HomeMy WebLinkAboutPermit Building 2010-3-8
ATTENTION: Oregon law requires you.t.o
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
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ContractJIU Center is HI00-332.2344). License
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Sta tus
Issued
225 Fifth Street, Springfield, OR
541.726.3753 Phone
541.726.3676 Fax
541.726-3769 Inspection Line
SITE ADDRESS: 14621 ST
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
Owner:
Address:
TAYLOE BETTY A
PO BOX 71610
EUGENE OR 97401
Contractor Type
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
F,'ontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00145
ISSUED: 03/08/2010
APPLIED: 02/03/2010
EXPIRES: 09/08/2010
VALUE: $ 2,000.00
Springfield TYPE OF WORK: Single Family Residence
1703362203700
~ ,'.
TYI'E OF USE:
BWOP- Enclosed west porch area into residence.
Alteration
Residential
Expiration Date Phone
BUILDING INFORMATION I
.,., ,
# of Sio,'ies:
R-3f:1eIght of ~tructure
Type of Heat:
VB Water Type:
IOnCE' Range Type: . . .
.'HIS PERMIT S~AtW~Rfi'I1~E IFTHEWORK.
\UTHORIZEDUAl'fl!\II'lffil~~~1WI1T IS NOli/a.
.~OMM~l>Wl'~ON-t:.
ANY18~ ...... .'.
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive R11d:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
Downspouts/Drains:
,;,.:"
I Valua~;on Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Pa2e I of2
-~.......~
Wt\i:~,~; .~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00145
ISSUED: 03/08/2010
APPLIED: 02/03/2010
EXPIRES: 09/08/2010
VALUE: $ 2,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetion Line
Total Yalne of Project
I ,.Fees Paid ~
Fee Descritltion
+ 12% State Snrcharge
+ 5% Technology Fee
Bnilding Permit
Amonnt Paid
Date Paid
Receipt Nnmber
$6.96
$2.90
$58.00
3/8/10
3/8/10
3/8/10
3201000000000000080
3201000000000000080
3201000000000000080
Total Amount Paid
$67.86
I Plan Reviews ~
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I Reouired InsDec~
" . <..
..~... "...
Framing Inspection: Prior to cover and after ~n rough'in inspections have been approved.
.,./ ..'
Final Bnilding: After all required inspectio~;:have beeri requested and approved and the bnilding is complete.
By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all
information hereon is true and correct, and I fnrther 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 of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structnre withont permission of the Community Services Division, Bnilding Safety.
I further certify that only contractors and employees who ,.re in compliance with ORS 701.005 will be nsed on this project.
I further agree to ensure that all required inspections arc requested nt the proper time, that each address is read:lble 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 dnring constructj\ '
\/1^ i\ 1 ~J r ,/;>,,-j(--/ ,. :3)'6 )J 0,
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Owner or Contractors Signature Date
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Page 2 of 2
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;;Structural Permit Application
'[)EPAfHM~NT,USEQNLY .'
~!i:::~ .,,~)~;'~~S]F~~f;J?ill~~~~g9~:;ItJt~~~~~
225 Fifth Street. Sprmgfield, OR 97477. PH(541)726-3753. FAX(S41)726-3689
Penn it noel 0- I L( 5-
Date: J V
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days ofissJance or if work is
suspended for 180 days.
;0:;', ',,~;: ,f<,'i.iq,C<Aji!.'9:['tEMMgl{'fjji4~i:@5;vAl\i~~1ii\\{~~lW'~%~\1
This project has final land-use approval.
Signature: Date:
This project has DEQ approval..
Signature: Date:
Zoning approval verified: 0 Yes 0 No
Property is within flood plain: 0 Yes 0 No
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'" '41) -"'.",~0j:2;;~ .1CATEG0RY?:Of, ~CONS1iRUC;r10N('Z@.;".!i)1~;;o''''';<:'~-~j''~;
~~"-~~""""""","1"""'~"_",,:, " ," _'~"_'n.""ni!,i\.. .._,,~., ."m._...__"" .". ._. C..! ...._~_<>"'.."'.. .-...1. ,~~.~ _.M-n."f",_~..
0 Residential 10 Government 0 Commercial
3~ik~~~~~!;:;~~~~'Q'~i{~s)j.~1,'fffF9_~:~A f!9'~fAN_R'~~~;'-GATI9:N~~;~~~~\t~S~
Job site address: j</J,J z.. I ( I
City: &\'l FL.t-, I State: (J-7L.. I ZIP <1'71.-1 f7~
Subdivision: I Lot no.:
Reference: I Taxlot:
';,' . . ;" p'ROPERTY gWNER.' ':",'(',
';'"
Name: Mrlc(:;- I 11-'"/(...'-'/= r
Address: / tf/J l- I .IF
City: 5epL-f) State: ~?"'-I ZIP:
Phone: - - Fax: - -
E-mail:
This installation is being made on residential or farm property owned by
me or a member of my immediate familznd is exempt from licensing
requirements under ORS 70 I~.
l)M < . '/L~
Sign here: .I L l r-
.. '. ~ONTRAC;r;O~ WSl'Al,LATIQNL",; .,/; .'.
Business name: (. )
Address:
City: State: I ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
;~ft~~~;trf_~;~t~~~~sQ$~GqN_J:R-AGJORf(N ~,O~M~mi9~~[~f~~~~i4k~~lk~M1
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
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:~X l~y~)_~~~tJfi.'fft(i!;ior#l:~:fl!iQ;r~Bl~:~~)f~1~~hJ1~i?)~~~f}~i1tl~,~Sf1:,~tf:;,~f1~~~~~,~:~-,
r~Lfr
(a) Job description:
Occupancy
Construction type:
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
o new Q.alieraiion
(b) Foundation-only permil?
Total valuation:
o addition
DYes
oNo
$
$
$
$
$ 'i~
$
(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 througb 2d):
(a) Plan review (65% x permit fee [2a]):
(b) Fire and life safety (40% x permit fee [2a]):
(e) Subtotal of fees above (3a and 3b):
~~Y::M~-~f~H.~~n19~~jte~~t**~~,f1~11t;;~~a~rf;;~N~t(I~1_~T;,;
(a) Seismic fee, 1 % (.01 x permit fee [2a]): $
TOTAL fees and surcharges (2e+3c+4a): $ &',/ ~
225 Fifth Street
Spr'ingfield, Oregon 97477
541-726-3759 Phone
iiiE~'
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000000000000080
Date: 03/0812010
I :27:49PM
Job/Journal Number
COM20 1 0-00 I 45
COM20 1 0-00 I 45
COM2010-00145
Payments:
Type of Payment
Check
cRcceint I
Description
Building Pennit
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MIKE TAYLOE
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
58.00
6.96
2.90
$67.86
Amount Paid
CJC
2155
$67.86
$67.86
In Person
Payment Total:
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Page I of I
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