HomeMy WebLinkAboutPermit Building 2014-09-24SPRINGFIELD
'1 CITY OF SPRINGFIELD
oaSG°N Building / Commercial Permit
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PROJECT STATUS: Issued
STATUS DATE: 09/24/2014
SITE ADDRESS: 101 S A ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703353206900
PROJECT DESCRIPTION: Roofing
OWNER: CITY OF SPRINGFIELD
ADDRESS: 225 5TH ST
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
perm itcenter@springfield-or.gov
ISSUED: 09/24/2014 EXPIRES: 03/23/2015
APPLIED: 09/24/2014
SCOPE: ReRoof
TYPE OF STRUCTURE: Commercial
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
General Contractor RIVER ROOFING INC CCB 79016 01/06/2016 541-746-5000
INSPECTIONS REQUIRED
Inspections
1620 Roofing Roofing: Prior to installing any roof covering.
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 Stale 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.
(1� Qzzz,7 =
Owner or ontraclor 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 1-1300.332-2344).
zy
Date
1:110) PERMIT SHALL EXPIRE IF THE WORK
1I1 HORIZED UNDER THIS PERMIT IS NOT
riIENCED OR IS ABANDONED FOR
".0 DAY PERIOD.
Springfield Building Permit 9/24/2014 2:32:11PM Page 1 of 1
Ex-L-7-A
NGFCITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
ONEGON
811-S P R2014-02073 541-726-3753
wmi.spnn9fie1d-orcgov 101 S AST permits nler@spnngfield-or.gov
RECEIPT NO: 2014002118 RECORD NO: 811-SPR2014.02073 DATE: 09/24/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 516.00
Continuing Education 224-00000-425606 2.50
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 61.92
Technology fee (5% of permit total) 100-00000-425605 2099 25.80
TOTAL DUE: 606.22
PAYMENTTYPE PAYOR CASHIER:RNOLMAN' COMMENTS 'AMOUNT PAID
Check River Roofing 606.22
33295
TOTAL PAID: 606.22
r. 1 1
$s.rx �'G41i,Y.: r1• .;fi LU�j'�daG'•$
r
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This permit is issued under OAR 918-460-0030. Permits expire if wort is not started within ]
suspended for 180 clays.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date:
This project has DEQ approval.
Signature:
Date:
Zoning approval verified: ❑ Yca ❑ No
Property is within Rood plain: ❑ Yes ❑ No
CATEGORY OF CONSTRUCT ON
L1 Residential ❑ Government Commercial
JOB SITE INFORMATION AND LOC TION
Job site address: 101 JbUt.:r" A
city: reI1.)GFIELD state. zip:glu7i
Subdivision: I Lot no.:
Reference: '� T'aelot: C) cog
PROPERTY OWNER
Name: •t t IJt3Ft.EL17
Address: ZZ ATL`
CityS P RtNC3tf-'tELii
State• Z1Pa"7477
Phone: - -
Fax: - -
E-mail:
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 tinder ORS 701.010.
Sign here:
_ CONTRACTOR INSTALLATION
Business na mI
e: VB ] Ne_>
Address: 14e4 !ESa-,L1_1JA �J-rrc ei! ;1
Ci1 N, r -1 C-
StatcirDR I ZIP 14.17
PboneO41-14(o 5e)M5
Fax641-7 I cl
E-mail:f'• VP_c-Y oopkYl a • COIV1
CCR Recuse no.. b I t�o/�
Print nante: OGffI— EF,10 ev r
Signature:
$
SUBCONTRACTOR INFORMATION
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
DEPARTMENT USE ONLY
Permit no.:�1_,oA
Date:
or
FEE SCHEDULE__
1. Valuation information
(a) Job description: I [J -AUU N)[y CC -,DAR
Occupancy
Construction type: pdl:�IKA(a.
Square feet: (04o®
Cost per square root:
Other information:
Type of Heat.
Energy Path:
❑ new ❑ alteration q addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
2. Building fees
(a) Permit fee (use valuation table):
$
(b)luvestigativefee (equal to (2a]):
$
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter n% surcharge (.12 x [2a+2b+2c)):
$
(e) Subtotal of fees above (2a through 2d)t
$
3. Plan review fees
(a) Plan review (65%x permit fee [2a)):
$
(b) Fire and life safety (40%x pemnit fee [2a)):
$
(c) Subtotal of fees above (3a and 3b):
S
4. Miscellaneous fees
(a) Seismic fee, 1%(.01 x permit fee [2a]):
$
TOTAL fees and snrc6arges (2e+3c+da):
$
GS
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