HomeMy WebLinkAboutPermit Building 2014-1-23 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Spnngfield,OR 97477
Phone 541-726-3753
1111E&
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00145
www.springlield-or goy permitcenter @springfieid-or goy
PROJECT STATUS: Issued ISSUED: 01/23/2014 EXPIRES: 07/22/2014
STATUS DATE: 01/23/2014 APPLIED: 01/23/2014
SITE ADDRESS: 1706 E ST,Springfield,OR 97477 SCOPE: Kitchen
ASSESOR'S PARCEL NO: 1703362118100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: ST-New header for kitchen and bath remodel
OWNER: DMH INVESTMENTS LLC Phone Number:
ADDRESS: 780 S 57TH ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER CCB 000000 08.0' 2225
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.
iIIiiEE -' VA., _ _
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Uti;ity
Notification Center. Those rules are set forth E.
In OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by :: 1='('lT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone ,..1-.D UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification CAD OR IS ABANDONED FOR
Center is 1-800-332-2344). ,.
.. 1,t' PERIOD.
Springfield Building PM* 1/23/2014 2 30 16PM Page 1 of 1
Pr
SPRINGFIELD CITY OF SPRINGFIELD
14 TRANSACTION RECEIPT Springrield,OR97477
541-726-3753
OREGON 811-SPR2014-00145
www.springfield-or.gov 1706 E ST permitcenterespringfield-or goy
RECEIPT NO: 2014000144 RECORD NO: 811-SPR2014-00145 DATE:01/23/2014
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
one: Don Horton 93.60
C6
TOTAL PAID: 93.60
•
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF SPRINGFIELD,OREGON 6,60 Permit no.: 5/4`/LIT
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON
Date: //21/I
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: Dale: p �
(a)Job description: er7-i
This project has DEQ approval. Occupancy
Signature: Date:
Zoning approval verified: ❑ Yes ❑ No Construction type: (Ay
Property is within flood plain: ❑ Yes ❑ No Square feet:
CATEGORY OF CONSTRUCTION Cost per square foot:
❑Residential El Government ❑Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat:
Job site address: V-10[, E -4 t' Energy Path:
City: qq I State: e1Z__ /IP5NN(g 7 ❑ new alteration ❑addition
Subdivision: J Lot no.: (b)Foundation-only permit? ❑Yes ❑ No
Reference: if 3 762/ Taxlot: / (F/06 Total valuation: S p
PROPERTY OWNER 2. Building fees
Name: t to (a) Permit fee(use valuation table): S X
Address: '1 5-7 7+ 6'-i 't— (b)Investigative fee(equal to pal): S
City: - 4,Q State: 0/Z I ZIP '7 y7e (c)Reinspection(S per hour):
Phone ?`� ?7-305-, l Fax: - (number of hours x fee per hour)
C II ,_�, .A/� (d)Enter 12%surcharge(.12 x 12a+2b+2c1): S r]�°
E-mail: Cipn wt nOrbtn G re-AA .Ce".►.
(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 12a1): S
Sign hers: `vv (b)Fire and life safety(40%x permit fee[2aj): S
❑This installation 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.
(a) Seismic fee. I%(.01 x permit lee 12a1): S
CONTRACTOR INSTALLATION
�j (b)Technology fee,5%(.05 x permit feel2a]): S
Business name: Ci`�!11�Yt1 �d
TOTAL fees and surcharges(2e+3c+4a+4b): S 3 J
Address:
City: State: I ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
SUB-CONTRACTOR INFORMATION
Name (Y'1;license 0 Phone Number
Electrical
Plumbing
Mechanical