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Permit Building 2014-4-23
SPRINGFIELD 225 Fifth St hir CITY OF SPRINGFIELD Springfield,OR 97477 \`00.EGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00889 www.springfeld-or.gov pennitcenter©springfield-or gov • • PROJECT STATUS: Issued ISSUED: 04/23/2014 EXPIRES: 10/20/2014 • STATUS DATE: 04/23/2014 APPLIED: 04/23/2014 SITE ADDRESS: 730 SHASTA BLVD,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1803021203700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Roof alteration OWNER: RUSSELL CATHERINE MARY Phone Number: ADDRESS: 730 SHASTA BLVD SPRINGFIELD OR 97477 . CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor DAVID ZARZYCKI GENERAL CONTRACTOR INC CCB 105626 04/26/2015 541-688-0243 INSPECTIONS REQUIRED 1 • 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. Owner or Contra.. ;nature Date ATTENTION: Oregon law requires you to NOTICE: - . • -' follow rules adopted by the Oregon Utility ' Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT EIS NOT in OAR 952-001-0010 through CAR 952 001 1t e rules by FOR COMMENCED OR IS ABANDONED 0090. You may obtain copes or,„, D rn 1 ANY 180 DAY PERIOD •C nbe the center. (WY: c,;�n - '_RMIT SHALL EXPIRr IF THE WORK ;nume r for the nre. ;;r l CC,,,,;r Is 1-b10-3J= °""I' `!ZED UNDER THIS PERMIT IS NOT Springfield Building Permit.._.. . 4/23/2014 2:59:01PM ,:`-FD OR IS ABANDONED FOR Page 1 of1 • / Cid PERIOD. SPRINGFIELD -- CITY OF SPRINGFIELD I - 225 Fifth St � ` TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 OREGON 811-SPR2014-00889 . www.spdngfield-ar.gov 730 SHASTA BLVD permitcenter @spdngfield-or.gov RECEIPT NO: 2014000904 RECORD NO:811-SPR2014-00889 DATE:04/23/2014 isl '1tlitu cirsf"'if.LS6.. 7.- tF ` .:9'a_r- ,F _.-:if ia-'w-'ACCOUNTttODE/TRANSICODE. :_._ I'. AMOUNT DUE:A State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.51 ' Structural Building Permit Fee 224-00000-425602 1002 162.61 Technology fee(5%of permit total) 100-00000-425605 2099 8.13 TOTAL DUE: 190.25 tPAYMENTeTYP.E : BAY,OR CASwee:.ccARPENTeR COMMENTS _ AMOUNTLPAID - +ten Credit Card DAVID ZARZYCKI GENERAL 190.25 01590s CONTRACTOR INC TOTAL PAID: 190.25 Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY ' CITY OF SPRINGFIELD OREGON ':' . " >a- 'w f .. ,r�.—r Permit no.: � 7_60 �`J 225 Fifth Street•Springfield,OR 97477•P11(541)726-3753•FAX(541)726-3689 OREGON Date: 7/2 7/l / 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. I. Valuation information Signature: Date: (a)Job description: f // 7 iy✓-77c7z. _' This project has DEQ approval. l�q Occupancy >> Signature: Date: Zoning approval verified: ❑ Yes ❑ No Construction type:vr3 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 Heat: Job site address: 13 s» 1 Energy Path: City: o T t�I (,ar - I(SSttat-e: CC ZIP:M 417 ❑ new teration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? ❑ Yes ❑ No Reference: Taxlot: Total valuation: $//j( '' PROPERTY OWNER ,`` �K ' 2. Building fees !' Name: 1�1 4�L� R i k%- 44 + VIV(S f (a) Permit fee(use valuation table): $//-2 ‘c Address: eft - (b)Investigative fee(equal to pal): $ 4� City: State: ZIP: (c) Reinspection($ per hour): �ris_21.32 (number of hours x fee per hour) $ • Phone: Pax: - - L'-mail: (d)Enter 12%surcharge(.12 x j2a+2b+2cj): $ LI s,�- (e) Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3. Plan review fees t (a) Plan review(65%x permit fee pap: $ Sign here: : id (b)Fire and life safety(40%x permit fee Pap: S ❑'Phis installation is heirs- t c on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): I 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, I%(.01-x permit fee pap: -$ CONTRACTOR INSTALLATION q (b)Technology fee. 5%(.05 x permit fccj 2ul): $�(/ Business name: 1;�„old24fl■(Che (Cm 4 (het. tom/ �- L�Yf/I(- 1 TOTAL fees and surcharges(2e+3e+4a+4b): S `t)Z Address: s City: � /�j�p� State: ZIP:) 4- Phone:� th_om_ Fax: -441.—O tell E-mail: d irycZely v4 dc—t & .3 ma;( , C.C1m CCI3 license no.: Lon 02 o Print name: U")Avit 7AP k Signature: t SUB- T ACTOR INFORMATION' Name CCB License# Phone Number Electrical Plumbing Mechanical