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HomeMy WebLinkAboutPermit Building 2014-5-16 SPRINGFIELD— 225 Fifth St kr CITY OF SPRINGFIELD Springfield,OR 97477 ^- Phone:541-726-3753 GON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00810 www.springf eld-or.gov permitcenter @springfieIdocgov PROJECT STATUS: Issued ISSUED: 05/16/2014 EXPIRES: 11/11/2014 STATUS DATE: 05/16/2014 APPLIED: 04/15/2014 SITE ADDRESS: 1001 10TH ST,Springfield,OR 97477 SCOPE: Cell Tower-Communication Tower ASSESOR'S PARCEL NO: 1703351103400 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Cell site-replace 3 antennas OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number: ADDRESS: 525 MILL ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone INSPECTIONS REQUIRED Inspections 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 r Jr, Date f Mf-lc �ti �z7/l7 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- ma obtain COMMENCED OR IS ABANDONED FOR 0090.callingothe ce er. (No cop the by ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 5/16/2014 2:55:07PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St ;( TRANSACTION RECEIPT Spdngfield,OR 97477 t E',\{tea 541-726.3753 • OREGON 811-SPR2014-00810 www.spnngfield-or.gov 1001 10TH ST permitcenter©springfield-or.gov RECEIPT NO: 2014001087 RECORD NO:811-SPR2014.00810 DATE:05/16/2014 (DESCRIPTION r IT ACCOUNT CODE/TRANS CODE AMOUNtDUE°• Building Permit Fee 224-00000-425602 1002 162.61 Planning-Minor Review-City 100-00000-425002 1231 119.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.51 Structural Plan Review Fee Commercial 224-00000-425602 1060 105.70 Technology fee(5%of permit total) 100-00000-425605 2099 8.13 TOTAL DUE: 414.95 I' PAYMENT•TYPE I .-PAYOR CASHIER:CCARPENTER , COMMENTS : AMOUNT PAIDr f e Check New Horizon 414S5 1250 TOTAL PAID: 414.95 • Structural Permit Application SPRINGFIELD DEPARTMENTUSE ONLY CITY OF SPRINGFIELD OREGON Permit no Sly. pQ Sio • 225 Filth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON /Od( /Ofd` s+ Date: 9/ /S��/�/ This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of ssuancE or if work is suspended for 180 days. LOCAL,GOVERNMENT APPROVAL , ,;‘7..- r „:FEE SCHEDULE ` • • `•' This project has final land-use approval. 1.Valuation information Signature: Dale: (a)Job description: REP4><e31M-remNhs This project has DEQ approval. Occupancy Signature: Date: Zoning approval verified: El Yes El No Construction type: ,v; Property is within flood plain: ❑Yes ❑ No Square fee: `"CATEGORY OF'"CONSTRUCTION ' ` "P`; Cost per square foot: ❑ Residential ❑Government ❑Commercial Other information: 'JOB SI.TE' INFORMATION.AND ..LOCATION. -.r + of Ilea: Job site address:0,SI0 /Otcrge et Energy Paa-t-h::�/ City: SP2/N 4 FiEL D State: O R ZIP: 9!7477 ❑new kimteration ❑addition Subdivision: Sp¢gN Fl(4-D HS Lot nn.: (b)Foundation only permit? El Yes Reference:/ 703 -/J s Taxlo: 0 3 go O Total valuation: $ /OS00. 00 +P40PERT =-'4PPtac:gArr 2 Building fees Name: SPRINT a/p Is/von) /1q AA17/J (a) Pemmit lee(use valuation table): *.' " $ l v 2 r Address: Z'!15 NW (Z S T PLAGL (h)Investigative fee(equal to(2a)): $ r City: PORT L4N b State: o2 ZIP: 72.21 (c) Reinspection($ per hour): (number of hours x fee per hour) $ Phone: 503- ,358. 442.4. Fax:51)3-%9. 0!14- E-mail: J 7y� en 401. cc Ai (d)Enter 12%surcharge(.12 x 12a+26+2c1): $ -J (e)Subtotal of fees above(2a through 2d): S / j s Building Owner or Owner's agent authorizing this application: '3 Plan review fees ' :`"= ` v ( (a) Plan review(65%x permit lee 12a1): `- $/o s",- Sign here: (b)Fire and life safety(40%x permit fee 12a1): $ ❑This installation being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): S me or a member of my immediate I imil}',and is exempt from licensing ::q. ,Miscellaneou F s fees` • requirements under ORS 701 010 . x ^ � "" CONTRACTOR,INSTALLATION1^ (a)Seismic fee I%(.01 x permit fee pal): $ -rep (b)'Fechnology fee.5%(.05 x permit fee(2a]): $ l/-� Business name: G TOTAL fees and surcharges(2e+3c+4a+4h): S � 9 5 Address: City: State: ZIP: Phone: - - - Fax: - - E-mai I: CCB license no.: Print name: Signature: it('SUB:CONTRACTOR':INFORMATION 7, „ ' . Name CCB License q Phone Number Electrical Plumbing Mechanical