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HomeMy WebLinkAboutPermit Building 2014-08-28SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springeeld,OR97477 61�ORJEGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01642 v .spnngfield-or.gov permitcemer@spnngfield-ocgov PROJECT STATUS: Issued ISSUED: 08/28/2014 EXPIRES: 02/23/2015 STATUS DATE: 08/28/2014 APPLIED: 07/31/2014 SITE ADDRESS: 839 CENTENNIAL BLVD, Springfield, OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1703264313800 TYPE OF STRUCTURE: Residential —PROJEET_DESCRIPTI.ON: S - New SFD (torealace existing SFD and detached garage) OWNER: BLOOM MATTHEW H & BECKY B Phone Number: ADDRESS: 10190 SW 149TH TER BEAVERTON OR 97007 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor RS PLUMBING CONTRACTOR INC CCB 103816 01/04/2016 541-461-4714 V _ General Contractor CONSTRUCTION UNLIMITE' INC r CCB .—_ 173725 01/05/2015 541-514-7688 Electrical Contractor ..--.______._.__ WILLIAM A GRAY JR CCB 21351 04!28/2016 541-485-3954 Mechanical Contractor' —._._...._....._...___..______-,.._____..—_—__._—_.______..____.__^_—_.__.__.._—_ HOME COMFORT HEATING.&AIR_C_---ONDITIONING INC CCB 84164 06/25/2015 541-345-2838 INSPECTIONS REQUIRED Inspections 1020 Zoning Setbacks 1110 Footing Footing: After trenches are excavated. 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 1160 UFER Ground Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1170 Post & Beam Post and Beam: Prior to Floor insulation or decking. 1220 Underfloor framing 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. 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 Springfield Building Permit Center is 1-800-332-2344). 8/28/2014 8:03:46AM rI RMIT SHALL EXPIRE IF THE WORK 'ORIZED UNDER FI -IIS PERMIT IS NOT "! i�!CED OR IS ABANDONED FOR 2 DAY PERIOD. Page 1 oft NGFIELD 225 Fifth St E-1 CITY OF SPRINGFIELD Springfield,OR 97477 i, �i Phone: 541-726-3753 -='- OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01642 w .springfield-or.gov permilcenter@spdngfield-ocgov 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 r Contractor ignature Date Springfield Building Permit 8128/2014 8:03:46AM Page 2 of 2 SPRINGFIELD - RECORD NO: 811-SPR2014-01642 CITY OF SPRINGFIELD DATE: 08/28/2014 TRANSACTION RECEIPT 226 Fifth St Springfield,OR97477 «, Continuing Education Fee 224-00000-425606 ' OREGON 811-S P R2014-01642 541-726-3753 mm.springfield-or.gov 839 CENTENNIAL BLVD permiteenter@spdngtield-or.gov RECEIPT NO: 2014001894 RECORD NO: 811-SPR2014-01642 DATE: 08/28/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 Planning - Major Review - City 100-00000-425002 1231 211.00 SDC: Improvement Cost - Local Wastewater 443-00000-448025 1184 858.24 SDC: Improvement Cost - Storm Drainage 440-00000-448028 1176 208.88 SDC: Reimbursement Cost - Local Wastewater 442-00000-448024 1183 1,758.36 SDC: Reimbursement Cost - Storm Drainage 441-00000-448029 1177 143.71 SDC: Total Storm Administration Fee Stale of Oregon Surcharge (12% of applicable fees) Structural Building Permit Fee Technology fee (5% of permit total) PAYMENT TYPE PAYOR :CASHIER: DDOWLSBY Check CONSTRUCTION UNLIMITED INC 2366 719-00000-426604 1180 17.63 821-00000-215004 1099 111.35 224-00000-425602 1002 927.92 100-00000-425605 2099 46.40 TOTAL DUE: 4,416.82 )MMENTS AMOUNT PAID i- 4,416.82 TOTAL PAID: 4,416.82 RECEIPT NO: 2014001647 RECORD NO: 811•SPR2014.01642 DATE: 07/31/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Structural Plan Review Fee Residential 224-00000-425602 1061 603.15 TOTAL DUE: 603.15 PAYMENT TYPE PAYOR CASHIER: CCARPENTER COMMENTS AMOUNT PAID - Credit Card John Moody Construction 603.15 112835 TOTAL PAID: 603.15 CITY OF SPRINGFIELD 4 _ F9SPRINGFIELD TRANSACTION RECEIPT 225 Fifth St Spnngfield,OR97477 541-726F3753 oRecoN 811-SPR2014-01642 mmspdngfield-or.gov 839 CENTENNIAL BLVD permitsenter@springfield-or.gov RECEIPT NO: 2014001647 RECORD NO: 811•SPR2014.01642 DATE: 07/31/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Structural Plan Review Fee Residential 224-00000-425602 1061 603.15 TOTAL DUE: 603.15 PAYMENT TYPE PAYOR CASHIER: CCARPENTER COMMENTS AMOUNT PAID - Credit Card John Moody Construction 603.15 112835 TOTAL PAID: 603.15 Show Receipt Detail RECEIPT Springfield SPRINGFIELD 225 5TH STREET Dave Puent Set ID: 839 CENTENNIAL Set Name: 839 CENTENNIAL Page 1 of 1 Payment Method Ret Number Amount Paid Payment Date Receipt No. Cashier ID Cash Drawer ID Received Comments Check $5,328.73 08/28/2014 6633 DBOWLSBY D)B https:Hay.prod.oregon. accela.com/portlets/fee/recciptV iew. do?mode=viewSct&setReceipt... 8/28/2014 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is 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 T esidentiat ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION '- Job site address: ' City: State: Qlr� ZIP: Subdivisio : Lot no.: Reference: I`103" ;U y3 1 Taxlot /,38'00 PROPERTY OWNER Name: Address: (J/'L. City: State:OfL ZtP: Phone: Fax: - - E-mail: Building Owne r Ow er's agent authorizing this application: Sign here: 4,2 ❑ This i tallation is being made on resid t I orfarm property owned by me or a em my immediate family, and is exempt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name: Address: (ppL- City: State: 11)/ I ZIP:%.0v Phone:Sy,(-.641Y-759G- Fax: - - E-mail: G.0 CCB license no.: 1,7 `j 25 - Print name: Signature: % (e) Subtotal of fees above (2a through 2d): U -CONTRACTOR IN RMATION 3. Plan review fees ame CCB License # Phone Number Electrical 0 ��y7 $ Sa/-5C c Plumbing 4: MiscellTaeous fees' bfecha_ njcal $ (b) Technology fee, 5% (.05 x permit fee[2a]): FEE SCHEDULE 1. Valuation information (a) Job description: NCUJ S Occupancy 14 rz Construction type: V Square feet: osLpeuquare_foot: Other information: Type of Heat: Energy Path❑: new alteration El 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): $ 3. Plan review fees (a) Plan review (65%x permit fee [2a]): $ ?S (b) Fire and life safety (40%x permit fee [2a]): $ (e) Subtotal of fees above (3a and 3b): $ 4: MiscellTaeous 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): $ /G` u ELD -- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 F�'Ln rayPhone: 541-726-3753 oReooN Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01851 www.springfiald-acgov permitcenter@springfield-or.gov PROJECT STATUS; Issued ISSUED: 08/28/2014 EXPIRES: 02/23/2015 STATUS DATE: 08/28/2014 APPLIED: 08/26/2014 SITE ADDRESS: 839 CENTENNIAL BLVD, Springfield, OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1703264313800 TYPE OF STRUCTURE: Residential —RROJFCT__DESCRIPTION- F - New-SFD-(to-replace-existing_SF2and detached_garage� OWNER: BLOOM MATTHEW H & BECKY B Phone Number: ADDRESS: 10190 SW 149TH TER BEAVERTON OR 97007 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Plumbing Contractor RS PLUMBING CONTRACTOR INC CCB 103816 01/04/2016 541-461-4714 General Contractor CONSTRUCTION UNLIMITED INC CCB 173725 01/05/2015 541-514-7588 Electrical Contractor WILLIAM A GRAY JR CCB 21351 04/28/2016 541-485-3954 ._..... .- __.-_—_. __ —.-.. __.—______ __...OR_ ____.__ _. _.._._ _._.___—_ ._....___..._ MechanicalConUactor HOME COMFORT HEATING&AIR CONDITIONING INC CCB 84164 06/25/2015 541-345-2838 INSPECTIONS REQUIRED Inspections 4120 UFER Ground 4220 Electrical - Service 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work 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. Owner or Cc t9-0-1or—gnature Date AT NION: Oregon law requires YOU to follOW rules adopted by the Oregon Utility Center. Those rules are set forth i ; rM GE: Notiflc 3tion in OAR 952-001-0010 through OAR 952.-001- ;!IS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by I1, lr'ORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone IS ABANDONED FOR mt ^• f the Oregon Utility Notification " !-1JCED OR or Center is 1-800-332-2344). `'1 �,') f• rIOII Springfield Building Permit 8128/2014 8:10:54AM Page 1 of 1 LRIGf IELD - CITY OF SPRINGFIELD - 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR97477 "- OREGON 541-726-3753 811-S P R2014-01851 vnwi.spnngfield-or.gov 839 CENTENNIAL BLVD permilcenter@springfield- t.gov RECEIPT NO: 2014001892 RECORD NO: 811-SPR2014-01851 DATE: 08/28/2014 DESCRIPTION ACCOUNT CODEITRANS`CODE AMOUNT DUE Each added 500 sq. ft. or portion 224-00000-426102 1004 56.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 Residence wiring 1,000 sq. ft. or less 224-00000-426102 1004 151.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 24.84 Technology fee (5% of permit total) 100-00000-425605 2099 10.35 TOTAL DUE: 244.69 Check CONSTRUCTION UNLIMITED INC 244.69 2366 TOTAL PAID: 244.69 Sep 07 14 02:17p Bill's Electric 541-343-1353 p.1 Sop Electrical Permit Applicationn DEPARTMENT.USE ONLY 5ea,„Gr,F,"-,. C EDate: 225 Fifth Street♦Springfield, OR 97477♦PB(541)726.3753+PAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. tL GOVERNMENT APPROVAL y FEE SCHEDULE verified? ❑ Yes ❑ No .1Vnmhar'nf Tot; VA 1 t;UUKT Ut- GVNJ 1 KUI; 1 (UN ❑ Residential I ❑ Government I ❑ Commercial JOB SITE INFORMATIONAND LOCATION Job site address; Reference: Name: Address: State: c�1 ZIP: Taxlot.: U OF `ill City: State: ZIP: Phone: - Fax: - E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sate, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). CONTRACTOR INSTALLATION Business name: (,'g rte• r'T C Address: IjZz S a 7 — City: f.3 • State: B V ZIP: q7yo z Phone,S;(I- S0,11 So 1 Fax: - - E-mail: Limited energy (2) CCB license no.: / • ,S 'BCD license no,: Signing supervisor's license no.: q© 5 Print name of signing superviso . $ 7q,00 Signature of signing supervisor: —rz� ; // t'"� r ,_ '[,• 440-2584-1 (5/21,2014/COM) Residential, per unit, service included: 1,000 sq, ft• or less (4) $151.00 $ Each additional 500 sq. ft, or portion thereof 28 00 $ $ Limited energy (2) $ 36,00 $ Each manufactured home or modular dwelling service or feeder (2) $ 7q,00 $ Services or feeders: immllation, alteration, relocation 200 amps or less (2) $ 91.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 S 601 to 1,000 amps (2) $270.00 S Over 1,000 amps or volts (2) $527.00 S Reconnect only (2) $ 71.00 S Temporary services or feeders: installatior4 alteration, relocation 200 amps or less (2) $ 71,00 $ 201 to 400 amps (2) $ 98.00 $ 401 to 600 amps (2) $142.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 7.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) S 62.00 $ Each additional branch circuit Miscellaneous fees: service or/eeder not included Each pump or irrigation circle (2) S 71.00 S Each sign or outline lighting (2) $ 71,00 S Signal circuit or a limited -energy panel, alteration, or extension (2) $ 82.00 $ Each additional inspection: (J) 582.00 $ APPLICANT 11 (A) Enter subtotal of above fees (Minimum Permit Fee $82,00) $ J (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (6% of (A]) $ (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): S 09/07/14 SUN 15:51 FAX 5417263689 CITY OF SPRINGFIELD 8k* RX REPORT RECEPTION OK T.X'/RX NO 7432 CONNECTION TEL 541 343 1353 CONNECTION ID ST. TIME 09/07 15:49 USAGE T 01'28 PGS, 1 RESULT OK 0 061 SPRINGFIELD - 225 Fifth St It x CITY OF SPRINGFIELD Springfield,01397477 JPhone: 541-726-3753 OREGON Building If Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01850 vmwapringfield-ocgov permitcenter@springfield-ongov, PROJECT STATUS: Issued ISSUED: 08/28/2014 EXPIRES: 02/23/2015 STATUS DATE: 08128/2014 APPLIED: 08/26/2014 SITE ADDRESS: 839 CENTENNIAL BLVD, Springfield, OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1703264313800 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: P - New SFD Ito replace existing SFD and detached garage_. OWNER: BLOOM MATTHEW H & BECKY B Phone Number: ADDRESS: 10190 SW 149TH TER BEAVERTON OR 97007 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone Plumbing Contractor RS PLUMBING CONTRACTOR INC CCB 103816 01/04/2016 541-461-4714 General Contractor CONSTRUCTION UNLIMITED INC CCB 173725 01/05/2015 541-574-7588 Electrical Contractor WILLIAM A GRAY JR CCB 21351 04/28/2016 541-485-3954 Mechanical Contractor HOME COMFORT HEATING&AIR CONDITIONING INC CCB 64164 06/25/2075 541-345-2838 INSPECTIONS REQUIRED Inspections 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 3315 Water Line 3400 Storm Sewer Storm Sewer Line: Prior to filling trench. 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3650 Shower Pan Shower Pan. Prior to covering and including required testing. 3999 Final Plumbing Final Plumbing: When all plumbing work 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 properly, and the approved set of plans will remain on the site at all times during construction. Q. d ar sires vou to _ Owner orCo/r'EioY-na£uooptedbyth Oregon Utility Date IotiPr ion Center. Those es are set forth in OAR 952-001-0010 through OAR 952-001- 00g0. 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 8/28/2014 8:08:24AM ('Emlcc: THIS PERMIT SHALL EXPIRE IF THE \NORI AuTHORI ED UND SRS. NDN DI FOS PERMT R ;1i\iy I �o DAY PERIOD' Page 1 of 7 RECEIPT NO: 2014001893 RECORD NO: 811-SPR2014.01850 CITY OP SPRINGFIELD LINGrIELID TRANSACTION RECEIPT 225 Fifth St Spnngfield,OR 97477 OREGON 811-SPR2014-01850 541-726-3753 m".spnngfield-or.gov 839 CENTENNIAL BLVD permits nter@springfield-ocgov RECEIPT NO: 2014001893 RECORD NO: 811-SPR2014.01850 DATE: 08/28/2014 DESCRIPTION ACCOUNT CODE/TRANS'CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 One Or Two Family Dwelling with Two Bath 224-00000-425603 1005 420.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 50.40 Technology fee (5% of permit total) 100-00000-425605 2099 21.00 TOTAL DUE: 493.90 PAYMENTTYPE PAYOR CASHIER:OBOwLSBY COMMENTS AMOUNT PAID'.` Check CONSTRUCTION UNLIMITED INC 493.90 2366 TOTAL PAID: 493.90 CFIELD 225 Fifth St LPR=-- CITY OF SPRINGFIELD Springfield,OR97477 Phone:541-726-3753 oResoN Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01849 twm.spring6eld-ocgov pemutcenter@sp6nggeld-ocgov PROJECT STATUS: Issued ISSUED: 08/28/2014 EXPIRES: 02/23/2015 STATUS DATE: 08/2812014 APPLIED: 08/26/2014 SITE ADDRESS: 839 CENTENNIAL BLVD, Springfield, OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1703264313800 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: M - New SFD (to replace existing SFO and detached garage) OWNER: BLOOM MATTHEW H & BECKY B Phone Number: ADDRESS: 10190 SW 149TH TER BEAVERTON OR 97007 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Liu Exp Phone Plumbing Contractor RS PLUMBING CONTRACTOR INC CC8 103816 01104/2016 541-461-4714 en -era_-__.._____--,. General Contractor _— `_-. .... _.......___..__.,.._...-..__. CONSTRUCTION UNLIMITED INC CCB r_ _—.._.__.-_..-_..__._ 173725 01/05/2015 541-514-7588 Electrical Contractor _ - WCC(MAGRAYJR.-w. _ - CCB 21351 04/28/2016__ 541-485-3954 Mechanical Contractor HOME COMFORT HEATING & AIR CONDITIONING INC CCB 84164 _ 06/25/2015 541445-2838 INSPECTIONS REQUIRED Inspections 2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required testing. 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical work 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. Owner or Contra tqr Signature Date ATTENTION: Oregoll lair requiros you to follow rules adopted by f to Oregon Utility n Oorth AR 952 00110010 th ougil OAR 952-00" n OA You may obtain copies of the rules by calling the Center. (Note: the telephone nutni) 0 ter eis re on I A- -332-2344)lfication 'IS PERMIT SHALT_ EXPIRE IF THE WORK IORIZED UNDER FHIS PERMIT IS NOT ENCED OR IS ABANDONED FOR ; o [I AY PFP10[1- Springfield Building Permit 8/28/2014 8:06:24AM Page 1 of 1 FIELO - 224-00000-425604 CITY OF SPRINGFIELD LIN - � TRANSACTION RECEIPT 225 Fdth St 5p-726-QOR97477 ` ONEGON 19.00 5411 -726-3753 224-00000-425604 811-S P R2014-01849 15.00 ww .springeeld-or.gov 839 CENTENNIAL BLVD permits nter@spdngtield-ocgov RECEIPT NO: 2014001891 RECORD NO: 811-SPR2014.01849 DATE: 08/28/2014 DESCRIPTION ACCOUNT, CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 First Appliance Fee 224-00000-425604 1006 82.00 Furnace - up to 100,000 BTU 224-00000-425604 1006 19.00 Range hood/other kitchen equipment 224-00000-425604 1006 15.00 Single -duct exhaust (bathrooms, toilet compartments, utility room: 224-00000-425604 1006 20.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 17.52 --Teehnelog"ee-(50/eFpermit-total) 180-00000-425605 099 "0 Vent for appliance other than furnace 224-00000-425604 1006 10.00 TOTAL DUE: 173.32 'PAYMENTTYPE PAYOR CASHIER:UBOWLSBY COMMENTS AMOUNT PAID Check CONSTRUCTION UNLIMITED INC 173.32 2366 TOTAL PAID: 173.32