HomeMy WebLinkAboutPermit Miscellaneous 2013-11-4 3) SPRINGFIELD 225 Fifth St •
CITY OF SPRINGFIELD Springfeld,OR 97477
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t�� Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone:541-726-3769 .
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02301
www.springfield-or.gov • permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 11/04/2013 EXPIRES: 05/03/2014
STATUS DATE: 11/04/2013 APPLIED: 10/15/2013
SITE ADDRESS: 533 W CENTENNIAL BLVD,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703274305805 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Kitchen fire suppression install
OWNER: CENTENNIAL SHOPPING CNTR LLC Phone Number:
ADDRESS: 7831 SE STARK ST STE 103 •
PORTLAND OR 97215
L. CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Fire Contractor EUGENE WELDERS SUPPLY CO COB 190543 05/06/2014 541-344-1438
INSPECTIONS REQUIRED
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Inspections
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 arerequested 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.
0 , /1- Lo3 •
Own or Contractor Signature Date
ATTENTION: Oregon law requires you to .
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- NOTICE: ,.
•
0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone
number for the Oregon Utility Notification AUTHORIZED UNDER.THIS PERMIT IS NOT
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR
',NY 180 DAY PERIOD.
•
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Springfield Building Permit 11/4/2013 9:13:46AM Page 1 of 1
SPRINGFIELD -- CITY OF SPRINGFIELD
TRANSACTION RECEIPT 225 Fifth St
Spdngfield,OR97477
541-726-3753
oae�oN 811-SPR2013-02301
www.spdngfieldar.gov 533 W CENTENNIAL BLVD permitcenter @spnngfield-or.gov
RECEIPT NO: 2013002414 RECORD NO:811-SPR2013-02301 DATE: 11/04/2013
lo]dYy•i1 Al1(ol: y, `} n`,r *'a sw ACCOUNT CODE/TRANS CODEiu 8a
Admin fee(10%of applicable fees) 224-00000-426605 1098 12.00
Balance of$120.00 Minimum Fire Fee 100-00000-424002 . 9116 90.00
Percent of fire system bid/contract value(3%) 100-00000-424002 9116 30.00
TOTAL DUE: 132.00
PAYOR tiCaiiiE ,A:ARSOx ._„_.,.,T :<COMMENTS.;�'..ms`s-�' _•:"°, s;i,�AMO .-_ PAID-� te,,, `- :??1
Check Benedettis Meat Market and Deli 132.00
1961
TOTAL PAID: 132.00