HomeMy WebLinkAboutPermit Building 2014-3-11 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
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OREGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00514
www.springfield-or.gov perrnitcenteraspringfie ld-or.gov
PROJECT STATUS: Issued ISSUED: 03/11/2014 EXPIRES: 09/07/2014
STATUS DATE: 03/11/2014 APPLIED: 03/11/2014
SITE ADDRESS: 455 23RD ST,Springfield,OR 97477 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1703361407900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: S-Bathroom/laundry remodel
OWNER: CREATIVE REAL ESTATE SOLUTIONS LLC Phone Number:
ADDRESS: 505 SW MILL VIEW WAY STE 250
BEND OR 97702
CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
General Contractor OWNER CCB 000000 08/01/2025
Mechanical Contractor OWNER CCB 000000 08/01/2025
Plumbing Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
1220 Underfloor framing
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 •.are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections - - requested at the proper time,that each address is readable from the street, that the
permit card is located at the front• e property, and the approved set of plans will remain on the site at all times during
constructio
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D
Owner o Signature Dae
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- NOTICE:
0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
Springfield Building Permit 3/11/2014 10:33:15AM Page 1 of 1
SPRINGFIELD....._ CITY OF SPRINGFIELD
I St
TRANSACTION RECEIPT 225 Fifth
Springtield,OR97477
��� 541-726-3753
OREGON 811-SPR2014-00514
wvnv.springfield-ocgov 455 23RD ST • permitcenter@springtield-or.gov
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RECEIPT NO: 2014000526 RECORD NO: 811-SPR2014-00514 DATE:03/11/2014
,DESCRIPTION -: ACCOUNT CODE/TRANS CODE_ _ �_._AMOUNTDUEv .
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
Credit Card JERAMY BROWN , 93.60
000965
TOTAL PAID: 93.60
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
A
CITY OF SPRINGFIELD OREGON i '. .; �i Permit no.: /j ( J
225 Fifth Street•Springfield,OR 97477•P11(541)726-3753•FAX(541)726-3689 OREGON �('y—�I/
Dater// ! / / t7
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days o 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: ®!Jy(„.r.4,291 a-7,94177.-z--
This project has DEQ approval.
Occupancy
Signature: Date:
Zoning approval verified: ❑ Yes ❑ No Construction type: liq
Property is within flood plain: ❑ Yes ❑ No Square feet:
CATEGORY OF CONSTRUCTION ' Cost per square foot:
Residential ❑Government ❑Commercial • Other information:
JOB SITE INFORMATION AND LOCATION Type of Heat:
Job site address: .b!5 3 a\'tip . Energy Path:
City: rcriR'- - rrich State: en ZIP: ❑ new alteration ❑ addition
Subdivis on: Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No
Reference: /?1/3 ye/L/ i TaxIoC e 7, OQ Total valuation: SG v
PROPERTY OWNER 2. Building fees •
Name: 4 gn �, 6ror� ri (a) Permit fee(use valuation table): $ y50
Address: V/��rJ /9VC (b) Investigative fee(equal to 12a1): $
City: G-/Cres State: 0'? 1 ZIP:�'/a) (c) Reinspection($ per hour): $
Phone: 7/ Va8 Fax: - - (number of hours x fee per hour)
E-mail: / °/,EeCip<< 9 477/(4) tnr Nec/— (d) Enter 12%surcharge(.12 x 12a+26+21): $ cOQ
(e) Subtotal of fees above(2a through 2d): 5
Building Owner or Owner's agent a -.fiiing this application: 3. Plan review fees
(a) Plan review(65%x permit fee 12a1): $
Sign here:
(b)Fire and life safety(40%x permit fee Pal): $
❑This instay Si;is being made on residential or farm property owned by (c) Subtotal of fees above(3a and 3b): $
me or a mew er of my immediate family.and is exempt from licensing 4. Miscellaneous fees '
requirements under ORS 701.010.
• - (a) Seismic fee, 1 o�.n(.01 x permit fee pap: $
CONTRACTOR INSTALLATION b Technology gn fee_ 5/u 05 x permit fee 2a $ Ye?,
Business name: ,� /�
/( 72 - ��60
"TOTAL fees and surcharges(2e+3c+4a+4b): $
Address:
City: State: ZIP:
Phone: - - Fax: - -
E-mail:
CCH license no.: •
Print name:
Signature:
• SUB-CONTRACTOR INFORMATION '
Name CC13 License# Phone Number - -
Electrical 5 /q -,/ 37s
Plumbing S / 1? _ 3'? G •
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Nlechanical 5'/v - 5f7 2
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