 Type of Heat: N A
Job site address: • Vire-MT* Energy Path: NA
City: Scxq ItIefr State: OR zip:oni-ri 0 new nalteration Araddition
Subdivisiac Lot no.: (b)Foundation-only permit? Ei Yes ago
Reference: I Taxa:18-03-02-33-04-110/0 Total valuation: s-5 co or
iarafamocoiEkttrowargnmetealai ::.i.n3--cifiriitems-tsaltio- ,..,rnescigreaagp
Name:5tfAti_4 c1ä S anUeC (a)Permit fee(use valuation table): $
Address: Sac And.erson lin, C) (b)Investigative fee(equal to[2a]): $
City:Sprint e.4 State:CA ZIP:91411 (c)Reinspection(S per hour): $
Phone:(54 I :;50).-.95“6 Fax: - - Il)/Pt (number of hours x fee per hour)
E-mail: A)iii% (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ 10 Pi
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application rirceremaigarsii,', eiwc•c747111:74IMSZ-Taigf
/ . (a)Plan review(65%x permit fee[2a]): $
/
Sign here:, ./1/ • g.........„ (b)Fire and life safety(40%x permit fee[2a]): $
0 This installation is •11 g made on residen• to arm property owned by (c)Subtotal of fees above(3a and 3b): $
I
me or a member of rny_immediate family,an is exempt from licensing r':4 ICI fcCe illgaitleelt-?c,i: '117;.7t.',..",.W.Ficiailfealgi
requirements under ORS 701010.
a( )Seisrnic fee, 1%(01 x permit fee[2a1): $
• ar55NThrefoilkliN—ST/CliaThoN53kirVeka ti ._
$
- ) - (b)Technology fee,5%(.05 x permit fee[2ap: so
Business name:
TOTAL fees and surcharges(2e+3c-h4a+4b): si y
Address:
City: State: ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
;:atair=-SSLIBCONTIatitHilNEORMATIONtlia-7.:alta .
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical
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