HomeMy WebLinkAboutPermit Miscellaneous 2013-12-19 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
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Phone: 541-726-3753
4 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02492
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www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 12/1912013 EXPIRES: 06/17/2014
STATUS DATE: 12/19/2013 APPLIED: 11/12/2013
SITE ADDRESS: 1919 LAURA ST, Springfield, OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703271003200 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Install fire suppression system in paint booth
OWNER: OLSSON INVESTMENTS LLC Phone Number:
ADDRESS: PO BOX 70413
SPRINGFIELD OR 97475
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Fire Contractor WESTERN STATES FIRE PROTECTION CO CCB 104570 03/06/2015 303-792-0022
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 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.
Owner or Contractor Signature Date
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NOTICE: . . Oregon law requires you to
follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABl}NL) NED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY TWA-, e `, calling the center. (Note: the telephone
number for the Oregon Utility Notification
(1 Center is 1-800-332-2344).
Springfield Building Permit 12/19/201 2:54:26PM Page 1 of 1
SPRINGFIELD •• - CITY OF SPRINGFIELD
It ',a.—: 225 Fifth St
Tr, �t TRANSACTION RECEIPT Springfeld,OR 97477
= t'N 541-726-3753
OREGON 811-SPR2013-02492
www.spdngfield-or.gov 1919 LAURA ST permitcenter @springfeld-or.gov
RECEIPT NO: 2013002712 RECORD NO: 811-SPR2013-02492 DATE: 12/19/2013
DESCRIPTION-_.._ te , , ?� ACCOUNTCODE/TRANS CODE_ - ,r .- ,_,_AMOUNT'DUE
Admin fee (10%of applicable fees) 224-00000-426605 1098 16.20
Percent of fire system bid/contract value (3%) 100-00000-424002 9116 162.00
TOTAL DUE: 178.20
' AMOUNT PAID
I PAYMENT-TYPE PAYOR CASHIER:JLARSON COMMENTS -
Check Omlid and Swinney 178.20
44773
TOTAL PAID: 178.20
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