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Permit Building 2013-6-21
SPRINGFIELD 225 Fifth St liii.- CITY OF SPRINGFIELD Springfield,OR 97477 Lai Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01027 www.springfield-or.gov permitcenter@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: 1060 53RD ST,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702283401700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New single family residence OWNER: CUMMINS INVESTMENTS LLC Phone Number: ADDRESS: 31221 OSPREY RD LEBANON OR 97355 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1999 Plumbing Contractor JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 General Contractor DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 Mechanical Contractor SUNSET HEATING 8 AIR INC CCB 171706 08/18/2014 541-554-2604 _ INSPECTIONS REQUIRED 11 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. 1220 Underfloor framing 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. 1520 Interior Shearwall Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior Shearwall 1540 GypsummoapttfpyeA gon law rBGDrywal'CPrioDto taping. Lath/Plaster: To be made after all lathing,and gypsum f0ltnlu rnlaa ardnntprl by the C.boardpipt¢rig(ynnd exterior are in place, but prior to plasteririg.'- 1999 Final EttiggiNstati011 Center. Those rUlESrialEBBileif gftIAfter all requirediirisp gixrs have been requested andiapproved'and In OAR 952-001-0010 through Qe.BtGldingagleomplete. THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT Springfield auimmQpb ThlDef for the Oregon( UtiliteNotiflcatir/. COMMENCED OR IS ABANDONED FOR ,... 6/21/2013 9:16:27AM „ -Page 1 012 Center is 1-800-332-2344). ANY 180 DAY PERIOD. SPRINGFIELD 225 Fifth St ' °- CITY OF SPRINGFIELD Springfield,OR 97477 ir .'(`t� Phone: 541-726-3753 ` OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01027 www,springfield-ar.gov permitcenter @springfield-or gav 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 9:16:27AM Page 2 of 2 SPRINGFIELD CITY OF SPRINGFIELD `tom TRANSACTION RECEIPT Spriingfeld,OR 97477 OREGON 541-726-3753 811-SPR2013-01027 www.springfield-or.gov 1060 53RD ST permitcenter @springfield-ar.gov RECEIPT NO: 2013001304 RECORD NO:811-SPR2013-01027 DATE:06/21/2013 (DESCRIPTION ' ' ' `.. :;AC000NTTCODE/TRANSCODE - -AMOUNT DUE_ Planning-Major Review-City 100-00000-425002 1231 211.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 124.00 Technology fee(5%of permit total) 100-00000-425605 2099 57.12 W Ilamalane fees-Single family detached 821-00000-215023 1074 2,083.01 TOTAL DUE: 2,475.13 ..., AMOUNT PAID �,-.PAYMENT TYRE__PAYOR _casMIER:ccnRPENreR � . -___COMMENTS- - �� Check DAVIS CONSTRUCTION SERVICES t 2,475.13 1907 TOTAL PAID: 2,475.13 • SPRINGFIELD CITY OF SPRINGFIELD h14 A. 225 Frith St rtEGON TRANSACTION RECEIPT Spring eId,OR97477 541-726-3753 811-SPR2013-01027 www.springfield-orgov 1060 53RD ST permitcenter©springtield-or.gov RECEIPT NO: 2013001303 RECORD NO:811-SPR2013.01027 DATE:06/21/2013 tDESCRIPTION . y_" __', %-:CODE ``` AMOUNT DUE. Address Assignment, each new or change 224-00000-425602 1020 42.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 92.55 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 779.79 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,392.04 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 320.57 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 262.12 SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 1,597.71 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 108.14 SDC: Reimbursement Cost-Storm Drainage .441-00000-448029 1177 • 220.06 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 76.64 SDC: Total Sewer Administration Fee 719-00000-426604 1175 118.87 SDC: Total Storm Administration Fee 719-00000-426604 1180 27.03 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 1,033.36 Willamalane fees-Single family detached 821-00000-215023 1074 1,326.99 TOTAL DUE: 8,513.68 II ' PAYMENT_TYPE"uPAYOR CASHIER:CCARPENTER -,r,_COMMENTS;._'_,,. ._.,." , 'AMOUNT PAID .., _. .3 Credit Card DAVIS CONSTRUCTION SERVICES-1 _____ i �� 8,513.68 015676 TOTAL PAID: 8,513.68 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St OREGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01027 wwws 1060 53RD ST pringfield-or.gov permitcenter @springfieltl-ocgov 1. RECEIPT NO: 2013001018 RECORD NO: 811-SPR2013.01027 DATE:05/22/2013 (DESCRIPTION- ' ,, ; ; ' t : r " .. _ACCOUNT CODEITRANS_CODE`-" ',:_�AMOUNT_DUEJ Structural Plan Review Fee Residential 224-00000-425602 1061 - 671.68 TOTAL DUE: 671.68 i.,=PAYMENT.TYPE PAYOR, :CASHIER:,DBOWLsev - .}COMMENTS `w AMOUNT PAID • '.I Credit Card scoff davis 671.68 07092d TOTAL PAID: 671.68 • • Structural Permit Application SPRIGFIELD DEPARTMENT U, N SEONLY . i4 SY( Z -Y t a. ll' f t 2t ' CITY/OF SPRINGFl_EI:D OREGON' ft2`"j 3 "T ice' Permit no. 93 6 Z 7 225 Fifth Street•Springfield,OR97477•PH(54I)726-3753•FAX(541)726-3689 i�:.ns,_OREGON Date: 572 -e,./3 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. ;:' a r LOCAL;GOVERNMENT. APPROVAL'b `.. .-0-r 'r` ri =%11 . 4tIM,.r°FEE SCHEDIJ(E ' , at 'Kg '^'�a� This project has final land-use approval. 1_ Valuatto¢_mfoimatio4�. �''„; 4 ,t gii1u t" ,:�w3!' Signature: Date: (a)Job description: 5f....7 e I R.,,;h. 1e1 This project has DEQ approval. Occupancy Signature: Date: �3 Zoning approval verified: ❑Yes ❑No Construction type: VT Property is within flood plain: ❑Yes ❑No Square feet: / 3 Ci 77 .S3 7 `?`';x,.12 ', `.;CATEGORY OF CONSTRUCTIONS _ .,iW ry;: Cost per square foot: ',tom , kl Residential ❑Government ❑Commercial Other information: 6rr� 1�,,✓"ve' +f ?56-11;SITE{INFORMATION'AND LOCATION,-a y1 Type of Heat irf d Job site address: /0(a 0 5-3-` Energy Path: rs 64 City: $pr,/) State: 0-i- ZIP: 87973 new ❑alteration ❑addition Subdivision: THiie5 ro,.0 MAC Lot no.: 9 (b)Foundation-only permit? ❑Yes No L/O Reference: 17OZZ O 3 1 Taxlot: O t.7 U U Total valuation: s/ 75.. ':.;-'t,';,+s- , ei c.PROPERTYebwNER_,.<..-=.."g .{..- s' .2:riiddmg;t'ees, a .I -r;4 t rv" `fLr Name: C✓.4t."^/N5 /N✓157 1 -7$ Lai c (a)Permit fee(use valuation table): $ 7o-37-..---- Address: 3 12'2 I 05 PRf 9 Pd. (b)Investigative fee(equal to[2a]): S City: Lf&A-NNO•- State: O.'- ZIP:q1 5c (c)Reinspection($ per hour): S Phone: S4 1 - 253 - z4..5-0 Fax: - - (number of hours x fee per hour) (d)Enter 12%surcharge(.12 x[2a+213+20:: $ /270 E-mail: T Ec 'e w S Con[Ai'. NTH (e)Subtotal of fees above(2a through 2d): S o Building Owner or Owner's agent authorizing this application: 3 plan revtewsxfe(::g gg,` r , ;. _e'er ,r;v:_.n 5 F/°°''/:rgtio lr (a)Plan review(65%x permit fee[2a]): $ t�7( -- Sign here: i - (b)Fire and life safety(40%x permit fee[20: $ ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing 4=;Miscellanetiits fees`:. F r,,t,!ia" ,..r` illy r'.P requirements under ORS 701.010. (a)Seismic fee, 1%(.01 x permit fee[20: S s S "�CONTRAQTOR INSTA(LATIONs:,.`--e;;�'.- ' o �-7 =+=`t' L.. .- . (b)Technology fee,5%(.05 x permit fee[2a]): $ S/ Business name: OA✓'S CON5bevc rl ors 5fa.44-15 Gec 7/ TOTAL fees and surcharges(2e+3c+4a+4b): S Address: 574.7 5 M£y r - rr-- City: S PP") State: 04 ZIP: 97170 Phone: 511- 56$ -629r/ Fax: - - /n/ E-mail: QA✓15C01 d 4440. Com N CCB license no.: I6 0 3 Y 7 Print name: Se0-Tr Da✓'$ Signature: 11 N wiIIaIraialane • tb Job. No. 57.7-1d2- / PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 NAME:G�,0yf A./Ny //V` PHONE: ADDRESS:3/L2_/ 6.71/J/2dV CITY:C5 471*-0X/ STATE: 04---ZIP: 573 TS- LOCATION OF PROPOSED BUILDING SITE: Street address: AOCCD STN.' Plat name: Tax Lot Number: 771)2- 2 d?y O/zed 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS / X$3,410 per unit= $ 7 /D 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.) (5 ) 3. TOTAL PARK AND RECREATION SDC ASSESSED $ _TWO City of Springfield Date of building permit submittal City of Springfield Date of building permit issuance SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 t a Phone: 541-726-3753 ' OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01030 www.springfield-or.gay pennitenter@springtield-or.gov PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05/22/2013 SITE ADDRESS: 1060 53RD ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702283401700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New single family residence OWNER: CUMMINS INVESTMENTS LLC Phone Number: ADDRESS: 31221 OSPREY RD LEBANON OR 97355 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 General Contractor DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 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. 3450 Drywell/Soakage Trench Drywell: Engineered Drywell is Required. 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. te IF IA,. 6174113 Owner or Contractor Signature Date Springfield Building Permit 6/21/2013 9:25:35AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD -,, i`O EGON TRANSACTION RECEIPT Spro gfield .OR97477 541-726-3753 811-SPR2013-01030 www.springfield-ar.gov 1060 53RD ST permltcenter©spnngfield-or.gov RECEIPT NO: 2013001300 RECORD NO:811-SPR2013-01030 DATE:06/21/2013 [DESCRIP_TION:' . :;` ..,.,__ACCOUNT CODE/TRANSCODE 7. ' -: ':.AMOUNT_D,UL_. One or Two Family Dwelling with Two Bath 224-00000-425603 1005 411.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 49.32 Technology fee(5%of permit total) 100-00000-425605 2099 20.55 TOTAL DUE: 480.87 I PAYMENT_TYPE 'PAYORCASwER:cgARPENJER'r ; ' ; COMMENTS, ' 'm :Sr ' , AMOUNT PAID - -" J Credit Card DAVIS CONSTRUCTION SERVICES L 480.87 015676 TOTAL PAID: 480.87 • • • SPRINGFIELD 225 Fifth St ___t_alii CITY OF SPRINGFIELD Springfield,OR 97477 hir., OREGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01029 www.Springfield-or.gov permitce nter @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: 1060 53RD ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702283401700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC -New single family residence OWNER: CUMMINS INVESTMENTS LLC Phone Number: ADDRESS: 31221 OSPREY RD LEBANON OR 97355 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 General Contractor DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 Mechanical Contractor SUNSET HEATING&AIR INC CCB 171706 08/18/2014 541-554-2604 INSPECTIONS REQUIRED Inspections 2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required testing. 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. 2210 Underfloor Gas Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. 2255 Gas Pressure Test 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. 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. Il k71. - 6/7/ 03 Owner or Cont ctor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility 'HIS PERMIT SHALL EXPIRE IF THE WORK Springfield Building Notification 952-001-0010 through h OAR 952-001- \UTHORIZED UNDER THIS PERMIT IS NOT ;. 0090. You may obtain copies of th&i1.8b'3 b}R2'25AM COMMENCED OR IS ABANDONED FO�be i er.1 calling the center. (Note: the telephcaio ANY 180 DAY PERIOD. number for the Canter 3 is 1-600 2-2344)Ification SPRINGFIELD CITY OF SPRINGFIELD 71.L A 225 Fifth St _ �O EGON TRANSACTION RECEIPT Springfield,OR 97477 ii 541-726-3753 811-SPR2013-01029 www.springfield-er.gov 1060 53RD ST permitcenter @springtield-or.gov RECEIPT NO: 2013001302 RECORD NO:811-SPR2013-01029 DATE:06/21/2013 DESCRIPTION . ACCOUNT CODE/TRANS CODE ,_..AMOUNT_DUE_J First Appliance Fee 224-00000-425604 1006 80.00 Furnace-up to 100,000 BTU 224-00000-425604 1006 18.50 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 40.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.26 Technology fee(5%of permit total) 100-00000-425605 2099 8.03 TOTAL DUE: 187.79 PAYMENT TYPE • PAYOR _CASHIER:CCARPENTER : , COMMENTS _ __. _ L.: AMOUNT PAID _ Credit Card DAVIS CONSTRUCTION SERVICES I 187.79 015676 TOTAL PAID: 187.79 ■ SPRINGFIELD 225 Fifth St ' — CITY OF SPRINGFIELD Springfield,OR 97477 CCB Phone: 541-726-3753 .OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01028 www.springtield-or.gov pennitcenter @spnngfieId-or.gov PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 05122/2013 SITE ADDRESS: 1060 53RD ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702283401700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New single family residence OWNER: CUMMINS INVESTMENTS LLC Phone Number: ADDRESS: 31221 OSPREY RD LEBANON OR 97355 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 General Contractor DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 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. 1 • 421113 Owner or Cor tractor Signature Date ATTENTION: Oregon law requires you to TAME: follow rules adopted by the Oregon Utility HIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth UTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by '!P4MEPJCED OR IS ABANDONED FOR calling the center. (Note: the tclept..: . NY 180 DAY P ERIOD. number for the Oregon Utility NOtittCft:,ur' Center is 1-800-332-2344). Springfield Building Permit 6/21/2013 9:20:02AM Page 1 of 1 SPRINGFIELD CITY 5Ffth St HELD __ _.... 225 Fifth St ��, TRANSACTION RECEIPT Springfield,OR 97477 1' OREGON 541-726-3753 811—S P R2013-01028 www.springfield-or.gav 1060 53RD ST permitcenter @springfield-or.gov RECEIPT NO: 2013001301 RECORD NO:811-SPR2013-01028 DATE:06/21/2013 I.DESCRIP_1ON ACCOUNT CODE/TRANS CODES AMOUNT„DUE Each added 500 sq.ft.or portion 224-00000-426102 1004 55.00 Residence wiring 1,000 sq.ft. or less 224-00000-426102 1004 147.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 32.58 Technology fee(5%of permit total) 100-00000-425605 2099 13.58 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 317.66 sf PAYMENT TYPE - - _ -CCARPENTER COMMENTS 14.._} Credit Card DAVIS CONSTRUCTION SERVICES 1 317.66 015676 TOTAL PAID: 317.66 • Electrical Permit Application DEPARTMENT USE ONLY ::. ma ry�y m"9�3'Ea .z�.: , 'a -h�. i-wita arc e i .. . . e rY ® �,SPaZING 9 ED 0.RE --9 -`d~� - 5/3 r :... .;.tF re$- . ':3 '" Vi. Permit no �O 2 225 Fifth Street•SpringOeld,OR 97477*PA(541)726-3753•FAX(541)726-3689 Date: 572-2--/47 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. :r , ,rLOCAL;'GOVERNMENT APPROVAL .i; 1 .,1- ? ,,4 ;FEE.':SCHEDULE __ , Zoning approval verified? ❑Yes ❑No Nomber of ins ectians er item Cost 'Total"; CATEGOFircbF:CONSTRUCTION " "' ' ' �/ Residential,per unit,service included: M Residential ❑Government ❑Commercial JOBSITE INFORMATION:=AND LOCATION 1,000 sq.R orless(4) $147.50 $ /1(7 52) Job site address: /496,o c3-' L.7 R9 Each additional 500 sq.ft or portion 2.$ 27.50 City: SfKIN6F114,0 -State: 0Q ZIP: 97y-"B Limited energy(2) - $ 35.00 S. Reference: /7i 2 Zp;57 Taxlot.:c7/760 Each manufactured home or modular gi-; DESCRIPTION OF..IWK 1;OR dwelling service or feeder(2) _ $ 69.00 $ Wevo S F R ) "7 72 ,8 1 t._ Services or feeders:installation, alteration,relocation 200 amps or less(2) $ 89.00 $ 41:1 gg , PROPERTY 'QINNER ,?s.'t 'c Y, , 201 to 400amps(2) $ 104.50 $ Name: CUMMINS /N✓• 1-1-4- 401 to 600 amps(2) $174.00 $ Address: 31221 ospg17 p.a. 601 to 1,000 amps(2) $225.50 $ City: LE;aN,JSN State: oft ZIP: 973SS Over 1,000 amps or volts(2) $516.00 $ Phone:5,1 25"8 Z(.5-o Fax: - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders:installation, alteration,relocation TEcumatNS e. LoMChyr . Nir This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $b 7 owned by me or a member of my immediate family. This 201 to 400 amps(2) property is not intended for sale, exchange, lease, or rent. OAR 6 96.00 $ 479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: - . Over 600 amps or 1,000 volts,see services or feeders section above ;:_ §i; CONTRACTOR INSTALLATION: _ ii Branch circuits:new alteration,extension per panel Business name: rA srs'0 E F LEC TEL' 4 im4 a.Fee for branch circuits with purchase of a service or feeder fee: 4 Address: 392S3 (3oscA6E Lp7. Each branch circuit $ 6.50 $ City: 5 plzt-4 Fr u-a State: 02 ZIP: 1-79-78 b.Fee for branch circuits without purchase of a service or feeder fee: Phone:5y f 9/c 91z g Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Rp K 1941 E yh i4,n o, Conn Each additional branch circuit $ 6.50 $ CCB license no.: 1 1-777 co BCD license no.: Miscellaneous fees:service or feeder not included I Signing supervisor's license no.: 9 ')Jl 7 5 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: 12o6ER km Er - Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisor: $ 80.00 $ "'9 alteration,or extension(2) Each additional inspection:(1) $80.00 $ E v b,A- ;.t u APPLICANT zits E. _, ' i t j; 34= (A) Enter subtotal of above fees $ 2'll 5v (Minimum Permit Fee$80.00) L 51 (B)Enter 12%surcharge(.12 x[A]) - $ 32 (C)Technology Fee(5%of[A]) $ 57 TOTAL fees and surcharges(A through C): $ '/ 440-2584-3(4/01/2013/COM)