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Permit Building 2013-12-12
SNKINGPItLD 225 Fifth St 4ii kr: CITY OF SPRINGFIELD Springfreld,OR 97477 4 Phone. 541-726-3753 OREGON Building l Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02655 www.springrieid-or.gov pormitcenter @springtield•or goy PROJECT STATUS: Issued ISSUED: 12/12/2013 EXPIRES: 06/10/2014 STATUS DATE: 12/12/2013 APPLIED: 12/12/2013 SITE ADDRESS: 977 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 L INSPECTIONS REQUIRED 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. 12 � I L.- 11....- Owner or Contractor Signature Date 1. I [GE: PERMIT SHALL EXPIRE IF THE WORK • • .... AORI[ED UNDER THIS PERMIT IS NOT i Ift `. vlE 'lCED OR IS ABANDONED FOR ;4•Pf• . 30 DAY PERIOD, Springfield Building Permit 12/12/201 2.23:11PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD ______Iii.ii TRANSACTION RECEIPT Spn gfietd,OR97477 541-726-3753 OREGON 811-SPR2013-02655 www sprngteld-or.gov 977 CLOVERLEAF LOOP permttcenter©springfield-or gov RECEIPT NO: 2013002655 RECORD NO: 811-SPR2013-02655 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 CITY OF SPRINGFIF..r.f. ()R1 c:r i 1 225 Fifth Street♦S R Pe prm¢field.OR 97477�PH(547)726-3753•FAJC(541)736-3689 nett no.: C 13„6 76� OREGON J! G� Date: 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: ❑Yes ❑No FEE SCHEDULE Property is within flood plain: ❑Yes ❑No 1. CATEGORY OF CONSTRUCTION (a)Valuation descript'onormRtigon El Residential ❑Government ' ` kit,/ _co/4r Y� ❑Commercial Occupancy JOB SITE INFORMATION AND LOCATION 7 Construction type; Job site address: 7 I O v e1„ ti t'�� � }} Square feet: City: Spc�1 I State: ©a 1 ZIP: '17 `177 Cost per square foot: Subdivision: Lot no.: Reference: j 7,e) 3 22.3 ( 1 Taxlot: D S 7 0 b Other information: PROPERTY OWNER Type of Heat: Name: oririL y S'v ivt n„MS Engrg}Path: Address: 1�7 V11 ilel tJkr I e Du- (b) new ❑alteration ❑addition City: �L5 eY`2 t State: £7/Z I ZIP:')7 Yo ' (b)Fouutdation only permit? ❑Yes ❑r o Phone: S"+f j )ti.v Se 17 Fax: - Total valuation: E-mail: 2.Building fees (a)Permit fee(use valuation table): j Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to Pal): S (c)Reinspection($ per hour): Sign here: 6��_ (number of hours x fee per hour) ❑This installation is being made on residential or farm property owned by (d)Ente 12%surcharge(.12 x[2a+2b+2c]): UM me or a member of my immediate family.and is exempt from licensing (e)Subtotal of fees above(2a through 2d): S requirements under ORS 701 010. 3.Plan review fees CONTRACTOR INSTALLATION (a)Plan review(65%x permit fee[2aj): S Business name: P4Ct'Fi L IA )IV,,.L14 1 !h (b)Fite and life safety(40%x permit fee[2aJ): Address: to (��( 90 (c)Subtotal of fees above(3a and 3b): City: , L� State: O,� I ZIP:°))LIUS 4.Miscellaneous fees phone 5y)-(?p ���- { Fax: - - (a)Seismic fee. I%(.01 x permit fee 2a : UM r f [ �) S E-mail: //a-KO l tiC t"6 c l•l yu [r.v, r i-eit n C. c, ,�►-t (b)Technology fee.5%(.05 x permit fee[2aj): S CCB license no.: 6 8 9 6 y 6 TOTAL fees and surcharges(2e+3c+4a+4b): S F Print name: (.1 c lAr,e Pe Ca h.k Signature: 7L,42:3,---- SUB-CONTRACTOR INFORMATION Name i CCB License it Phone Number Electrical I