HomeMy WebLinkAboutPermit Building 2013-6-3 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
v' - Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769 •
• Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01090
www.springfleld-or.gov permitcenter @springfieId-or.gov
PROJECT STATUS: Issued ISSUED: 06/03/2013 EXPIRES: 11/29/2013
STATUS DATE: 06/03/2013 APPLIED: 05/29/2013
SITE ADDRESS: 2822 20TH ST,Springfield,OR 97477 SCOPE: Family Room
ASSESOR'S PARCEL NO: 1703244204700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Adding Vaulted Ceiling
OWNER: MOWER RICHARD L&PEGGY A . Phone Number:
ADDRESS: 2822 20TH ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER COB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
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.
Owner or Coo \'ractor Signature Date
ATTENTION: Oregon law requires you to •
follow rules adapted by the Oregon Utility NOTICE:
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephurc
number for the Oregon Utility Notification ANY 180 DAY PERIOD. •
Center is 1-800-332-2344). •
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Springfield Building Permit 6/3/2013 3:46:39PM Page 1 of 1
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. SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
hr OREGON 541-726-3753
811-SPR2013-01090
www.spnngfield-or.gov 2822 20TH ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2013001094 RECORD NO:811-SPR2013-01090 DATE:06/03/2013
D R 'TION°Vr aliii''' ,0!°Ird1 t `:fl0a4. y' .r:`. +aAOCOUNT CODERRANS,cODE S AMOUNT- 3 I
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 12.08
Structural Building Permit Fee 224-00000-425602 1002 100.65
Technology fee(5%of permit total) 100-00000-425605 2099 5.03
TOTAL DUE: 117.76
WAYMENTPTNBE P.AYO'R cas is J RSOx COMMENTS _ AMOUNTraelp ,
Check MOWER RICHARD L& PEGGY A 117.76
1232
TOTAL PAID: 117.76
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Structural Permit Application sPRINGFIELD - vritlIDEPARTMENTIUSE ONLY;
r,°A :i x r•:,;-, r a Tj.ci i 1 i gs x:13,,, ri +.-c 4 a+i k i f ,.
C i ?' fl }CIJY-IOF SPRINGFIELD iPREGON'�5s r v�sk : if S J
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Uda 'a'O REGON
Date: 5/z 9// 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.
i(? :LOCAL=GOVERNMENT'_APPROVAL , ,,_ ,_ * la ,i itrkt,,. FEE_SCNEDULE i ,u_ 1'"''I`i ''.:,,r
This project has final land-use approval 1:Valua[tou_inform,a/hoasz e , e ?�r -�m';�:�=aC:
Signature: Date: (a)Job description: //74LT /fT /...4.)L/ /1.---
This project has DEQ approval. Occupancy /13
Signature: Date:
Zoning approval verified: ❑Yes ❑No Construction type: (/l?
Property is within flood plain: ❑Yes ❑No Square feet:
�,L ,�s CATEGOR.Y OF CONSTRUCTION„+, ; Cost per square foot:
R4esidential ❑Government ❑Commercial Other information:
. ',,,,. , `,JOB+,SITE.`INFORMATION�W'AND LO.CtATION . Type of Heat:
Job site address: yg27� .,�t/T 14• \ t Energy Path:
Cityarb Si(icl ELIM I(StateOt- I ZIPE{71{7-7 ❑new alteration ❑addition
Subdivision:W1(—L4.f, MZ,V Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: _I Taxlot: 1703 V.4 9Z0t1700 Total valuation: $
Ti~ x.:: ,t;; . ..PRoPERuT01NNER-.e F.2_°.d`._ K.._.aA. .2_Buddu giCe sit% i1 .*?v ,w b?'`.:'r, + `.?fit Z r .. F'
Name:b0,[}Ayz.p LA WEGC,Ni A-YYlatf -- (a)Permit fee(use valuation table): $/004
Address: 2.9 ZZ. '20"T S`t, (b)Investigative fee(equal to[2a]): $
City:5aa1 N(rp%.Lb State()Y(.� ZIPS 7477 (c)Reinspection($ per hour): $
"7 Fax: - -
Phone:st1 7-Q7Ct (number of hours x fee per hour)
.(� .-7 o�
E-mail: pccv-nct t.J �Y- ®Yck.ht)o .corn (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ �2
T' (e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: 3 fPlari revtew;',fees .s-r `r,0 s :`' rb::",4 °.3 :s i
(a)Plan review(65%x permit fee[2a]): $ 0q4 2-
Sign here: .1 "J A�_----- (b)Fire and life safety(40%x permit fee[2a]): $
IA 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 4-;Mtscellaneuirsfees °x 4A, } a,= :`'q : .:
requirements under ORS 701.010. } (a)Seismic fee, 1%(.0l x permit fee[2a]): $ u 3
,r,';--', .4bA - ONTRACTOR INSTALLATIOITI I. ,..d..V. (b)Technology fee,5%(.OS x permit fee[2a1): $ S —
Business name: Syr_/ — ` /
vv�� TOTAL fees and surcharges(2e+3c+4a+46): $ /G� -
Address:
City: State: ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.: -
Print name:
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Signature:
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mot -gSUB CONTRACTOR;INFORMATION ._ _.
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical