HomeMy WebLinkAboutPermit Building 2014-09-09LRINELD "
OREGON
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CITY OF SPRINGFIELD
Building / Commercial Permit
PERMIT NO: 811-SPR2014-01949
PROJECT STATUS: Issued
STATUS DATE: 09/09/2014
ISSUED: 09/09/2014
APPLIED: 09/09/2014
SITE ADDRESS: 3912 MAIN ST, Springfield, OR 97478
ASSESOR'S PARCEL NO: 1702314101401
OWNER: COPELAND INVESTMENTS 2 LLC
ADDRESS: 37124 HILLS CREEK RD
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
Permitcenter@spri nglield-ocgov
EXPIRES: 03/07/2015
SCOPE: Interior
TYPE OF STRUCTURE: Commercial
Phone Number:
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
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.
1999 Final Building Final Building: After all required inspections have been requested and approved and
the building is complete.
By signature, I slate and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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.
-.. 'Y -
caner br Contractor Signature Dale,
I C il"r.
I it TIS PERMIT SHALL. EXPIRE IF THE WORK
AUTHORIZED TINDER TEAS PERMIT IS NOT
GOf4N1EN( Ep OR IS Al3ANDONED FOR
AMY 180 DAY PERIOD.
ATTENTION: Oregon law requires you to
follow ruff:s adopted by the Oregon Utility
Nofillnttfion 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 9/9/2014 2:43:55PM Page i of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
t TRANSACTION RECEIPT Springfield,OR97477
OREGON
811-SPR2014-01949 541-726-3753
vrvnv.spdngfield-or.gov 3912 MAIN ST permitoenter@spdngfield-or.gov
RECEIPT NO: 2014001980 RECORD NO: 811-SPR2014-01949 DATE: 09/09/2014
Building Permit Fee 224-00000-425602 1002 82.00
Continuing Education 224-00000-425606
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
2.50
9.84
Technology fee (5% of permit total) 100-00000-425605 2099 4.10
TOTAL DUE: 98.44
Che" Jeremy Wheeler 98.44
520
TOTAL PAID: 98.44
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Structural Permit Application
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3669
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This permit is issued under OAR 918-460-0030. Permits expire if work is not started within I
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
I ❑ Government -Commercial
JOB SITE INFORMATION AND fOCATION
Job site address:
City: i'r ac -T l State: b ZIP: CiAl
Subdivision: I Lot no.:
Reference: Taxlot:
PROPERTY OWNER
_
' (n
Name: , �. 11411
Address: 're-, ('L P IA,., 51 -
City: ,,,., .;r.
state: 0Z ZIP: It? %Jj'
Phone: V7 -o2 a5
Fax: -
E-mail: Seer Lrol C4r
Building Owner or Owner's agent authorizing this application:
Sign here:
'his install on is 4 ing made on residential or farm property owned by
me or a mem r of my immediate family, and is exenpt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION
Business name:
Address:
City:
State: ZIP:
Phone: -
Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
$
SUB -CONTRACTOR INFORMATION
Name
CCB License #
Phone Number
Electrical
(c) Subtotal of fees above (3a and 3b):
S
Plumbing
(a) Seismic fee, 1%(01 x permit fee [2a]):
Mechanical
(b) Technology fee, 5%(.05 x permit fee[2a]):
$
IDEPARTMENT USE ONLY
Permit no.: �/1K
Date: ?I5l/4l I
nr if wnrk is
FEE SCHEDULE
1. Valuation information
(a) Job description: 11/7 2U vPI— 6,�
Occupancy
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:
$ r]
2, Building fees
(a) Permit fee (use valuation table):
$ Xv
(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]):
$ 5)
(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):
S
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):
S
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