HomeMy WebLinkAboutPermit Building 2014-4-17 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
. PERMIT NO: 811-SPR2014-00837
www.springfield-or.gov perm itcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/17/2014 EXPIRES: 10/14/2014
STATUS DATE: 04/17/2014 APPLIED: 04/17/2014
SITE ADDRESS: 1455 S 58TH ST,Springfield,OR 97478 SCOPE: Fire Damage
ASSESOR'S PARCEL NO: 1802033200900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Fire restoration
OWNER: WHITNEY MICHAEL M JR&SAREN L Phone Number:
ADDRESS: 1455 S 58TH ST
SPRINGFIELD OR 97478
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor PACIFIC FIRE&FLOOD INC CCB • 173615 12/28/2014 541-726-5896
INSPECTIONS REQUIRED
Il
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1430 Insulation Wall Wall Insulation: Prior to cover.
1440 Insulation Ceiling Ceiling Insulation: Prior to cover.
1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum
board, interior and exterior are in place, but prior to plastering.
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.
4 -eytri "-I? P-fil
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
NOTICE: in OAR 952-001-0010 hough 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).
Springfield Building Permit 4/17/2014 9:37:26AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
OREGON TRANSACTION RECEIPT Springfiem,oR97477
541-726-3753
811-S PR2014-00837
www.springfield-or.gov 1455 S 58TH ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000841 RECORD NO:811-SPR2014-00837 DATE:04/17/2014
tDESCRIPTION __ __:_ _��_. , _r__� ,._. _,_ACCOUNT-CODE/TRAN&CODE _ ' AMOUNT DUE
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 63.20
Structural Building Permit Fee 224-00000-425602 1002 526.66
Technology fee (5%of permit total) 100-00000-425605 2099 26.33
TOTAL DUE: 616.19
LFAYMENT TYPE_^PAYOR„,_CASHIER CCARPENTER COMMENTS. ' ,° j ; AMOUNTPAID.
Check PACIFIC FIRE& FLOOD INC 616.19
1251
TOTAL PAID: 616.19
•
•
Staucturi al Permit Application SPRINGFIELD-- DEPARTMENT USE ONLY
CITY OF SPRINGFIELD, OREGON 'F ti 't,j' s;C '�% Permit no 5t'- '7
225 Fifth Street•Springfield,OR 97477•1111541)726-3753•FAX(541)726-3689 OREGON
Date: 44//7//il
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i nce or if work is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
This project has final land-use approval. 1. Valuation information
Signature: n
Date: (a)Job description: /LE , ^.- ir`-77 07.--•
'this project has DEQ approval. _ 72..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: •
71,2esidential ❑Government ❑Commercial Other information:
' JOB SITE INFORMATION AND LOCATION Type of Ileac
Job site address: I4 SS c 4% Energy Path:
City: Spn.r- 4 State: ce ZIP:'/7ry7.- ❑ new ❑alt ir
fm ❑addition
Subdivisioln: �^ Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No
Reference: /po2 01572-4iixIoe 09500 Total valuation: $5-- Q,Yy
PROPERTY OWNER - 2. Building fees
Name: �'7ikze C01,10.n.e7 (a) Permit fee(use valuation table): S (p
Address: 7I'ISS S t'?4+ (b) Investigative fee(equal to Pal): $
City: 9pr (� State: O,O ZIP:7fl (c) Reinspection(S per hour): $
Phone: 00 Pas: - - (number of hours x fee per hour)
(s'n) La- `fs{So
• E-mail: (d)Enter 12%surcharge(.12 x j2a+2b+2c]): $ / Z
(e) Subtotal of fees above(2a through 2d): S Ott''
Building Owner or Owner's agent authorizing this application: 3. Plan review fees
(a) Plan review(65%x permit fee I2a]): $
Sign here: - - —" (h)Fire and life safety(40%x permit fee[2a)): $
i
['This installation is eing 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. o
(a) Seismic fee, I%(.01 x permit fee[2a]): $
. CONTRACTOR INSTALLATION o y�l
p p (b)Technology fee,5/u(.05 x permit fee[2aj): $
_Business name: •Frye/42.. /4-,..--r a-,..1 Peer, / I
TOTAL fees and surcharges(2e+3c+4a+4b): S / ........_---
Address: Hy c)4, 5-
City: 5/0 / CC ZIP: ?7y97
Phone:5w-724- -.616 Fax: - -
E-mail: 57-y&tee€i it ii.,-.0.,,,,,e/c.c./.. e.Airy,
CCB license no.: )73675
Print-name: L-,.,,,+ , /a s A
Signature: 6 � eC
SUB-CONTRACTOR INFORMATION
Name CCB License# Phone Number
Electrical
Plumbing
:Mechanical