HomeMy WebLinkAboutPermit Miscellaneous 2013-7-5 •
SP_SPRINGFIELD 225 Fifth St
° CITY OF SPRINGFIELD Springfeld,OR 97477
y`4,u`' Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2013-01541
www.spnngfield-cr.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/05/2013 EXPIRES: 12/31/2013
STATUS DATE: 07/05/2013 APPLIED: 07/05/2013
SITE ADDRESS: 303 S 5TH ST,STE#153,Springfield,OR 97477 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1703350000307 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Asbestos abatement and floor underlayment
OWNER: CITY OF SPRINGFIELD Phone Number:
ADDRESS: 225 N 5TH ST
SPRINGFIELD OR 97477 .
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor ATEZ INC COB 64090 02/02/2015 541-995-6008
L INSPECTIONS REQUIRED •
Inspections
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 Contractor Signature Date
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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 952-001-
. THIS PERMIT SHALL EXPIRE IF THE WORK 0090.1 9 t y obtain pies of
he center. (No oteh rules by
e ue
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 - 7/5/2013 8:46:05AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
•
it
SPRINGFIELD
225 Fifth St
\OREGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2013-01541
www.springfield-or.gov 303 S 5TH ST. STE 153 permitcenter @springfield-or.gov
RECEIPT NO: 2013001445 RECORD NO: 811SPR2013-01541 DATE:07/05/2013
In1X.'1a1:11:A gilt ' 015 ..h-<.-�.-,,'Kr: ?`_.Y.,x. `".-z,:r.--'-,. `'ACCOUNT CODE/TRANS.CODE,):� `_i _1''AMOUNTiDUE=s
Building Permit Fee _ 224-00000-425602. 1002 80.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
PAYMENTvTryPE ApAy.OR carirEa.c rgiyeEri - EOMMENTS s ¢MOUN PQIU .,
Credit Card Jim Polston/City of Springfield 93.60
076095
TOTAL PAID: 93.60
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
;t.
CITY OF SPRINGFIELD,OREGON {`w% Permit no. S/ 3—/SL�/
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 `oaEGON
Date: 7/5// 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.
LOCAL GOVERNMENT •APPROVAL - 'FEE SCHEDULE
•This project has final land-use approval. :'1. Valuation'information
Signature: Date: (a)Job description: /1415C-370,./ ,9 '/ '47 £
This project has DEQ approval. ig r
Occupancy eljL pZ ,
Signature: Date:
Zoning approval verified: ❑Yes ❑No Construction type:
Property is within flood plain: ❑ Yes ❑No Square feet:
. . CATEGORY OF •CONSTRUCTION- ' Cost per square foot:
❑Residential grn
ovement ❑Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat:
Job site address: /3o 3 S 5-1`Sf Energy Path:
City: rr f/YerG/r State: DC— ZIP: ❑ new ❑alteration ❑addition
Subdivision:_ ! << Lot no.: (b)Foundation-only permit? ❑Yes ❑No �-y q(J
Reference: 1763 5') 00 Taxlot: 0r2 To 7 Total valuation: $a- D
'PROPERTY OWNER:. - .._.
' ,2 ,Building,fees :..'
SIL
PR
Name: �/Y , senr.,�y�d (a)Permit fee(use valuation table): $ �i�-
Address: (b)Investigative fee(equal to[24): $
City: SI Jry�Q efe,, State: Q'(i ZIP: (c)Reinspection(S per hour):
(1 (number of hours x fee per hour) $
Phone: Fax: - -
E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ °,kg-
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: 3.'Plan review.fees ' _ _
(a)Plan review(65%x permit fee[2a]): S
Sign here: (b)Fire and life safety(40%x permit fee[2a]): 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 licensing 4.Miscellaneous fees _
requirements under ORS 701.010.
_ _ ,. _ (a)Seismic fee, 1%(.01 x permit fee[2a]): S
CONTRACTOR.INSTALLATION - L`p_i
- - �,, - '- (b)Technology fee,5%(.05 x permit fee[2a]): S L
Business name:
� � ^/ TOTAL fees and surcharges(2e+3c+4a+4b): $97 ig dig
Address: 4;1 f
City: / /5brn e State: 02-- ZIP:
//
Phone:�j-\4:6 'OO5 Fax: - -
E-mail:
CCB license no- of GCw C%)
Print Print name: /"' �iy7/-V`
Signature:
., _ 'aSUB-CONTRACTORI`.INFORMATION Wc:_ii
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical
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