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Permit Building 2013-7-17
SPRINGFIELD 225 Fifth St C�° =� CITY OF SPRINGFIELD Springfield,OR 97477 • \ EGON Phone: 541-726-3753 Building / Commercial Permit Inspection Phone:541-726-3769 Fax:541-726-3676 PERMIT NO: 811-SPR2013-01615 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/17/2013 EXPIRES: 01/12/2014 STATUS DATE: 07/17/2013 APPLIED: 07/17/2013 SITE ADDRESS: 960 16TH ST,Springfield,OR 97477 SCOPE: ReRoof ASSESOR'S PARCEL NO: 1703362204603 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Reroof • OWNER: MCKENZIE MEDICAL LLC Phone Number: ADDRESS: 541 WILLAMETTE ST STE 109 EUGENE OR 97401 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor CL LARGE INC COB 60147 05/24/2014 541-344-1415 INSPECTIONS REQUIRED Inspections 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. 1620 Roofing - Roofing: Prior to installing any roof covering. 1630 Roof Sheathing Roof Sheathing 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 ATTENTION: Oreg on by . law the requires you to JTIOE: " follow rules adopted Notification Center. Those rules are Oregon set Uti forlity th in OAR 952-001-0010 through OAR 952-001 �UTHORI EID UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by calling the center. (Note: the teleph4ric OMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notiflcation ANY 180 DAY PERIOD. Center Is 1 800-332-2344). Springfield Building Permit 7/17/2013 1:32:05PM Page 1 of I SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfleld,OR 97477 OREGON 541-726-3753 811-SPR2013-01615 www.springfield-or.gov 960 16TH ST permitcenter©spnngfield-or.gov RECEIPT NO: 2013001554 RECORD NO:811SPR2013-01615 DATE:07/17/2013 [DESCRIPTION 7 - :- `- ACCOUNTCODE/TRANSCODE AMOUNT DUE Building Permit Fee 224-00000-425602 1002 402.92 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 48.35 Technology fee(5%of permit total) 100-00000-425605 2099 20.15 TOTAL DUE: 471.42 LPAYMENT PAYOR° rCASHIER:CCARPENTER : COMMENTS AMOUNT PAID „_ I Check CL LARGE INC EVERGREEN ROOFIt 471.42 1188 TOTAL PAID: 471.42 / .3 Structural Permit Application SPRINGFIELD DEPyARTiMENSUSE ONLYA if., . n, CITY OF SPRINGFIELD, OREGON . ' t w Permit no.:5^/3—/ 5 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON Date: 7179//j This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i an or if work is suspended'for 180 days. tf rye1,7z,,rLOCALliGOVERNMENT APPROVAL11X4� --=i � �'`� �_F,EE`tSCHEDULE w',,,�,,;,��u"-rte �.,-,`;� ;`'r v.L�_� x_-� f ir... This project has final land-use approval. ° .,,?- "" .� "'; - " r " ' tom`,L _Valuttonmformapon,i, , .,-ate 3€ ,y ~ - Jx".�*tr cit Signature: _ Date: (a)Job description: 14E7b00 f This project has DEQ approval. . Signature: Date: Occupancy ( Z Zoning approval verified: ❑Yes ❑No Construction type: Property is within flood plain: ❑Yes ❑No Square feet: ;• t*! tcATEGORY OF;,GONSTRUCTION t2 't` j6:4;; Cost per square foot: ❑Residential ❑Government •Commercial Other information: ," ` i,:'JOB�-ISITEINFORMATIrON AND)LOCATIONyi ' ti' Type of Heat: Job site address: q�f ,(�{~ Energy Path: City: -_-; T-7/((y�. II State:(XC zip: flg1g ❑new ❑alteration- ❑addition Subdivision: Lot no.: .. (b)Foundation-only permit? ❑Yes ❑No Reference: /79,779 7 G�Taxlot 01-7/6O.) Total valuation: $.-0:10 ?Pa.41' l?>nt`';Ef.ra:PROPERTY,',..0_WNER°"+-'N» .i _1,.�..z: .,e F2cBuildmgfeestrym `:.; "g' „i '+*I�' ,z-zL " r �i', i" Name: /r'[,1�E y/� Ale--2). LGG- (a)Permit fee(use valuation table), $ LAO). Address: Vie./ L.J[L � i-4-netts 77—er (b)Investigative fee(equal to[2a]): $ City: V_ State:die ZIP17 4(0/ (c)Reinspeclion($ per hour): (number of hours x fee per hour) $ Phone: Fax: - - E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ �p 9 :75. (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: f3 Plan review fees c "C; ZZ r ; ti " t (a)Plan review(65%x nautili fee[2a]): $ Sign here: (b)Fire and life safety(40%x permit fee[2a]): $ ❑This installation is being made on residential or faun property owned by (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing ,q MIscellat eous fees ' -t . r; t sZ . ' "$13, requirements under ORS 701 010 (a)Seismic fee, I%(.01 x permit fee[2a1): $ ;' ;,`-iii c: CONTRACTOR INSTALTION? le1" - i: (b)Technolo gy fee,5%(.05 x permit fee 2a $ .� Business name: eJr �Q,.p\ J3[) C�/Xtat 11 2_ .1 TOTAL fees and surcharges(2e+3c-f4a+4b): $ 7/ Address: "�Ma-i u $-E Au City: W Sy va State: C r ZIP:q-icii Phones(`/� 1-F Fax: -( j(-0780, E-mail: \' px...c C�J Cr tcn-u. \ o1.-...\ .COv✓% CCB license no.: n 6p 1 114"1 Print name: ��4t 46Cac✓h Signature: f 's,r. '' aISUB.0.NT CTORINFORMATION ; Name CCB License# Phone Number - Electrical Plumbing Mechanical