HomeMy WebLinkAboutPermit Building 2014-09-12SPRINGFIELD-.-..
225 Fifth St
6nR960N
CITY OF SPRINGFIELD
Springfield,OR97477
Phone: 541-726-3753
Building / Residential Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01982
m"v.springfieldor.gov
permitcenter@spdngfield-ocgov
PROJECT STATUS:
Issued ISSUED: 09/12/2014
EXPIRES: 03/11/2015
STATUS DATE:
09/12/2014 APPLIED: 09/12/2014
SITE ADDRESS: 2440 HAYDEN BRIDGE RD, Springfield, OR 97477
SCOPE: Interior
ASSESOR'S PARCEL NO:
1703240000200 TYPE OF STRUCTURE:
Residential
PROJECT DESCRIPTION: Raise roof beam to flush/w ceiling
OWNER: SANCHEZ-PHILLIPS SYLVIA & PHILLIPS K T
ADDRESS: 2440 HAYDEN BRIDGE RD
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
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.
1430 Insulation Wall Wall Insulation: Prior to cover.
1440 Insulation Ceiling
Ceiling Insulation: Prior to cover.
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 Safely. 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 locate�t the front of the property, and the approved set of plans will remain on the site at all times during
or Contractor
0IIS PERMIT SHALL EXPIRE IF THF WORK
AUTHORIZED UNDER THIS PERMIT IS PLOT
CO/ "11.4FNCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD,
D e
FlTTENTION: Oreaon late requires you 10
follow rtde , adopiod by the Oregon Utility
Notifit ,ilou Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain conies of the rules by
nunhbe for thil)q Me e1oregol)lltility�Notif c lt on
Center is 1-800-332-2344),
Springfield Building Permit 9/12/2014 2:19:35PM Page 1 of 1
SPRINGFIELD- --
>�; tom?
"'`"' OREGON
v .spdngfield�r.gov
TRANSACTION RECEIPT
811-SPR2014-01982
2440 HAYDEN BRIDGE RD
CITY OF SPRINGFIELD
225 Fifth St
Spnngfield,OR 97477
541-726-3753
permiloenler@spdngfield-ocgov
RECEIPT NO: 2014002026 RECORD NO: 811-SPR2014.01982 DATE: 09/12/2014
Continuing Education Fee 224-00000-425606 2.50
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 11.10
Structural Building Permit Fee 224-00000-425602 1002 92.52
Technology fee (5% of permit total) 100-00000-425605 2099 4.63
TOTAL DUE: 110.75
Gl1ecK SANCHEZ-PHILLIPS SYLVIA & PHILL 110.75
1035 K T
TOTAL PAID: 110.75
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i4mance or if work is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
This project has final Ian d -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
❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: _
City: State: 0P_ I ZIP.
Subdivision: I Lot no.:
Reference: Taxlot 622122
PROPERTY OWNER
Name: G I
Address: H{� ,� 6
City: 5; .
State: ZI .
Phone: t5_*1 7_-.> ?+- aZ
I Fax. 2-
E-mail: 6'e
Building Owner or n 'sae tho 'zing this application:
Sign here:
This installal n is being made on reside i 1 or fans property owned by
me or a member of my Immediate family, and exempt 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:
(e) Subtotal of fees above (2a through 2d):
SUB -CONTRACTOR INFORMATIO
,
Name
CCB License N
Phone Number
Electrical
$
(c) Subtotal of fees above (3a and 3b):
Plumbing
4. Miscellaneous fees
Mechanical
$
(b) Technology fee, 5% (.05 x permit fee[2a]):
FEE SCHEDULE
1. Valuation information
(a) Job description: 6>' ,...,
Occupancy �jyt 0,
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:
$
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]):
$
(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]):
$ G'
(c) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
$ ��
0
e-/Y-/f-�
0