HomeMy WebLinkAboutPermit Building 2014-1-24 i
SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Spnngfield,OR 97477
Phone 541-726-3753
OREGOrr Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00147
www springfield-or.gov permitcenter Ld'spnngtield-or.gov
PROJECT STATUS: Issued ISSUED: 0112412014 EXPIRES: 07/2312014
STATUS DATE: 01124/2014 APPLIED: 0112412014
SITE ADDRESS: 1875 MOHAWK BLVD,Springfield,OR 97477 SCOPE; Hotel!Motel
ASSESOR'S PARCEL NO: 1703251300702 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replace porte cochere flat roof with pitched roof
OWNER: REALVEST VILLAGE INN LLC Phone Number:
ADDRESS: 1111 MAIN ST STE 700
VANCOUVER WA 98660
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor KIMBALL PROPERTIES LLC CCB 192390 11/23/2014 541-357-7663
INSPECTIONS REQUIRED II
Inspections
1260 Framing Framing Inspection Prior to cover and after all rough in inspections have been
approved.
1630 Roof Sheathing Roof Sheathing
1999 Final Building Final Building. After all required inspections have been requested and approved and
the building is complete.
1110 Footing Footing: After trenches are excavated.
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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6.61::.;:f:Contractor Contractor Signature Date
rWS PERMIT SHALL EXPIRE 1FF THE IS OR1
;.I�� 'lfir1-ED UNDER THIS PERMIT
-•- � ;ANDONED FCR
Spnngfield Building Permit 1/24/2014 10 12 30AM Page 1 of 1
1SPRINGFIELD CITY OF SPRINGFIELD fi TRANSACTION RECEIPT Springeld,OR97477
1111L11161- 541-726-3753
OREGON 811-SPR2014-00147
wwwspnngfield-orgov 1875 MOHAWK BLVD permitcenter @spnngfield-or gov
RECEIPT NO: 2014000148 RECORD NO: 811-SPR2014-00147 DATE:01/24/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 317 50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 38.10
Technology fee(5% of permit total) 100-00000-425605 2099 15.88
TOTAL DUE: 371.48
PAYMENT TYPE PAYOR CASHIER;CCARPENTER COMMENTS AMOUNT PAID
Credit Card KIMBALL PROPERTIES LLC 371.48
00246g
TOTAL PAID: 371.48
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF SPRINGFIELD, OREGON & Permit no.: 1 I Li
225 Filth Street•Springfield,OR 97477♦P1-1(541)726.3753•FAX(541)726-3689 ` OREGON Sad " f
Date: iii Zy J/II
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: ,Date: (a)Job description: /W,Wr `r ra
This project has DEQ approval.
Occupancy
Signature: Date: �j
Zoning approval verified: ❑Yes El No Construction type: U
Property is within flood plain: ❑ Yes ❑No Square feet: ra a
CATEGORY OF CONSTRUCTION Cost per square foot:
❑Residential ❑Government ['Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of]feat:
Job site address: l-F7 5 lea ". _ (C (vim Energy Path:
City:S Pr-, t. .tee State: Q, 1 I ZIP: f 7G/7 ❑ new ]alteration ❑ addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No
Reference: _ Taxlot: Total valuation: I S2-5°°(-)
PROPERTY DJ OWNER 2.Building fees
Name: X�-vt '/ r lr.t L - r.✓L (a) Permit fee(use valuation table): $ 3/7 Tsa
Address: 75— ( ic, Jt ,,,, (L (b)Investigative fee(equal to Pal): S
City: SPwg - ,- c.tee State: o/Z I ZIP:4 7'i7 (c) Reinspection(S per hour):
S
Phone: fz a56 7c-07 Fax: - - (number of hours x fee per hour)
Email (d)Enter 12%surcharge(.12 x 12a+2b+2c1): $ J2 JO
(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 here: (b)Fire and life safety(40%x permit fee Pap: 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. o
(a) Seismic fee, 1%(.0I x permit fee[2a1): S
CONTRACTOR INSTALLATION S
(b)Technology fee,5%(.05 x permit fee(2a1): S f
Business name: (c f rp,,,-j` , ,w S
/4,-.s.--
`�' 3 1 �' 1 C TOTAL fees and surcharges(2e+3c+4a+4b): s-Tri1 if fr
Address: ,`) Az---
City: ��$,—ve_ State: d el. ZIP: ?7`/rs(
Phone (-32('- Z4/1= -K Fax:/5V-357 73.-s7
E-mail: ,, 0,-,,,.,..,- ( A2,�b-•'�`- 1rt,e,c.P,'"6
CCB license no.: e?z 31cr
Print name: 162 r4*-a,,., 4,,,,...( S-F."- _
Signatu
SUB-CONTRACTOR INFORMATION
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical