HomeMy WebLinkAboutPermit Building 2014-2-6 SPRINGFIELD 225 Fifth St
• CITY OF SPRINGFIELD SpringfieldOR 97477
• `tomb Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00245
www.springfieldcr.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/06/2014 EXPIRES: 08/05/2014
STATUS DATE: 02/06/2014 APPLIED: 02/0612014
SITE ADDRESS: 193 62ND PL,Springfield,OR 97478 SCOPE: Garage Conversion
ASSESOR'S PARCEL NO: 1702343103200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Revert BWOP garage conversion back to garage
OWNER: NEIGHBORHOOD ECONOMIC DEVELOPMENT CORP Phone Number:
ADDRESS: 212 MAIN ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor ERIC MATTHEW MASON COB 125028. 09/12/2015 541-729-7619
_ INSPECTIONS REQUIRED
Inspections
1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum
board, interior and exterior are in place, but prior to plastering.
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.
Owner or Contractor Signature Date
s! 134000
NOTICE: (ttsz zss ooe-1 wnu
uo!1e01 !1oN Al!I!1(1 U0 ! aUl t°I aaq
THIS PERMIT SHALL EXPIRE IF THE WORK eUogdelei 0111 :B1°N) 7&11000 a I Gu!!le°
AUTHORIZED UNDER THIS PERMIT IS NOT - Aq saint a !1�° senora/otco 10o zs�NHO
COMMENCED OR IS ABANDONED FOR Goo zs5 ado q 1a;u^0 U0t1 0!;!1°N
411O11as aaa satni a.,oal e itl1d nnp°1
ANY 180 DAY PERIOD. Aul!1n uobe.I0 aq1 Aq paiP
- o1
noA sattnbaa mte! ucoaa0 'NOtlid311d
Springfield Building Permit 2/6/2014 9:25:01AM . Page 1 of 1
Structural Permit Application SPRINGFIELD 'DEPARTMENT--.USE ONL=Y':
CITY OF SPRINGFIELD, OREGON ', cLas Permit no .,.S/(-( —2'-i S
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 " ,OREGON
Date: 7/6// Y
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.
I ti'..*".(:LOCAL;;GOVERNMENLAPPROVAL ;" ;it ;.":1-c- Plumbing
This project has final land-use approval.
Signature: Date: Mechanical
This project has DEQ approval.
Signature: Date:
Zoning approval verified: ❑Yes ❑No ':]4!!'€:;f',..;; n ,' FEE SCHEDULE 1{:&rn
Property is within flood plain: ❑ Yes ❑No :1 Valuation information r Fi ( ,i , vt 1.,'-e`-
is y" ' ^,,,,Fi;' CATEGORY4OF':CONSTRUCTION :`,a"„ „ 4. (a)Job description: go-7/CC-7 , 2),/4, j?,iy4 t 7,Vt/e,zS/U✓
' esidential ❑Government ❑Commercial Occupancy, to 77 'fNGt i
. 6p 4
(....4:1: tJ08'SITE, NFORMATION 'AND LOCATION ��'� - � Construction ype:
Job site address: Jq3. N. 622/117 Pt Square feet:
City:SP/Z ,, /EGO State:O2 ZIP: Cost per square foot:
Subdivision: Lot no.: Other information:
Reference: /762 3Y j/ Taxlo[ 07. 0 Type of Beat:
C']. tti-t,-., .Mtr PROPERTY'OWNER -,_M, ° ` (;“I(har`';[
' Energy Path:
Name: A/EDGL7 ❑new gtalteration ❑addition
Address: Z t z r/\a.e S.*• (b)Foundation only permit? ❑Yes ❑No
City: Sr:-.cc g at State:Or ZIP:9I7$177
y� C Total valuation $
Phone: S'41 _3c4e _ 7 le(a Fax:'NI-,545-- 9'SOy '- i h .?fit ,rr - e w 2 B,mldng?fees 1 .. .- - v # rr
sb,-
E-mail: Lori (1eac-ocOL. Gel (a) Permit fee(use valuation table): $ .6�c7
1 �
Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to[2a]): $
(c) $(
Reinspection per hour): $
(number[ion hours x fee per hour)
Sign here: d a-...- cJ
(d)Enter 12%surcharge(.12 x[2a+2b+2e]): $@1i
❑This installation is being made on residential or farm property owned by
me or a member of my immediate family,and is exempt from licensing (e)Subtotal of fees above(2a through 2d) $
requirements under ORS 701.010. - fi3.:PlarLrevieN fees _ , , '5.a..t t,.,
;; CONTRACTOR"INSTALLATION; .' - .- ' (a) Plan review(65 x permit fee[2a]): $
Business name: epic_ OAfseSOY� Co.t,5kaa.,�4-.a-h (b)Fire and life safety(40%x permit fee[2a]): $
Address: Le •2_ aAaf,me a'Q-. (c)Subtotal of fees above(3a and 3b): $
City: CV4.e8nR State: OR.- ZIP:170 74 Miscellaneous fees,;, ,,F_J ,.. r -.I:, 5,,,, airs
Phone:53,ft,=,7xy=1(p19 Fax:SW 40-7.311t( (a) Seismic fee, l%(.01 x permit fee [2a]): $ '
E-mail: `�i<e- AMgSOY1, 11A50./.COWS, (b)Technology fee, 5%(.05 x permit fee[2a]): $ /
CCF3 license no.: /o Qczt TOTAL fees and surcharges(2e+3e+4a+4b): $ q3j
Print name: Ec tt WIA5014
Signature: .:- i it/V1 a4.0-1,--
; l3 ,;_SUB CONTRACTOR.INPORMATION .,::1:11Y_?::
Name CCB License 4 ' Phone Number
Electrical
(
SPRINGFIELD CITY OF SPRINGFIELD
._. 225 Fifth St
R
OREGON TRANSACTION RECEIPT Springfleld.OR 97477
' C
541-726-3753
811-SPR2014-00245 •
www.springfield-or.gov 193 62ND PL permitcenter@springtield-or.gov
RECEIPT NO: 2014000238 RECORD NO: B11-SPR2014-00245 DATE:02/06/2014
DESCRIPTION,____.- _ : ACCOUNT CODE/TRANS CODE m _ _ 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
L,PAYMENT TYPE PAYOR CASHIER:CCARPENTER. COMMENTS_ _;_ - - - AMOUNT PAID
Check ERIC MASON CONSTRUCTION 93.60
5758
TOTAL PAID: 93.60
•