HomeMy WebLinkAboutPermit Building 2014-08-18SPRIN�OJUGON
225 Fifth St
I
CITY OF SPRINGFIELD
Springfield,OR97477
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Phone:541-726-3753
`l' Building /Residential Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01625
vmv.springfield-or.gov
permitcenter@spdngfield-or.gov
,
PROJECT STATUS: Issued ISSUED: 08/18/2014
EXPIRES: 02/13/2015
STATUS DATE: 08/18/2014 APPLIED: 07/29/2014
SITE ADDRESS: 3792 OREGON AVE, Springfield, OR 97478
SCOPE: Single Family Residence
ASSESOR'S PARCEL NO: 1702314208202 TYPE OF STRUCTURE:
Residential
-PROJECT-DESCRIPTION! Patio-covor
OWNER: GARCIA RALPH & JEAN T
Phone Number:
ADDRESS: 3792 OREGON AVE
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type
Lie No Lie Exp Phone
General Contractor OWNER CCB
000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
1110 Footing Footing: After trenches are excavated.
1260 Framing Framing Inspection: Prior to cover and after
all rough in inspections have been
approved.
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
constritaflon.
Own cr Contractor Sig ure Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
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, (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
1'40TICE:
I Ills PERMIT SHALL EXPIRE IF THE WORK
,.t1 tI IORIZED UNDER THIS PERMIT IS NOT
Clod t4ENCED OR IS ABANDONED FOR
/IVY 180 DAY PERIOD.
Springfield Building Permit 8/18/2014 11:28:19AM Page 1 of i
SPRINGFIELD - CITY OF SPRINGFIELD
t 225 Fifth St
� � TRANSACTION RECEIPT Springfield.OR97477
"' OREGON 541-726-3753
811-SPR2014-01625
mm.spdngfield-or.gov 3792 OREGON AVE permitcenter@spdngfield-orgov
RECEIPT NO: 2014001798
RECORD NO: 811-SPR2014-01625
DATE: 08/18/2014
DESCRIPTION
ACCOUNT CODE/TRANS CODE
AMOUNT DUE
Continuing Education Fee
224-00000-425606
2.50
Planning - Minor Review - City
100-00000-425002
1231
119.00
Residential Fire (.05 Per Sq Foot)
100-00000-424005
9111
19.00
SDC: Improvement Cost - Storm Drainage
440-00000-448028
1176
149.63
SDC: Reimbursement Cost - Storm Drainage
441-00000-448029
1177
102.94
SDC: Total Storm Administration Fee
719-00000-426604
1180
12.63
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Structural Building Permit Fee
Technology fee (5% of permit total)
224-00000-425602 1002 155.65
100-00000-425605 2099 7.78
TOTAL DUE: 587.81
PAYMENTTYPE 'PAYOR 'CASHIER:CCARPENTER COMMENTS 'AMOUNT PAID
Credit Card GARCIA RALPH & JEAN T 587.81
062814
TOTAL PAID: 587.81
SPRINGFIELD — CI "I'1' OF SPRINGFIELD
225 Fdih St
TRANSACTION RECEIPT Spnngfield,OR97477
811-SPR2014-01625 541-726-3753
% v Yspnngfield-or.gov 3792 OREGON AVE permitcenter@spnngfield-or.gov
RECEIPT NO: 2014001630 RECORD NO: 811-SPR2014-01625 DATE: 07/29/2014
DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE'
Structural Plan Review Fee Residential 224-00000-425602 1061 101.17
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This permit is issued tinder OAR 918-460-0030. Permits expire if work is not started within 1
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 10 Government I ❑ Commercial
JOB SITE INFORMATION AND LOCATION '
Job site address: d U I,,—
City. (R29 1
State: ZIP: Y
Subdivi ion: Lot no.:
Reference:
TaxloC o
PROPERTY OWNER
Name PC C) —. (J ° t
Address: U
City:
44/-7,�/�6(,4S-06fFax:
ate:Phone:
- -
E-mail:
this application:
Building Owner or Owner's agent 76:
Sign here: -
❑ This installation is be' made on residential or farm property owned by
me or a member of my mediate family, and is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION'
Business name: Gjj
Address:
City:
State: ZIP:
Phone: - -
Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
3. Plan review fees
SUB -CONTRACTOR INFORMATION
Name
CCB License 9
Phone Number
Electrical
(c) Subtotal of fees above (3a and 3b):
$
Plumbing
(a) Seismic fee, 1%(.01 x permit fee [2a]):
Mechanical
(b) Technology fee, 5% (.05 x permit fee[2a]):
$ ---
DEPARTMENT USE ONLY
Permit no.:
Date: 2
80 days ofissuand or if work is
-FEE SCHEDULE
1. Valuation information
(a) Job description:
Occupancy 4A
Construction type:
Square feet:`
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
❑ new ❑alteration addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
I $
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+2e]):
$
(e) Subtotal of fees above (2a through 2d):
$
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
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
$ 2y5,_,._