HomeMy WebLinkAboutPermit Miscellaneous 2014-1-14 SPRINGFIELD 225 Fifth St
.''. CITY OF SPRINGFIELD Springfield,OR 97477
c.c Phone: 541-726-3753 .
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00077
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: . 01/14/2014 EXPIRES: 07/13/2014
STATUS DATE: 01/14/2014 APPLIED: 01/13/2014
'SITE ADDRESS: 225 5TH ST,Springfield,OR 97477 SCOPE: Interior
ASSESOR'S PARCEL NO: 1703353103300 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Exit path modification
OWNER: CITY OF SPRINGFIELD Phone Number:
ADDRESS: 344 NORTH A ST
SPRINGFIELD OR 97477
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CONTRACTOR INFORMATION 1
Contractor Type Contractor Name Lic Type • Lic No Lic Exp Phone
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.
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•wner�.ntractor Signat re / D- e
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Springfield Building Permit 1/14/2014 3:56:53PM Page 1 of 1
SPRINGFIELD — • CITY OF SPRINGFIELD
225 Fifth St
cro TRANSACTION RECEIPT Springfield.OR 97477
541-726-3753
OREGON
• 811-SPR2014-00077
www.springfield-or.gov 225 5TH ST permitcenter @springfield-ocgov
RECEIPT NO: 2014000094 RECORD NO: 811-SPR2014-00077 DATE:01/14/2014
1111*.ii1:11:mirei l7 F,ICT ? £2414, rate: :_' ACCOUNT CODE/TRANS CODE! i ra i-.7AMOUNT DUE r
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 .
O'PAMENT4TEWE PAYOR CnSHIER CCARPENTER. COMMENTS '?MOUNT P.AIDJ
Credit Card CITY OF SPRINGFIELD 93.60
065638
TOTAL PAID: 93.60
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
'i:K`';',/;?:LCITY'OF SPRINGFIELD OREGON
pr _ ;�'•O+- Permit no.: S(t-(,� 7
225 Filth Strcei•Springfield,OR 97477•P11(541)726-3753•FAX(54I)726-3689 OREGON
• Date:. 'I
� 9 / / L/
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. I. Valuation information
Signature: Date:
(a) Job description:
This project has DItQ approval p /0,77,-/
Occupancy 3
Signature:
Date:
•
Zoning approval verified: ❑ Yes 1:1 No Construction type: 14:2
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 Ilcat:
Job site address: ?-c Energy Path:
City: ekky k(Q State:0662_ %IP:g1tk 11 ❑ new fniteration ❑ addition
Subdivision: Lot no.: (b) Foundation-only permit? ❑ Yes ❑ No
Reference: Taxlot: Total valuation: $2'
PROPERTY OWNER 2. Building fees
Name: SfP.IA/, � (a) Permit fie(use valuation table): $
Address: 22_-S" (b) Investigative fee(equal to I2aD): $
City: e12..• —af, State: /_IP:C7tf17 (c) Reinspection(S per hour): $
Phone: . 7 Liq/5-z) Fax: - - (number of hours x fee per hour)
E-mail: (d)Enter 12%surcharge(.12 x I2a+2b+2cD): $
(e) Subtotal of fees above(2a through 2d): S
Building Owner or Owner's agent authorizing this application: 3- Plan review fees
(a) Plan review(65%x permit fee 124: $
Sign here: s -
' (h)Fire and life safety(40%x permit fee 12a p: $
❑This instalfon 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. o
(a) Seismic fee. I%(.01 x permit fee Pap: $
CONTRACTOR INSTALLATION
(b)Technology Ice 5%(.05 permit fcel2ap: $
Business name: j �_ yi
G�
TOTAL fees and surcharges(2e+3c+4a+4b): S C3 /
Address:
City: State: ZIP:
Phone: ' - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
• SUB:CONTRACTOR INFORMATION
Name CCI3 License# Phone Number
Electrical
9_5 fl >71794'6.% Sr 0)s
Plumbing
Ncchanical
•