HomeMy WebLinkAboutPermit Building 2014-7-1 4'
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01418
www.springfield-or.gov pe rmitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/01/2014 EXPIRES: 12/27/2014
STATUS DATE: 07/01/2014 APPLIED: 07/01/2014
SITE ADDRESS: 637 MAIN ST,Springfield,OR 97477 SCOPE: ReRoof
ASSESOR'S PARCEL NO: 1703353109400 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Reroof
OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number:
ADDRESS: 525 MILL ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor MCKENZIE ROOFING INC CCB 106300 05/16/2016 541-744-2446
INSPECTIONS REQUIRED
Inspections
1620 Roofing Roofing: Prior to installing any roof covering.
1630 Roof Sheathing Roof Sheathing
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.
�� � Date
ner or Contractor gnature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility • NOTICE:ICE:
Notification Center. Those rules are set forth ,
THIS OAR 952-001-0010 through OAR 952-001• HIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTRIZED 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 7/1/2014 9:57:47AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
ka.r.oFt4,_ 225 Fifth St
,��yy TRANSACTION RECEIPT 596496940R 97477
i ���J 541-726-3753
OREGON 811-SPR2014-01418
www,springfield-or.gov 637 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2014001426 RECORD NO: 811-SPR2014-01418 DATE:07/01/2014
DESCRIPTION__ _.:, _ _._,m -_ v ___:__ .. . _...._ ACCOUNT-WOE/TRANS CODE,_,,, „__::, :-AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 187.22
Continuing Education 224-00000-425606 2.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22A7
Technology fee(5% of permit total) 100-00000-425605 2099 9.36
TOTAL DUE: 221.55
L PAYMENT TYPE =;_PAYOR._, -CASHIER:CCARPENTER-. _COMMENTS: _ _ AMOUNT PAID
Credit Card MCKENZIE ROOFING INC 221.55
04382g
TOTAL PAID: 221.55
•
'Structural Permit Application SPRINGFIELD ' DEPARTMENT USE ONLY`
t . .
� E " -_; t _a� ,•.wi.r c r *tom .r R2� w.rs.,, +rtm ii71 : 4,:- `7 .-
C1:Y OF SPRINGFIELD;OREGON -, g.5 I /_/�/ /[\�
1~ t...., ,,,b...... <. _a... Permit no.: C/( / ( V
225 Fifth Street*Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 DxEGOH J
Date: .77/ Ill (
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.
': `?tLOCAL .GOVERNMENT'AFPROYALti,<' a _ `FEE SCI-JOIJ F
This project has final land-use approval. 1:Valuation information -t..ij-- ` 4 t, '.;, * 1M1'
Signature: Date; (a) Job description: ?/= fir '
This project has DEQ approval. /
Occupancy L
Signature: Date: _
Zoning approval verified: I: Yes S No
Construction type: VI
Property is within flood plain: ❑ Yes ❑No Square feet:
;1 CATEGORYt;OF CONSTRUCTIONS _c, , : ," Cost per square foot:
❑Residential 2-Government ❑Commercial Other information:
.'JOBSITE INFORMATION,?AND,LOGATION li ;e . n? Type of Heat:
Job site address: 63'7 main or Energy Path: --
City: 3fFJJ State:O,e ZIP: 12497 ❑new teration __Et-addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference: / 7o 5 r5 5 -JJraxlot Q /9e° Total valuation: $//72c
": ;,` > :PRO PERTY OWNERx" '• .r. .,,?. � ' -3iBmldirig'fee �°- a t r. 1:k
+,t
Name: -■p4G;L d r
of b15E„•C.I (a)Permit fee(use valuation table): $ iF 7 2 Z
Address: .5Z5 fy/,/I 4r (b)Investigative fee(equal to[2a]): $
City: ... p>G/J State: Q t. ZIP: m7921 (c)Reinspection($ per hour): $
Phone: Fax: - - (number of hours x fee per hour)
E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): s2.2,-17
(e) Subtotal of fees above(2a through 2d): S
Building Owner or Owner's agent authorizing this application: 73:Plan'review fees., -s ;r 'r, an,,.tAR,.6,
(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 m residential or farm property owned by (c) Subtotal of fees above(3a and 3b): S
me or a member of my immediate family,and is exempt from licensing j 7 o y'. : sw w '
;4:Mtscellaneousfees z , •, „t,, 4 :, ,, �y ':"k 5f;"'
requirements under ORS 701.010 °
(a) Seismic fee, 1%(.01 x permit fee[2a]): $
,CONTRACTOR INSTALLATION
(b)Technology fee,5%(.05 x permit fee[2a]): $ �76
Business name: /nth?0 or 1:- i€00 1 hq
Address: /4i /M' gr
G J (c)Continuing Education Fee$2.50 52.50
City: .rj prid State: (,,e.„ ZlP:1,94/ TOTAL fees and surcharges(2e+3c+4a+4b+4c): S .22/ SS
Phone:5w-7HWf 2998 Fax: - -
E-mail: r" ' _
CCB license no.: yea 3,50
Print name: 7.50 t_, D Bing./
Signature: A 04..1/4
'; r .'SUBCONTRACTOR INFORMATION : S,ac
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical