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Home My WebLink AboutPermit Building 2014-3-21 1 • • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 { Phone: 541-726-3753 Oa EGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00590 • www.springfield-or.gov permitcentert springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/21/2014 EXPIRES: 09/17/2014 STATUS DATE: 03/21/2014 APPLIED: 03/20/2014 SITE ADDRESS: 2470 G ST 1,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1703361106700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Dryrot and mist bldg envelope repairs OWNER: BASARABA DANIEL Phone Number: ADDRESS: 1233 KENRAY LOOP SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB• 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor HAROLD 8 MADISON INC CCB 168164 01/20/2016 541-688-3648 INSPECTIONS REQUIRED Inspections • 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1460 Insulation 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. 4111114111/ yz /Ay Owner or Contractor Signature Date NOTICE: ATTENTION: Oregon law requires you to' • follow rules adopted by the Oregon Utility Notification Center. These rules are setforth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Springfield Building Permit 3/21/2014 9:39:54AM Center IS 1-500-332-2344. Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD • k'S.L.40:9 225 Fifth St GON TRANSACTION RECEIPT Springfield,OR 97477 • 541-726-3753 811-S PR2014-00590 www.springfieid-or.gov 2470 G ST 1 permitcenter @springfieid-or.gay RECEIPT NO: 2014000607 RECORD NO:811-SPR2014-00590 DATE:03/21/2014 (DESCRIPTION -. _ _ : ..: : .ACCOUNTCODE/TRANS CODE AMOUNT DUE State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 30.66 Structural Building Permit Fee 224-00000-425602 1002 255.54 Technology fee(5%of permit total) 100-00000-425605 2099 12.78 TOTAL DUE: 298.98 t_PAYMENTTYPE: •PAYOR CASHIER:CCARPENTER. COMMENTS- • _AMOUNT PAID i 1 Check HAROLD&MADISON INC , 298.98 5080 TOTAL PAID: 298.98 • • • • • • :,Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY 4, a '! "'CITYOF S-PRINGFIELD'+ OREGON ° ,a;>x-r ;r`:; j+,. Permit no.: 5/L/ 00 J < 225 Fifth Street•Springfield.OR 97477•P11(541)726 3753•I Ah(54I)726-3689 '- OREGON Date: 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: , Q go j) Signature: (a)Job dcscripti• ,,,,,r This project has DItQ approval. I _ I ) Occupancy - • ,1✓t, tr u-- Signature. Date: • r Zoning approval verified: ❑ Yes ❑ No Construction type: c4- tc i v. — A-64- Property is within flood plain: ❑ Yes ❑ No . Square feet: / 1 L/Q CATEGORY OF CONSTRUCTION Cost per square foot: Ai -csidential ❑Government ❑Commercial Other information: I )12 54 ' gc, i 1+" 19 4-43 / J 'I .t JOB SITE INFORMATION AND LOCATION Type '(« J . C,e � Job site address: 2 V?0 tit 61 54 rz_a 4 Energy Path: City: 9 pt 3-? (J State: 0 K.. ZIP:9'75/7 ❑ new alteration III addition Subdivision: J Lot no.: (b) Foundation-only permit? ❑ Yes IVo Reference:1703 3 rnfaxlot: D 6 7 D O Total valuation:' $ /2, Soo PROPERTY OWNER 2. Building fees q S� Name: /4 ow'o ICS l'IR.Sie (a) Permit fee(use valuation table): $L—,S 5— Address: 2.0 SO (Zo olc t e_ t-I lC k oe( (h)Investigative fee(equal to 12aD): $ City: Tare-L.A.2 State: e2 ZIP:°!7-`(Ot (c) Reinspection($ per hour): $ �y �.. �O Fax: (number of hours x fee per hour) / Phone: Sy I — 5� - - 30 g‘ It mail: A a,o(e( 9 bv:t Let14A co v`S tt.�tCJ kS Cow (d)Enter 12%surcharge(.12 x 12a+26+2c1): $ JJJ3 (e) Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3. Han review fees Sign here: A-11--1:2217( (a) Plan review(65%( 0%permit fee permit e: $ (b)Fire and life safety(40%x permit fee pap: $ ❑'this installation is being made on residential or faun property owned by (c) Subtotal of fees above(3a and 3b): S nie or a member of my immediate tinnily.and is exempt from licensing 4. Miscellaneous fees requirements under ORS 70 1.010. u� (a) Seismic fee. I%(.01 x permit fee )2aO: S 1 2 78 CONTRACTOR INSTALLATION (b) luhnolo s Ice. 5/m OS x permit fee a $ Business name: "1'O"fAl,fees and surcharges(2e+3c+4a+4b): $ [S Q Q 8 Address: ( O City: . . State: ZIP: Phone: - - Fax: - - E-mail: . CC!) license no.: • Print name: Signature: SUB-CONTRACTOR INFORMATION - Name CCB License H Phone Number Electrical 1 Plumbing Mechanical • . Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: • Name CGS Expiration Date will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. /76t v0 62 j/Ue5- Print Name of Permit Applicant ydoeV- 3/i /K Signature of Permit Applicant Date Permit#: 7 5-'70 S`�l7 5-9`/ 52 F • Address: Jr Z477o -7 Q n&Z Issued by:C Date: 7/7///j/ 1859 This Copy for Permit Offices •