HomeMy WebLinkAboutPermit Fire 2014-6-30 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
"`' Phone: 541-726-3753
i`-__t OREGON Building / Commercial Permit . Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01209
www.springfield-orgov - pemiitcenter @springfield-orgov
PROJECT STATUS: Issued ISSUED: 06/30/2014 EXPIRES: 12/26/2014
STATUS DATE: 06/30/2014 APPLIED: 06/04/2014
SITE ADDRESS: 1195 MAIN ST,Springfield,OR 97477 . SCOPE:
ASSESOR'S PARCEL NO: 1703354107600 TYPE OF STRUCTURE: .
PROJECT DESCRIPTION: Install replacement kitchen hood suppression system
OWNER: PJK INVESTMENTS LLC Phone Number:
ADDRESS: 3474 SPRING BLVD
EUGENE OR 97405
CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Fire Contractor UMPQUA VALLEY FIRE SERVICES INC CCB 179319 11/16/2015 541-229-0911
INSPECTIONS REQUIRED
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Inspections
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 fron the property,and the approved set of plans will remain on the site at all times during
er,„,a1thariVirmat
Owner or Contractor Signature Date
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK on law requires you to
AUTHORIZED UNDER THIS PERMIT IS NOT ATTENTION: Oregon
by the Oregon Utility
COMMENCED OR IS ABANDONED FOR follow rules SOP hOAR 952001-
ANY 180 DAY PERIOD. Notification Center. Those rules are set forth
in OAR You may obtain through
of the rules by
0090. Note:the telep
•calling the center. ion Utility Notification
number for the Ore
2344).
Springfield Building Permit 6/30/2014 10:02:42AM Center is 1-600-332- Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
i ..e'A.- ', '`•a 225 Fifth St
wtt <„ TRANSACTION RECEIPT Springfieltl,OR 97477
OREGON 541-726-3753 •
811-S P R2014-01209
wvnv.springfieltl-or.gov 1195 MAIN ST permitcenter @springfield-or.gav
RECEIPT NO: 2014001409 RECORD NO:811-SPR2014-01209 DATE:06/30/2014
LDESCRIPTIONM _�__ -ACCOUNT CODE/TRANS CODE',':_ _-_,:AMOUNT
Admin fee(10%of applicable fees) 224-00000-426605 1098 12.00
Balance of$120.00 Minimum Fire Fee 100-00000-424002 9116 105.00
Percent of fire system bid/contract value(3%) 100-00000-424002 9116 15.00
TOTAL DUE: 132.00
<..PAYMENT TYPE.,,___PAYOR...;,-CASHIER;CCARPENTR _ ,. : __,COMMENTS. - _ AMOUNT-RAID
Check UMPQUA VALLEY FIRE SERVICES IP 132.00
19791
TOTAL PAID: 132.00
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