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Permit Building 2014-6-5
SPRINGFIELD— 225 Fifth St , hiras CITY OF SPRINGFIELD Springfield,OR 97477 Gii Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01221 www.springfield-or.gov perm itcenter @sprin gfiel d-or.gov PROJECT STATUS: Issued ISSUED: 06/05/2014 EXPIRES: 12/01/2014 STATUS DATE: 06/05/2014 APPLIED: 06/05/2014 SITE ADDRESS: 333 58TH ST,Springfield,OR 97478 SCOPE: Commercial Miscellaneous ASSESOR'S PARCEL NO: 1702343200100 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: Siding replacement-South and West sides 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 1420 Insulation Vapor Barrier 1920 Miscellaneous Building 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. OwneWntractor Signature Date El O3N NOla3d (y0 08t ION SI11Wa3dNNb8b SI a0 03NN3UV6t03 NaOM 3141 di 3asdX3 a30N(103ZIa0H ATTENTION: Oregon law requires you to lIV1 "11W 1nt, follow rules adopted by the Oregon Utility aid SIHJ Notification Center. Those rules are set forth . :33110N in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 6/5/2014 9:57:28AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfie 141,013 97477 'cc. OREGON 811-SPR2014-01221 541-726-3753 www springfield-or 333 58TH ST permacenter©springfield-or gov RECEIPT NO: 2014001226 RECORD NO:811-SPR2014-01221 DATE:06/05/2014 ;DESCRIPTION ' • - ACCOUNT.DODEITRANSDODE_ AMOUNT DUE, Building Permit Fee 224-00000-425602 1002 524.00 Continuing Education 224-00000-425606 2.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 62.88 Technology fee(5%of permit total) 100-00000-425605 2099 26.20 TOTAL DUE: 615.58 ' _PAYMENT-TYPE 1---_,_FAYOR_ GASHIERLCCAFTENTIR_ COMMENTS__ I . AMOUNT PAID Credit Card SPRINGFIELD SCH60115ISTRICT1c. 615.58 125720 TOTAL PAID: 615.58 Structural Permit Application SPRINGFIELD--, DEPARTMENT';USE ONLY yr 14x °3T Y'y n € ` a atbe � tt tfin . °_ f. ,OITY OF SPRNGFIELD SOREGON.r�'? fJ t ,, c" n �j Y�. w= i Permit no J/ (/ z Z/ 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON Date: /S//(� 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. :''"4,,, ti,--.LOCAL',GOVERNMENT APPROVALi`;' Kk 5` - , fi`r, FEE`.SCHEDULE ,, i , This project has final land-use approval. ;1 Valuation mforitiation z' [7 to r +1't otqN t D Signature: Date; g (a)Job description: S �;N S f3), ZQ 1. .�- iz This project has DEQ approval. Occupancy (� '1 N-ru^ N Signature: Date: Zoning approval verified: ❑ Yes ❑No Construction type: Property is within flood plain: ❑ Yes ❑No Square feet: L?'CATEGORY OF`CONSTRUCTION y;; ''-* Cost per square foot: ❑Residential OGovemment ❑Commercial Other information: r�pi r JOB,SITE INFORMATION AND (LOCATION �t14e= Type of Heat: Job site address: 333 Energy Path: City: .S'P/Uti.iyiaif7 State: et ZIP:cT7 ❑new alteration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? ❑ Yes ❑No Reference: /2 Z ( � G'Taxlot (,L'9'&..6) Total valuation: $ ROPERTY OWNER Wac *_ �.. r`.."�` < Name: SQtAAil f6 z.c SClaco L.%'f k (a) Permit fee(use valuation table): $ 5-2c( Address: /816/� A). 5/2.'1 (b)Investigative fee(equal to[2a]): $ City: Spd fic-i/&S StateO/ ZIPg75in (c) Reinspection($ per hour): (number of hours x fee per hour) Phone: / ry.0375- Fax: Si/ 9yy 6a7 y E-mail: ! w S4Zsr•A,w Q S7u`..e,c z�1. �L./l.( . US• (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ 62'• (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: `31 i review fees ';s',i,}` ;Z,i' f'�° , w ',.4 s i7M(`� / / (a)Plan review(65%x permit fee[2a]): $ Sign ere: I .'fa + (b)Fire and life safety(40%x permit fee[2a]): $ ❑This installati. is bei g made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $ me • a member of my immediate family,and is exempt from licensin g '4 n Mscela ne«, slfees € x gi a ,tom r requi • 1. under ORS 701.010 °`!< (a) Seismic fee, 1%(.01 x permit fee [2a]) $ "`CbNTRgCTOR INSTALLATION'S ,' ° �/G6 o (b)Technology fee,5%(.05 x permit fee[2a]): $ Business name: �"K� (c)Continuing Education Fee$2.50 $2.50 Address: 11 YY City: State: ZIP: TOTAL fees and surcharges(2e+3c+4a+4b+4c): $ 6/5-5.1— Phone: - - Fax: - - E-mail: CCB license no.: Print name: Signature: ,;a& tQ$ fSUBCONTRACTOR1INECRMATION `"V',,' ;' a Name CCB License 4 Phone Number Electrical Plumbing Mechanical