HomeMy WebLinkAboutPermit Fire 2014-08-14SPRINGFIELD
225 Fifth St
w CITY OF SPRINGFIELD
Springfield,OR97477
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Phone: 541-726-3753
OR6eoN Building / Commercial Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01723
mn v.springfield-or.gov
Permitcenler@springfield-ocgov
PROJECT STATUS: Issued ISSUED: 08/14/2014
EXPIRES: 02/09/2015
STATUS DATE: 08/1412014 APPLIED: 08/08/2014
I
SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477
SCOPE:
ASSESOR'S PARCEL NO: 1703220004102 TYPE OF STRUCTURE:
-PROJE43-T-0ESCRIPTION PeaeeheaIt"amma-Knife-Project--relocate-oxlsting-heads
OWNER: PEACEHEALTH
Phone Number:
ADDRESS: 1116 SE 164TH AVE
VANCOUVER WA 98683
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type
Lie No Lie Exp Phone
Fire Contractor HARVEY & PRICE CO CCB
77 10/31/2014 541-746-1621
INSPECTIONS REQUIRED
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 front of the Property, and the approved set of plans will remain on the site at all times during
construction.
Owner or Contractor Signature
!W') PERMIT SHALL EXPIRE IF THE WORI<
UI ItORIZED UNDER THIS PERMIT IS NOT
`NCED OR IS ABANDONED FOR
'! RAY PERIOD.
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).
Springfield Building Permit 8/1412014 10:45:56AM Page i of 1
SPRINGFIA CITY OF SPRINGFIELD
LN
225 FRIh St
TRANSACTION RECEIPT Sp ng(eId,OR97477
1, 'OREGON 541-726-3753
811 -SP R2014-01723
mm.sptlngfield-ocgov 3333 RIVERBEND DR permitcenter@springfield-or.gov
RECEIPT NO: 2014001765 RECORD NO: 811-SPR2014.01723 DATE: 08/14/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Admin fee (10% of applicable fees) 224-00000-426605 1098 6.00
Hourly Plan Review Fee (Less than 20 heads) 100-00000-424002 9120 60.00
TOTAL DUE: 66.00
'PAYMENTTYPE PAYOR CASHIER:RHOLMAN COMMENTS AMOUNT PAID
Check HARVEY & PRICE CO 66.00
035911