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HomeMy WebLinkAboutPermit Miscellaneous 2013-8-15 • SPRINGFIELD 225 Fifth St "'hit�` CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 Ct� lOREGON Building I Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01409 www.springfield-or.gov perm itcenteraspringfield-or.gov PROJECT STATUS: Issued ISSUED: 08/15/2013 EXPIRES: 02/10/2014 STATUS DATE: 08/15/2013 APPLIED: 06/26/2013 SITE ADDRESS: 937 SUMMIT BLVD,Springfield,OR 97477 SCOPE: Cell Tower-Communication Tower ASSESOR'S PARCEL NO: 1703341105600 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Cell antenna and cabinet upgrade OWNER: WILLAMALANE PARK 8 REC DIST Phone Number: ADDRESS: 250 S 32ND ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor WESTOWER COMMUNICATIONS INC CCB 140471 01401/2014 601-898-4450 INSPECTIONS REQUIRED Inspections 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. . 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. /%�� ili S (3 Owner or Contractor Signature - Date • ATTENTION: Oregon lathe requires reen Oregon Utility • follow rules adopted by 9 o NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- UTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by • •IENCED OR IS ABANDONED FOR calling the center. (Note: the teleph::/ r: r,q•{ PERIOD. numbeCenteris01.800-332.2344�ification Springfield Building Permit 8/15/2013 8:46,45AM Page 1 of 1 • 'SPRINGFIELD CITY OF SPRINGFIELD • 6_____ zzs Finn St C`O EGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-S PR2013-01409 www.springtield-or.gov 937 SUMMIT BLVD permitcenter©springfield-or.gov RECEIPT NO: 2013001771 RECORD NO:811-SPR2013.01409 DATE:08/15/2013 [DESCRIPTION__ . _ __ A.:__.. ACCOUNT CODE/TRANS CODE AMOUNT DUE_LI Building Permit Fee 224-00000-425602 1002 245.21 Planning-Minor Review-City 100-00000-425002 1231 119.00 • State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 29.43 Technology fee(5%of permit total) 100-00000-425605 2099 12.26 TOTAL DUE: 405.90 _PAYMENT TYPE PAYOR„`..cnSHIEe:.LARSON - COMMENTS ' _ . ::".':. AMOUNT PAID . I Check WESTOWER COMMUNICATIONS INC 405.90 0011300 TOTAL PAID: 405.90 • SPRINGFIELD""", CITY OF SPRINGFIELD k„, { TRANSACTION RECEIPT 5pr-190E16,0R 97477 �S' OREGON 541-726-3753 811-SP R2013-01409 www.springfieldor.gov 937 SUMMIT BLVD permittenter@springfield-or.gov RECEIPT NO: 2013001358 RECORD NO: 811-SPR2013-01409 DATE:06/26/2013 !DESCRIPTION ,,, ACCOUNT CODEnRANS CODE? ' _.., ,-,AMOUNT_D_UE• -': Structural Plan Review Fee Commercial 224-00000-425602 1060 159.39 TOTAL DUE: 159.39 J'%PAYMENT TYPE a�_ PAYOR. CASHIER:ccnzReRreR ' '°••COMMENTS ' `- • -Ft..- .�, AMOUNT,PAIDt- ..:. -'I Check WesTower Communications 159.39 3270 TOTAL PAID: 159.39 • IIPP EU05 Structural Permit Application DEPARTMENT USE ONLY SflIMO•I• O CITY OF SPRINGFIELD, OREGON 225 /3- �(-/Q 225 Fifth Street•Springfield,OR 97477•PB(541)726-3753•FAX(541)726-3689 a1 Date: zo // j 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 This project has final land-use approval. Signature: N/A Date: FEE SCHEDULE This project has DEQ approval. 1.Valuation information Signature: N/A Date: (a)Job description: C6LL {841];1,/V e4 t4 P4 gat: Zoning approval verified: ❑Yes ®No Occupancy�S.-2-J & Property is within flood plain: ❑Yes ®No Construction type: I IB CATEGORY OF CONSTRUCTION Square feet: 336 ❑Residential I ❑Government IN Commercial Cost per square foot:N/A JOB SITE INFORMATION AND LOCATION Other information: Job site address:937 Summit BLVD Type of Heat: N/A City:Springfield State: OR I ztP:97477 Energy Path: N/A Subdivision:N/A I Lot no.: N/A 7 3 3 N// I ❑new ®alteration ❑addition Reference: 17 Tex10t:17003391105602 PROPERTY OWNER OSt0d (b)Foundation-only permit? ❑Yes El No Total valuation: I S17,500.00 Name:City of Springfield 2.Building fees Address:255 Fifth Street a S rin field I 97477 (a)Permit fee(use valuation table): S Zy5 City: P g State:OR ZIP: Phane:541_726- 3753 Fax:N/A- _ (b)Investigative fee(equal to[28]): S (c)(number $ action(S per hour): E-mail:N/A (number of hours x fee per hour) 2 This installation is being made on residential or farm property owned by (d)Enter 12%surcharge(.12 x[2:1+26+21): S Z9 U3 me or a member of my immediate family,and is exempt from licensing requirements under ORS 701.010. (e)Subtotal of fees above(2a through 2d): $ Sign here: N/A 3.Plan review fees CONTRACTOR INSTALLATION (a)Plan review(65%x permit fee[2a]): $ /S Business name: we sTower Communications (b)Fire and life safety(40%x permit fee[2a]): $ Address:7 52 5 SE 24th St (c)Subtotal of fees above(3a and 3b): S City:Mercer Island State:WA I ZIP:98040 4.Miscellaneous fees /Z zG Phone:206_236-411s Fax:N/A (a)Seismic fee, I%(.01 x permit fee pall: S E-mail:N/A TOTAL fees and surcharges(2e+3c+4a): $ 9/4 n CCB license no.: /174 Print name: George rce /��ZSignaNrev! l.. SUB-CONTRACTOR INFORMATION Name CCB License Number Phone Number Electrical N/A Plumbing N/A Mechanical N/A II