HomeMy WebLinkAboutPermit Building 2014-09-26ELD
225 Fifth St
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CITY OF SPRINGFIELD
Springheld,OR97477
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Phone: 641-726-3753
OREGON
Building / Commercial Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-02089
ww .springlield-or.gov
permitcenler@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/26/2014 EXPIRES: 03/25/2015
STATUS DATE: 09/2612014 APPLIED: 09/26/2014
SITE ADDRESS: 883 28TH ST, Springfield, OR 97477 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1702310001300 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Frame new interior wall
OWNER: PATAKY INVESTMENTS LLC Phone Number:
ADDRESS: 28945 CROW RD
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor ROY HAROLD HAUGLAND CCB 136110 10/26/2015 541-343-9030
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 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.
'/Y-Wr l —� e�- ad . y
Owner or ont actor ignature Date
,1�3TlCE:
TI IIS PERMIT SHALL EXPIRE IF THE WORK
AUI I-iORiZED UNDER (HIS PERMIT IS NOT
,f11,4PAENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
ATTE=NTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notijic�tion Center. These rules are set forth
n OAR r952.001 0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
numberente is e1e800.33344)
Utility
C
Springfield Building Permit 9/26/2014 8:50:44AM Page 1 of 1
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CITY OFSPRINGFIELD
-• -225
V;5�1i--O
TRANSACTION RECEIPT
Fifth St
Springfield,OR 97477
RON
811-SPR2014-02089
541-726-3753
w v.spnngfield-orgov
883 28TH ST
pormitcenter@spdngfiald-or.gov
RECEIPT NO: 2014002136 RECORD NO: 811-SPR2014-02089 DATE: 09/26/2014
DESCRIPTION ACCOUNT CODE/TRANS'CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 113.57
Continuing Education 224-00000-425606 2.50
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 13.63
Technology fee (5% of permit total) 100-00000-425605 2099 5.68
TOTAL DUE: 135.38
PAYMENTTYPE PAYOR CASHIER:CCARPENTER COMMENTS AMOUNT PAID 4.
Check ROY HAROLD HAUGLAND 135.38
7081
TOTAL PAID: 135.38
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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
a
❑ Residential
❑ Government Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: f g L)S t4
f State:a✓� ZIP:
City: JJ 7
Subdivision: Lot no.:
Reference: Taxiot:
PROPERTY OWNER
Name:
Address: & ' a29-�O S/—
%City:
City: ,5?,e ^
State: ZIP:9) i 7
Phone:
Fax: - -
E-mail:
Building Owner or Owner's agent authorizing this application:
Sign here:
❑ This installatio6 is being made or residential orfarm 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: •y- S�rNS
Address: Ro, t f
City: 51PP Ft>
State: 0it—, ZIP: 7 7
Phone /
Fax: - -
E-mail:
CCB license no.: G
Print name: R 0 C7 L d
Signature:
$
S -CONTRACTOR INFORMATION_,
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]):
DEPARTMENT USE ONLY
Permit no.:
Date: 9
80 days o issuance or if work is
FEE SCHEDULE
r1. Valuation information
(a) Job description: IAII
Occupancy
Construction type: �7
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
❑ newalteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
$
2. But]ding fees
(a) Permit fee (use valuation table):
$ 1-7
(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]):
$ 13
(e) Subtotal of fees above (2a through 2d):
$
. 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]):
$ `—q?
(c) Continuing Education Fee $2,50
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
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