HomeMy WebLinkAboutPermit Building 2013-11-12 SPRINGFIELD 225 Fifth St •
wis......ii CITY OF SPRINGFIELD SeldOR
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Phone:pringfi 541,-726-375397477
-- koREOON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02488
www.springtield-or.gov permitcenter @springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 11/12/2013 EXPIRES: 05/11/2014
STATUS DATE: 11/12/2013 APPLIED: 11/12/2013
• SITE ADDRESS: 770 HARLOW RD,APT#100,Springfield,OR 97477 SCOPE: ReRoof
ASSESOR'S PARCEL NO: 1703223402800 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Reroof-adding second layer over one existing layer of three-tab
OWNER: SUN RETIREMENT CORPORATION Phone Number: 541-744-2116
ADDRESS: 200 HAWTHORNE AVE SE A-140 •
SALEM OR 97301
. L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor JAMES PATRICK LEE CANTERBERRY CCB 187881 08/31/2015 541-937-4290
INSPECTIONS REQUIRED
Inspections
1620 Roofing Roofing: Prior to installing any roof covering.
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 isi 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.
ner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by
the Oregon Utility ;t)TIICE:
h OAF 952 001- HIS PERMIT SHALL EXPIRE IF THE s NO
Notification Center. Those rotes areset forth
in OAR 952-001-0010 copies of the rules by �UTHORI7_ED UNDER THIS PERMIT IS NOT
00 Cal You may obtain copies COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-300-332-2344).
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Springfield Building Permit 11/12/201 8:03:24AM Page 1 of 1
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SPRINGFIELD cl'Fy OF SPRINGFIELD
1 i A 225 Fifth St
``08EGON TRANSACTION RECEIPT SpringtielQOR 97477
541-726-3753
811-S P R2013-02488
www.springfield-orgov 770 HARLOW RD. APT 100 permitcenter @springfield-or.gov
RECEIPT NO: 2013002476 RECORD NO:811-SPR2013-02488 DATE: 11/12/2013
!DESCRIPTION' - ACCOUNT C.ODE/TRANS CODE AMOUNT DUE-_
Building Permit Fee 224-00000-425602 1002 245.21
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: 286.90
LPAYMENT TYPE PAYOR CASHIER:CCARPENTER COMMENTS_ , _. . AMOUNT_ PAID ' j
Cash JAMES PATRICK LEE CANTERBERR 286.90
TOTAL PAID: 286.90
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Structural Permit Application SPRINGFIELD ' DEPARTMENT USE ONLY
Y R �s aCITY OF SPRINGFIELD OREGLINt'It',1* di &;,.._ " etti Permit no.: 5/7 24/5-i
225 Fifth Street♦Springfield,OR 97477•P11(541)726-3753•FAX(541)726 3689 OukGOH
Date: //// 2-//2'
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i suance or if work is
suspended for 180 days.
LOCAL.GOVERNMENT APPROVAL FEE SCHEDULE
This project has final land-use approval. 1.Valuation information
Signature: pq(.6-r0,16' Date: (a)Job description: yerea f
This project has DEQ approval. u
Occupancy /2,2,...
Signature: Date: pp
Zoning approval verified: ❑ Yes ❑No Construction type: 'v I�
Property is within flood plain: ❑ Yes ❑No Square feet:
CATEGORY OF CONSTRUCTION ' Cost per square foot:
❑Residential ❑Government ❑Commercial Other information:
' . - JOB SITE INFORMATION AND LOCATION Type of Heat:
Job site address: '77f00 /n Lec440 py Energy Path:
City: SPPt46(1Gt0 State: ZIP:-`! ❑ new [ia#leration ❑addition
Subdivision: Lot no.: (h)Foundation-only permit? ❑ Yes ❑No
Reference: I Taxlot: Total valuation: $ 0,0
- PROPERTY OWNER' ` 2: Building fees -
Name: t3tt(t,e, w(M f[C.td R
!son"vitbi .4 (a) Permit fee(use valuation table): $ 2 c'( z/
Address: 110 WoYt isuj RA. u. (b)Investigative fee(equal to[2a]): $
City: Sorel rt c tejA State: Cf 2 I ZIP:11411 (e) Reinspection($ per hour): $
Phone: 541-144-9(t ce Fax:scf(-(t(q t I Q3 (number of hours x fee per hour)
E-mail: 1 (d)Enter 12%surcharge(.12 x[2a+26+20): $ 2? (.71
`a (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[2a1): $
Sign here:)C Sail" tO(I �. l).X_Q (b)Fire and life,safety(40%x permit fee[2a I): '$
❑This installation is being made on resitltl''eeVAhhti�al 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 4. Miscellaneous fees _ " -
requirements under ORS 701.010. ..
(a) Seismic fee. 1%(.01 x permit fee[2a]): $
CONTRACTOR--INSTALLATION" " ; i.;"• 22:,,
r _ ' .(b):Technology fee,5%(.05 x permit feel2a)): $ 72
S .
Business name: N 2V e o ,W$: TOTAL Pees and surcharges(2e+3c+4a+4b): $ 2-3 Sb
Address: 83 S5 ez t U RA "
City:Fq«, CE ,K State: ewe. z1Pi7.t ,Y.
Phona- ' -tiaaga Fax: - -
E-mail: a /! (r: ' !� togs 1 Ai. /I
CCU license no.: lei f t 1 '' - ..
Print name: •,1 a 1 ' i -
i
Signature: £i.ai tirear
. SUB-CONTRACTOR INFOR y*-2"- '
,_.
Name CCO Licensett Phmie,Nuin tier -
Electrical - ' .
-(W . . .,
Plumbing'
Mechanical
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