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HomeMy WebLinkAboutPermit Building 2013-6-21 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 • Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01019 www.springfield-or.gov pennitcenter @springtield-or.gov PROJECT STATUS: Issued ISSUED: 06/2112013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05/22/2013 SITE ADDRESS: 6132 Graystone LOOP,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1802032204900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New single family residence OWNER: BRUCE WIECHERT CUSTOM HOMES INC Phone Number: ADDRESS: 3073 SKYVIEW LN EUGENE OR 97405 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor BRUCE WIECHERT CUSTOM HOMES INC CCB 101717 09/16/2014 541-686-9458 Electrical Contractor L 8 E ELECTRIC INC COB 105475 03/30/2014 541-933-2598 Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06127/2013 541-726-0100 Plumbing Contractor STEVEN R JOHNSON CCB 65065 03/12/2014 541-342-3765 • L INSPECTIONS REQUIRED Inspections 1020 Zoning Setbacks 1090 Street Trees 1110 Footing Footing: After trenches are excavated. 1118 Footing Drain 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 1160 UFER Ground Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1170 Post&Beam Post and Beam: Prior to floor insulation or decking. 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1370 Masonry Veneer 1410 Underfloor insulation nTr,-�+iIC'J Gcyun ;cm IG1.lull es you t0 1420 Insulati iy�9orUl e�rieefuuDted bV the Or?`On lltility N©rjCE' • 1430 InsulafllSrr'waftion Center. Those rulestanerl ut h Prior to cover. THIS PERMIT SHAT C^.i c C Cot 031C t.Il uuyl l ql 5-2_0Q HU I NORIZEDI UNDER EXPIRE FIF THE ' 1440 Insul el Y2+ nq psul`htlon: Prior to cover. may obtain conies o 1f1e7uleC ga(fiiH IYaGRal&i $ANDONEDI FR Nvr 1520 Interior SaftvAhe center. .(Note: th ApNaIl Na ng: Before coverings nuntor for the 0.e o.. LA ty Nuuttueu un • •'O DAY PEHIUD. 1530 Exterior Shearw.lbnter is 1-800-332-2344). 1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. Springfield Building Permit 6/21/2013 8:32:30AM Page 1 of 2 SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 l Phone: 541-726-3753 \OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01019 wwwspringfield-ocgov pe rmitcenter©springfield-or.gov 1920 Miscellaneous Building By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true 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 or 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 that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable 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 during construction. Owner or Contractor Signature Date • • Springfield Building Permit 6/21/2013 8:32:30AM Page 2 of 2 SPRINGFIELD CITY OF SPRINGFIELD • . - . +t: -ss, 225 Fifth St .,�� TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-01019 www.springfield-or.gov 6132 Graystone LOOP pennitcenter @springfield-or.gov RECEIPT NO: 2013001288 RECORD NO:811-SPR2013-01019 DATE:06/21/2013 DESCRIPTION-_,____ __ -. ACCOUNT.CODE/TRANS.CODE ,_ `_AMOUNT,DUE_1 Address Assignment,each new or change 224-00000-425602 1020 42.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 134.00 SDC:Administrative Fee-MWMC Regional Wastewater SDC 611-00000-426604 1189 10.00 SDC: Compliance Cost-MWMC Regional Wastewater SDC 444-00000-426607 1113 22.61 SDC: Improvement-Transportation SDC 447-00000-448027 1174 955.33 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 949.31 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,392.04 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 491.85 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 262.12 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 1,945.03 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 108.14 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 337.65 SDC:Total MWMC Administration Fee–Local 719-00000-426604 1121 76.64 SDC:Total Sewer Administration Fee 719-00000-426604 1175 144.72 SDC:Total Storm Administration Fee 719-00000-426604 1180 41.47 SDC:Total Transportation Administration Fee 719-00000-426604 1190 60.87 Second Permit Discount 201-00000-428060 1148 67.00 Structural Building Permit Fee 224-00000-425602 1002 1,462.60 Willamalane fees-Single family detached 821-00000-215023 1074 996.62 TOTAL DUE: 9,500.00 LPAYMENT;TYPE _ .PAYOR._. -cnswER:JLARSON w _COMMENTS. _,,;;„' . _ AMOUNT PAID Credit Card BRUCE WIECHERT CUSTOM HOME: 9,500.00 015988 INC TOTAL PAID: 9,500.00 SPRINGFIELD CITY OF SPRINGFIELD hits\tn 225 Fifth St > TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-01019 www.springfield-ocgov 6132 Graystone LOOP permitcenter©springfield-or.gov RECEIPT NO: 2013001292 RECORD NO:811-SPR2013-01019 DATE:06/21/2013 a DESCRIPTION_` _ACCOUNT CODE/TRANS CODE AMOUNT DUE Planning-Major Review-City 100-00000-425002 1231 211.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 175.51 Technology fee(5%of permit total) 100-00000-425605 2099 78.58 Willamalane fees-Single family detached 821-00000-215023 1074 2,413.38 TOTAL DUE: 2,878.47 ' AMOUNT'PAID ' " L PAYMENT TYPE__,,PAYOR CASHIER:w�RSON '-: . � COMMENTS , �y�-:,, ` �„ ...J Check - BRUCE WIECHERT CUSTOM HOME: 2,878.47 22734 INC TOTAL PAID: 2,878.47 • • • SPRINFIELD G CITY OF SPRINGFIELD t, �tx TRANSACTION RECEIPT 5P5 g eId,OR 97477 OREGON 541-726-3753 811-SPR2013-01019 www.springfield-or.gov 6132 Graystone LOOP permitcenter @springrield-or.gov RECEIPT NO: 2013001012 RECORD NO:811-SPR2013-01019 DATE:05/22/2013 ;DESCRIPTION_ .. . _ ,1 .<, _ _ .ACCOUNT CODE/TRANS,CODE_.. .. .._ __AMOUNT.DUE_-I Structural Plan Review Fee Residential 224-00000-425602 1061 950.69 - . _.-- - -. - - _ _ - _ __ . _. _ _ _ TOTAL DUE: 950.69 _ CASHIER:DeowLSev a� _ COMMENTS;� "' - AMOUNT PAID ° , ' 1 PAYMENT TYPE_ - :, -_ Credit Card BRUCE WIECHERT CUSTOM HOME: 950.69 045914 INC TOTAL PAID: 950.69 5/3 -00/ 5/2 .7 I❑ SAME AS: I I LOCAL GOVERNMENT APPROVAL This project has final land-use approval. FEE SCHEDULE Signature: Date: 1.Valuation information This project has DEQ approval. (a)Job description:New Single Family Dwelling,detached Signature: Date: Occupancy: R3/U Zoning approval verified: G Yes ❑ No Construction type: VB Property is within flood plain: ❑ Yes El No Square ft: House:1 22421 G:1 485 (Other. I CATERGORY OF CONSTRUCTION Cost per square foot: $107.08 $40.62 $20.31 0 Residential I❑ Government I ❑ Commerdal Other information: JOB SITE INFORMATION AND LOCATION Type of Heat:Gas forced air Job site address: 6132 Graystone loop Energy Path:ESA and CAI City: Springfield (State:OR ZIP: 97478 ISI New ❑ alteration U addition Subdivision: Mt gate west I Lot no: 78 (b)Foundaltion-only permit? ❑ Yes G No Reference: 1 $OZ 0)Z Z1Taxlot: I 04 70o Total valuation: I $259,774.06 PROPERTY OWNER 2.Building fees Name: Bruce Wiechert Custom Homes (a)Permit fee(use valuation table): $1,462.60 Address:3073 Skyview Ln. (b)Investigative fee(equal to [2a]): City: Eugene State:OR (ZIP:97405 (c) Reinspection($ per hour): Phone: 541-686-9458 Fax: 541-344-3362 (number of hours x fee per hour) This installation is being made on residential or farm property (d)Enter 12%surcharge(.12x[2a+2b+2c]): $175.51 owned by me or a member of my immediate family,and is exempt (e)Subtotal of fees above(2a through 2d): $1,638.11 from licensing requirements under ORS 701.010. 3.Plan review fees / Sign here: (a)Plan reveiw(65%x permit fee[2a]): $950.69 Y CONTRACTOR INSTALLATION (b)Fire and life safety(40%x permit fee[2a1) Busisness name:Bruce Wiechert Custom Homes (c)Subtotal of fees above(3a and 3b): $950.69 Address: 3073 Skyview Ln 4. Miscellaneous fees: 5%Tech $73.13 City: Eugene State:OR (ZIP:97405 (a)Seismic fee, 1%(.01 x permit fee [2a]): Phone: 541-686-9458 Fax: 541-344-3362 TOTAL fees and surcharges(2e+3c+4a): $2,661.93 E-mail: wiecherthomes @comcast.net CCB license no: 101717 Print name: Derrick Westover Signature: SUB-CONTRACTOR INFORMATION Name: CCB License Number Phone Number E L&E Elect. 105475 541-933-2598 P Steve's Plumbg. 65065 541-342-3765 M Comfort Flow 460 541-726-0100 Updated 4/1/2013 P?awillannalane deb Park and Recreation District 2 Job. No. .S/ ✓ - /(9( PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 NAME: WL�I I PHONE: „9 01-CO ADDRESS: 307J ccL(v(E--L.) CITY: OA-4. STATECJ'- ZIP: C47'YDS LOCATION OF PROPOSED BUILDING SITE: Street address: 4' I � Z 4' /LA ti ITO Nl Plat name: kl&TC{ft-TE kJtr '13'78 Tax Lot Number: /J01- a32 Z 09'960 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS / X$3,410 per unit= $ 3`((0 B. Single-Family Attached • NO. OF UNITS X$3,385 per unit= $ C. Multi-Family Apartment NO. OF-UNITS X$3,021 per unit= $ D. Single Room Occupancy • NO. OF UNITS X$1,510 per unit= $ E. Accessory Dwelling Unit NO. OF UNITS • X$1,705 per unit= $ 2. SDC CREDIT(If applicable.SDC payer must furnish proof of credit approval.) - ($ 3. TOTAL PARK AND RECREATION SDC ASSESSED $ • 3f'(c) / 27 /.7 City of Springfield Date of building permit submittal ��- / 2 (i /3 City of Springfield Date of building permit issuance SPRINGFIELD 225 Fifth St hEN CITY OF SPRINGFIELD Springfleld,OR 97477 to OREGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR201 3-01 021 www.springfield-or.gov permitcenter @springfieltl-or.gov PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05/22/2013 SITE ADDRESS: 6132 Graystone LOOP,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1802032204900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New single family residence OWNER: BRUCE WIECHERT CUSTOM HOMES INC Phone Number: ADDRESS: 3073 SKYVIEW LN EUGENE OR 97405 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor BRUCE WIECHERT CUSTOM HOMES INC CCB 101717 09/16/2014 541-686-9458 Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06/27/2013 541-726-0100 L INSPECTIONS REQUIRED Inspections • 2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required testing. 2210 Underfloor Gas Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. 2255 Gas Pressure Test 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2995 Final Gas Final Gas: When all gas work is complete. 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true 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 or 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 that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable 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 during construction. ll // ....,... V✓� 6 NOTICE: 'iHE WORK :.:.. Owner or Contractor Signature - Date THIS PERMIT SHALL EXPIRE IF ATTENTION: Oregon law requires Utility AUTHORIZED UNDER THIS PERMIT IS NOT follow rules adopted by the Oregon COMMENCE OR IS ABANDONED FOR Notification Center. Those rules are set forth ANY 180 DAY PERIOD. in OAR 952-001-0010 through OAR 952 001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephc/=1' Springfield Building Perrfl.Jmber for the Ore on Utility Notification g 6/21/2013 8:30:04AM Page 1 011 Center is 1-800-332-2344). SPRINGFIELD CITY OF SPRINGFIELD A i1 .(a 225 F1fth St TRANSACTION RE ^-A`O OREGON RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01021 • www.springfield-or.gov 6132 Graystone LOOP pennitcentergspringfield-or.gov RECEIPT NO: 2013001289 RECORD NO: 811-SPR2013-01021 DATE:06/21/2013 iDESCRIPTION _ ACCOUNT_CODE/TRANSCODE' ' - AMOUNTDUE Air conditioner 224-00000-425604 1006 18.50 First Appliance Fee 224-00000-425604 1006 80.00 Flue vent for water heater or gas fireplace 224-00000-425604 1006 10.00 Furnace-up to 100,000 BTU 224-00000-425604 1006 18.50 Gas Piping-each additional above 4 224-00000-425604 1006 9.00 Gas Piping up to 4 outlets 224-00000-425604 1006 7.50 Range hood/other kitchen equipment 224-00000-425604 1006 14.50 Single-duct exhaust(bathrooms, toilet compartments, utility room: 224-00000-425604 1006 50.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 24.96 Technology fee(5%of permit total) 100-00000-425605 2099 10.40 TOTAL DUE: 243.36 -- rk-' - AMOUNT.PAID �.PAYMENTTYPE,___-;;,:PAYOR :cnsRIER ,ILnasoR _ COMMENTS " �..� - ;,° �- _- .,„, • t " ,1 i Check BRUCE WIECHERT CUSTOM HOME: 243.36 22734 INC TOTAL PAID: 243.36 • • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 C Lou - Phone: 541-726-3753 • ` OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01020 www.springfield-or.gov pennitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05/22/2013 SITE ADDRESS: 6132 Graystone LOOP,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1802032204900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New single family residence OWNER: BRUCE WIECHERT CUSTOM HOMES INC • Phone Number: ADDRESS: 3073 SKYVIEW LN EUGENE OR 97405 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor BRUCE WECHERT CUSTOM HOMES INC CCB 101717 09116/2014 541-686-9458 Plumbing Contractor STEVEN R JOHNSON CCB 65065 03112/2014 541-342-3765 INSPECTIONS REQUIRED Inspections • 3130 Footing/Foundation Drains 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 3315 Water Line 3400 Storm Sewer Storm Sewer Line: Prior to filling trench. 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3999 Final Plumbing Final Plumbing: When all plumbing work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all • information hereon is true 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 or 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 that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable 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 during construction. ff_,TTE�p N: Oregon law requires you to 6 i Z ►ol>owf ITes adopted by the Oregon Utility Not;Cit,aiiwt (,enter. Those rules are set forth Owner or Contractor SigrPdhBr�THE ORDER OF Date in OAR 952-001-0010 through OAR 952-001- FINGFIELD BRANCH NQTI�' USBANK 0090. You may obtain copies of the rules by THIS PE tTEt gtQN pIRE IF THE WORK calling the center. (Note: the teleph a-c: AUTH(1 , 'll,i!A 4 FI IJ PERMIT IS NOT number for the Oregon Utility Notification COMMG CZD OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180 DAY PERIOD. Springfield Building Permit 6/21/2013 8:27:20AM Page 1 of 1 y SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St OREGON TRANSACTION RECEIPT Springfield,OR97477 ,OREGON 541-726-3753 811-5 PR2013-01020 www.springfield-or.gov 6132 Graystone LOOP permitcenter @springfield-cr.gov RECEIPT NO: 2013001291 RECORD NO: 811-SPR2013-01020 DATE:06/21/2013 [DESCRIPTION y , _ ACCOUNT CODE/TRANS_CODE 1,AMOUNT;DUE One or Two Family Dwelling with Three Bath 224-00000-425603 1005 483.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 57.96 Technology fee(5%of permit total) 100-00000-425605 2099 24.15 TOTAL DUE: 565.11 PAYMENT TYPE_ PAY,OR� CASHIER:uuARSON .` COMMENTS ') s `' 'AMOUNT PAID Check BRUCE WIECHERT CUSTOM HOME: 565.11 22734 INC TOTAL PAID: 565.11 • SPRINGFIELD - 225 Fifth St °- CITY OF SPRINGFIELD Springfield,OR 97477 - Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01022 www.springtield-or.gov pe rmitcenter@springfield-or.goy PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05/22/2013 SITE ADDRESS: 6132 Graystone LOOP,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802032204900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New single family residence OWNER: BRUCE WIECHERT CUSTOM HOMES INC Phone Number: ADDRESS: 3073 SKYVIEW LN EUGENE OR 97405 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor BRUCE WECHERT CUSTOM HOMES INC CCB 101717 09/16/2014 541-686-9458 Electrical Contractor L 8 E ELECTRIC INC CCB 105475 03/30/2014 541-933-2598 INSPECTIONS REQUIRED Inspections 4000 Temporary Power Service 4225 Service or Feeder 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true 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 or 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 that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable 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 during construction. G- ? /.13 Owner or Contractor Signature - Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification 952 Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in,CAR 952-001-0010 through OAR 952-001- n0 You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT r fha tsle?'.,./> ,: COMMENCED OR IS ABANDONED FOR "'c ....'n ANY 180 DAY PERIOD. • • Springfield Building Permit 6/21/2013 8:23:49AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD v )�. 225 Fifth SSt PRINGFIELD TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01022 www.springfielo-or gov 6132 Graystone LOOP permitcenter@springfielo-or.gov RECEIPT NO: 2013001290 RECORD NO: 811-SPR2013-01022 DATE:06/21/2013 [DESCRIPTION_- -. ,_v. _ , :....-. _ _ _ ._ _• ACCOUNT:CODE/TRANS CODE_..: - AMOUNT DUE,2 Each added 500 sq ft or portion 224-00000-426102 1004 110.00 Residence wiring 1,000 sq. ft. or less 224-00000-426102 1004 147.50 Stale of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 39.18 Technology fee(5%of permit total) 100-00000-425605 2099 16.33 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 382.01 L PAYMENT TYPE_ _PAYOR CASHIER:JLARSON : ' , COMMENTS , 1 AMOUNT PAID -.: • r I Check BRUCE WIECHERT CUSTOM HOME: 382.01 22734 INC TOTAL PAID: 382.01 • • Electrical Permit Application _ .i` DEPARTMENT`USE ONLY ��a5t_ BPgIgOeldO � -�^+e {§` epot t,Nis (,pFUibv S 'Fs `, ' _ e , --C.9,4- , f n :-.: y"; 3 e T��.l�'SE Ar G I:�'t�� Rj �%0 ' ,i 0 Permit no.: .52,7—40 2-2— 225 Fifth Street•Springfreld,OR 97477•PH(541)726-3753•FAX(541)726-3689 0 Date: (r17 17Z 2-7/ 3 This permit is issued under OAR 918-309-0000.Permits are nontransferable.Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. alts .TEPV.,1 .0cA a GOVERNMENT:APPROVAL .._ ;WPg ° J`00wfe<' : ,'FEE?SCHEDULE't to ax3;, ; ,,F. s Z Zoning approval verified? • ❑Yes I• i ry �, $$rr, s ` }``Cfost Tutor'. ❑No fr Nlumber of inspections_per ttem a Qty 4'L� : t.cost'AS `CATEGORY'aOF.;:CONSTRUCTION a yqx Residential,per unit,service included: ❑Residential ❑Government ❑Commercial /L 507 i)ni:JOEnSITtiNF.ORMATION AND LOCATION r �'_,;,i' 1,000 sq.ft.or less(4) wirer-7-) 5/y;`D Each additional 500 sq.ft.or portion /J Job site address: b /3 Z 6 f4..7 51-8 h thereof 7 '7/3 City: State: ZIP: Limited energy(2) $ 32.00 $ Reference: Taxlot.: Each manufactured home or modular dwelling service or feeder(2) . $ 63.00 $ g ft� ti 4 DESCRIPTION"OF`;WORKZ f ^ a-W- 14///Lt /74 1` TL7F�i° p4,✓/2-- Services or feeders:installation,alteration,relocation 200 amps or less(2) $ 81.00 $ ysz t ;(a _,;""-`.PROP.ERTY;OWNERi'1 ; . WSto-r 1k 201 to 400 amps(2) $ 95.00 $ Name: (23•r t) ce-- W'; e c L eVt- Cu 5 1-ow. 1-67 rim c it 401 to 600 amps(2) $158.00 $ Address: 3 0 7 3 S k�, b`c.,) 1 N to 1,000 amps(2) $205.00 $ City: f,)5 e;..t. I State:0 rt. ZIP: el 7'j o) Over 1,000 amps or volts(2) $469.00 $ Phone:541-64- el `l S$ FaxS4(-34 Y 3 3(, Z Reconnect only(2) $ 63.00 $ Temporary services or feeders:installation, alteration relocation E-mail: L„) , e.c,Le..a-I n o't`c5 (v j op Mc c - . N,4- 200 amps or less(2) 5 .60 $& 5 This installation is being made on residential or farm property owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale,exchange,lease,or rent.OAR 479.540(1)and 479.5600). 401 to 600 amps(2) $126.00 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above r la , a=CONTRACT.OR 'INSTALLATIONitge ti Branch circuits:new,alteration,extension per panel Business name: 1.-. 4- 6 Elec.-'y<c_ a.Fee for branch circuits with purchase of a service or feeder fee: Address: 7z g ;; "Sores AGtres Each branch circuit $ 6.00 $ City:5pC\e State()l� ZIP: 9 7 y7 3 b.Fee for branch circuits without purchase of a service or feeder fee: Phone:1/ -52- \ 1-1 1q g Fax6`1 J- 9'-33 2 S-9 sE First branch circuit(2) $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: ( p 5 9 75' BCD license no.: Zj 33 L Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 4 /7 y - S- Each pump or irrigation circle(2) $ 63.00 $ Print name of signing supervisor: C� De j. u, e n Each sign or outline lighting(2) $ 63.00 $ Signature of signing supervisor: Pi-01\314f Signal circuit x nsion(2)energy panel, $ 63.00 $ ( alteration,or extension(2) Each additional inspection:(1) $58.00 $ n _ enTKO0LICAIJT Lit Ea.3 t* s i:4"r'= / ' -L rn (A) Enter subtotal of above fees l!� 1 C G S e (Minimum Permit Fee$58.00) $324 50 Y �' (B)Enter 12%surcharge(.12 x[A]) $ /z,1 r (C)Technology Fee(5%of[A]) $ ✓/4 Z TOTAL fees and surcharges(A through C): $ 12,__°/ 440-2584-7(9/08/COM)