HomeMy WebLinkAboutPermit Building 2013-11-1 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
aC . Phone- 541-726-3753
• OREGON Building ! Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02428
wow spring(field-or.gov permitcenter @spnngrield-or gov
PROJECT STATUS: Issued ISSUED: 11/01/2013 EXPIRES: 04/3012014
STATUS DATE: 11/01/2013 APPLIED: 11/01/2013
SITE ADDRESS: 863 MAIN ST,Springfield, OR 97477 SCOPE: Retail
ASSESOR'S PARCEL NO: 1703354207100 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replace Light Pole
OWNER: CAR LIT OR SPRING LLC Phone Number:
ADDRESS: 360 E JACKSON ST
MEDFORD OR 97501
OWNER: PATTISON SIGN GROUP INC Phone Number:
ADDRESS: 555 ELLESMERE RD
TORONTO M1R4E8
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor SITEWORK CONSTRUCTION INC CCB 119652 02/09/2015 541-744-9204
INSPECTIONS REQUIRED J
Inspections
1110 Footing Footing: After trenches are excavated.
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 orty 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 I. ated at t - front of the property. and the approved set of plans will remain on the site at all times during
construction.
1 1 ► J Si, l t 1 i 1 I
Own- - ontractor Signature Date
ATTENTION: Cregan law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth i L OTICE:
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by UNDER THIS PERMIT IS NOT
calling the center. (Note: th? telephone
number for the Oregon Utility Notit cation ENCED OR IS ABANDONED FOR
Center is 1-800-332-234-4). r, ,r i 0 DAY PERIOD.
Springfield Building Permit 11/1/2013 10:39 11AM Page 1 of 1
SPRINGFIELD CITY Y OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield:OR97477
541-726-3753
OREGON 811-SPR2013-02428
www.springfield-or gov 863 MAIN ST permitcenter@springfieid-or gov
RECEIPT NO: 2013002405 RECORD NO: 811-SPR2013-02428 DATE: 11/01/2013
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 80.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9 60
Technology fee (5% of permit total) 100-00000-425605 2099 4 00
TOTAL DUE: 93.60
PAYMENT TYPE PAYOR CASHIER:CCARPENTER COMMENTS AMOUNT PAID
Check Site Work Construction 93.60
12683
TOTAL PAID: 93.60
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
ilike* Permit no.:
225 Fifth Street♦Springfield.OR 97477♦PH(541)726-3753♦FAX(541)726-3689 OREGON i)1 t Z.t'•5 o7.4-( 2..
Date: r . (//,/,
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 FEE SCHEDULE
This project has final land-use approval 1.Valuation information
Signature: Date. 1 .
,L
gn (a)Job description: li �17p� bA.C"._
This project has DEQ approval.
Signature: Date: Occupancy
Zoning approval verified: ❑Yes ❑No Construction type:
Property is within flood plain: ❑Yes ❑No Square feet:
CATEGORY OF CONSTRUCTION Cost per square foot:
['Residential ❑Gut emment ❑Commercial — Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat:
Job site address: p v% Energy Path:
City:cpa -1p I State: Q[ ZIP:5-14-11 ❑new ❑ahetation ❑addition
Subdivision: k _ Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: I Taxlot: Total valuation: S P57),Q,Q)
PROPERTY OWNER 2. Building fees
Name:LAY L c Speaac LL.(-- (a) Permit fee(use valuation table): $
Address: y)(49 1'p gv S� (b)Investigative fee(equal to[2a1): $
City: rneiA eo rik State: b(tf ZIP:'i1501 (c)Reinspection($ per hour):
Phone: Fax: - - _
(number of hours x fee per hour) $
E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c)): S
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: 3.Plan review fees
(a) Plan review(65%x permit fee pal): $
Sign here: (b)Fire and life safety(40%x permit fee pal): $
❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): S
me or a member of my immediate family,and is exempt from licensing 4.Miscellaneous fees
requirements under ORS 701.010.
(a)Seismic fee, 1%(.0l x permit fee[2a1): $
CONTRACTOR INSTALLATION
l-- . (b)Technology fee,5%(.05 x permit fee[2al): S
Sl i►1
Business name: )nv (L (0Asr -co ( TOTAL fees and surcharges(2e+3c+4a+4b): $ ? Cr?
Address: -p,Q, '6)( 24014-7)
City: *r--,1r-p y,« State:Oat I ZIP:91144JL
P h o n e:C 3-f t-- l41{-q OL Fax:S`ll 144+-o 11
E-m.. : of silk UOlr-IC(OtAS414.4e0✓I �Ii(.C.4 EOM
CCB icense no.: ( i (e
Print a ti. - '____
Signature: t/ �
L ; r : ONTRACTOR INFOR •TION
Name CUB Licen. # Phone Number
Electrical
chr C-un laridifc-t 45V 96.411 co
Plumbing
Mechanical
16/16/2009 10:26 FAX 5418538868 HATE 0 CVC la 002
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