HomeMy WebLinkAboutPermit Building 2014-5-20 I '
6PRINGFIELD ' 225 Fifth St r),- J �. 9
CITY OF SPRINGFIELD Springfield,OR 974 6'fif fI
OREGON Phone: 541-726-3753 • •Z
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Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01108
v ww.sprtngfield-or.gov - permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/20/2014 EXPIRES: 11/15/2014
STATUS DATE: 05/20/2014 APPLIED: 05/20/2014
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SITE ADDRESS: 1003 S 69TH ST,Springfield,OR 97478 SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1802022307800 TYPE OF STRUCTURE: Residential
•
PROJECT DESCRIPTION: S-Finish basement,add bathroom •
OWNER: _ DEMERS LOUIS R 8 JANET A Phone Number:
ADDRESS: 1003 S 69TH ST
SPRINGFIELD OR 97478
•
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor MICHAEL ALAN BROWN CCB 164093 04/07/2015 541-536-7960
General Contractor LOWES WEATHERIZATION INC CCB - 176741 06/19/2015 541-485-2282
Mechanical Contractor LOWES WEATHERIZATION INC CCB 176741 06/19/2015 541-485-2282
BC ELECTRIC CO CCB 66799 06/04/2016 541-998-3736
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.
Owner Contractor Signature Date K
•
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NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
N'ctification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in oAR 952-ooi-oolo through 6AFi 952-001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 5/20/2014 11:49:56AM Page 1 of 1
t
SPRINGFIELD - CITY OF SPRINGFIELD
:14 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
OREGON 541-726-3753
811-S P R2014-01108
vnvw.springfield-or.gov 1003 S 69TH ST pennitcenter @springfield-or.gov
RECEIPT NO: 2014001104 RECORD NO:811-SPR2014-01108 DATE:05/20/2014
(DESCRIPTION..,, -. ,_ _.-..ACCOUNT CODE/TRANS CODE :_.:: m' ,AMOUNT DUE__1
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 557.12
SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 1,141.44
SDC:Total Sewer Administration Fee 719-00000-426604 1175 84.93
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 42.76
Structural Building Permit Fee 224-00000-425602 1002 356.33
Technology fee(5%of permit total) 100-00000-425605 2099 17.82
TOTAL DUE: 2,200.40
PAYMENT TYPE PAYOR CASHIER:CCAaPENTER. ' COMMENTS . .-AMOUNT PAID
Check Bent Nail Enterprises 2,200.40
2043
TOTAL PAID: 2,200.40
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
}rt CITY OF SPRINGFIELD OREGON , - �f :i'•*. 4,'- Permit no.: _/) �C{
-_. OREGON �// / /OC/
225 Fifth Street♦Springfield.OR 97477•PH(541)726-3753•FAX(541)726-3689 7
Date: c/z d//7
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:
This project has DEQ approval. ft JvtS t"I �itl^-�t'✓ f
Occupancy
Signature: Date:
Zoning approval verified: ❑ Yes ❑No Construction type: 7' ' /Cram/Ay
Property is within flood plain: ❑ Yes ❑ No Square feet: /.6—‘Q
Cost per square foo#3 0. 64.
CATEGORY OF CONSTRUCTION P' 1 3 �ODD
Residential 0 Government ❑Commercial Other information:
JOB.SITE INFORMATION AND LOCATION Type oflleat: qp 4n- 4 Are a/AC
Job site address: 003 ey S' - Energy Path:____.
City: . t.tJ,y2 e/f State: OXQ ZIP: 97978 ❑new alteration ❑addition
Subdivision: ✓ Lot no.: (b)Foundation-only permit? ❑ Yes 0-No
Reference: Taxlot: Total valuation: S3066
PROPERTY OWNER 2. Building fees g 3
Name: _ „ ' - I-, s (a) Permit fee(use valuation table): $ J S6
Address: /003 Lid' S. St (b) Investigative fee(equal to 12)1): S
City: S�ntwe State:0, ZIP:97fl9 (c) Reinspection(S per hour): $
Phone: s49 73L—/57 Pax: - - (number of hours x fee per hour)
E-mail: (d)Enter 12%surcharge(.12 x 12a+2b+2c1): $ £/ _ 7�
(e) Subtotal of fees above(2a through 2d): S
Building Owner or Owner's agent authorizing this application: 3. Plan review fees
la
(a) Plan review(65%x permit lee 12a1): $
Sign here: (b)Fire and life safety(40%x permit Ice 12a1): , $
❑This inst atio)is being made on residential or Peon property owned by (c) Subtotal of fees above(3a and 3b): S
me or a m er of my immediate family.and is exempt from licensing 4. Miscellaneous fees
requirements under ORS 701.010. u
(a) Seismic fee. 1%(.01 x permit fee 12a1): $
CONTRACTOR INSTALLATION 1-
/n� ` (h)Technology fee. 5"/o(.05 x permit fee[2a1): $ /7i
Business name.tf,2 Loozi; A Zir/et-q Scut,- t
�d�JC �/-3.37 /y "TOTAL fees and surcharges(2e+3c+4a+4h): S L/(/� 9.
Address: I
City: Ev e.Je State: OQ ZIP: 97V4
Phone: St` 857-8922 Fax: - -
E-mail: T/,ct ID 71 l i.�i✓eryy Safer _cbiln.
CCI3 license no.: 767V/L .
Print name: ,77.-.).#6,77.-.).#64j, / ,f,J
Signature: f a SUB-CONTRACTOR''INFORMATION
Name CCII License# Phone Number
Electrical Sig v
BC /e /i e 6799 f5-3-6Y99 5l 7 - (73')
• Plumbing 1
,q , t tme•✓r x709/3 rS5- 81° SI t( ' III
Nlechanical
Pr £, ieyy O .er /76 �V/ 8 8 22 5114
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