HomeMy WebLinkAboutPermit Building 2013-6-12 SPRINGFIELD.. ... 225 Fifth St
�°— CITY OF SPRINGFIELD Springfield,OR 97477
'f, :ice Phone: 541-726-3753
OREGON • Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01265
www.spnngfieldor.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/12/2013 EXPIRES: 12/08/2013
STATUS DATE: 06/12/2013 APPLIED: 06/12/2013
SITE ADDRESS: 3234 VIRGINIA AVE,Springfield,OR 97478 SCOPE: Carport
ASSESOR'S PARCEL NO: 1702313402812 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Carport closed on three sides
OWNER: ELDER MITCHELL HILL 8 AMICK-ELDER DAVENA Phone Number:
ADDRESS: PO BOX 50642
EUGENE OR 97405
CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections •
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 located at the front of the property, and the approved set of plans will remain on the site at all times during
construction.
of a l�
Owner or Contractor Signature Da
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
•
Notification Center. Those rules are set forth
NOTICE: in OAR 952-001-0010 through OAR 952-00 -
THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by
calling the center. (Note: the teleph:,,
AUTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon Utility Notification
COMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344).
ANY 180 DAY PERIOD. .
•
Springfield Building Permit 6/12/2013 11:00:30AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
OREGON
�;. 541-726-3753
811-SPR2013-01265
www.springfield-or.gov 3234 VIRGINIA AVE permitcenter @springfield-or.gov
RECEIPT NO: 2013001213 RECORD NO:611-SPR2013-01265 DATE:06/12/2013
DESCRIPTION ,", .a', ,_•`; 1112.141; 171.7 LJ ACCOUNT-CODE/TRANS CODE N.`; ` k:i AMOUNT DUE"11
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Structural Building Permit Fee 224-00000-425602 1002 80.00
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
011PAY.MENTRT(PE r.P,AYOR cnstiglin`"RSDR GOMMEN, Aka-, 3 -`'*s-. (AMOUNT{PAID _
Credit Card ELDER MITCHELL HILL&AMICK-EL[ 93.60
09345Z DAVENA
TOTAL PAID: 93.60
•
•
Structural Permit Application SPRINGFIELD DEPARTMENT USEONLY'.
tt 6Yf 4 %4 L .. M-. r g.4Y'`j4P aZMaY+ .t `y°. >lja ,ILL dy 1+ a$+5
,.1 Yt C1ToY OaSPRINGRIELD;OREGON�V.%:Eli �.i.V4i iri c r Permit no.• e tt zol3 of Z(
225 Fifth Street•Springfield,OR97477•PH(54I)726-3753•FAX(541)726-3689 a OREGON
Date: 6 42 / (-5
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.
•".:r "''tAITRLOCAL'"[GOVERNMENT APPROVAL`',`+„{`#'#'ter 6t:4-'411 „rr S'a;,._ --'..FEE,SCHEDt1LE 4 ,'fay. 'egl
This project has final land-use approval. 11-.':;Valuattoninform4hou }`m +:WARP,x tP"_Yl,di{;"l r:+-
Signature: Date:
gn (a)Job description: t n_rPv 4-
This project has DEQ approval. Occupancy / /
Signature: Date:
Zoning approval verified: ❑Yes ❑No Construction type:
Property is within flood plain: ❑Yes ❑No Square feet:
i sCs =„";_xCATEGORY OF CONSTRUCTION+ F,,tt;_ E' Cost per square foot:
❑Residential ❑Government ❑Commercial Other information:
r.,.ir°s' r`'RJOB SITE,iNFORMATION;.AND LOCATIONtL K;-i1 '',]r Type of Heat:
Job site address:3�N V 1 r j i is Ave • Energy Path:
City: e,106. t 4jd State: M zip 47yi' ❑new ❑alteration ❑addition
-,\(, City: J ,' Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: I Taxlot: Total valuation: S
, ., .- d . ' . Si 9' f
w':`�+*,aY?n?-Y .-;.,,.-...�' PROPERTY.011iMER.:r,.,,t_°': . ' .,_, ..i 17 r"y. 2cBuilding.fC 5? 3 s'",'ti-z t�"s 1°iii�„ `t]iL�';.iv'' -....H,. `'
Name: /1'1 j-pke I( Dap r 41�I1�iJt /IA Arw1i et-f U 1) (a)Permit fee(use valuation table): $
(\__ Address: B23'j I 11 j o){s j 4, 4- — (b)Investigative fee(equal to[2a]): $
City: C - •, c p Iott State: ZIP:'f7tf7� (c)Reinspection($ per hour): $
Phone: 7 N7(p Fax: K�� (number of hours x fee per hour)
N'1_7 y 7 (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $
E-mail: t'11eje,lelefe) AetstetitQ.-
(e)Subtotal of fees above(2a through 2d): S
Building Owner or Owner's agent authorizing this application: 3.Plan evte`w fees ,-t .,:=.0 x"i'A'. : w n; W .641..t i
(a)Plan review(65%x permit fee[2a]):. $
Sign here: �j� (b)Fire and life safety(40%x permit fee[2a1): S
❑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 licensin g q:iMiscellneeto oits fee ..s„ =-4 _ s,. , * °sv I- r+;
requirements under ORS 701.010. (a)Seismic fee, l%(.01 x permit fee[2a]): $
:gglr, il•I i CONTRACTOR p„INNST'ALLATION r _,, :+ ,, , (b)Technology fee,5%(.05 x permit fee[2a]): $
Business na�n e;L. ry�" ��r �7y,(I N5 TOTAL fees and surcharges(2e+3c+4a+4b): S 73,Ipo
Address: 130 �/V.7xnr1- N—
City: 0-04--- "VV Date: f ZIPg79 /
KPhone: - - '�1 r J_ Fax: - -
( ` E-mail: /n�/
CCB license no.: V
Print name:
Signature:
SUB CONTRACTOR_INFORMAT[ON
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical