HomeMy WebLinkAboutPermit Building 2013-12-3 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
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�`oa¢ooiv Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02600
www.springfield-or.gov permitcenter @spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 12/03/2013 EXPIRES: 06/01/2014
STATUS DATE: 12/03/2013 APPLIED: 12/03/2013
SITE ADDRESS: 2001 7TH ST,Springfield,OR 97477 SCOPE: Garage Conversion
ASSESOR'S PARCEL NO: 1703261301400 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Permits for bathroom and garage conversion by proir owner
OWNER: SELCO COMMUNITY CREDIT UNION Phone Number:
ADDRESS: PO BOX 7487 ..
SPRINGFIELD OR 97475
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
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INSPECTIONS REQUIRED
Inspections
1220 Underfloor framing
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1410 Underfloor insulation
1420 Insulation Vapor Barrier
1430 Insulation Wall Wall Insulation: Prior to cover.
1440 Insulation Ceiling Ceiling Insulation: Prior to cover.
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
ATTENTION: Oregon law he es u t2/
NOTICE: follow rules adopted by Oregon
Not fication Center. Those rules are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK • fn OAR 952-001-0010 through OAR 952-0 b
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain COP ies of the rules by
SpringfieI Butldl g1Per`l cED OR IS ABANDONED FOR 12/3/2013 4:01:21PM calling the center. (Note: the telephone
ANY 180 DAY PERIOD. number ton the Oregon Ut2ity 44tificzPay@ 1 of 1
Center is 1-800-332-2344).
. SPRINGFIELD CITY OF SPRINGFIELD
l .man,., 225 Fifth St
E�oN TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SPR2013-02600
• www.spdngfield-ar.gov 2001 7TH ST permitcenler @spnngfield-or.gov
RECEIPT NO: 2013002595 RECORD NO:811-SPR2013-02600 DATE: 12/03/2013
!e1 •�(;1 ill: .1-' +. _c z _`-ACCOUNT.CODE/TRANSYo[olo] ;.F nAMOUNT
DUES'
SDC: Improvement Cost-Local Wastewater - 443-00000-448025 1184 278.56
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 570.72
SDC: Total Sewer Administration Fee 719-00000-426604 1175 42.46
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: 985.34
�`-PAYMENTtiIYFE P.AYOR cgsRIER:ecARP.ERrER. COMMENTS - AMOUNT'P,AID
Credit Card Daren Roberts 985.34
029546
TOTAL PAID: 985.34
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Structural Permit Application SPRINGFIELD PDnEPAoRTME� USE ONLY rw,CITY OF SPRINGFIELD, OREGON S GOO
225 Fifth Street•Springfield,OR 97477•P1I(541)726-3753•FAX(541)726-3689
Date: /Z j 3 (/:52
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 APPRO VAL _ Plumbing //
This project has final land-use approval. 517 -- 2 K3-i'�
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Signature: Date: Mechanical
This project has DEQ approval.
Signature: Date:
Zoning approval verified: El Yes ❑ No ;'FEE SCHEDULE 'r,r0,l, r ' 1'
Property is within flood plain: ❑ Yes ❑ No 1.Valuation information r
CATEGORY OF CONSTRUCTION (a)Job description: A9D V-17( q Ct "t- (lvly v_ I
-0Residential ❑Government ❑Commercial Occupancy) (R(Ow`o-urt— -
JOB SITE INFORMATION AND LOCATION Construction type: w/s /9/141-)
Job site address: 2001 1 7 7V3 `5-.Ge_f Square feet:
City: Spr t Cie(d I Slate: O2 ZIP:9-N-1`i Cost per square foot:
Subdivision: J Lot no.: Other information:
Reference:T/4#-0?1503$ I Taxlot: c)1400 Type of Heat:
PROPERTY"RTY OWNER
_ - - Energy Path:
Name: SbLC 0 ❑new ❑alt re anon
❑ addition
Address: Q,0 , C3o74 -7-1{g-; (b)Foundation-only permit? ❑ Yes ❑No
City: ,�C State: 642 ZIP:911-115 Total valuation: $ 'pQ�
Phone: Fax: - - . .. . _. .. ,
2 Building fees,
E-mail: dare G✓ -{-re3 re C.) • C c e (a) Permit fee(use valuation table): $ Oj-
Building Owner or Owner's agent authorizin this application: (b)Investigative fee(equal to[2a]): $
(c)(number of ($ per hour): $
(number of hours x fee per hour)
Sign here:
' (d)Enter 12%surcharge(.12 x 12a+2b+2c]): $ @3%
❑This installation is being lade on residential or farm property owned by
me or a member of my immedt to family,and is exempt from licensing (e)Subtotal of fees above(2a through 2d): S
requirements under ORS 701.010. 3. Plan'review fees
' (a) Plan review(65%.x permit fee[2a]): $
;,[ ,C,ONTRACTORINSTALLATIOtJ ;
Business name: (b)Fire and life safety(40%x permit fee[2a]): $
Address: (e)Subtotal of fees above(3a and 3b): S
City: State: ZIP: 4. Miscellaneous fees ,
Phone: - - Fax: - _ (a) Seismic fee. I%(.01 x permit fee [2a]): $
E-mail: (b)Technology fee,5%(.05 x permit fee[2a]): $ /7,e—
CCB license no: TOTAL Tees and surcharges(2e+3c+4a+46): S 6
Print name:
Signature: COY\ —CA
SUB-CONTRACTOR-INFORMATION u rr r 2a r1-S\ t"\PP
Name CC13 License 4 Phone Number t v ' 'et-L\ --- e-,..e. E5\-z.\-e
Electrical
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