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HomeMy WebLinkAboutPermit Miscellaneous 2014-1-14 • SPRINGFIELD-- 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 "'this, OR Ecor+ • Building / Residential Permit. Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00094 www.springfieldor.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 01/14/2014 • EXPIRES: 07/13/2014 STATUS DATE: 01/14/2014 APPLIED: 01/14/2014 SITE ADDRESS: 5240 MAIN ST,Springfield,OR 97478 SCOPE: Interior • ASSESOR'S PARCEL NO: 1702333104402 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Compliance verification permit-restore unpermitted duplex to single-family dwelling OWNER: WILLIAMS MARILYN A&SCOT Phone Number: ADDRESS: 5117 INNSBROOK WAY EUGENE OR 97402 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 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 oft - . or Oregon pertaining to the work described herein, and that NO -- OCCUPANCY will be made of any structure •ut •> fission of the Community Services Division, Bu. •••g-Safety tfurther certify that only contractors and em. • -es who.: e in compliance with ORS 701.005 • e. on this project. I further agree to ensure that all required ins.- ions are-rested at the proper time •- --c address is readable from the street, that the permit card is located - e front of-the property, and the as- ••-• set of plans will remain on the site at all times during construction. Owiie actor Signature Date • NOTICE: ATTENTION: Oregon law requires you to . • • THIS PERMIT SHALL EXPIRE IF THE WORK foilow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT in OAR Son Center. Those rules are set 001- in OAR 952-G01-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 1/14/2014 10:08:38AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St ;, " TRANSACTION RECEIPT Spnngfield,OR 97477 c 541-726-3753 OREGON. 811-SPR2014-00094 www.springfield-cr.gov 5240 MAIN ST permitcenter @spnngfeld-or.gov RECEIPT NO: 2014000082 RECORD NO: 811-SPR2014-00094 DATE:01/14/2014 :41 t.i "y`„ ..:AGCOUNDCODE/iRANSCODE £- 11�1o1olyd nl'1 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 "_P . T. ,?5:::. COMMENTS°5. 1'i' �, ` _.=•`,._e <3..<AMOUNT `S.- .AYMENTrTYPE �f��.. PAYOR � .' Credit Card WILLIAMS MARILYN A&SCOT 93.60 214181 TOTAL PAID: 93.60 Sttuetural Permit Application SPRINGFIELD DEPARTMENT USE ONLY CITY OF SPRINGFIELD, OREGON E,`c R Permit no 5 j 1-( -'GOO)-`Y/ 225 Filth Street•Springfield,OR 97477•PI3(54I)726 3753•FAX(541)726 3689 OREGON Date: /7/ v/11-7 . 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 7ICS%7)K6 i tg 4‘,66—A. 70(a) Job description: This project has DEQ approval. ?P Occupancy Signature: Date: �� P Zoning approval verified: ❑ Yes ❑No Construction type: 'Vt7 Property is within flood plain: ❑ Yes ❑No Square feet: CATEGORY OF CONSTRUCTION Cost per square foot: esi/de ntial ❑Government ['Commercial Other inlbrmation: JOB SITE INFORMATION AND LOCATION Type of Heat: Job site address: <2 HO R' cats,cats, N TI Energy Path: City: *Cr C V.(1 State: OR ZAP: ❑ new aulteration ❑ addition Subdivision: I Lot no, (b) Foundation-only permit? ❑ Yes ❑No Reference: /702-' r (1 'Faxlot: /i7 l{O7/ 'Total valuation: $G-,2000 PROPERTY OWNER 2. Building fees Name: Sr KA.) A \\ \ci,„NAT1( (a) Permit fee(use valuation table): $ ropa , Address: 5117 --i---,....) ,..3 \.,....).3-a--\ ' (b) Investigative fee(equal to 12a1): $ City: EL) Stater ZIP: (c) Reinspection($ per hour): $ et � q"� (number of hours x fee per hour) Phone: Pax: - - 13-mail: '1/4.1,,,,,M \(,� C QQ (d)Enter 12%surcharge(.12 x 12a{2b+2e1): $ CO°iv\ �- (e) Subtotal of fees above(2a through 2d): S • 13uilding Owner or ( iner's tent authorizing t 's application: 3. Plan review fees (a) Plan review(65%x permit fee 12a1): $ Sign here: (h)Fire and lift safety(40%x permit fee 12a1): $ ❑This• stallation is being made on residential,or faun 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. u (a) Seismic fee, 1%(.01 x permit fee I2aJ): $ CONTRACTOR INSTALLATION (b)Technology fee.5%(.05 x permit feel2a1): $ V Business name: gt-LCV e, - TOTAL fees and surcharges(2e+3c+4a+4b): S @3G__— Address: City: State: ZIP: Phone: - - Fax: - - E-mail: CCB license no.: Print name: Signature: . SUB-CONTRACTOR INFORMATION - Name CCB License if Phone Number Electrical Plumbing wleehanical