HomeMy WebLinkAboutPermit Miscellaneous 2014-1-15 •
SPRINGFIELD'-°--. < 225 Fifth St
•CITY OF SPRINGFIELD Springfield,OR97477
i Phone: 541-726-3753
`OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
•
PERMIT NO: 811-SPR2014-00107
www.springfield-or.gov permitcenter @springfield-or.gov •
PROJECT STATUS: Issued ISSUED: 01/15/2014 EXPIRES: 07/14/2014
STATUS DATE: 01/15/2014 APPLIED: 01/15/2014
SITE ADDRESS: 303 S 5TH ST,STE#153,Springfield,OR 97477 SCOPE: Interior . r'
ASSESOR'S PARCEL NO: 1703350000307 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replaced Two foot wide door with ADA compliant door
OWNER: CITY OF SPRINGFIELD Phone Number:
ADDRESS: 225 N 5TH ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor TIMBERLINE PAINTING&REMODELING INC CCB 157974 12/12/2015 541-912-7777
INSPECTIONS REQUIRED
Inspections
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 inspecti• -re requested at the proper time, that each address is readable from the street,that the
permit card is lop=r'-d at the fro t of •- property, and the approved set of plans will remain on the site at all times during
construction)
\41/
- --/fre‘e
Own- or Contractor Signature Date
• ATTENTION: Oregon la the Oregon Utility
follow rules adopted by
Notification Center. Those rules are set forth
in OAR 95`2-001-0010 through of tlRe 52-001
• you to
0090. You may obtain cop. hone
ROME: • calling the center. (Note: the telep
number for the Oregon Utility Notification
THIS PERMIT SHALL EXPIRE IF THE WORK Center is 1-800-332-2 344).
'!UTHORIZED UNDER THIS PERMIT IS NOT
,;O;tiMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD. •
•
Springfield Building Permit 1/15/2014 1:21:30PM Page 1 of 1
•
SPRINGFIELD — CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Svlpl gti 97477
17—ta -11 OREGON 811-SPR2014-00107
vmayspringfie1d-or.gov 303 S 5TH ST. STE 153 permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000102 RECORD NO: 811 SPR2014.00107 DATE:01/15/2014
R P.: ION '°:.M -S .7?-72 s. S . ` :: . - .r P4.1 L +_ACCOUNT CODE/TRANS CODEL T x:a La..-
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
adz m..-rn .:,.3PAYMENP?YPE �:ks PAYOR_i="-CASHIER:dLaesoN :MS.:ita_";C-M MENTS .+AMOUNTIPAID:ce .
Credit Card CITY OF SPRINGFIELD 93.60
008136
TOTAL PAID: 93.60
Structural Permit Application SPRINGFIELD—. DEPARTMENT USE ONLY
rcIT,y, OF'SPRINGFIELD, OREGON ,.' t .at s Permit no.:
225 Fifth Street•Springfield,OR 97477•PI-1(541)726-3753♦FAX(541)726 3689 OREGON
C,),ll 2.nt3 Odo7
Date: ///S// '/
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. 1. Valuation information
Signature: Dote: (a)Job description: 1�� 44 tk Devi O
This project has DEQ approval. �-'1G-�� roO IT-
Occupancy i/tSS t ktzt JCS
Signaturc:� Date:
Zoning approval verified: ❑ Yes ❑ No Construction type: Gipo r o 1 R Al
Property is within flood plain: ❑ Yes ❑ No Square feet: 5- 91 7 -L on"CO
CATEGORY OF CONSTRUCTION Cost per square foot:
❑ Residential ❑ Government ❑Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat:
Ti
Job site address: 303 5—`� SC/r T� / Energy Path:
City: .or(Ns 6-Ft State(Pr ZIP/7>z2,7 ❑ new alteration ❑addition
Subdivision: Lot no.: (h) Foundation-only permit? ❑ Yes ❑ No
Reference: TaxloC 'total valuation: $ ao C
PROPERTY OWNER / 2. Building fees
Name: <t d-{ 'CPR) J fi�l (a) Permit fee(use valuation table): $
Address: -Z f I S r, (b)Investigative fee(equal to pap: $
City: SeR) f-)6-f'i L State: Q1, ZIP9?t77 (c) Reinspection(S per hour):
�J 3 .3 6 cen (number of hours x fee per hour) $
Phone:S p Fax: - -
E-mail: Tori r,1/4._Gicficy^o,e..... • �1/4...) (d)Enter 12%surcharge(.12 x 12a+2b+2c1): $
(e) Subtotal of fees above(2a through 2d): S
Huilding Owner or Ot: ts agent auto .ing thi�pplication: 3. Plan review fees ,
• (a) Plan review(65%x permit fee I2a1): $
Sign here: �/Jln to (b)Fire and life safety(40%x permit fee pal): $
❑This install. Ion is being made residential or fa property owned by (c) Subtotal of fees above(3a and 3b): S
me or a mei. ter of my immediate family.and is exempt from licensing 4. Miscellaneous fees ,
rcquirem its under ORS 701.010.
(a) Seismic Ice. I%(.01 x permit fcc Pal): $
CONTRACTOR INSTALLATION
/O Icchnolo€y Ice. S°/o(.OSc permit Cce I2aJ)
S
Business name: TM b .(( )r p....) YCi\ i7 cylb iReAtjQ
TOTAL fees and surcharges(2e+3c+4a+4b): S-�3Z42-
Address:
City: State: _
Phone: - - Fax: -
E-mail:
CCI3 license no.: .
Print name:
Signature:
SUB-CONTRACTOR INFORMATION" - •
Name CCI4 License# Phone Number
Electrical .
Plumbing
Mechanical