HomeMy WebLinkAboutPermit Building 2014-4-16 a`Il
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
C �ar - Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00824
www.springfield-ocgov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/16/2014 EXPIRES: 10/13/2014
STATUS DATE: 04/16/2014 APPLIED:• 04/16/2014
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SITE ADDRESS: 820 S 55TH PL,Springfield,OR 97478 SCOPE: Miscellaneous
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ASSESOR'S PARCEL NO: 1802041101200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Small retaining wall with minor surcharge
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OWNER: COLEMAN TAMMARA A&SANDEFUR MARKS Phone Number:
ADDRESS: 820 S 55TH PL •
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB 000000 06/01/2025
INSPECTIONS REQUIRED
•Inspections
1190 Retaining Wall
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 al equired inspections are requested at the proper time, that each address is readable from the street,that the
permit c. d is I. :fed . - • ont of the property, and the approved set of plans will remain on the site at all times during
cons Au ion.
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O ner .r Contr. for SI.. Date
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ATTENTION: Oregon law requires you to
NOTICE: follow rules adopted by the Oregon Utility
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THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth.
in OAR 2
AUTHORIZED UNDER THIS PERMIT IS NOT
0090. Y You may obtain copies of t O
the rulesby
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
number 180 DAY PERIOD. g
er for the Oregon Utility Notification
Center is 1-800-332-2344).
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Springfield Building Permit 4/16/2014 11:46:15AM Page 1 of 1
SPRINGFIELD -- CITY OF SPRINGFIELD
a:1 As. 225 Fitch St
rrt0 EGON TRANSACTION RECEIPT Springfield,OR 97477
;`y. 541-726-3753
811-SPR2014-00824
www.springfield-or.gov 820 S 55TH PL permitcenter @springfield-or.gov
RECEIPT NO: 2014000828 RECORD NO:811-SPR2014-00824 DATE:04/16/2014
DESCRIPTION_ _ --2_ _ ' .. ACCOUNTCODE/TRANSCODE_ . ,_^ _.,AMOUNTDUE;.J
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
,PAYMENT TYPE__ PAYOR CASHIER:ccARPENiER , COMMENTS _ _ _
- ' AMOUNTPAI _D _ - ': i
Cash - COLEMAN M
TAMARA EF
A& SANDUI - 93.60
MARK S
TOTAL PAID: 93.60
Structural Permit Application • SPRINGFIELD ' DEPARTMENT USE ONLY
CITY OF SPRINGFIELD OREGON 'z( .: `.4 Permit no u
225Jfifth Street•Springfield.OR 97477•PH(541)726-3753•I AX(541)72G 3689 '- -- OREGON S� ( _ �2
• Date: 47//6,,fiy
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: P i 4047iL/Ns' /.r./`/_
(a) lob dcscri non:
"Phis project has DL'Q approval.
Occupancy t&
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:
4IResidential ❑ Government ❑ Commercial Other information:
JOB SITE INFORMATION AND LOCATION , Type of Beat:
Job site address: 3 _O S. 5.5 ill PL Energy Path:
City: SPFLt) State: 02 ZIP:176/}e ❑new ❑alteration ❑ addition
Subdivision: IZOyA I R-+41t Lot no.: , (b)Foundation-only permit? ❑ Yes ❑ No
Reference: Taxlot: Total valuation: jCQ
PROPERTY OWNER 2. Building fees
Name: MA R-/c SANdegv- (a) Permit fee(use valuation table): $ U(/ d
Address: nap � S. 5 6}t' Pt (b) Investigative fee(equal to 12a)): $
City: �P P12 -- .3-ELi) StateFat ZIP: / Sq ?-8 (e) Reinspcetion($ per hour):
Phone: 5 /- 3 A-1-A - (number of hours.x fee per hour) $
� � �c - /3 3 Fax:
F-7,- (d)Enter 12%surcharge(.12 x 12a+2b+2ep: $ 9€°_—
E-mail: re Mv-v, k¢7 9 @ µSN ,Co.-t ,
(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 lee I2aD): ' S
Sign here: (b)Fire and life safety(40%x permit fee (2ak): $
❑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 fancily,and is exempt from licensing 4, Miscellaneous fees
requirements under ORS 701.010.
(a) Seismic fee, I%n (.01 x permit fee[2a1): $
`
CONTRACTOR INSTALLATION . J
(b)Technology fee.5%(.05 x permit fee)2aJ): $ 11?-=
Business name: ^�
� — TOTAL fees and surcharges(2e+3c+4a+4b): S '2
Address: - -
City: State: ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
SUB-CONTRACTOR INFORMATION
Name CC13 License p Phone Number
Electrical
Plumbing
Mechanical