HomeMy WebLinkAboutPermit Fire 2014-4-23 I -
TSPRINGFIELD . -
- 225 Fifth St
• CITY OF SPRINGFIELD Springfeld,OR 97477
§ c_Phone: 541-726-3753
• OREGON Building / Commercial Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00809
www.spnngfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/23/2014 EXPIRES: 10/20/2014
. STATUS DATE: • 04/23/2014 APPLIED: 04/15/2014
SITE ADDRESS: 3198 GATEWAY ST,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703222002700 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Install new suppression system
OWNER: LEE FAR MAN Phone Number:
ADDRESS: 90790 COBURG RD
EUGENE OR 97408
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Fire Contractor UMPQUA VALLEY FIRE SERVICES INC CCB 179319 11/16/2015 541-229-0911
INSPECTIONS REQUIRED
Inspections
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 Iota -- - e front oft - •-rty, and the approved set of plans will remain on the site at all times during
construction.
4,_,, _,...„
Owner or ontractor Signature Date •
•
ATTENTION: Oregon law requires you to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone .ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•. Springfield Building Permit 4/23/2014 10:50:09AM - Page 1 of 1
•
;SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR 97477
" 'OREGON 541-726-3753
811-SPR2014-00809
www.springfield-or.gov 3198 GATEWAY ST permilcenter @spnngfeld-or gov
RECEIPT NO: 2014000897 RECORD NO:811-SPR2014-00809 DATE:04/23/2014
_ 5 iu-�•.as y - .q..r 1 r te_- -d _ _
F !O ,. �_� ��.r. � _ _�� _ , ..x��� __ACCOUNTdGOD i BRANS CODE=/a2lra•MOUNT DU
Admin fee(10%of applicable fees) 224-00000-426605 1098 12.00
Balance of$120.00 Minimum Fire Fee 100-00000-424002 9116 15.00
Percent of fire system bid/contract value(3%) 100-00000-424002 9116 105.00
TOTAL DUE: 132.00
_„ -E
It-PAYMENT-TYPE �'i�:PAYOR'•�-CASt11eR:.1LAR5oN +,�;-��.4#.'.GOMMENTS 4;�r..�,..,.���4'. ,tu, . 0 D."-„a`STi_..,:r...�--a.:.rJ-
Check UMPQUA VALLEY FIRE SERVICES It, 132.00
19637
TOTAL PAID: - 132.00