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Permit Building 2013-6-24
• SPRINGFIELD 225 Fifth St Imir" CITY OF SPRINGFIELD Springfield,OR 97477 L L1 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01370 www.sprtngfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/24/2013 EXPIRES: 12/20/2013 STATUS DATE: 06/24/2013 APPLIED: 06/24/2013 SITE ADDRESS: 776 V ST,Springfield,OR 97477 . SCOPE: Bathroom ASSESOR'S PARCEL NO: 1703261201503 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ST_New upstairs bathroom, reconfigure downstairs bathroom: Only one new shower/tub, all other fixtures relocated. . OWNER: CROSSWHITE CURTIS C Phone Number: • ADDRESS: 776 V ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION• II .. Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 . Electrical Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections • 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1999 Final Building 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 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 .cons . • • 6 - a4-+ - r3 Ow t,e or Contractor Signatur: . Date • uires ou to ATTENTION: Oregon lathe Oregon Utility NOTICE: follow rules adopted by 1. Notification Center. Those rules OAR 952-001- THIS"PERMIT'SNDEL EXPIRE IF THE WORK • in OAR 952-001-0010 t cop es of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may COMMENCED OR IS ABANDONED FOR calling the center. (Note:ri tility Notification • ANY 180 DAY PERIOD. number for the Oregon Center is 1-800.332-2344). Springfield Building Permit 6/24/2013 12:07:13PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD +t - 225 Fifth St " ORE GON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01370 www.spdngfieldor.gov 776 V ST pennitcenter©springfield-or.gov RECEIPT NO: 2013001328 RECORD NO:811-SPR2013-01370 DATE:06/24/2013 DESCRIPTION tl aa.a! ne tea;, .�_�nh l .r.FL�_ r �� ACCOUN7GODE/TRANS�CODE'�'_::"M _.rAMOUNT"DUEia4J State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Structural Building Permit Fee 224-00000-425602 1002 80.00 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 P,AVMENT TYPE PAYOR casNtER:=ARPENTER COMMENTS - . ANIQUNT{PA_ID �_, Check CROSSWHITE CURTIS C 93.60 126 TOTAL PAID: 93.60 • Structural Permit Application SPRINGFIELD DEPARTMENTUSE ONLY CITY OF SPRINGFIELD, OREGON r6 0N 3 Permit no.: S/ 1370 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: 672 A J This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days o if'ssuance or if work is suspended for 180 days. ' ! LOCAL,GOVERNMENT APPROVAL • ;'. ,a `FEE:•SCHEDULE ' - This project has final land-use approval. °I.Vaiatian•inforiatioh . _ . Signature: Date: (a)Job description: y 'Z This project has DEQ approval. Occupanc- Signature: Date: _ . .____ ' Construction type: t/ t Zoning approval verified: ❑Yes ❑No I'-' Property is within flood plain: ❑Yes ❑No Square feet: 4 _'CATEGORY-OF:,CONSTRUCTION _ .-, Cost per square foot: yr Residential ❑Government ❑Commercial Other information: JOB SITE INFORMATION AND LOCATION Type of Heat: Job site address: 77{j V t S4, Energy Path: City: rs Ant State:O p ZIP: )7Z/71 ID new ❑alteration El addition Subdivision: i7 Lot no.: (b)Foundation-only permit? ❑Yes ❑No Reference: Taxlot: Total valuation: SL U0 ,..... PROPERTY,OWNER - gf ' . Name: diA Otti CcOSSLAN:\f. (a)Permit fee(use valuation table): S 7 Address: 776 1,/, s4, (b)Investigative fee(equal to[2a]): S City: rryy�tId State:DO - ZIP: /710 (c)Reinspection(S per hour): Phone ys f 32- 0 g-69._ Fax: - - (number of hours x fee per hour) S E-mail:(t ,r�s Go.tst9VA @ y.`I'`"D. cot'.. (d)Enter 12%surcharge(.12 x[2a+2b+2c]): S 9 0 (e)Subtotal of fees above(2a through 2d): $ : - Building Owner or Owner's agent authorizing this application: _ ,3-Plan review fees - _ __ (a)Plan review(65%x permit fee[2a]): S Trr Sign here (b)Fire and life safety(40%x permit fee[2a]): S is insta - emg made on residential or farm property owned by (c)Subtotal of fees above(3a and 3W: $ me or a member of my immediate family,and is exempt from licensing :.4:Miscellaneous fees'.,,;., requirements undo ORS 701.010. (a) Seismic fee, I%(.01 x permit fee[2a]): $ ...'CONTRACTOR 'INSTALLATION -' �- I (b)Technology fee,5%(.05 x permit fee[2a]): 5 Business name: ( /C.�� /o /v TOTAL fees and surcharges(2e+3c+4a+4b): S cy3 Address: City: State: ZIP: Phone: - - Fax: - - . E-mail: CCB license no.: • Print name: • Signature: -=±3f4. ''z Name CCB License# Phone Number Electrical 5/3 d77/13� Plumbing /? 2-3 ON -- Mechanical J 5-171 372 , Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or PL I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • Print Nap,= of Permit Applicant • air P Sig "of Permit Applicant / Date Permit#: S/3__./37O, /311 /37Z /323 o f Address: 77& Sr c1 Fl_D ox_ c/-2q7) m '• ° ; CO-- ,p� fry Issued by: Bate: [�/Zy/u� • f 59/ This Copy for Permit Offices • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,0R97477 it `I Phone: 541-726-3753 `OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01371 wv w.springfield-ar.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/24/2013 EXPIRES: 12/20/2013 STATUS DATE: 06/24/2013 APPLIED: 06/24/2013 SITE ADDRESS: 776 V ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703261201503 - TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: EL-New upstairs bathroom,reconfigure downstairs bathroom:Only one new shower/tub, all other fixtures relocated. OWNER: CROSSWHITE CURTIS C Phone Number: ADDRESS: 776 V ST SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 OB/01/2025 • Electrical Contractor OWNER COB 000000 06/01/2025 Mechanical Contractor OWNER CCB 000000 OB/01/2025 Plumbing Contractor OWNER CCB 000000 OB/01/2025 INSPECTIONS REQUIRED Inspections 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 constructi•n. Owner . . tractor Signat Date ATTENTION'. Ore ed by re QYe9 SUtf forth the follow rules adop se rules are p01 Cent0010 through OAR 952 NOTICE' Notificatio2 pp1 co ies of the rules by THIS in OAR 952 may obtain p be:�J PERMIT SHALL op9o" Yoihe center. (Note.the Notifcation AUTHORIZED UNDER EXPIRE IFTHE WORK calling Oregon Utility number Genteeis 1-3Q 0_332-234 4). COMMENCED THIS PERMIT IS NOT ANY 780 D OR IS ABANDONED FOR AY PERIOD. Springfield Building Permit 6/24/2013 12:06:15PM Page 1 of 1 SPRINGFIELD--- CITY OF SPRINGFIELD $t ' OREGON TRANSACTION RECEIPT Spnn 225 Fifth St 97477 541-7263753 811-SPR2013-01371 www.spnngfieldorgov 776 V ST permitcenter @spnngfield-or.gov RECEIPT NO: 2013001329 RECORD NO:811-SPR2013-01371 DATE:06/24/2013 lo]�Yo3:71 Jldc:]'C t r,'a.> a,a . _ .r .5.e.. a `ACCOUNTiCODE/TRANS CODE,""171 .'-:: t o o rt3, Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 IMP. YMENTAYP.E "" PAYYOR cASHIERraloAEFENTER . -COMMENTS ¢MQUNTERAID Check CROSSWHITE CURTIS C 93.60 126 TOTAL PAID: 93.60 Electrical Permit Application DEPARTMENT;USE ONLY ' ; y $PNINGFIEIO AFit4ief}5. tVoit rg&iilt .ntE4,,:t nt tl.+ ..Y b . '"a' t` r ..amw.e.' ? CIµTY QF SPRINGNjI LD, 4RE `TON 6 Permit no.: SI J 7 r. :_ rift , 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 // Date: (O/z`//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. =t,it;riLOCAL.,GOVERNMENT',;,APPROVAI `_ -' _:- x ;n:r ' A.FEEat'SCHEDUL^EA;s;ti 't, „^ 1- Zoning approval verified? Yes No a: , 'c ry 4i t` Cost Total <; Zoning PP ❑ ❑ Number of inspections perlttem Off,'" Qty L7,4-a;1`7.1 ';cosh, tw,.„ ,;_,CATEGORYIOF'.;,CONSTRUCTION ,' 1�.• Residential,per unit,service included: £U1Residential ❑Government ❑Commercial 000 sq. ft.or less(4) $147.50 $ JOB?ISITEANFORMATION AND;;LOCATIONa t Job site address: / `' ` Each additional 500 sq.ft.or portion (� 7{ �76 y , S thereof $ 27.50 $ City: ns\C•tyt State:DR ZIP:g7t)7 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ - 4 ;.. t>r. o.. dwelling service or feeder(2) :^ u,@ .° ,,'*BDESCRIPTION, QF WORK` s t , .,; k t �! 1 \ Services or feeders: installation, alteration,relocation e1A1f,4 I l0-T Conn 200 amps or less(2) $ 89.00 $ ,x1"+`a li t,I; '4aPROPERT3Y; OWNER + _j 201 to 400 amps(2) $ 104.50 $ Name: e-V,;i Q, ,rf v\. 401 to 600 amps(2) $174.00 $ Address: 776 v, S.41 601 to 1,000 amps(2) $225.50 $ City: 'fins .416//\ State: wt,n ZIP:17477 Over 1,000 amps or volts(2) $516.00 $ Phone/-65a Q V2 Fax: - - Reconnect only(2) $ 69.00 $ E-mail: e tiF}.` .CCbsiCL.t 1 0. co Temporary services or feeders: installation, alteration, relocation This installation is being made on reside tial or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale, exchan•e lease, or rent. Ss ' 479.540(1)an 79.560(1 401 to 600 amps(2) $138.50 $ Signature Over 600 amps or 1,000 volts,see services or feeders section above 'ga�''4i.e'+�a,+�};�ty O .�},C,TOR,`g1 .+ - ^ ION t=fit�:;�: Branch circuits: roew, alteration, extension per panel Business name: a. Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit $ 6.50 $ City: - State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, - $ 80.00 $ g g g P - alteration,or extension(2) Each ad4jtjpq I i spection (I) — 7' $80.00 $ P'� t , : r'-Elia fAPP,LICANTTUSE =W C""{a� (A) Enter subtotal of above fees $ _ vy� (Minimum Permit Fee$80.00) apC�IO1 (B)Enter 12%surcharge(.12 x[A]) - $ 9 J U (C)Technology Fee(5%of[A)) $ �[j G� TOTAL fees and surcharges(A through C): $ /�i • 440-2584-1(4/012013/COM) 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-SPR2013-01372 www.springfeld-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/24/2013 EXPIRES: 12/20/2013 STATUS DATE: 06/24/2013 APPLIED:. 06/24/2013 SITE ADDRESS: 776 V ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703261201503 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: ME-New upstairs bathroom,reconfigure downstairs bathroom: Only one new shower/tub, all other fixtures relocated. OWNER: CROSSWHITE CURTIS C Phone Number: ADDRESS: 776 V ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER COB 000000 08/01/2025 Electrical Contractor OWNER COB 000000 08/01/2025 Mechanical Contractor OWNER COB 000000 08/01/2025 Plumbing Contractor OWNER COB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 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 construon. al i 4 6 al-,. %x . . Owner olor Signature / Date • uires you 1.0 ATTENTION. Ore9 dby the Oregon ettio th toltow rules&r .those rules are s 0010 through OAR 952-001- Notitication Center. rules by NOTICE: 1'0'090. u may 1ethe tetep the ,:., pAR 952-pp1 obtain cop oft h:;f13 THIS PERMIT SHALL EXPIRE 1F THE WORK .vo the center. (Note: the NotiUcatron • AUTHORIZED UNDER THIS PERMIT IS NOT number tot the Oregon 44), COMMENCED OR IS ABANDONED FOR center is 1-8°Q-332-23 ANY 180 DAY PERIOD. Springfield Building Permit 6/24/2013 12:05:13PM Page 1 of 1 • • SPRINGFIELD, CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01372 www.springfieid-or.gov 776 V ST permitcenter @spnngfieid-or.gov RECEIPT NO: 2013001330 RECORD NO:811-5PR2013-01372 DATE:06/24/2013 ACCOUNT CODE/TR,4NSrCODE 3;.F�a AMOUNTIDUEw_), First Appliance Fee 224-00000-425604 1006 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 �-- TOTAL DUE: 93.60 AYIIAEN TTYPE P,AYOR ASHiE cnt Eri7eR COMMENTS �. aier °1 AMOU DWRIMMIRI Check CROSSWHITE CURTIS C 93.60 126 TOTAL PAID: 93.60 • SPRINGFIELD 225 Fifth St brCITY OF SPRINGFIELD Springfield,OR 97477 (\4 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01373 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/24/2013 EXPIRES: 12/20/2013 STATUS DATE: 06/24/2013 APPLIED: 06/24/2013 SITE ADDRESS: 776 V ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703261201503 TYPE OF STRUCTURE: Residential .PROJECT DESCRIPTION: PL-New upstairs bathroom,reconfigure downstairs bathroom: Only one new shower/tub, all other fixtures relocated. OWNER: CROSSWHITE CURTIS C Phone Number: ADDRESS: 776 V ST SPRINGFIELD OR 97477 .[ CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER COB 000000 08/01/2025 Electrical Contractor OWNER COB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED 1 Inspections 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. Owner % . - or Signature Date littOS °1'1 to pTTEIST10Nadoped b. the Os are etttlorttl rules hose rule R952-0ot- follow center. wetcatt°n Cen 0010 through o f he rules by NOTICE: In OAR952may obtain cop1ethe telepht a THIS PERMIT SHALL EXPIRE IF THE WORK 0090. Y0 the °enter. mote:tility Notitrcatron AUTHORIZED UNDER THIS PERMIT IS NOT number{0f ther _800_332-2344)• COMMENCED OR IS ABANDONED FOR center ANY 180 DAY PERIOD. . • Springfield Building Permit 6/24/2013 12:03:47PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD _itsgii 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 kreN"OREGON 541-726-3753 811-SPR2013-01373 www.springfieldar.gov 776 V ST permitcenter @springfield-orgov RECEIPT NO: 2013001331 RECORD NO: 811-SPR2013-01373 DATE:06/24/2013 DESCRIPTION, ._e 0741 sF L`T _ 2S.. _;ACCOUNTCODE/TRANS•CODE -`` ... Sn AMOUNTDUE Fixture 224-00000-425603 1005 . 126.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 15.12 Technology fee(5%of permit total) 100-00000-425605 2099 6.30 TOTAL DUE: 147.42 BAYMETmTYP.E' P,AYOR CASHIER: aRP,ENIER COMMENTS AMOUNTI_P.AID Check CROSSWHITE CURTIS C 147.42 126 TOTAL PAID: 147.42