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HomeMy WebLinkAboutPermit Building 2010-5-25 Structural Permit Application ! PEPARTMENT USE ONLY, SPRINO..la:LO ~-- .,. . --;-~'-'-, ..:- -- . .<. -~ <..:, '" _ .. r #, - CITY OF SPRINGFIELD,'OREGON' - . 225 Fifth Stree' < Springfield, OR 97477 < PH(541)726-3753 < FAX(54 1)726-3689 Permit no.:OiO- tt'IJ3' Date: This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of ssuan e or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL 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 fiood plain: 0 Yes 0 No CATEgORY OF CONSTRUCTION o Commercial Subdivision: Reference: 7 PROPERTY OWNER Name: Address: -r Sign here: Business name: Address: City: Phone: E-mail: CCB license no.: Print name: Signature: I -SUB-CONTRACTOR INFORMATION;" , Name CeB License Number Phone Number Electrical )/,A Plumbing IrA. Mechanical . AlA FEE SC8EDULE 1. Valuation information . (a) Job dcscription: 1>QVi17'" ilfl1d f'/4I1ucrl:.. Occupancy lilt ~ Construction type: NA Square feet: - Cost per square foot: - Othcr infonnalion: fh,leef ;ne-/vlt!J <"ik....",lc. o,,1v. Type of Heat: Energy Path: o new 181 alteration o addition (b) Foundation-only permit? o Yes t8I No Total valuation: $/tQ. fX>O 2., Building fees p , , .- (a) Permit fee (use valuation table): $ (b) Investigative fee (equal to 12al): $ (c) Reinspeclion ($ per hour): $ (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x (2a+2b+2cl): $ (e) Subtotal of fees above (2a through 2d): $ '3. Plan review fees ' " , - (a) Plan rcview (65% x penn it fee [2a]): $i )i" 'i2- (b) Fire and life safcly (40% x pennit fee [2a]): $ (c) Suhtotal of fees ahove (3a and 3b): $ 4. Miscellaneous fees " '. - " (a) Seismic fec, 1% (.01 x permit fee [2aD: $ TOTAL fees and surcharges (2c+3c+4a): $ ~