HomeMy WebLinkAboutPermit Building 2014-6-9 •
SPRINGFIELD 225 Fifth St
WT_‘... CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01248
www.springfield-or gav permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/09/2014 EXPIRES: 12/05/2014
STATUS DATE: 06/0912014 APPLIED: 06/09/2014 •
SITE ADDRESS: 2274 10TH PL,Springfield,OR 97477 SCOPE: Bathroom
ASSESOR'S PARCEL NO: 1703261204100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Compliance for unpermitted work by prior owner-contractor's letters attached
OWNER: FERRY REANDA Phone Number:
ADDRESS: 2274 N 10TH 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 cardi located at the front of the property, and the approved set of plans will remain on the site at all times during
constructio -
Gobl1Ll
Owner or Contrac r Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility •
NOTICE: ,°ty • Notification Center. Those rules are set forth .
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone
COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification
ANY 180 DAY PERIOD. Center is 1-800-332-2344).
Springfield Building Permit 6/9/2014 3:11:35PM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
t! „ 225 Fifth St
ACV TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-SPR2014-01248
www.springteld-or.gov 2274 10TH PL permitcenter@springfield-ar.gov
RECEIPT NO: 2014001256 RECORD NO: B11-SPR2014-01248 DATE:06/09/2014
:DESCRIPTION_ _ _ __�vi` ACCOUNT CODE/TRANS_CODE ,AMOUNT DUE
Continuing Education Fee 224-00000-245606 2.50
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 487.48
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 998.76
SDC:Total Sewer Administration Fee 719-00000-426604 1175 74.31
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.84
Structural Building Permit Fee 224-00000-425602 1002 82.00
Technology fee (5%of permit total) • 100-00000-425605 2099 4.10
TOTAL DUE: 1,658.99
PAYMENT TYPE,_ _ --PAYOR _,CASHIER:,ccARPEN7ER __ COMMENTS _ _ ` AMOUNT PAID^._
Credit Card Stephen Ferry 1,658.99
024338
TOTAL PAID: 1,658.99
•
•
Structural Permit Application
` s SPRINGFIELD 'DE
PART
MENT USE-ONLY, :. .
-" w + ° .." s u r c .,:::.yn^{5s ,'s +3,: . ;a x , .„..� CIYOE)Ise .9FIED ;,OR ,99N941±_ ?, r,, sj: k' Permit no.: S`OREGON
225 Fifth Street*Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689 /Y
— /2yJ
Date: 0//v
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.
6_, ;;LOCAL';GOVERNMENT AP.PROVALs r..= :4 ; :' ',)x t. : s” Frti z= '
,x„':F,EE SCHEDULE M���H ",�
This project has final land-use approval. ?1 Valuation mformation'i, ;ice'ns Av r?aa ;t, i�
Signature: Date; (a)lob description:4 //j (Ar - ,O ?V
This project has DEQ approval. ! f�
OccupancyA5 /402(hA 1 —
Signature: Date:
tiaZoning approval verified: ❑ Yes ❑No Construction type:
Property is within flood plain: ❑ Yes ❑No Square feet:
' •i '.'CATEGORYOF CONSTRUCTION a;._s. ' ?K` Cost per square foot:
,JZ"Residential ❑ Government ❑Commercial Other information:
Lr,o .,*'JOB SITE'INFORMATION,$AND;L'OCATION` 5:Rkt`` Type of Heat:
Job site address: 'L Z-/9 l.p+s Qty Energy Path: _
City: SP.Ft,I) State: pr_ ZIP: m i- ❑new alteration ❑addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: /707:4 / /' Taxlot: OV/60 Total valuation: 5,2a00
a m .5•.t4 .! iikk0 1:0SANEO 11;1:M±_.,.:fxF:c7° .2 Butldii g fees,fl 111k r' z.,0 t,>x,=fz V 1,. !Ors
Name: e4gy-10 A Ica-1/41 (a) Permit fee(use valuation table): $ Xz
Address:j„a2.f$+ i ' 4- SIC.d44t—M4AOIA (b)Investigative fee(equal to[2a]): $
City: t E Je-Sp.t_ State: AL. ZIP: t7-yo'l (c) Reinspeclion($ per hour):
Phone:a:5141.- X31 -S(pZ 1- Fax: - -
(number of hours x fee per hour) $
E-mail: ru.�.w/KVl Q _' 1y-4I I'e a..— (d)Enter 12%surcharge(.12 x[2a+26+2c]): $
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: -:3?Plan revtew,feesl;'' f r-+'';” .,;, t v`g:,_ ;'S''-F-
(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 3b): $
me or a member of my immediate family,and is exempt from licensing '4'',iMtscellaneous fe`s>`-{i 's„?' ,SM [`(#t ig "„f,J:
requirements under ORS 701.010 -"
permit fee[2a]): - $
p,r;. : . • „F!CONTR,4CTOR INSTALLATION,3 of .4 ,* t o /�
(b)Technology fee,5%(05 x permit fee(2a]): $ Y�'
Business name:
Address: _ (c)Continuing Education Fee$2.50 $2.50
City: State: ZIP: TOTAL fees and surcharges(2e+3c+4a+4b+4c): $ 7 �
Phone: '' - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
], '5,, tIWSUBICONTRACTOR(INFORMATION ,: , r,5"y i'
Name CCB License# Phone Number
Electrical
Plumbing
•
Mechanical