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HomeMy WebLinkAboutPermit Building 2014-09-18LSPRINGFIlit.13 ORE GON mrc .spdngfield-or.gov CITY OF SPRINGFIELD Building / Commercial Permit PERMIT NO: 811-SPR2014-02022 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe(mitoenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/18/2014 EXPIRES: 03/17/2015 STATUS DATE: 09/18/2014 APPLIED: 09/18/2014 SITE ADDRESS: 303 S 5TH ST, STE# 195, Springfield, OR 97477 SCOPE: Modular Unit ASSESOR'S PARCEL NO: 1703350000307 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: Replace rail -car restroom with prefab modular restroom OWNER: CITY OF SPRINGFIELD ADDRESS: 225 N 5TH ST Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone INSPECTIONS REQUIRED Inspections 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 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 1 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. 12 Owner or Contractor Signature ate OU to ATTENTION: Oregon la te �Oriegouresn Utii ty follow rules adopted by h Notification Center. Those rales are set forth In OAR 952.001.0010 through OAe rule ROby 0090. You may obtain cop's calling the center. (Ntn' 111/ t"I"'hone number for the Oregon tion Center is 1 a00-332 23°t`#) PI: RMIT SHALL EXPIRE IF THE WORK 10RIZED UNDER THIS PERMIT IS NOT ENCLD OR IS ABANDONED FOR Y 180 DAY PERIOD, Springfield Building Permit 9/18/2014 9:54:21AM Page 1 of 1 RECEIPT NO: 2014002065 RECORD NO: 811-SPR2014.02022 DATE: 09/18/2014 CITY OF SPRINGFIELD F,n�, TRANSACTION RECEIPT 225 F'dth St Springfield,OR97477 2.50 Modular Building 224-00000-425602 OREGON 811-S P R2014-02022 541-726-3753 wmtspnngfield-ocgov 303 S 5TH ST. STE 195 permitoenter@spnngfield-ocgov RECEIPT NO: 2014002065 RECORD NO: 811-SPR2014.02022 DATE: 09/18/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE' Continuing Education 224-00000-425606 2.50 Modular Building 224-00000-425602 1042 444.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 53.28 Technology fee (5% of permit total) 100-00000-425605 2099 22.20 TOTAL DUE: 521.98 `PAYMENTTYPE .PAYOR CASHIER:RHOLMAN COMMENTS AMOUNT PAID Credit Card Greenbrier 521.98 035885 TOTAL PAID: 521.98 This permit is issued under 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 ❑'Government [0 Commercial JOS SITE INFORMATION AND LOCATION Jobsiteaddress: 3 3 SortA g'= G4ree City: State: pOZ ZIP:g7g7 Subdivision: I Lot no.: Reference: 5_Z?0 1 Taxlot: ,W PROPERTY OWNER . Name: o F S R n re Address: �Cfst City: State: ZIP: Phone: Fax: - - E-mail: Building Owner or Owner's agent authorizing this application: Sign here: ❑ This installation is being made on residential or fano property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name: %e_ �,W ✓lam K_ Address: City: State: ZIP: Phone: - - - Fax: - - E-mail: CCB license no.: Print time: Signature: (e) Subtotal of fees above (2a through 2d): SUB -CONTRACTOR INFORMATION Name CCB License H Phone Number Electrical (b) Fire and life safety (40%x permit fee [2a]): $ Plumbing S 4. Miscellaneous fees °. Mechanical (a) Seismic fee, l%(.01 x permit fee [2a]): $ DEPARTMENT USE ONLY Permit no.: Date: nr if work is FEE SCHEDULE _ 1. Valuation information (a) Job description: 1ppa41PPV 9"/jtwiz,_• — e4 Occupancy ,X4 n 41 Construction type: Square feet: _360 Cost per square foot: Other information: Type of Heat: Energy Path: new ❑alteration ❑ addition (b) Foundation -only permit? ❑ Yes ❑ No Total valuation: $ (l'� 2. Building fees (a) Permit fee (use valuation table): $ efgq G (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]): $li' (e) Subtotal of fees above (2a through 2d): $ 3. Platt 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, l%(.01 x permit fee [2a]): $ (b) Technology fee, 5%(.05 x permit fee[2a]): $ j, (c) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (2e+3c+4a+4b+4c): S5 1%� mY —.'n a "iam�a. 3E ON :A9 Iul£.SAb5a1 /3ma yLL 3a Atn r6l.aia r BZZO LLZ tL6 a0 AllJ f\0`J3a0 ON :A© a >iW 'Sw �y1yTy' 9V(l0A !Oa `•1 'Sb3l 31.a0rY JI31jbd :a0] 4lOZ Of AOf 'ddb NNVaO OZ4tl-S>C (POZ) MVf SUZAN LZS[-90C IPOZ) 3\O d 81b0 sYis-9iA 3soe '3501 i38H5 of 0.0 s 'L00131J'JVtld5391tl351Ytl tl3b6Y33ti9 tii^A Hlq � rk. mon av r.°°°zn unobd vrooals3a - sz x .zl :1J3roaa 5e767 a 3VM OYyCB eor 0—i., 'J �! nrlO ® • `VI Y J 3riY3 Sr.. Eu � � LL� � do ❑ 6' °K{rc I9¢E��ka o � 2 � p� ARM"!� Im',� j U� 6 adz Y�y2 Qk ,nl Ha w' ;��� glry t ISi §; iz ;alb So � Q� e ? 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