HomeMy WebLinkAboutPermit Building 2014-09-15SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfleld,OR97477
aar Phone: 541-726-3753
- OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01904
w v.spdngfieldacgov permitoenter@spdn9rield-orgov
PROJECT STATUS: Issued ISSUED: 0911612014 EXPIRES: 03/14/2015
STATUS DATE: 09/15/2014 APPLIED: 09/04/2014
SITE ADDRESS: 224 W D ST, Springfield, OR 97477 SCOPE: Shop
ASSESOR'S PARCEL NO: 1703352306300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: S• Building a new workshop.
OWNER: THOMAS ROSE M TE
ADDRESS: PO BOX 232
Phone Number:
BLUE RIVER OR 97413
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor BRETT ROBERT DEAN CCB 55937 03/05/2015 541-337-7459
INSPECTIONS REQUIRED
Inspections
1110 Footing Fooling: After trenches are excavated.
1120 Foundation Foundation: After forms are erected but prior to concrete placement.
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
1460 Insulation
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 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
Oregon law requires you to
ted by the Oregon Utility
ATTENTION:
follow rules adop h OAR 952 001
Notification Center, Tljh ou�Lltlesaresetfort
in OAR 952-001 obtainNoteethe toj elephone e rules y
0090. YOu In center. ( otlllcation
calling precJon Utility N
nulnber for the
Center is 1.000 32-2344).
Date
�; PERA4IT SITAIL EMPIRE IF THE WORT
IOI;IZf D UNDER THIS PERMIT IS NOT
JM\iCED OR IS A3ANDONEp FOR
V 'i 8o DAY PERIOD.
Springfield Building PermH 9/15/2014 1:38:55PM Page 1 of 1
SPRINGFIELD--
61-,
,.�
:OREGON
OREGON
mm.spdngfieldor.9ov
811-SPR2014-01904
224 W D ST
CITY OF SPRINGFIELD
225 Fifth St
Spnngfield,OR 97477
541-728-3753
permitcenter@spdngffeld-or.gov
RECEIPT NO: 2014002036 RECORD NO: 811SPR2014-01904 DATE: 09/15/2014
Continuing Education Fee
224-00000-425606
2.50
Planning - Minor Review - City
100-00000-425002
1231
119.00
Residential Fire (.05 Per Scl Foot)
100-00000-424005
9111
16.00
SDC: Improvement Cost - Local Wastewater
443-00000-448025
1184
429.12
SDC: Improvement Cost - Storm Drainage
440-00000-448028
1176
133.88
SDC: Reimbursement Cost - Local Wastewater
442-00000-448024
1183
879.18
SDC: Reimbursement Cost - Storm Drainage
441-00000-448029
1177
92.11
SDC: Total Sewer Administration Fee
719-00000-426604
1175
65.42
SDC: Total Storm Administration Fee
719-00000-426604
1180
11.30
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
26.25
Structural Building Permit Fee
224-00000-425602
1002
218.78
Technology fee (5% of permit total)
100-00000-425605
2099
10.94
TOTAL DUE:
2,004.48
5375
Brett Dean Construction I Brett Dean - 2,004.48
TOTAL PAID: 2,004.48
LNELD � CI"TY OP SPRINGPIBLD
..: ',..225 Fifth St
��„TRANSACTION RECEIPTSp nggeld,OR97477
OREGON 541-726-3753
811-S P R2014-01904
ww .spdngfield-orgov 224 W D ST permitcenler@springfield-or.gov
RECEIPT NO: 2014001929 RECORD NO: 811•SPR2014-01904 DATE: 09/04/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Structural Plan Review Fee Residential 224-00000-425602 1061 142.21
TOTAL DUE: 142.21
'PAYMENTTYPE , PAYOR CASHIER:RHOLMAN COMMENTS AMOUNT PAID
Credit Card BRETT ROBERT DEAN 142.21
04754p
TOTAL PAID: 142.21
Structural Permit Application
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
SPRINGFIELD,'-
�✓3
OREGON
DEPARTMENT USE ONLY
Permit no.:
Date:
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
40 Residential I ❑ Government I ❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 2'L4- w. V
City: Li y'ivt r4G1M State: 01- 1 ZIP: -1
Subdivision: Lot no.:
Taxlot:
Reference:jib
ROPERTY OWNER
Name: Rog 114s WIAS
Address: 'ZLN' W
City: rivet C� g
State:6lL zrn:R 411
Phone:
Fax: - -
E-mail:
Building Owrrer or Owrrer's agent authorizing this application:
Sign here:
❑ This installation is being made on residential or farm 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: 13R0I)C-A" C-C)KITF
Address: (' � "e
�,.I.
City: Eu6E�Cystate:
Oe ZIP: N19
Phone• 1-3 1
rax: - -
E-mail:
C55`131 mAaL o eox-t
CCB license no.: ! 5ei
Print name: R Lys._ I)F
Signature:
3. Plan review fees
"<SUB -CONTRACTOR INFORMATION
Name
CCB License #
Phone Number
FlMrIC
OXS 5K
5viwbtElectrical
-u
Plumbing
JAC7 i rl1 IVF ( ��9�U i% Stfl b8? -753
Mechanical
FEE SCHEDULE
1. Valuation information
(a) Job description: (vjV3 S]t0 IF
Occupancy tl - o e
construction type: .- &
Square feet: [ t >C `jd' —' -7jZD
Cost per square foot: Q24- K 800/0 =4
other information: :(qAt- t/V./-t7C'r 4 or,(8 '
'type of Reap 91A
Energy Path: V/141
0 new ❑alteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
$
2. Building fees
(a) Permit fee (use valuation table):
$ -% .X
(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):
S
3. Plan review fees
(a) Plan review (65%x permit fee [2a]):
Z�
$ z
(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[2aj):
$%
TOTAL fees and surcharges (2c+3c+4a+4b):
S (pp
ELD
Issued ISSUED: 09/15/2014 EXPIRES: 03/14/2015
225 Fifth St
L-i'"
CITY OF SPRINGFIELD
Springfield,OR97477
oaecoN
PROJECT DESCRIPTION:
Phone: 541-726-3753
OWNER: THOMAS ROSE M TE Phone Number:
Building / Residential Permit
Inspection Phone: 541-726-3769
BLUE RIVER
OR 97413 '
Fax: 541-726-3676
CONTRACTOR INFORMATION
PERMIT NO: 811-SPR2014-01965
Contractor Name Lie Type Lie No Lie Exp Phone
w .springfield-or.gov
JACKO PLUMBING INC CCB 169047 03/14/2016 541-683-7535
permitcenter@spdngfield-or.gov
PROJECT STATUS:
Issued ISSUED: 09/15/2014 EXPIRES: 03/14/2015
STATUS DATE:
0911512014 APPLIED: 09/11/2014
SITE ADDRESS: 224 W D ST, Springfield, OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO:
1703352306300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
P- Rough -in for future bathroom in new shop.
OWNER: THOMAS ROSE M TE Phone Number:
ADDRESS: PO BOX 232
BLUE RIVER
OR 97413 '
CONTRACTOR INFORMATION
Contractor Type
Contractor Name Lie Type Lie No Lie Exp Phone
Plumbing Contractor
JACKO PLUMBING INC CCB 169047 03/14/2016 541-683-7535
INSPECTIONS REQUIRED
Inspections
3150 Underslab Plumbing
Underslab Plumbing: Prior to filling the trench and including required testing.
3500 Rough Plumbing
Rough Plumbing: Prior to cover 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.
Owner or Contractor Signature
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 1-600-332-2.344).
Date
11S PERMIT SHALL EXPIRE IF THE WORK
�!7I10RI7ED UNDER PHIS PERMIT IS NOT
,,, LACED OR IS ABANDONED FOR
10 DAY PERIOD.
Springfield Building Permit 9/15/2014 1:34:18PM Page 1 of 1
RECEIPT NO: 2014002035 RECORD NO: 811-SPR2014-01965 DATE: 09/15/2014
Balance of Minimum Plumbing Permit Fees
224-00000-425603
CITY OF SPRINGFIELD
LINELD
TRANSACTION RECEIPT
225 Fifth St
2.50
Spdngfield,OR97477
OREGON
811-SPR2014-01965
547-726-3753
w .springfieldacgov
224 W D ST
permito nter@spdngfield-ocgov
RECEIPT NO: 2014002035 RECORD NO: 811-SPR2014-01965 DATE: 09/15/2014
Balance of Minimum Plumbing Permit Fees
224-00000-425603
1005
19.00
Continuing Education Fee
224-00000-425606
2.50
Shower/Shower pan
224-00000-425603
1005
21.00
Sink/basinflavatory
224-00000-425603
1005
21.00
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
9.84
Technology fee (5% of permit total)
100-00000-425605
2099
4.10
Water closet
224-00000-425603
1005
21.00
TOTAL DUE:
98.44
Brett Dean Construction / Brett Dean
5375
98.44
TOTAL PAID: 98.44
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Structural Permit Application SPRINGFIELD
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 oaecort
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within
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
W Residential I ❑ Government ❑Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 2.24, W , f p
City: Li rt✓. r4cvlJ State: e.VL- ZIP: TKII
Subdivision: Lot no.:
Reference: Taxlot: Ot
ROPERTY OWNER
Name: R05.6 vvtAS
Address: ?Zq W. 't>' `77 k-ftT
City: rlw Pei-tp
state: oA— Zin-7 41-1
Phone:
Fax: - -
E-mail:
Building Owner or Owner's agent authorizing this application:
Sign here:
❑ This installation is being made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION
Businessname: 13R&YF DCAOJ C_C1VA '`
Address: U6 j�l(� � 4V&
�
City: Etk('JC
f.'
State: DP ZIP: 7tiD
Phone• '-gO0
Fax: - -
E-mail
c55°131 /y1/WL .. CUAn
CCB license no.: 55131
Print name:
Signature:
S
SUBCONTRACTOR INFORMATION
Name
CCB License
Phone Number
Electrical
Xs 01
$
INI.46.623
DEPARTMENT USE ONLY
Permit no.:
Date:
180 days of issuance or if work is
Plumbing
111 [o/
Mechanical
FEE SCHEDULE
1, valuation information
(a) Job description: ( 34t'A S ]{D
Occupancy (/' OL
Construction type: :st.- &
Square feet: [(ptK -220' 7� 'ZjZ%
Cost per square foot:
Other information: ffiAfi VMAe- 4[0°(82'
Type of beat p1
Energy Path:
® new []alteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
i
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):
S
3. Plan review fees
(a) Plan review (66% x permit fee [2a]):
$ Z�
(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]):
$
TOTAL fees and surcharges (2e+3c+4a+4b):
S
- - �� �,�`