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HomeMy WebLinkAboutPermit Building 2014-5-21 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 k,' Phone: 541-726-3753 • G'3•'- OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01128 vnvw.springfieldor.gov - permitcenter©springfeld-or.gov PROJECT STATUS: Issued ISSUED: 05/21/2014 EXPIRES: 11/16/2014 • STATUS DATE: 05/21/2014 APPLIED: 05/21/2014 SITE ADDRESS: 3333 RIVERBEND DR,Springfield,OR 97477 SCOPE: Hospital ASSESOR'S PARCEL NO: 1703220004102 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Resubmittal of expired permit 811-SPR2012-02290 OWNER: PEACEHEALTH Phone Number: ADDRESS: 1115 SE 164TH AVE VANCOUVER WA 98683 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor JOHN HYLAND CONSTRUCTION INC CCB 46071 . 07/11/2014 541-726-8081 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 or Contractor Signature Date • • • on lawreGu{resy�tlry NOTICE: AI TENTION:Ore ed by the Oregon etJorlh THIS PERMIT SHALL EXPIRE IF THE WORK foTow rules adoP 001= AUTHORIZED UNDER THIS PERMIT IS NOT 1 0010 throu1eS otthe 5o?s by Notification Center. Those rules are 95200 COMMENCED OR IS ABANDONED FOR • in OAR You may obtain co e:the te{ephone ANY 180 DAY PERIOD. 0090. the center. Uti{ity Notiflcat!on number for Inr.u\10-332-s 2344): Springfield Building Permit 5/21/2014 2:25:12PM Page 1 of 1 • SPRINGFIELD -- CITY OF SPRINGFIELD 225 Fifth St ""• eooN. TRANSACTION RECEIPT Spdngfield,OR97477 541-726-3753 811-SPR2014-01128 www.spdngfieldor.gav 3333 RIVERBEND DR permitcenter @springfield-or.gov RECEIPT NO: 2014001128 RECORD NO: 811SPR2014-01128 DATE:05/21/2014 o - TIO c..7:2`427.`,n W ,'.119.1 E,tii }.. ?ia.g -ACCOUNT'CODE/TR/ANSCODE-7eitAMOUNTMAZ Building Permit Fee - 224-00000-425602 1002 187.22 Continuing Education 224-00000-425606 2.50 Special Occupancy Fee 224-00000-425602 1097 1.87 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22.47 Technology fee(5%of permit total) 100-00000-425605 2099 9.36 - TOTAL DUE: 223.42 , VallEN ZI E• 'PAYrErg liITa antrGOMMENTS AMOUNTPAID r Credit Card JOHN HYLAND CONSTRUCTION INC 223.42 021517 TOTAL PAID: 223.42 • • • • Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY CLOY OF SPRINGFIELD OREGON ,. `o `-a Permit no.: S(c�'_/72 225 Fifth Street•Springfield,OR 97477•P11(541)726-3753•FAX(541)726 3689 OREGON Date: ,S7ytf/ 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: i 5L_0/SG. Dad (7l al- This project has DEQ approval. Occupancy i - Z Signature: Date: Zoning approval verified: ❑ Yes ❑No Construction type: Property is within flood plain: ❑Yes ❑No Square feet: 74 r- . CATEGORY OF CONSTRUCTION Cost per square foot: 14, ❑ Residential ❑Government ommercial Other information: JOB SITE INFORMATION AND LOCATION Type of Ileac: Job site address:3333 124c tee3ee [e t/6 Energy Path: City: S Q el, -. a , State: (_X�1—' ZIP: ❑new Reration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? ❑ Yes ❑No Reference: J Taxlot: Total valuation: $ '2,700.E p /P�,R�O�P�ERRTTY ,W,7NER '" 2. Building fees " Name: f'c 4eett E/1 t_77 of"' (j(/YC ta.E3TN (a)Permit fee(use valuation table): $ j72� Address: /2.3 1i -4 A-7 Ole CC,.4 (b)Investigative fee(equal to[2a]): $ City: S fp_1 ac F,`J State: op- ZIP: (c) Reinspection($ per hour): Phone: rj'0] -71)) "4-77( Fax: - y-/ (number of hours x fee per hour) $ E-mail: i i -uJ ej fiats\ 0 Pe4`4 L`'24t` - o(-5 (d)Enter 12%surcharge(.12 x[2a+2b+2c1): $ ;2 `(.7 (e) Subtotal of fees above(2a through 2d): S Building Owner or Owner's agent authorizing this application: 3. Plan review fees - • (a)Plan review(65%x permit fee[2a]): $ Sign here: (b)Fire and life safety(40%x permit fee[2a]): $ ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3W: $ 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[2a]): $ / e G ? , CONTRACTOR INSTALLATION . �(� °'It� � . (h)"Technology fee, 5%(.05 x permit fee[2a]): $G7 J Business name: LD or- (c)Continuing Education Fee$2.50 $2.50 Address: 1 4-J p-A- c( rt z- City: cpp-t 06, tz9 State: ZIP: TOTAL fees and surcharges(2e+3c+4a+4b+4c): ' S 223 Phone: - - Fax: - - E-mail: CCB license no.: Print name: Signature: ' V SUB-CONTRACTOR INFORMATION Name CC13 License# Phone Number Electrical Plumbing Mechanical