HomeMy WebLinkAboutPermit Building 2013-12-12 SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR 97477
" � ` Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone. 541-726-3769
Fax- 541-726-3676
PERMIT NO: 811-SPR2013-02657
www.springfield-or.gov permitcenter @sprmgfield-or gov
PROJECT STATUS: Issued ISSUED: 12/12/2013 EXPIRES: 06/10/2014
STATUS DATE: 12/12/2013 APPLIED: 12/12/2013
SITE ADDRESS: 979 CLOVERLEAF LOOP,Springfield,OR 97477 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1703223105700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Roof mount solar panel installation
OWNER: EMORY F SUMMERS REVOCABLE LIVING TRUST Phone Number:
ADDRESS: 2647 VALLEY FORGE DR
EUGENE OR 97408
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor PACIFIC UNLIMITED INC A CORPORATION OF FLORIDA CCB 189646 02/19/2014 541-603-4805
INSPECTIONS REQUIRED II
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.
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Owner or Contractor Signature Date
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Springfield Building Permit 12/12/201 2:19 47PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT SpringfieldOR97477
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541-726-3753
OREGON 811-SPR2013-02657
www.spnngfield-or gov 979 CLOVERLEAF LOOP permitcenter @spnngfield-or.gov
RECEIPT NO: 2013002652 RECORD NO: 811-SPR2013.02657 DATE: 12/12/2013
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9 60
Structural Building Permit Fee 224-00000-425602 1002 80.00
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 PACIFIC UNLIMITED INC A 93.60
4214 CORPORATION OF FLORIDA
TOTAL PAID: 93.60
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
'_25 Fitch Street•Springfield.OR 97477 P11(541)726-3753 FAX(541)726-3689 EGt?N Permit no.:S/�{. 071C �I
Date: e /2/ ( 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.
LOCAL GOVERNMENT APPROVAL Plumbing
This project has final land-use approval.
Signature: Date:
This project has DEQ approval. Mechanical
Signature: Date:
Zoning approval verified: 0 Yes 0 No FEE SCHEDULE
Property is within flood plain: ❑Yes ❑No 1.Valuation information
CATEGORY OF CONSTRUCTION a)Job description:( P �,9 (/kill _co Alp- 1►"1
.A Residential I ❑Government I ❑Coimnercial Occupancy
JOB SITE INFORMATION AND LOCATION
Construction type:
Job site address: �e 9 C f b'eu- (4ct
Square feet:
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City: Sec t• [State: 0 R I ZIP: `17 q 7? -
Cost per square foot; .
Subdivision: I Lot no.:
Reference: Other information:
I ro3 Z Z 3 I Taxlot: �S7`�J�
PROPERTY OWNER
Type of Heat:
Name: 0�i S'J M pm e'er Energy Path:
Address: t/ VII I ❑new ❑alteration ❑addition
City (b)7 v (b)Foundation-only permit? ❑Yes ❑No
y.e State: Oa_ ZIP:/ t?
Phone: $ y 1 3 Y S / / Fax: - -
Total valuation: 1 s)414""
E-mail: 2.Building fees
(a)Permit fee(use valuation table): So
Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to[2a]):
S
(c)Reinspection(S per hour):
Sign here: ter_ (number of hours x fee per how-) S
❑This installation is being made on residential or farm property owned by (d)Enter 12%surcharge(.12 x[2a+2b+2c]r S
me or a member of my unmediate family-and is exempt from licensing (e)Subtotal offers above(2a through 2d): S
requirements under ORS 701 010 3.Plan review fees
CONTRACTOR INSTALLATION (a)Plan review(65%x permit fee[2a]): $
Business name: P4 f i VA Iii c1`"e( . ,h (b)Fire and life safety(40%x permit fee}2a]): S
Address: f10 /3 I.7( -�9Q (c)Subtotal of fees above(3a and 3b): 5
City c.,,��� State: QfL_ ZIP:' )yeas 4.Miscellaneous fees
Phones /-$1,0S YFar I Fax: - - (a)Seismic fee, 1%(.01 x permit fec[2a]): S
E-mail: 1 n C n t e H „ t u t } 1'tie. Co q't'r (b)Technology fee. 5%(.05 x permit fee[2a]): S
CCB license no.: f (<3 g 6 s 6 TOTAL fees and surcharges(2e+3c+4a+4b): S ��
Print name: E.t C 1tigrQ Pa.. tR...k.
Signature:
-
SUB-CONTRACTOR INFORMATION 1
Name CCB License#I Phone Number
Electrical