HomeMy WebLinkAboutPermit Fire 2014-4-7 •
SPRINGFIELD - 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
;=.g Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00735
www.springfield-orgov permitcenter @springfield-ar.gov
PROJECT STATUS: Issued ISSUED: 04/07/2014 EXPIRES: 10/04/2014
STATUS DATE: 04/07/2014 APPLIED: 04/07/2014
SITE ADDRESS: 1120 FAIRVIEW DR,SPC#45,Springfield,OR 97477 SCOPE: Fire Damage
ASSESOR'S PARCEL NO: 1703273100600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Fire damage repairs
OWNER: NOVACOFF BRANDON Phone Number:
ADDRESS: 1120 FAIRVIEW DR SPACE 45
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER COB 000000 08/01/2025
•
_ INSPECTIONS REQUIRED b
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. /
•
�1�rN��, a- EsLQ to O (-1 ! b 6 �/9
Owner or Contractor Signature Date
•
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT nooAR 952-001 0010 through OAR 952-001-
COMMENCED OR IS-ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 4/7/2014 11:27:18AM Page-1 of 1
•
SPRINGFIELD—"- CITY OF SPRINGFIELD
_ 225 Fifth St
'R'i`o��o TRANSACTION RECEIPT Spnngfiatd,OR 97477
541-726-3753
811-SPR2014-00735
wwwspringeeld-or.gay 1120 FAIRVIEW DR. SPC 45 permitcenter @spdngfietd-ar.gov
RECEIPT NO: 2014000744 RECORD NO: 811SPR2014-00735 DATE:04/07/2014
DESCRIPTION ' taVni ga 'sera.` trACCOUNTCODE/TRANSCODEI a l+s-3 ei''. AMOUNT DUEL,
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
� - y,} TOTAL DUE: 93.60
g+ r''-AY,MENTutgl:F :i`:. IEA raikraSHIERrCCARPEN7ERGyt;¢ obrAlikrIt! ''re'r'n", Ver i.?.s AMQUNT4PAID,R„
Cash MEDINA 93.60
TOTAL PAID: 93.60
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
< 1.1
CITY OF SPRINGFIELD• OREGON.: tX.41. z
1 71/4
Permit no.
225 Filth Street•Springfield,OR 97477•PH(541)726 3753•FAX(541)72( 3689 OREGON
Date: 17/7/ / V
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issu nee 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: 7yy, t4 C ...e&79/9n..../
(a)Job description: � /'�/ I'f^
This project has DEQ approval.
Occupancy
Signature: Date:
Zoning approval verified: ❑ Yes ❑No Construction type://
Property is within Rood plain: ❑ Yes ❑No Square feet:
,,,,,--iiiff,,,,,'''' CATEGORY OF, CONSTRUCTION Cost per square foot:
+Residential ❑Government ❑Commercial Other inlin'mation:
1 JOB SITE INFORMATION AND LOCATION Type of Ilcat:
Jobsiteaddress: i 120 W . c comm el") Dn. . 5fc.Q� Energy Path:
• City: _sea,NfoFlElb 1 State: Oil • ZIP:9)-(.1P [I]new Oaken-don ion ❑addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No
Reference: 7axloC Total valuation: $ e-ixer
'PROPERTY OWNER ' -•, 2. Building fees'
Name: Lug Tits N e D nvA IN 1$,F • (a)Permit fee(use valuation table): $
Address: Litiki 0A1S 1/44 ST. tl-lc1 (b)Investigative fee(equal to 12x1): $
City: Sp o(n r(-J/‘•[e 1 State: Q n 7_IP: ��cl{� (c)12einspection($ per hour):
Phone:c5,40�2 - 1{20 Fax: - -
(number of hours x fee per hour) $
E-mail: (d)Enter 120,0 surcharge(.12 x pa'2h 2c�): $
(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 12x1): $
Sign here. ) Loren A �•-�CP 1 r\ (b)Fire and life safety(40%x permit fee 12x1): $
❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $
me or a member of my immediate family,and is exempt from licensing 4.Miscellaneous fees
requirements under OI2S 701.010.
(a) Seismic lee. 1%(.01 x permit lee Pal): $
•- CONTRACTOR'INSTALLATION 6 lechnolo�S l'ee 5/(.OSs permit fee 2a $
O 6.' ° P I)
Business name: t '
Nb7•.— I'O'I)V,fees and surcharges(2e+3e+4a+4b): S 95.et°
Address: r-{Gj .1-- AISM c 1 . ,IJ:q • •
City: CO2 /1.3 erLCLt-) State: rt2 ZIP:9;1-19LS
Phone:591-232- (nog Fax: - -
CCB CB license no.:
Print name: 1, 0 r r c t-k. -ci■ ✓l a
Signature: L. ox-ev\q ltA eat ry0,
.' SUB CONTRACTOR INFORMATION-
Name CCI3 License tt Phone Number
Electrical 5
n
Plumbing
Mechanical
•