HomeMy WebLinkAboutPermit Building 2010-5-26
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20I0-00679
ISSUED: OS/26/2010
APPLIED: OS/26/2010
EXPIRES: 11/26/2010
VALUE: $ 2,000.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 228 WEST
ASSESSOR'S PARCEL NO,: 1703352301800
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Springlield TYPE OF WORK: Single Family Residence
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TYPE OF USE: Addition
PROJECT DESCRIPTION: Final building and mechanical/gas for expired permit 02-00276-01- All other
inspections have passed.
Residential
Owner:
Address:
GRAY AMY R
228 WEST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type' Contractor
License
.Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Sec,ondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
.,# of Stories:
Height of Structure
Type of Heat:
~~!er_Iy.p~,
,Range,TYRo: ,
Energy P'.'cth:
Sl)~inkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
, ,
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Jnstruction:
I PUBLIC JMPROVEMENTS ~ \ equires you to
AI I t:" I 'v' : Ore~on aw r ;Q~e on Utility
follow rules ad~~~~~les ire set forth
Notification cen~~i~W8BijrThJNR!Q52-001.
In OAR 952-001- btain copies of the rules by
0090. You may 0 N te' the telephone
calling tfhe tC~~~:~~o~ Utility Notification
number or, 2-2344).
Notes:
i'
Square Footage
or Bid Amount
" -
, Value
Date Calculated
Pa!!e 1 of2
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00679
ISSUED: OS/26/2010
APPLIED: OS/26/2010
EXPIRES: 11/26/2010
VALUE: $ 2,000.00
: ..i(',,'
Total Value of Project
l...fees Paid ., ,
':'f~~r.f; ~~:;f~ 17;: ::;. .t
Fee DescriPtion
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Building Permit
Amount Paid,)'!'
:~i,11' .
$16.44 '
$6.85
$79.00
$58.00
i,
Date Paid
Receipt Numher
" j",
5/26/10
5/26/10
5/26/10
5/26/10
2201000000000000578
2201000000000000578
2201000000000000578
2201000000000000578
Total Amount Paid
$160.29
Plan Reviews, ~,
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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.
L ReQuiredJnsDections .
Final Building: After all required inspections,have,been"n;quested and approved and the building is complete.
._;,::~~~, 'r[;;l.. ft. ','" ,', ,
Final Gas: When all gas work is complete. ,,'
ld j ~
Final Mechanical: When all mechanical work',is corripiete.
By signature, I state and agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is trne and correct, and I further certify that any and all work performed shall he 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 structure withont permission of the Commnnity Services Division, Bnilding Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701,005 will be nsed on this project.
I further agree to ensure that all required inspections are requ'ested a(jthe proper time, that each address is readable from the
. I'"
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 construttion. ;.( , .
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J . ,~'},d. 'r
J~alttb_-
Date
<-,
Owner or Contractors SIgnature
r ~
. !;Xl',;.';li '; :,.I1.~L1,,,-r',., ~ ,
"'~y;. ~ ':,;; :r;p[ige"2,~f 2"
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.':r.~ '~
~tructural Permit Application
~
DEPARTMENT USE ONL y
{'(,..~ ~ e::4j~ 'C"~:'t~!+~S"~::':'''-'';1 ~e:'r~'-lf ~~:C"~~iJ~:tZ~E~J..r~,;~",,q!;:t:.t?;~~
,:~: -;P':!~,;:': Er~'QF, ~~~p,Fl!ilpq:\\ilREp,Q,~~?:~<)' 'e::';:
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
ZIP9?1f1?
City:
Subdivision:
Reference:
Name:
Address: :2-::1- ~
City: Sf'
Phone:
',P.ROPERTV OWNER
14.--1
.,.,. IE' Sf
State:~
Fax:
E-mail:
This installation is being made on residential or farm property owned by
me or a member afmy immediate family, and is exempt from licensing
requirements under ORS 701.010.
:1
Sign here:
STAt_LATION'
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
State: ZIP:
Fax:
Print name:
Signature:
1;~f:~~;~~~iWl~f';:~0S{)B--GO-N}j]~AG;t9RJI_NB9J~_IVIJ\rtlQN~t1~~~~1~'if~t
Name CCO License Number Phone Number
Electrical
Plumbing
Mechanical
permitnoCI0-&70
Date:
::'~';' "=.;' '~~;:;-::?';'~:~:~'::;~'~~'~;;~~';';-;'Y:EE~"~~~H~pi1~~r~'f.:{'," ;:' .
(0
.;.r?Y_at_~~~ti.9'n{intO'rrnit:tfQ~Y~~}'~{1f~~~~i!~)~~~~,~~'~*~i{r~)tt~',~i,fIZi:~4,~~;i+:N'l'
':;'1.
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
o new 0 alteration
(b) Foundation-only permit?
Total valuation:
Baddition
DYes
DNo
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.
';i;,~SIfO.CA~ '9Qy:~@~gt.jt~~pFf8'QYlill{;!~}:;::',?JJ,~,~j
This project has final land-use approval.
Signature: Date:
This project has DEQ approval..
Signature: Date:
Zoning approval verified: DYes D No
Property is within flood plain: DYes D No
~'f,,1\'i~i!ii;l;'fi~ICA'rEb0Ry~i0F"cONSTR(jtiT\0i\i'{~i;Jl;t".id#'ii,,,"
,,^i:K~V.l;".'cv'r~,,~;, ,. . ,. ..... '-...._.'''.....,,,,.;..1-li:. ..,,~..... ..__. ........J..,:"..._,,, ..,~;.._" ,........;;."i;i.~"".,':;'~:n""-';':Y0,"J~,.-;:
ffResidential 0 Government 0 Commercial
iif":,,,!i.i%,~t~9Ef~sl;rEl.fN~9RMA'J'j0N~AN[W~O.CA:fIQNI~J0!l~l1$~~;
:2- g.VV C .if
fr7}7:B,~~H~In.g:,:.f~'~~~~t~i,~1~J;\ti~"~1;Y~1;~;~!i~':2if,~Jl,:;~?:,~~'~~o ,.~~:~~~~"i':'i:~;{if,_,~\,'\;~'~
$
(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+2e]):
(e) Subtotal of fees above (2a through 2d):
$ ,;;.---
$
$
$
$
$
$
$
S
$ 11
(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):
t1t~,M~!r~!i.~Jt~9:ifs1:f~~~~!%)';_it~f~~*~~.;~:tt:~~i"
(a) Seismic fee, 1 % (.01 x permit fee (2aD:
TOTAL fees and surcharges (2e+3c+4a):
MIl ty/fcff 7~~
-r> /11-"/4 t:l"1
/&OC!
225 Fifth Stre.et
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000578
Date: OS/26/2010
II :4S:0SAM
Job/Journal Number
COM20 I 0-00679
COM20 I 0-00679
COM20 I 0-00679
COM2010-00679
Payments:
Type of Payment
CreditCard
cReceinll
Description
Building Permit
1 st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
AMY GRAY
,..t\"" .,'i:"\.~.
Amount Due
58,00
79.00
16.44
6.85
$160.29
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Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
njm
$160.29
$160.29
098808 In Person
Payment Total:
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Page 1 of I
5/26/2010