HomeMy WebLinkAboutPermit Miscellaneous 2013-7-30 •
SPRINGFIELD -- 225 Fikh St
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CITY OF SPRINGFIELD Springfeld,OR97477
P hone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00667
www.springfield-or.gov permitcenter @springfiel d-or.gay
PROJECT STATUS: Issued ISSUED: 07/30/2013 EXPIRES: 01/25/2014
STATUS DATE: 07/30/2013 APPLIED: 04/01/2013
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SITE ADDRESS: 801 42ND ST,Springfield,OR 97478 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1702320000105 TYPE OF STRUCTURE: Industrial
PROJECT DESCRIPTION: Construct guard shack access road .
OWNER: IP EAT THREE LLC Phone Number:
ADDRESS: PO BOX 2118
MEMPHIS TN 38101
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
1996 Final Inspection-Planning •
. 1055 Rough Grading for Paving Rough Grading: After gravel is in place but prior to placing concrete.
1059 Final Paving Final Paving: After paving 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
constructs . i
4-/-
j //:— .
Owner or Con ractor ignature Date
/ATT.ENTION::Oregon'law-requiresyoutto
ffol low'rules•adoptedbythe'OregontUtility NOTICE:.
1 <°
:Notification Center. Those rules are setforth
in:OAR 952-001-0010 through OAR952L00i- THIS,PERMITSHALLEXPIRE.IFTiHE:V,itORK. .
.0090. 'You may obtain copies of the rulesLby AUTHORIZED UNDER THIS'PERMI1f'IS>N.OfTi ..
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calling the center. (Note: the telephi.mo COMMENCED OR IS ABANDONED)EOR;
number for the Oregon Utility Notification ANY 180 DAY PERIOD.. .
Center is 1-800-332-2344).
Springfield Building Permit 7/30/2013 11:41:57AM Page 1 of 1
SPRINGFIELO•assl CITY OF SPRINGFIELD
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=r t TRANSACTION RECEIPT Spnngfield`OR 97477
0 OREGON 541-726-3753
811-SPR2013-00667
wvnv.springfield-or.goy 801 42ND ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2013001659 RECORD NO:811-SPR2013-00667 DATE:07/30/2013
!DESCRIPTION , • C. - ACCOUNT CODEITRANS CODE_ - : - . AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 4,703.80
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 564.46
Technology fee(5%of permit total) 100-00000-425605 2099 235.19
TOTAL DUE: 5,503.45
r PAYMENT TYPE PAYOR'-' CASHIER:CCARPENTER .COMMENTS° - .. ' ': ! , : ", AMOUNT PAID , ,`
Credit Card Cheryl A Thompson . 5,503.45
027341
TOTAL PAID: 5,503.45
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Structural Permit Application SPRINGFIELD - PA T
.DERTMEN USE ONL'•-Yr4
CITY OF SPRINGFIELD, OREGON : ' _{ {ei
Permit no Sri 62(97 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 - \OREGON
Date: y�p/�` Y�„ q
This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days df issudnef or if work is
suspended for 180 days.
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r mot+" Y,_ ILOCALRGOVERNMENTcAPPROVAL `"' .. M- `-`
.,.� w ; ^`LL= � r* ' FEE SCHEDULE '� t"" "' ` '-'
.- �.._._:.�� 4 a. .,.-_ -,fr .,* ::«_r a,w�. t ....�C.ivi.::4 a_��' ys_>u:::�
_ r` fi n5% -
This project has final land-use approval - T Valuahon�.mforma[ion�a2�,g�r�, a_z�i,&�, _usa-.. ,.�k-4'`...�^:.
Signature: Date: (a)Job description: �/�,,,, /ff /9
This project has DEQ approval. G1yt�n.-�7 �r r`��L " ' "
. Occupancy
Signature: Date:
Zoning approval verified: ❑Yes •❑No - Construction type: .i
Property is within flood plain: ❑Yes ❑No Square feet:
h'": et`)4r'yaliCATEGORY(OF,,;`->GONSTRUCTIOJN/� nr, iu,,, N Cost per square foot:
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❑Residential ❑Government IQ Commercial Other information:
. ' [ •*;JOB1?SITEgINFakiATA ONs''A EK Oaf:ION5 x` ` Type of Heat:
Job site address: VO I. 4 Z N ) Energy Path:
City: Ste Iti) Stater ZIP: 1-7 y?i 1a new ['alteration ❑addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: /7o2 3210 Taxlot: a9/Or Total valuation: Sf(VrJ "J
it aG 4� s, i 2PROPERT.YZOWNER'3;'� ?;f,:=i�z`..x ; ssv` 2tiiiiidtu`fees fi<,.^,'=e•.'fr. ...F 74 f a TJ;Tpr s"riarP?:.-
g: �. �'t4'.. u4s*.�+Si�^a3�.t�.tli wkzY bn:�`
Name: /7E447- // : (a)Permit fee(use valuation table): $ 1/20f G2 a t
Address: l C�xL, 7i/1 e (b)Investigative fee(equal to[2a]): $
City: � r/'f! f Stater ZIP: Si/o/ (c)Reinspection($ per hour):
Phone: Fax: - - �/
(number of hours x fee per hour) $
(d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ -7/� ZO
E-mail: • /. �
- (e)Subtotal of fees above(2a through 2d): $
Building Own r Owner's ag authorizing this application: _3ytPlan ere i w fees .;t..it "'1,.. ,`... w'.'R`,.; ?S ",,< ,il°'.'v
(a)Plan review(65%x permit fee[2a]): $70,04.2-
Sign here: l (b)Fire and life safety(40%x permit fee[2a]): $
El This installation is eing de on residen I 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 :-"q Mtscella eous fees ,' ¶1 r ' " ` J
requirements under ORS 701.010. _Q :r ; a -x rr
(a)Seismic fee, 1%(.01 x permit fee[2a1) $
tt.AS s CONTRACTOR INSTALLATION',' _,;`,-5 2737 mot`
-- -x v, .t�� •- "'------- (b)Technology fee,5%(.05 x permit fee[2a]): $
Business name4751) /^9 Z
TOTAL fees and surcharges(2e+3c+4a+4b): 6e
Address:
City: State: ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature: -
. .i..s.Z...;p=.SUBI ONTRACTOR;IINFORMATION ,
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical
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