HomeMy WebLinkAboutPermit Building 2014-4-21 SPRINGFIELD= 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
e: ( Phone: 541-726-3753
OReGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00867
www.Springfield-or,gov permitce nter@s pringtield-or.gov
PROJECT STATUS: Issued ISSUED: 04/21/2014 EXPIRES: 10/18/2014
STATUS DATE: 04/21/2014 APPLIED: 04/21/2014
SITE ADDRESS: 6901 JESSICA DR,Springfield,OR 97478 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1802022603200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Tree damage repairs
OWNER: CHASE RONALD C&SANDRA K Phone Number:
ADDRESS: 6901 JESSICA DR
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor EHLERS CONSTRUCTION INC CCB 4231 11/19/2014 541-689-6177
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved. -
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.
N— z/—,
Owner or Contractor Signature Date •
kTTENTION: Oregon law requires you to
Mow rules adopted by the Oregon Utility r-: •
Itification Center. Those rules are set forth S PERMIT SHALL EXPIRE IF THE WORK
OAR 952-001-0010 through OAR 952-001-
90. You may obtain copies of the rules by 1 HORIZED UNDER THIS PERMIT IS NOT
;ailing the center. (Note: the telephone AMENDED OR IS ABANDONED FOR
umber for the Oregon Utility Notification I`( 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 4/21/2014 1:47:08PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
'Ii ..t__ 225 Fifth St
`� TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-S P R2014-00867
www.springfield-or.gov 6901 JESSICA DR permitcenter @springfield-ar.gov
RECEIPT NO: 2014000875 RECORD NO: 811-SPR2014-00867 DATE:04/21/2014
'DESCRIPTION_ ' `__-_,.:__ _ACCOUNT CODE/TRANS CODE:;-;.-,;:. ,:_`;,,AMOUNT, DUE
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 34.38
Structural Building Permit Fee 224-00000-425602 1002 286.52
Technology fee(5%of permit total) 100-00000-425605 2099 14.33
TOTAL DUE: 335.23
LPAYMENTTYPE -- PAYORCASNIER:ccARPENTER COMMENTS =' _. - • AMOUNT PAID ' +t
Check OILERS CONSTRUCTION INC - 335.23
2131
TOTAL PAID: 335.23
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•
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF-SPRINGFIELD, OREGON 7 '#" /�x %r 1 OREGON Permit no.:5/) tf �ll/i 7
225 Fifth Streets Springfield,OR 97477•P11(541)726-3753•FAX(541)726-3689
Date: yn///y
• This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i suance or if work is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
This project has final land-use approval. I. Valuation information
Signature:
Dale: (a)Job description: ?L,, p�_A�_7 /Anti As
This project has DE()approval. rl°r !_
Signature: Date: Occupancy ///
l •
Zoning approval verified: ❑ Yes ❑No Construction type
Property is within flood plain: ❑ Yes ❑No Square feet:
• CATEGORY OF CONSTRUCTION ' Cost per square foot:
❑ Residential ❑ Government ❑Commercial Other information: •
' JOB SITE INFORMATION AND LOCATION Type of lleat:
Job site address: (`20/ �/f.f-S,eA AiG. Energy Path:
City: C/• /,.i6F/eL12 State: 32 y new Rnitcration ❑ addition
Subdivision: FIT.ot no.: (b)Foundation-only permit? ❑ Yes Ern-C)
Referenc/ 2 t) Taxlot: 672,60 Total valuation: $_72- 2O
PROPERTY OWNER - 2. Building fees
�p��S)-
Name: I�.o../ � ,Sv9Np,iao G/Ji4J�- (a) Permit Ice(use valuation table): $ 6(X7
Address: 5 Arvt.f- • (b)Investigative fee(equal to[2a]): $
City: State: ZIP: (c) Reinspection($ per hour):
Phone: Se/7- r Y Fax: - - (number of hours x lee per hour)
7iv - 7' -
B-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2cj): $3 y 3Y
(c) Subtotal of fees above(2a through 2d): S
Building Owner or Owner's agent authorizing this application: 3. Plan review fees
�NGFZJ &NS>WvLTt�.✓
(u) Plan review(65%x permit fee Pal):
Sign here: x 1 042-tJ 3Lv ' (b)Fire and life safety(40%X permit fee 12111):
❑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 12aI): $
CONTRACTOR INSTALLATION
(b)Technology lee, 5°/u(.05 x permit fee[2aI): $
Business name: �/'/LtnJ Ce:..s-✓i-��Tt.�.-r '2 S
TOTA I,fees and surcharges(2e+3c+4a+4b): S
Address: /UJ ' /NAriL"va f t
City: s0.tI&612 EGD State: O(t-- /_IP:17yp_$
Phone:SY/-4,n 4/-77 Fax: - -
E-mail: eit/e,-J Q eAte,-f ih
CCB license no.: y2 3/
Print name: Ciipzis
Signature: d L
SUB-CONTRACTOR INFORMATION
Name CCI) license N Phone Number
Electrical
Plumbing
•
Mechanical
•