HomeMy WebLinkAboutPermit Building 2014-4-1 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
1 S`; eco Phone: 541-726-3753
Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00704
www.springfieldocgov permitcenter @springfield-or.gov
PROJECT STATUS: Issued • ISSUED: • 04/01/2014 EXPIRES: 09/28/2014
STATUS DATE: 04/01/2014 APPLIED: 04/01/2014
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SITE ADDRESS: 1025 56TH PL,Springfield,OR 97478 SCOPE: Garage Conversion
ASSESOR'S PARCEL NO: 1702331108500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Garage Conversion
OWNER: LITSTER DAVID W 8 LINDA K Phone Number:
ADDRESS: 1025 NO 56TH PL
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type - Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER GCB 000000 08/01/2025
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.
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Owner or Contractor Signature • Date •
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility . NOTICE:
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
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Springfield Building Permit 4/1/2014 1:31:06PM Page 1 of 1 ,
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SPRINGFIELD' - - CITY OF SPRINGFIELD
TRANSACTION RECEIPT
225 Fifth
541-726-3753
OREGON 811-SPR2014-00704
www.springfield-ar.gov 1025 56TH PL - permitcenter @springfeld-or.gov
RECEIPT NO: 2014000708 RECORD NO: 811SPR2014-00704 DATE:04/01/2014
.. _ _ =emu -..,�
L�i.,�,k-��i_ :_*�,_.?,�.`",=a� l;�a�`a-�-'ACCOUN?: o o e;; ;, CODE � 2_"AMOUNT�DUE tyr
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
P,AY,MENT4TWO:E ;r PAYOR CASMERF ie ON- OOMMENTS - 'AMOUNTAPAID
Check LITSTER DAVID W& LINDA K • 93.60
11262
TOTAL PAID: 93.60
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF SPRINGFIELD, A., r „Q � Ir- ; .�; Permit no.:
225 Filth Street•Springfield,OR 97477•P11(541)726-3753 FAX(541)726-3689♦ AX(541)726-3689 OREGON >/g
1 '7 ily 090'1
Date: y ///, 7
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: t /'
(.)Job description: GQ/E.;{P �P77.,e/Seo9
This project has DEQ approval.
Occupancy
Signature:
Date:
Zoning approval verified: ❑ Yes ❑ No Construction type:
Property is within flood plain: ❑ Yes ❑ No Square feet:
�,� CATEGORY OF CONSTRUCTION Cost per square foot:E esidential ❑Government ❑Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of llcat:
Job site address: l0„2 r.56t /�/a e Energy Path:
City: �pr/i9L4^ft/e/� State: �/ 1ZIP:9174/7 ❑ new ❑alteration ❑ addition
Subdivision: ��JJ Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No
Reference: Taxloc Total valuation: $ Z7
• PROPERTY OWNER 2. Building fees
Name: ,l 7,a L/0 tJ - , (31-42R (a) Permit fee(use valuation table): $
Address: /v a ,S-, 75 4 t-4 (b) Investigative fee(equal to 12a1): $
City: SipoC/-I StattgP ZIP97q''gg (c) Reinspection(S per hour):
Phone: L//- 7e1/-/03`e Fax: - (number of hours x fee per hour)
,5
E-mail: (d)Enter 12%surcharge(.12 x 12a+2b+2c1): $
(e) Subtotal of fees above(2a through 2d):
Building Owner or Owner's agent authorizing this application: 3. Plan review fees
(a) Plan review(65%x permit fee 12a)): $
Sign here r � (b)Fire and life safety(40%x permit fee [2a1): $
['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. 1%(.01 x permit fee[2aj): $
CONTRACTOR INSTALLATION
(b)Technology fee.5°U(.05 x permit feel2al): $
Business name: .wyJ� I
/,/ TOTAL fees and surcharges(2e+3c+4a+4b): S �f j
Address: ' I c -
City: �.(/J "" -� State: ZIP:
Phone: - - Fax: - -
E-mail:
CCI3 license no.:
Print name:
Signature: OJ74,1
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'°SUB-CONTRACTOR INFORMATION'
Name CCB License it Phone Number
Electrical
Plumbing
Mechanical