HomeMy WebLinkAboutPermit Building 2013-9-17 •
SPRINGFIELD - 225 Fifth St
T CITY OF SPRINGFIELD Springfield,OR 97477
or 1 Phone: 541-726-3753
OREGON
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02090
www.springfieldar.gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/17/2013 EXPIRES: 03/16/2014
STATUS DATE: 09/17/2013 APPLIED: 09/17/2013
SITE ADDRESS: 126 W OLYMPIC ST,Springfield,OR 97477 SCOPE: Site Work Only
ASSESOR'S PARCEL NO: 1703274106700 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Accessible sidewalk repairs
OWNER: HOUSING AUTHORITY&URBAN Phone Number:
ADDRESS: 300 W FAIRVIEW DR
SPRINGFIELD OR 97477
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CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor WALTER L BELL CONSTRUCTION LLC CCB 187820 08/24/2015 541-988-0331
INSPECTIONS REQUIRED
Inspections
1065 Sidewalk
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
con - 7r7.7
Owner Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to
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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-
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
ANY 180 DAY PERIOD. number for
1-800-332-2344).fication
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Springfield Building Permit 9/17/2013 2'35:15PM Page 1 of 1
SPRINGFIELD — CITY OF SPRINGFIELD
a.Yk,- -' 225 Flfth St
cait TRANSACTION RECEIPT Spnngfield1OR97477
—.OREGON 541-726-3753
811-SPR2013-02090 '
www.spnngfeldor.gov 126 W OLYMPIC ST permitcenter @spnngfield-or gov
RECEIPT NO: 2013002049 RECORD NO:811-5PR2013-02090 DATE:09/17/2013
121 .Y4- =1274 a s he c M2''.=1 i:. ,.4 €" 41 mss,:.'. . a o o •RANS:CODE 1t o .T-DUE' y
Building Permit Fee 224-00000-425602 1002 141.96
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.04
Technology fee(5%of permit total) 100-00000-425605 2099 7.10
TOTAL DUE: 166.10
PAVMEN7TYPE PAYOR castles iee:°cca RePR COMMEN7S_ � AM__OUmssa.ID'� "'t"�"-' 4�
Check - WALTER L BELL CONSTRUCTION LL 166.10
4218
TOTAL PAID: 166.10
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4.
I Structural Permit Application SPRINGFIELD oEP utTMENfile o v%y
CITY OF SPRINGFIELD, OREGON Sidci Permit no J 19 Z&9i
225 Fifth Street•Springfield,OR 97477♦PH(541)726-3753•FAX(541)726-3689 OkEGON
Date: 67// �/ / 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.
qt1�4-s , � LOCAnG.O VERNiEtiT rAPP,ROVA Lris r k W ',:; a Gre .�r.it�FEEr S CHEDltE x FC LIu141
This project has final land-use approval. lValu ;tn moMm a[ n r sftl � ,I ICV
Signature: Date: (a)Job description: "if� 4(/ete
This project has DEQ approval. Occupancy ��• !!!
Signature: Date:
Zoning approval verified: ❑Yes ❑No Construction type:
Property is within flood plain: ❑Yes ❑No Square feet: .
G`aF`'--s '= (a,CATEGO��RY OC.CONST tTcTIONa` ° � .yi ;`�`;; Cost per square foot:
,I Residential F L�Government ❑Commercial Other information:
w ,}JOBgSITE,.INFORMATIONrAND'?LOCATION j Type of Heat:
Job site address: 72�' ✓/ A c7 c9(�}�7'f� r rO Energy Path:
City: ,�f/'(;et g�" c/I State:V ZIP:7?y77 ❑new ❑alteration ❑addition - • - • -
Subdivision: J Lot no.: (b)Foundation-only permit? ❑Yes ❑No m,�y,�
Reference: I Taxlot: Total valuation: $ >GC�/
`'r� x e: "x<.x- PROPERTYAOWN ERle tta a*4Z� _.Buiidngf eaa*w-maca,.�.ry r:..P `‘W�sM N
. Name: r�� (a)Permit fee(use valuation table): $ / I a-t
Address: D
e. )', W. PC1/! (b)Investigative fee(equal to[2a]): S
City: SirOruert6 ;P( State, ZIP: 7 (c)Reinspection($ per hour): S
Phone: . /� .2.2 Fax:c w yg75— (number of hours x fee per hour)
E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ / 7
(e)Subtotal of fees above(2a through 2d): • $
Building Owner or Owner's agent authorizin this application: ',3�' lan rev_rew fees t ,t:�xY. r�;+ @(.:�;s'$ .,.u_ ,. ?JLnz 4�"'..P 3.�y"�
�/ (a)Plan review(65%x permit fee[2a]): $
Sign here: C��' (b)Fire and life safety(40%x permit fee[2a]): $
❑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 s'8 S" .m..a+'x } + . fl`= na 9�n yra "-
44 Mrscellaueous5f aLllar tit-Je:?�`; fi _ ..°.nif..t S:Zec
requirements under ORS 701.010. (a)Seismic fee, I%(.01 x permit fee[2a]): S
;,¢_AJ I4 ,CONTRACTOR,INSTALLt TION?,,` k s- 't <vrn'�=3s:. (b)Technology fee,5%(.05 x permit fee 2a - S f)
Business name: /L^-�/// r ] )/-�1 7
�/ � TOTAL fees and surcharges(2e+3c+4a+4b): $ ((!/
Address: y/
City: t-�aT� ZIP: L��
Phone' r Z . T' /, i. . I r
S�d�s, 0 �� ,v 'a.
E-mail: t�7Tl(�
CCB license no.: 15 70
Print name: Q tai , /
Signature: U/ � / Arc
e, E[" P£+SUB CONTRACTOR;INFORMATION
Name CCB License i3 Phone Number
Electrical
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Plumbing
Mechanical