HomeMy WebLinkAboutPermit Building 2018-09-11SPRINGTIETD City of Springfield
Development and Public works
225 Fifth Street
Spnngfield, OR 97477
54 t-7 26-37 53
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OR€GO Building Permit
Residential Structural
Permit Number: 81 1-18-001978-STR
IVR Number: 81 10049'l 5731
Web Address: www.springneld'or.gov EmarlAddress: permitcenter@sp.rngneld or gov
TYPE OF WORK
Category of Const uction: Single Family Dwelling Type of Work: Repair
Submitted Job Value: $46,000.00
Description of Work: Fire restoration/repair-NO INSPECTIONS waiting for plans to be submitted
JOB SITE INFORMATION
Worksite add.ess
611 1gTH ST
Springfield, OR 97477
Parcel
1703361212900
Owner:
Address:
AYRES CHRIS
29974 HWY 99 W
CORVALLIS, OR 97333
LICENSED PROFESSIONAL INFORiIATION
Business name
XXL INC - Primary
License number
'109867
Phons
541 -7 47 -5413
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work Contact the issurng
jurisdiction indicated on the permit to determine required inspecttons for this project
Schedule or track inspections at www.buildingpermits oregon.gov
Schedule by phone call 1-888-299-2821 use IVR number: 81 100491573'1
Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store
PERMIT FEES
Fee Description
Technology Fee
Structural building permit fee
State of Oregon Surcharge - Bldg (12o/o of applicable fees)
Quantity
Total Fees:
P€rmits musl be posted in clear view on the worksite. Permits expire if work is not started within 180 Oays of issuance or if work is
suspended for 180 D.ys or longer dependjng on the issuing agency's policy.
All provisions of laws and ordinances governing this type ot work will be complied wilh vrhether specifiod herein or not. Granting of
a permit does not presume to give autho.ity to violate or cancel the provisions ot any other state or local la\iv regulating coostruction
or the pedormance of conslruction.
ATTENTION - CALL BEFORE YOU DIG: Oregon law requires you to follow rules adopted by the Oregon Lrtility Notilication Center.
Those rules are set fonh in OAR 952{01-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at
(877) 668-4001 or dial 811.
All persons or entities pe.forming work under lhis permit are required to be licens€d unless exempted by ORS 70'1.010
(StructurauMechanical), ORS 479.540 (Electrical), and ORS 693.010{20 (Plumbing).
Pnnbd on 9/'11118 Page 1 ol 1 sld_Burtdrngpemit pr
Fee Amount
$29.60
$591.90
$ 71.03
$692.s3
Permit lssued: September 11, 2018
License
CCB
SPRINGFIELD
,b
OREGON
www.springfield-or gov
Worksite address: 611 'lgTH ST, Springfield, OR97477
Parcel: 17033612'12900
Transaction Receipt
81 1-18-001978-STR
Receipt Number: 467992
Receipt Date: 9/11/18
Oevelopment and Public Works
225 Fifth Street
Springfield. OR 97477
541-7 26-37 53
permitcenter@springfi eld-or.gov
City of Springfield
Fees Paid
Transaction date
9t11t18
Units
1.00 Ea
Description
Structural building permit fee
State of Oregon Surcharge - Bldg (12% of
applicable fees)
Account code
22 4 -OOOOO - 425602 - 1 030
Fee amount
$591.90
Paid amount
$591 90
9t11t18
9t11t18
1.00 Ea
1.00 Automatic Technology Fee
821-00000-215004-0000
100-00000-425605,0000
$71 03
$29 60
$71.03
Payment lvethod: Check number: 17810 Payer: Mckenzie Taylor Construction Payment Amount $692.53
Cashier: Katrina Anderson Receipt Tota l:$692.53
Pnnred th 1/18 2 48 prn FIN_TransactionRece pt_pr
$29.60
Structural Permit Application DEPARTMENT USE ONLY
Pe'mitno: lb blq?g
Date: fi llc IZ
ll5 Fifth Slrect . SprinSlicld. OR 97477 . PII(J.l1)726-3753 . [AX(5-11)7]6,:1689 ffi
This permit is issued under OAR 918-460-0030. Permits expire if work is not started withir 180 days of issuance or if rvork is
suspended for 180 days.
FEE SCHEDULE
l. Valuation information
(a) Job descriprion: FlrCg ftef*tA
Construction 5pe
Square f'eet lbfo
t )1hcr rntbnDstion
Tr pe of Hert
E n"" fialteration I addrrion
(b) Foundationrnly permit'l ! Yes ts f,{o
Total laluation s {6,uw
2. Building fees
(a) Permit fee (use valuation table)\
O) lnvestigative lee (equal to [2a])
(c) Reinspecrion (S per hour)
(number ofhours x fee per hour)s
(d) Enrer l2o% surcharge ( l2 x [2a+2b+2c])!
(e) Subtotal of fees above (2a through 2d)!
3. Plan rerierv fees
(a) Plan review (65% x permit lee [2a])J
(b) Fire and lilL salety (65% x permit fee [2aj)s
(c) sublotil of fees aboye (Jr rnd 3b)
4. Nliscellaneous fees
(a) Seismic tee, lolo (.01 x permit fee [2a])S
(b) Tech fee, 5% (.05 x permit fee[2a]+PR fee []cl)\
JOTAL fees and surcharges (2e+3c+44+b):
Ae^o - <a E?o lLT
(a-attt arv - 'fu.t4 J tfl"€.'t/o"us.
€ LE <--( r.l cAc ' (Ltd r Ae / mrta*f f 7e'"tt'l
(CvaFtrvG - /Z€P'+te €rUTl /vG
l/vlu.-A1 toN - /L€/LAc€ €XLlr('vt'
D /L! uv Avt-
F(/{AC
>+#-.a"-' q^"q\D-"4 wdL'J w*
Em- U;;";*J ?'-+"--r- k1'
LOCAL GOVERNMENT APPROVAL
'fhis project has final land-use ap,proval
Signature:Dare:
This project has DEQ approral
Srgnature:Date:
Zoning approval verilied: I Yes E No
Prope(y is within Iood plain: IYes ENo
CATEGORY OF CONSTRUCTION
fln*,,r..r,"t I Govemment E Commcrcial
JOB SITE INFORMATION AND LOCATION
Job site address 6 // t ?ta J7.
CNv: SPEIA/GFIELD state: 0R--zrP:? 7177
Subdivision Lot no
ReLrence Taxlor: / 7- 03' 7b" l)-1?tot
PROPERTY OWNER
Name: 4Va*e5, c-Het!
^ddrcss: 2717 ''l U ou/ 7 7 {.r'
Ciry. Co lLV 4 cL I t stat : oz-ztP:?7ij)
phone: S{/- 337- 72217
E-rnail
Building Owner or Owner's agenl authonzing this application
--'@,-Sign here
E fni. i*t tt"rid. [eing made on residmtial or larm pmperty ouned by
me or a member of my immediate lbmily, and is exempt ftom licensing
requireme[ts under ORS 701.010.
CONTRACTOR INSTALLATION
Business name XXL / NC
eddress: j 1-? ( a-Y.tt Pt c {7.
city: SffL4 State: OA ztP: ? ?'.U
Ph""..s,u-)t7- rf13 Fax:s41 -7tt-o|78
/vtT. .o
CCB lic
E-mail
1o?
@ SmB6t'7etre Set-t-
Signature
INFORMATION
('(lB l,icense #Phone Numbcr'
flectricrl
boue Parue,r- Elfc./tt,t(t t,-lt- L4 ),15eoo \
Plumbing
Nlechanical
Las( edited 5-5,2017 BJones
CITY oF SPRTNGFIELD. oREGoN
Occupancy
Cost per square foot:
Etrergt Path:
$
Fax
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