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HomeMy WebLinkAboutPermit Building 2013-7-9 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 • Phone: 541-726-3753 �OREG°" Building / Residential Permit Inspection Phone:541-726-3769 F.ax: 541-726-3676 • PERMIT NO: 811-SPR2013-01567 www.spnngfieldor.gov permitcenter©spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 07/09/2013 EXPIRES: 01/04/2014 STATUS DATE: 07/09/2013 • APPLIED: 07/09/2013 SITE ADDRESS: 2609 5TH ST,Springfield,OR 97477 SCOPE: Bathroom ASSESOR'S PARCEL NO: 1703233409900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Moving Wall Out OWNER: WIDMER AMY LYNNE Phone Number • ADDRESS: 2609 5TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED j Inspections 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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. arkit,, (�ldmcC 4 13 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted 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- 1595. Yni-nay obta'n cooies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT el?h .-= o '-OMMENCED OR IS ABANDONED FOR ^'Y 180 DAY PERIOD. Springfield Building Permit 7/9/2013 2:57:57PM Page 1 of 1 • SPRINGFIELD— CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spdngfield,OR 97477 ' 541-726-3753 OREGON 811-SPR2013-01567 www.springfieldor.gov 2609 5TH ST permitcenter @springfieldor.gov RECEIPT NO: 2013001471 RECORD NO: 811SPR2013-01567 DATE:07/09/2013 j f_4t ,yliattsa _.. ;z °,.l-«„=,_.-;:.12= .sue;". •=r_• °ACCOUNTiCODETTRANS.CODE.di _r .<=-A OUNTWUE'.:; 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 "i=.PAYMENTBT;YP.E`�"h�r� PAY.OR casRiER:ICCnRgeNreR. ,,GOINMENTeStg_ :-: ` M.MOUNTOMDB.1, Credit Card WIDMER AMY LYNNE 93.60 03014C TOTAL PAID: 93.60 • • • • • • • • Structural Permit Application SPRINGFIELD •DEPARTMENT USE ONLY CITY OF SPRINGFIELD,OREGON Permit no.: 225 Firth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON J!7 i 20(3 0(5 ') Date: G /7/9//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. - 'LOCAL'GOVERNMENT APPROVAL FEE SCHEDULE - This project has final land-use approval. 1.Valuation:information Signature: Date: (a)Job description: This project has DEQ approval. Occupancy 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 ❑Government ❑Commercial Other information: JOB SITE INFORMATION AND LOCATION' Type of Heat: Job site address: COQ 5'h 5* Energy Path: City: 5rin5fcld State: OC ZIP:97977 ❑new ['alteration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? 111 Yes ❑ No Reference: Taxlot: Total valuation: Vi p p $ :.PROPERTY OWNER 2.•Buiiding fees Name: afyili liii dmaf (a)Permit fee(use valuation table): $ Address: %C ' Oh Si- (b)Investigative fee(equal to[2a]): S City: Svi.1-411 el ci State: OR. ZIP: g7y117 (c)Reinspection(S per hour): Phone: Fax: - - (number of hours x fee per hour) • 5-1 l 'iSS O43 E-mail: Qmclilidmczelnofrn ai 1. Corn (d)Enter 12%surcharge(.12x[2a+26+2c]): iS (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3:Plan review fees. //..11 .�1"��� (a)Plan review(65%x permit fee[2a]): S Sign here: (IN.( W iQ,Ovt (b)Fire and life safety(40%x permit fee[2a]): S ❑This installation is eing made on residential or farm property owned by (e)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing 4. M_iscellaneous fees requirements under ORS 701.010. ° (a)Seismic fee, 1%(.01 x permit fee[2a]): $ _ • . ,CONTRACTOR INSTALLATION / (b)Technolo gy fee,5% OS x permit fee[2a]). $ Business name: QL,Jvt e 60 TOTAL fees and surcharges(2e+3c+4a+4b): $ y 3 Address: City: State: ZIP: Phone: - - Fax: - - E-mail: CCB license no.: Print name: Signature: IN = TI ErtSUWCONTRACTOR INFORMATIONM..'N12 rte 1 Name CCB License# Phone Number Electrical Plumbing Mechanical