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Home My WebLink AboutPermit Building 2010-4-6 -;....... ...... 'j ~.~ i - CITY OF SPRINGFIELD I r, . '.'.. ,. Building/Combination Permit " .. ^........M_~...'.__.., _,' ",-_,"" Status Issued PERMIT NO: COM2010-00428 225 Fifth Street, Springtield, OR ISSUED: 04/06/2010 541-726-3753 Phone APPLIED: 04/06/2010 541-726-3676 Fax EXPIRES: 10/06/2010 541-726-3769 Inspection Line VALUE: $ 2,000.00 .., -""'" , " SITE ADDRESS: 883 MCKENZIE CREST DR' ," . , 'Springtield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCEL NO.: 1703234304900 I~rl, \ , TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Repairs for sagging roof framing Arret IT!?~l' "l'on"n 1~w reau1res ~u to Owner: LA WDER EVELYN L TE follow rules adopted by the Oregon ~~~ Address: 883 MCKENZIE CREST D~otification Center. Those ru~e~:~e~;~.oot. SPRINGFIELD OR 97477 In OAR 952-001-001~ throug of the rules by Owner: rJei You may obtain copies LAWDER FAMILY LIVI 'lrI~lihe center. (Note: the telephone Address: 883 MCKENZIE CREST DR number for the Oregon Utility Notillcatlon SPRINGFIELD OR 97477 Center is 1_800-332-2344). I '. ,f I CONTRACTOR INFORMATION ~ Contractor Type Contractor License Expiration Date Phone Architect GORDON ANSLOW .. ~, General ANSLOW & DEGENEALT , . ....". ",~,(:, -~~ ..:t:,'; 484-0070 I BUILDING INFORMATION ~,."., # of Units: NOTICE: WIRE IF THE WORK Lot Size: Primary Occupancy Group: R_3TH1S PER~ i . f{'Wl\5'f'ERMIT IS NOT Sq Ft 1st Floor: Secondary Occupancy Group: AUTHORIZ '-BANOONEO FOR .,' Sq Ft 2nd Floor: Primary Construction Type VBCOMMEN ~Pr : . . '.' Sq Ft Basement: Secondary Construction Type: ANY 180 rmnglffl .' .' Sq Ft Garage/Carport # of Bedrooms: Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMA nON I REQUIRED PARKING Front yard Setback: Overlay Dist: Total: Side I Setback: # Street Trees Rqd: Handicapped: Side 2 Setback: Paved Drive Rqd: Compact: Rcaryard Setback: o/~ of Lot Coverage: Solar Setbacks: l I PUBLIC IMPROVEMENTS ~ Street Improvements: Sidewalk Type: Storm Sewer Available: Downspouts/Drains: Special Instruction: Notes: ~~.n~ ",G..';;:;" 'r,'; ... l :1 ~t: .. . , , Paee I of 2 ~."N'"~~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00428 ISSUED: 04/06/2010 APPLIED: 04/0612010 EXPIRES: 10/0612010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description ~ Description Bid Amount Type of Construction Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 2,000.00 Value Date Calculated ,'Total Value of Project $2,000.00 $2,000.00 04/06/20 10 >.,"',.' .J; 'f~: , Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Building Permit Amount Paid Date Paid Receipt Number $6.96 $2.90 $58.00 4/6/10 4/6/10 '4/6/10 2201000000000000326 2201000000000000326 2201000000000000326 Total Amount Paid $67.86 Plan Revie~s ~ To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Ren'uired'liIsDect~ ':.JII 'c' Framing Inspection: Prior to cover and aftefaii rou;gh~ in inspections have been "approved. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. By signature, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is trne and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUP '\PlCY will be made of any structure without per"1ission of the Community Services Division, Building Safety. I further certify mat 'only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I furtheragr~e t4 enshre that all required inspections ,are requested at the proper time, that each address is readable from the stre.!t,(that th~ permit card is located at the fronl'of the propCl'ty, and the approved set of plans will remain on the site at all . I d" / I /. times unng,constructton. VI 1'\ ", t-:::: : \ o~n~ con\:jrs Signatnre 1/ b/l 0 I I Date Pa2e 2 01'2 '.<- :~:~i'~\ 1~~t.. j, Structural Permit Application DEPARTMENT USE ONLY .. ", , ;, '- "......~ :." 1'"1. i-,~~=",.;-- ~;fi.<.';'.: '<lz-$:,:=,:,"o.,F!-+'4:'1;!J:,,'&)":. ..~";,.. -~. . '" :':"" _ -qEr~Y0F,.s~R!Nq~LJi;!jq?<@R~IIi@N~ 1:"'~'7-";, '<)'~~=:- 225 Fifth Street. Springfield, OR 97477. PH(54 ])726-3753. FAX(54])726-3689 Pennit no. a/U - 'IJ-J Date: 'I IIJ This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. - . ".,:.,...,- ,." _, ,.,. .. ~,.~"".,,"_... _, ,-.".",',' .... '-'-<:j ," c. ,."',~,',v..' ,_,~_" ~ _'I', :,._\~.',..;.;;:, ":~.i"."}iF':~;;;j.'''' ;ii'lc9CAk 'G9).'ERNM.i;:N];AB.Il~9YAl!,\~(,;):"';.!i\\W%,,~t";l 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 Ves 0 No e',""',@,/,'ZI43#,0ii",,'C'A'T"E' 'G'O"R"v'~O:'''"'.''C.O'''N''S'''; 'R'''U''C. ""0': 'N''3i';;'Ji:j,:",,~,;;::t\'I;~,.., :#:'tAV:'NL;~~HU.~' _~___,-, "w,~"" '_I~ _,F<Q,; _ __ ___..._11'',_.m' ,LI;'_n _,_~:8;i;:,~-W,/:ik'iF;iL'OE;:;4;f;'-;: o Residential 0 Government 0 Commercial j~~';~gl;~4i{tj9'~;iS'JEl.,f.i~9RMA tiqN~ANQ~~9?3Ati(jN~~~tt~;::~fi.( Job site address: 6, '31\^ < 1C2fJl..Il? c.!le~T City: SfiUN C- p,6L.O O'f:. ZIP: Subdivision Rl\/e(l.. G-t.CN '1') Reference: '" P,ROPERTYOWNER Name: LIWJDa<:. Address: \ '1 . ~ Gf>NJ <?N f;N "'- CitY: 0J ~ State: Die... ZIP: '17'103 Phone: 1'tI -~(!'t- o~n 0 Fax:5i\ -681-0(,'iG E-mail: GtYLo~f0e.lMl.Me~.COM This installation is being made on residential or farm property owned by me or a member of rh~ifllinedi~te family, and is exempt frol!) Ji ensing requirements under ORS 7011010. ___ IA Sign here: I . . 90NJ;RA TPR,INS'rALLATl9N'c...., L() If De: lB'WGT' aJ fl(J'Z 'c.'- Business name: Address: ('I 5 -S City: 6) C:'eNC" State: Phone: S~I-46'i- D070 Fax""] E-mail: &vNiDf'J eMMM<C)'w/'-- CCB license no.: q '11 <:, 0, C"'o,t!J".,J II /) ZIP:'j', 't D J o6l{ b M - !Cl- Print name: 5' ell .,J Signature: -~ - " " ~1N;;:?'i','))l;{~!\1'S\J.B~~ONJ:Mc:::r;dRi'NF()RMM!()N~~i;1:,1'l'rfi:<\}\'j,;~5ii Name CCB License Number Phone Number Electrical Plumbing Mechanical :':'..~:':'~.~t~,'.;:':.,)l:\r.?;J.FE.E -\.S9H'~.pU['~~;~.'~': _ ~ -" .>:('?~':i'1i?')..>:-..", \. ; ',", .~l~:Y~1~~jip'!iJ'i'p-f6riii~:t~_o~~~:~?tff:;~~tM~;hj~~;:&W<-o:}Lt;i-,~~H.t;:.l,;.~-,::H;~!.~: ~!i/ (a) Job description: 'Or r~r.v Occupancy P- Construction type: V 6" Square feet: Cost per square foot Other information: ~/~,<L.. Type of Heat: Energy Path: o new .Q-atte'ration (b) Foundation-only permit? Total valuation: o addition DYes DNo ~I $ ?LJCO i:~7):;~.U~J41ng::fe~t~~~1~f~~;~mL~f!f#;~~;i~!~;{~t~J;!-L~,i\J'i(:'~~:'~;;:Rii,_r:~'.f:io~_,":"':' (a) Pem,it 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 through 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): ~~_~~:'MJKc'~It~t~~"c;"~~jl~~~xi~~~1l;i,t,f:'Yl#N~6~~< c (a) Seismic fee, 1% (.01 x permit fee [2a]): TOTAL fees and surcharges (2e+3c+4a): 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000326 Date: 04/06/2010 II: 19:23AM Job/Journal Number COM20 I 0-00428 COM20 I 0-00428 COM20 I 0-00428 Payments: Type of Payment CreditCard cReceintl Description Building Penn it + 12% State Surcharge + 5% Technology Fee Paid By GORDON ANSLOW Received By cjc Check Number Batch Number ';l 'x,. ,t.-J,~' ", 'j. .,. \".,,:r. ,.I ., Page 1 of 1 Item Total: Authorization Number How Received Amount Due 58.00 6.96 2.90 $67.86 Amount Paid 071311 In Person Payment Total: $67.86 $67.86 4/6/2010