HomeMy WebLinkAboutPermit Building 2013-6-25 •
SPRINGFIELD 225 Fifth St
■ 1 - - 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-SPR201 3-01 384 •
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/2512013 EXPIRES: 12/21/2013
STATUS DATE: 06/25/2013 APPLIED: 06/25/2013
SITE ADDRESS: 4980 D ST,Springfield,OR 97478 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1702332304100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace roof framing
OWNER: LONG WILLIS&KAY Phone Number:
ADDRESS: 38401 OLD PENGRA RD
FALL CREEK OR 97438
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor ROY HAROLD HAUGLAND CCB 138110 10/26/2013 541-343-9030
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.
,airal_ 2 c ( 3
Owner or ••ntra for Signature Date
f y `
n s-I . NOTICE:
Ir, : 0 0,
ATT€NTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE W°}11(
follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT
Notification Cente'r.tThose rules are set forth 4. .I COMMENCED OR IS ABANDONED FOR
in OAR 952-001-0010 through OAR 952-001-
ANY 180 DAY PERIOD. - '
0090. You may obtain copies of the rules by
�callll�iyIn�g the center. (Note: the teleph::,fo
SpringfelEBUiIEASB bfors the Oregon Utility Notification
Other is 1-500-332-2344). 6/25/2013 1:49:57PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
't .A4. 225 Fifth St
C TRANSACTION RECEIPT Springtield,OR 97477
OREGON 541-726-3753
811-SPR2013-01384
www.springfield-ocgov 4980 D ST permitcenter @springfield-or.gov
RECEIPT NO: 2013001342 RECORD NO: 811-SPR2013-01384 DATE:06/25/2013
[DESCRIPTION _; ACCOUNT CODE/TRANS CODE AMOUNTDUE_:.3
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 15.80
Structural Building Permit Fee 224-00000-425602 1002 131.63
Technology fee(5%of permit total) 100-00000-425605 2099 6.58
--- -- - ,_--- -------1... . - -- '— ---- -- TOTAL DUE: 154.01
;:_PAYMENT TYPE,_: ,,_;_PAYOR_1 CASHIER.eCCARPENTER. _. _. COMMENTS:— __ '_ . y AMOUNT PAID t `Y I
Check ROY HAROLD HAUGLAND 154.01
6983
TOTAL PAID: 154.01
•
..■•••• •••
Structural Permit Application SPRINGFIELD Eitcop?N‘tiyipirtusc.:2Ni+y::??,
rgs*:?:-.5A?pwczwiti:14,:twartiwilfiregit:eitai.2-azi.v.r.c.titgA.c,w61.4.5m4 _
Permit no S7 —73(r-zi
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON
Date:
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.
F7F,%:i?..1(41.2.)1L0bAll'coOVERRiVIE1■10:TA0.012OVACM :".11:tf gli1.17;44a14715:F;;Y:gel.-r8. 1;1011icEggz?..?",Z:iniWOW
This project has final land-use approval.
Signature: Date: (a)Job description: 72_4,-;:-/-<-4,44-p--/ g /2az)F
This project has DEQ approval. Occupancy F/5
Signature: Date:
typ s../
Zoning approval verified: 0 Yes 0 No Construction e: a
Property is within flood plain: 0 Yes 0 No Square feet:
Cost per square foot:
Residential 0 Government 0 Commercial Other information:
dJOB SITE iNFORMATION AND LOCATION Type of Heat:
Job site address: 9960 riS 57— Energy Path:
City: SPA rb State:04 zre:57/-2 r 0 new ...alle;--Mion Eliclehttar--
Subdivision: Lot no.: (b)Foundation-only permit? 111 Yes fl No
Reference: Taxlot: • Total valuation: $-70i0
Name: 4-6A/G (a)Permit fee(use valuation table): $ / 6-re
Address: Wis.-0 t (b)Investigative fee(equal to[2nD:
City: _SFRI:Tb State: 02_ ZIP:f7sor (c)Reinspection($ per hour):
(number of hours x fee per hour)
Phone: Fax: - -
E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ /5Z0—
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application:
(a)Plan review(65%x permit fee[2a]):
Sign here: (b)Fire and life safety(40%x permit fee[2nD:
ID 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 ICTii6.(01174.;j1047irgistifirtlZI:giriligcM;j5,"iI:VriA%4R7">"'
requirements under ORS 701.010.
(a) Seismic fee, 1%(.01 x permit fee[20:
(o)Technology fee,5%(.05 x permit fee[2a]):
Business name: H4a6 c+AS S 6,0 S
TOTAL fees and surcharges(2e+3c-F4a-F4b): $ /Sy t"
Address: f.0, 9 r
City c?kri State: a at
PhoneWj -95 843 Fax: -
E-mail: /4 A e corm met
CCB license no.: /
Print name: X 4 A c_ /Y-1)
Signature: Its
I7
13ZG_ONTERW)RiINFORMATIOS ---W-tE
Name CCB License 4 Phone Number
Electrical
Plumbing
Mechanical