HomeMy WebLinkAboutPermit Building 2014-4-30 SPRINGFIELD 225 Fifth St
:'_' CITY OF SPRINGFIELD Springfield,OR 97477
" `'=' C Phone: 541-726-3753
I.. ' OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00161
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/30/2014 EXPIRES: 10/27/2014
STATUS DATE: 04/30/2014 APPLIED: 01/27/2014
SITE ADDRESS: 868 6TH ST,Springfield,OR 97477 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1703352101200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New/relocated windows,infill existing window,add fireplace: Historic(minor)review
required per J.D.
OWNER: GOOD MARILOU Phone Number:
ADDRESS: 868 6TH ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
• INSPECTIONS REQUIRED
Inspections •
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved. _
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.
3D 2,0
Owner or Contractor Signal Dat-
Oregon law requires you to
ATTENTION:
the Oregon Utility
•
NOTICE: follow rules adopted hY h OAR 952.001-
PERMIT IS ORK Notification pp1ter. through are set ley Those
THIS PERMIT SHALL EXPIRE IF THE WORK In OAR ies of the rules by
AUTHORIZED UNDER THIS you may obtain cop telephone
COMMENCED OR IS ABANDONED FOR
0090.alling the center. (o�tUti�tly Notifification
ANY 180 DAY PERIOD. number for center goo-332.2344).
Springfield Building Permit 4/30/2014 2:32:00PM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
hrs1'.i +� 225 Fifth 5t
� ; TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-SPR2014-00161
www.springtield-or.gov 868 6TH ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000960 RECORD NO: 811-SPR2014-00161 DATE:04/30/2014
,DESCRIPTION_ _ _ __,_ _ __ ___. _ :. __ ACCOUNT CODE/TRANS_CODE __ , __ _ ,AMOUNT DUE .,-
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
-1 AMOUNT PAID -
�__PAYMENT TYPEj,,,_�PAYOR__casxieR:ccnRPENrEa.T ^_ _COMMENTS_,, __ __ -_ _,___ _ -_ __:,,�__
Credit Card GOOD MARILOU 93.60
00162c
TOTAL PAID: 93.60
•
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OF SPRINGFIELD OREGON I: 'kit,;�_ 7. 6� Permit no.: 5,t/ _ /&/
225 Fifth Street•Springfield,OR 97477•P11(541)726 3753•FAX(541)726 3689 OREGON 1
Date: //Z 7//y
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: (a) Job description: //✓POt✓ ///��� ZOC4
oo kr
This project has DEQ approval.
Occupancy 3
Signature: Date:
Zoning approval verified: ❑ Yes ❑ No Construction type: J ,
Property is within flood plain: ❑ Yes ❑ No Square feet:
CATEGORY OF CONSTRUCTION Cost per square foot:
AResidential El Government ['Commercial Other information:
JOB SITE INFORMATION AND LOCATION Type of I teat:
Job site address: d 9,}fait* Energy Path:
City: ���//jj n A A 1 State:C ZIP:1 4-17 - El new U:f(teration ❑ addition
Subdivisio'h S f tate
I lot no.: (b)Foundation-only permit? ❑ Yes INKfo
Reference: 1 703 3 S Zl Taxlot: D ( Zoo Total valuation: $
PROPERTY OWNER 2. Building fees y_
Name: Mart 1 o & clo (a) Permit fee(use valuation table): $ 01)
Address: 9 t (ft= (b)Investigative fee(equal to 12a1): $
City: t n n cj Q 1a- State: 3 I ZIP: 49-4 (c) Reinspection($ per hour): $
C\ (number of hours x fee per hour)
Phone: � 'Lj y4-- 5j7 Fax: - -
E:mail: �j d D fit-tea✓c ,• ��� • t�, (d)Enter l2°/a surcharge(.12 x �2a�26+2c�): $tak h 6\"I (e) Subtotal of fees above(2a through 2d): S
Building caner or Owner's agent aut oriring this application: 3. Plan review fees
` �( (a) Plan review(65%x permit fee(tap: $
Sign hert:--� "� (b)Fire and life safety(40%x permit fee 12a1): $
❑This installation is being made on residential or lunn 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 fcc. I%(.01 x permit fee 120: S
CONTRACTOR INSTALLATION
(b)Technology fee. 5%(.05 x permit fee t2t I) $
. Business name: ,LI s 1,e_ 1-1.x✓r12✓
TOTAL fees and surcharges(2e+3c+4a+4b): S ---7
Address:
City: State: ZIP:
Phone: SLR c{33 Zbbo Fax: - - ft •
E-mail: (C1.�!� .1(k `
CCB license no.: �N n
Print name: )tkP Tttir n 2e— 1
Signature:
, "SUB-CONTRACTOR INFORMATION - '
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical