HomeMy WebLinkAboutPermit Miscellaneous 2013-6-21 SPRINGFIELD-- 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
ietw Phone: 541-726-3753
'OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01253
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: ' 06/21/2013 EXPIRES: 12/17/2013
STATUS DATE: 06/21/2013 APPLIED: 06/12/2013
SITE ADDRESS: 445 HARLOW RD,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703224407200 TYPE OF STRUCTURE:
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PROJECT DESCRIPTION: Hanger Clinic-fire alarm system
OWNER: RLS HOLDINGS LLC Phone Number:
ADDRESS: 445 HARLOW RD STE 200
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Fire Contractor WESTERN STATES FIRE PROTECTION CO CCB 104570 03/08/2015 303-792-0022
INSPECTIONS REQUIRED II
Inspections
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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.
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/Aid (efrO
Owner• Contractor rre Date
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ATTENTION: Oregon law requires you to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth
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 ,enter. (Note: 'he taept,,.>.:: ANY 180 DAY PERIOD.
numL. fc..• is , `;f,•; ,.:un
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Springfield Building Permit 6/21/2013 8:06:38AM Page 1 of 1
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SPRINGFIELD"- CITY OF SPRINGFIELD
aS 225 Fifth St
,c car TRANSACTION RECEIPT Spnnglleld,OR97477
541-726-3753
811-SPR2013-01253
www.spnngfieldar.gov 445 HARLOW RD permitcenter @spnngfeld-or.gov
RECEIPT NO: 2013001287 RECORD NO: 811SPR2013-01253 DATE:06/21/2013
�71>;A6COUNTCODERRANS,CODES sAMOUNT,DUE:="
Admin fee(10%of applicable fees) 224-00000-426605 1098 12.60
Percent of fire system bid/contract value(3%) 100-00000-424002 9116 126.00
TOTAL DUE: 138.60
PAYMENThTiYPE P.AYOR_ caswER:,auRSOR COMMENTS, -. AMgUNTRAID
Credit Card - WESTERN STATES FIRE PROTECTI( 138.60
005816 CO
TOTAL PAID: 138.60