HomeMy WebLinkAboutPermit Building 2014-08-06SPI2ING�IELU
OREGON
www.spnngfield-ocgov
CITY OF SPRINGFIELD
Building If Residential Permit
PERMIT NO: 811-SPR2014-01274
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@spdngfield-ocgov
PROJECT STATUS: Issued ISSUED: 08/06/2014 EXPIRES: 02/01/2015
STATUS DATE: 08/06/2014 APPLIED: 06/11/2014
SITE ADDRESS: 1696 KELLY BLVD, Springfield, OR 97477 SCOPE: Fire Damage
ASSESOR'S PARCEL NO: 1703274100101 TYPE OF STRUCTURE: Residential
--- -PROJECT DESCRIPTION:
by
ESCRIPTION:
by contractors. Truss doe's deferred
OWNER: HEAD START OF LANE COUNTY Phone Number:
ADDRESS: 221 B ST
SPRINGFIELD OR 97477
OWNER: HOUSING AUTHORITY & URBAN Phone Number:
ADDRESS: 177 DAY ISLAND RD
EUGENE OR 97401
OWNER: RENEWAL AGENCY OF LANE CO Phone Number:
ADDRESS: 177 DAY ISLAND RD
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lie No Lie Exp Phone
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1420 Insulation Vapor Barrier
1430 Insulation Wall Wall Insulation: Prior to cover.
1440 Insulation Ceiling Ceiling Insulation: Prior to cover.
1460 Insulation
1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum
board, interior and exterior are in place, but prior to plastering.
1550 Firewall Firewall: Located and constructed according to plans.
1999 Final Building Final Building: After all required inspections have been requested and approved and
the building is complete.
AI—I EN1ION: Oregon law requires you to
follow rules adopted by the Oregon Utility
NOTICE: Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
THIS PERMIT SHALL EXPIRE IF THE WORK
009 You may obtain copies of the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT
calling
ing 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 8/6/2014 9:6628AM Page 1 of 2
SPRINGFIELD
-- '' OREGON
w v.springfeld-orgov
CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SPR2014-01274
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 641-726-3769
Fax: 541-726-3676
perm iteenter@springrield-or.gov
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
Owner or Contractor Signature
oft/&ti
Date
z0r4
Springfield Building Permit 8/6/2014 9:55:28AM Page 2 of 2
E
N
CITY OF SPRINGFIELD
.. 225 Fifth St
TRANSACTION RECEIPT Spnngfeld,OR97477
-
811-S P R2014-01274 541-726-3753
vmw.spnngfield-orgov 1696 KELLY BLVD permits nler@spnngrield-or.gov
RECEIPT NO: 2014001679 RECORD NO: 811-SPR2014-01274 DATE: 08/06/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Continuing Education Fee 224-00000-245606 224-00000-425E 2.50
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
Structural Building Permit Fee 224-00000-425602 1002
78.18
651.50
Technology fee (5% of permit total) 100-00000-425605 2099 32.58
TOTAL DUE: 764.76
'PAYMENTTYPE PAYOR CASHIER:CCARPENTER COMMENTS AMOUNT PAID
HOUSING AUTHORITY & URBAN
99352
TOTAL PAID: 764.76
Structural Permit Application
225 Fifth Street 1 Springfield, OR 97477 ♦ PH(541)726-3753 + FAX(541)726-3689
SPRINGF19LO --
aaecaH
I DEPARTMENT USE ONLY I
Permit no.: 9 Yi /Z ?Y
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
Residential ❑ Government ❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 1&18! (61(q Kt- LL`t' R L V D .
City: 2>ff,( PC�1;' 6 "D State: 0 K ZIP:g7` 7
Subdivision: I Lot no.:
Reference: 7777777T-Taxiot: 1'7,-0'3 .-2'7.41 ,067
PROPERTY OWNER
Name: RAC,cS(-% ofNC-..Cout-yTY
Address: pp W ES'C ((,VIlw T)(Z(u�—
City:
I State: b V?-- I ZIP: 710 S
Phon . S -{k
JFax: -5(1- 667--3P�75-
E-mail: 4 6 EA y CS & e U 5
Building Owner Owner's agent rizing this application:
Sign here:
❑ This infilMlation is bei made r residenti or fans property o by
me or a member of my immedia family, is exempt from licensit
requirements under ORS 70 L0 0.
CONTRACTOR INSTALLATION;
Business name: -7151)
Address:
City:
State: ZIP:
Phone: - -
Fax: -
E-mail:
CCB license no.:
Print name:
Signature:
$ ,�--
.-SUB-CONTRACTOR,INFORMATION,,
Name
CCBLicensek
Phone Number
Electrical
$
(b) Fire and life safety (40%x permit fee [2a]):
Plumbing
(c) Subtotal of fees above (3a and 3b):
$
Mechanical
(a) Seismic fee, 1%(.01 x permit fee [2a]):
or if work is
-FEE SCHEDULE
1. Valuation information
(a) Job description: � t`!
!L -
Occupancy 2'
Construction type:
Square feet:
Cost per square foot:
Other information:
Type of Heal:
Energy Path:
❑ newalteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
$
2. Building fees
(a) Permit fee (use valuation table):
$
(b) Investigative fee (equal to [2a]):
$
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
$ ,�--
(e) Subtotal of fees above (2a through 2d):
S
3. Plan review fees
(a) Plan review (65%x permit fee [2a]):
$
(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
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
$