HomeMy WebLinkAboutPermit Building 2009-11-3
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225 Fifth Street,'; Sp'~irig'fi~ld, 'O)C~c':~,::"
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541-726-3753 Phoner',' .
, 541-726-3676Fax': :"
541-726-3769 In~peciiOl;:Line.
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CITY OF SPRINGFIELD
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Building/Combination Permit
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PERMIT NO: COM2009-01533
ISSUED: 11/03/2009
APPLIED: 10/20/2009
EXPIRES: 05/03/21110
V ALUE:$ 10,000.00
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Springfield TYPE OF WORK: Single Family Residence
11
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SITE ADDRESS: 760 14TH ST '
ASSESSOR'S PARCEL NO.: 1?,03362205200'
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PROJECT DESCRIp,TlON:"" Car drove into house - see attached police report from 10/16/09 Structural and
r'; ." electrical permits required, Also a New business, sign permit required
'Owner: "
Address:
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'BRYSON MELVIN PERRY JR
46833 GOODPASTURE.RD
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VIDA OR 97488 '
Residential
.,. ICONTRACTO~ INFORMATION I
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Contractor Type;!' ;". Contractor
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General " EHLERS CONSTRUCTION INC
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Electncal i:...' CROW V ALLEY ELECTRIC
# of Stories:
Height of Structure
Type of Heat:
." Water Type:
Range Type:
Energy",bath:
, ' ~~I~~uilding nla
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, , o~ \lflnbtlt~~~i;NFORMATlON I
O\e~ 0 ~~~r.,y LtU~I, '''I
...~~O~''iJ.~of?\0 ~'r'oOse ~'r'o Ol"'~, ~\eS .
Frontyard Setback: ,t--~" uW~ '~0\' \'C\\OU. s~1!r ~ '
Side 1 Setback:;" .....'.XO'll t"'ofiG ,.J:fCi\O cof?\~ ....eN! s Rqd:
, "",O"'~c"'\\ 1;)0' ~~~ ~e.'\.\',.
Side 2 Setback:; , ~~o\l\ ~..'a'6'l; ~'1 0 t ~o \)\i'l'te rive Rqd:
Rearyard Setba~k: : \~ 01" '{oU ~ ce~\~~e~o~ ~ ot Coverage:
Solar Setbacks: l~ .~: 0091'\X\~~ \~ \ \'C\e \~. ,
, r:a:. ..\0 ,..\S
(\~\\'~ C!l".J I PUBLIC IMPRO.vEMENTS I 'tJrJA1. t,
Street Improvements: ,,-~""'. =' ~'f!f\Wle~~ l
t..'Q1\Ct. ,~\~ "~f>.\.\. flt:~' '-tl. ',,'r:\
\" 1:1'0.1"\ \" 1:1'0. 'P~l 'f"I'.' c ,; ,", :
I\'IIS? II:I) I.\t-\I) r>.~f>.t-\\)U\".".,:", <',
[>.1.\1\'101'0.1 I) OR \S ,'" '.
CO\'J\\'J\I:t-\CI:[>.'i ?I:RIOI).
[>.t-\'i '\ SO I)
# of Units:
1,)
Primary Occupancy Group: B
Secondary Occ,!p:t.n~YJ~[o,!p.:,~ .i: ~h1, .
Primary Constr_u~tiq,u, ~ype ' " VB
Secondary Construction Type:
# of Bedrooms:..: ' '.
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Storm Sewer Available: '
Special Instruction:'. '_~
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Notes:
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License
04231
149834
Expiration Date
11119./2010 ']1
12/1312009
Phone
541-689-6177
crowvalleyelectr
BUILDING IN~ORMATlON I
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Lot Size: II
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Sq Ft 1st Floor:
Ii
Sq Ft 2nd Floor:
, IE
Sq Ft Basement:
Sq Ft Garage/€arport
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Sq Ft Other: :1
Occupant Load:
II
REQUIRED PARKING
, Ii
Total: i
Handicapped:
11
Comp~ct:
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Page 1 of 3
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CITY OF SPRI1~\.J1'1ELD
BUilding/c~mbihation Permit
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Status tss~ed;;T ::~:". 0, "";,
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225 Fifth Stree(Sprlngfield, OR.
541-726-3753 PI1'one:" .:::;:.
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541-726-3676 Fax' , ',""
541-726-37691nspection Line
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PERMIT NO: COM2009-01533
ISSUED: 11l03/2()09
APPLIED: 10/20/2009
EXPIRES: 05/03/2()10
VALUE: $ 10,00Q.00
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I Valu.~ti?!1'~es~r,iD,ti?!1 ,
Descriptio~:,
Estimate
'\o' Tvpe of Constrnction
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$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
10,000.00
Value
Date Calculated
:~
Total Value of Project
$10,000,00
$10,000,00
11/03/2009
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F~~. P1W
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Fee,DeSCrjPtion~ ; ir " . ."
t. 12% State. Surcharge,
+ 5% Tech'nology;Fee chi:
Building Permit - ',',r. ;;"","
Plan Review CommllndlPublic io'
'$16.32
$6,80
$136.00
$88.40
11/3/09
11/3/09
11/3/09
1113/09
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Receipt Number
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1200900000000001223
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1200900000000001223
1200900000000001223
1200900000900001223
Amount Paid
Date Paid
Total Amount Paid
"$247.52
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Structural Review ,
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11/03/2009
Plan Reviews I
11/03/2009 APP
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Engineered repairs. No change of
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use, structural or footprmt mods.
To Request an inspection calt'the 24 hour recording at 726-3769. All inspections requestJd before 7:00
a.m. will be made the same working 'day, inspections requested after 7:00 a.m. will 'be ma~e the following
work day. ., , ~. " ::t :r' I
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Shear Wall Nailing:
: Uleollire~ In,~p~~ti~
Before.covering she.athing with linish materials.
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Framing Inspection: Prior to cover and after aU rough in inspections have been approved.
Wall Insulation: Prior to cnver. ,)
Ceiling I...sulation: Prior t~ ~over.
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Drywall:; Prior to taping.
Fino! Bu.i,ldi~g: ,~fter all required inspections bave been requested and approved and the b~i1ding is complete.
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Paee 2 of 3
CITY OF SPRINGFIELD
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Building/Combination Permit
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, Status: IssiJ(~d,;!\':f1.', . 'iy:,R; "
225 Fifth Street, Springfield; OR;P:;;' "
541-726.3753 Phone '
541-726-3676 Fax
541-726-3769 Inspection Line ;"(/;;,,
PERMIT NO: COM2009-01533
ISSUED: 11103/2009
APPLIED: 10/20/2009
EXPIRES: 05/03/2010
VALUE: $ 10,000.00
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By signatnre, I state 'and agree, that I have carefully examined the completed application and do hereby certify that all
, information her~o'1~ tr~,e and c?rr~ct; and I furtber certify that any and all work performed shall be done in accordance with
the Ordinances ofthe City. of.Springfield and the Laws of the State of 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 tliat only contractors and employees who are in compliance with ORS 701.005 will be used on this project,
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I furtber agree to ensure that all req!,ired i,!spections are requested at the proper time, that each address i~ readable from the
street, that the permit card is loc~tedat the front of the property, and the approved set' of plans will remain on the site at all
times during construction. ,;:~.;.'/;~{,-:~~if'; " "
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Owner, or Contractors Signature
Date
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Pace 3 of 3
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StfudtiralPermit Application
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225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726.3689
'[)~P'ARrM~NT, US~9'N~y'l
r0W1Z00'-O! ~:SJ:
Permit no,:
Date: //- J.O ~
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 da,J's of issuance Dr if work is
, suspended for 180 days, . ' '
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I ~~~~;~o;eect has tinalland-use approvaL Date: 1 1':/,; <:? :f\';::,;;;:(.;;i~~E;S'CHEplJLgiii!: '
,.[ This project has DEQ approval. 1 '1~;'t~~y~tfi~iJ9W;"i~1~1r]#W.H9~W{~~;ff~j;:t~xi:\lE:,L~~A;:!~l~~~:Mll.:i,~{:{h~i;;t,~:n:,-:J::}$;\~::i:~~:1
Signature: ' ,Date: I (a) Job description: 'PiA'iA.;~ ~:lAM,:';6-,S~_f.rJ:,-JL I
1 Zoning approvalveritied: 0 Yes 0 No ' ' 1 I Occupancy B ]
=~';ir:!~!!~"~~li~~~ : ~::::::.. w~~ ,--~ s-. I
11';::::;~"'~~~~~,V~I~E~~IiPR,~:i~~:~Rj:~9PA:1'iQNf'1~~~;f.i'f1:':11 Other information:
..,. Type of Heat:
I City: .::::::fltl.I.0b ~1~\..O 1 State: ()(L 1 ZIP: <17,/-"1 I EnergyPatb:
I Subdivision: I Lot no,: 1 I 0 new D alteration
iReterence 1701; ~;~~T~T~~~ERC> SZC:>C]II (b) Foundation-only permit?
'M E::.-L- P,e..-<' SorJ 1 Total valuation:
l/ b 'l:n b-ood f' ~~r~ iL- ~ 1
\J I ~ A-- I ~:~' ~ 1 ZIP cr'7fl/.f
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o additi'i.. LU' ,A', ."_
o Yes ~o
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I Name:
Address:
I City:
1 Phone:
I E-mail:
This installation is being made on residential or farm property owned by
me or a member, of my immediate family, and is exemptfrom licensing
requirements under ORS 701.010,
Sign here:
I (a) Permit'fee (use valuation table):
I (b) Investigative fee (equal to [2a]):
I (c) Reinspection ($ per hour):
(number of hours x fee per hour)
I (d) Enter 12% surcharge C12 x [2a+2b+2c]): . $
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(e) Subtotal of fees above (2a through 2d): S
1~'~1~~~J~~v:~y~~W:I~~~r~~~t~~~~rt~B~~ll~~~f~R~~~m;~1~~~*~t~~;!~'fl
1 (a) Plan review (65% x permit fee [2a]): $ I
I (b) Fire and life safety (40% x permiffee [2a]): $ I
,I (c) Subtotal of fees above (3a and 3b): $ I
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$
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I Address: 1 D '$ 51"! A" l) <::;..11-,-\ <:;'''(";'_ L 1
I City: . (;:..0 c.-"'--' f:>- I State: D P- 1 ZIP: '11 'to 21
1 Phone: 5'1- (6'5'1 0/77 Fax: 54-/-631 ~"1Sfl
1 E-mail: I 1
I CCB license no,: [) ,-/-'2.. '3 \ 1
I Print name: ~ A.t-J OY ';:J, I.-D () &.c 1
I Signa;ure 62<. Q -:J. ~. t? - 1
I "CONTRACtOR ,IN!HAtLA'H9N,...
1 Business name: GA-L \..-0-It-'S W ,...,~..,
1 (al Seismicfee. ] % CO] x permit fee [2a]): I $
I TOTAL fees and surcharges (2e+3c+4a): I $
r'10S!r;~;,.;~:'::"~SlJE!'-COcNg~R~:~~~~~~~~~MA1l~~~::~':;:~17,1j'~;1
I Electrical 1
I, Plumbing 1
I Mechanical J
225 Fifth ~ltreetf:;;".>;;> ,"
Springfield, O~~~~~~7~77';;~':::;fL:,;',..
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541-726-3759 Phone, ,,"',
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City of Springfield Official Receipt
Development SerVices Department
Public Works Department
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Date: 11/03/2009
, .RECEIPT;#:' ',.' 1200900000000001223
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Job/Journal Number:{;::rDe~cf:ipiio~'. , ..~
COM2009-01533 5:',: "Plan Review CommlIndlPublic
C0M2009,0] 533 ,.. :,,;.;,JBuilding 'Permit,'
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COM2009,0]533 "j:" \+'5%TechnologyFee
COM2009-01533 t' i2% St,teSurch~ge' ,
Payments:
Type of Payment
Check
9:55:I3AM
, Item Total:
Check Number Authorization
Batch Number Number How'Received
, 6621 In Person
Payment Tota,l:
Amount Due
88.40
]36,00
6,80
16.32
$247,52
Amount Paid
.Paid.By,.' Received By
, "EHLERS CONSTRUCTION INC djb
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$247,52
$247,52
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