HomeMy WebLinkAboutPermit Building 2014-07-16SPRIN�OR
225 Fifth St
CITY OF SPRINGFIELD
Springfield,OR 97477
Phone: 541-726-3753
`' '°EGON
Building /Commercial Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01239
mi .spnngfield-orgov
permitoenter@spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 07116/2014 EXPIRES: 01/11/2015
STATUS DATE: 07/16/2014 APPLIED: 06/06/2014
SITE ADDRESS: 600 HAYDEN BRIDGE WAY, Springfield, OR 97477 SCOPE: Church
ASSESOR'S PARCEL NO: 1703233412600 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Rebuild platform (stage) 453SF
OWNER: INTERNATIONAL CHURCH OF THE FOURSQUARE Phone Number:
ADDRESS: 600 HAYDEN BRIDGE WAY
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
General Contractor JERRY B TABOR CCB 18222 08/05/2015 541-746-0179
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
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. A
,
Owhe of r Contractor Signature Date
At ' i-i•ll Irl fl: Ura" n
follow rules adopted by the Oregon Gtllity
Notification Center. Those rules are Set forth
In OAR 952-001.0010 through OAR 952.001-
0090. You may obtain copies of the rules by
calling the center. (Nate: the telephone
Humber for the Oregon Utility Notification
Center Is 1.800.332-2344).
t XE:
MIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR ;
ANY 180 DAY PERIOD.
Springfield Bullding Permit 7/16/2014 9:28:37AM Page 1 of 1
LNGPIEID CITY OF SPRINGPIGLD
225 Fifth St
�,TRANSACTION RECEIPT Spnngfield,OR97477
OREGON 541-726-3753
811-SPR2014-01239
www. springfield-ocgov 600 HAYDEN BRIDGE WAY permitcenter@springfield-or.gov
RECEIPT NO: 2014001524 RECORD NO: 811•SPR2014-01239
DATE: 07/16/2014
DESCRIPTION
ACCOUNT CODE/TRANS CODE
AMOUNT DUE
Building Permit Fee
224-00000-425602
1002
134.61
Continuing Education
224-00000-425606
2.50
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
16.15
Structural Plan Review Fee Commercial
224-00000-425602
1060
87.50
Technology fee (5% of permit total)
100-00000-425605
2099
6.73
TOTAL DUE: 247.49
PAYMENT TYPE PAYOR CASHIER: CCARPENTER
COMMENTS
AMOUNT PAID
Credit Card Steven Erickson
247.49
094080
TOTAL PAID:
247.49
Structural Permit Application
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
LSPRINGfIELO
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`= daEGdN
I DEPARTMENT USE ONLY I
Permit no.: /K /2
Date:
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date;
This project has DEQ approval.
Signature:
Date:
Zoning approval verified: ❑ Yes ❑ No
Property is within flood plain: ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
esidential ❑ Government ❑ Commercial.
JOB SITE INFORMATION AND LOCATION
Job site address: /JA'
A4 -IV
City: Y•;rV ;G/,/
Slate:C] ZIP q?7
Subdivision: 1 Lot no.: /,, g' pp
Reference: / 7 0 23 -5 Taxlot
PROPERTY OWNER
Name: -r'e/ i h C
Address: - ) C WAV
City:
Stated Z1P: 7f/7�
Phone:$ /- Cj -gdlV
Fax: $ / 7,Y�15 -866 i
E-mail:
Building Owner or Owner's agent authorizing this application:
Sign here:
❑ This installation is being made on residential or fa property owned by
me or a member of my immediate family, acrd is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION'-
Business name:
E %bd E CW Y c!o
Address: 2833pgo
City: State: 6 R ZIP: 97`177
Phone: elll Q / 7 y Fax: -
E-mail:
CCBlicenseno.:
Print name: Jc)m
-rA6
Signature:
B -CONTRACTOR INFORMATION'
8
Name
CCB License ff
Phone Number
Electrical
Y,,4 =l
(b) Fire and life safety (40%x permit fee [2a]):
$
Plumbing
$
4. Miscellaneous fees
Mechanical
(a) Seismic fee, 1% (.01 x permit fee [2a]):
$
or if work is
FEE SCHEDULE
1. Valuation information
(a)Job description: 'l�
Occupancy �3
Construction type.
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
❑ new 0alteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
_
Total valuation:
$ SQ
1 Building fees
(a) Permit fee (use valuation table):
$
(b) Investigative fee (equal to [2a]):
$
(e) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
$ ` r ---
(e) Subtotal of fees above (2a through 2d):
8
3. Plan review fees �=
(a) Plan review (65%x permit fee 12a]):
$
(b) Fire and life safety (40%x permit fee [2a]):
$
(c) Subtotal of fees above (3a and 3b):
$
4. Miscellaneous fees
(a) Seismic fee, 1% (.01 x permit fee [2a]):
$
(b) Technology fee, 5% (.05 x permit fee[2a]):
$ ✓
(c) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4e):
$
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