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HomeMy WebLinkAboutPermit Building 2013-6-4 Structural Permit Application sPRINGFIELD DEPARTMENT USE ONLY ? lY,1 x: .„r u ' *r ig can ,kt d r id i IF. : aswi 1 ,:tirz atEITY OF SPRINGFIELIDSOREGOne9's g' t t4.#; L °' >° 14+ Permit no.:S C —/ � 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON q� Date: b/y/l/ 3 This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days o issuance or if work is suspended for 180 days. C4 .., u-y�s' y7/SAM(//oN TIM 1 6 ?r '" 'LOCAL;GOVERNMENT. APPROVAL ,a } 'y s'ry `GY3Y��--`FEE SCHEDULE a+. :- rt *S"� f This project has final land-use approval. f Valuatro`u information; +',jamr;,,37:1;7 >.;'g v'ttl"' Signature: Date: (a)Job description: , `i SFr7 This project has DEQ approval. Occupancy /77 A.A. Signature: Date: �/r� Zoning approval verified: ❑Yes ❑No - Construction type: V b Property is within flood plain: ❑Yes ❑No Square feet: 9 ' t tit:CdATEGORY OF CONSTRUCTION i:` Cost per square foot: ,yJ•Resrdenhal ❑Government ❑Commercial Other information: zi,:i; gJOB SITE,INFOORMATlOO9N�AND L�OtLCATIONtii :< Type of Heat 0 ezX Job site address: 5.17 31 1 .1c3c c C 4-En Energy Path: City- €13••(-€ State: 6J K ZIP: ew ❑alteration ❑addition Sub'divi on �+� 7 Lot no.: (b)Foundation-only permit? ❑Yes ❑No Reference: / a O` D'A l I Taxlot 07/0 0 Total valuation: S/3S er7. t l ;Al ,.r^ `. ._. c,PROPnERTY;;OWNER-;ielAf ,._, .,' .?4 2:-BuildingifeesVt' ?°' °°' +T2i4In,'«.c4A atWil- .W Name: c' VIM (a)Permit fee(use valuation table): Set ZCO Address: L .go ft ') yy;;((��}} (b)Investigative fee(equal to[2a]): $ City:4� Lry,ve{ �,�(/\ StateD -__. ZIP: (c)Reinspection($ per hour): S c� (number of hours x fee per hour) Phone: CPI 7-(3Q 74 Faz: . - - E-mail: (d)Enter 12%surcharge(.12 x[2a+26+2c]): S ti 97 (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3 fPlan ivi w fees g.f-M NY -r;d#94 +*...rV r ,J * ? �i, (a)Plan review(65%x permit fee[2a]): $ ?i'7 S S. 4 . Sign here— - _ (b)Fire and life safety(40%x permit fee[2a]): $ c.,------7- k. s ❑This installation is being ..i:de on residential or farm property owned by (c)Subtotal of fees above(3a and 36): S me or a member of my immediate family,and is exempt from licensing "'u' 7¢r c:. ?-f s ti `a + r °?i- " { -,4=iMtscellaneous fees-.,r.ri�3 „as., ,,. .: ss f ,.Y: s ., requirements under ORS 701.010. (a)Seismic fee, 1%(.01 z permit fee[2a]): $ .,.-v 1 ,i'"tt CONTRACTOR«INSL4LJJ�TION ,_ .} - ;9 = (b)Technology fee,5%(.05 x'permit fee[2a]): $ d4 Business name: * .rtl�� yt I �� di TOTAL fees and surcharges(2e+3c-4a+4b): S a6 /7 Address: I0 ur'O/irni i 6f47,04 City: _•i t State: CTh--- ZIP: jzJf Phone;;; Fax: - - E-mail: 6)/3'r ' • C- 7 CCB license no.: _..stn/g C _ o / Print name: .--ildsa.e � Signature:� ; "_ SUB CON._RACTOR INFORMATION Name CCB License# Phone Number Ele ctrD ical ,...--1 Plum ing I �ti )QA,`�(7,9 a) Mechanical 64a/L4,-'21 L willamalane deb Park and Recreation District Job. No. J/ - /,J C PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 • NAME: /9120-44c- PHONE: 73 2 0277 ADDRESS: G/'7O (0 sr CITY: cf/GC,)) STATE: c.. ZIP: 974/72 LOCATION OF PROPOSED BUILDING SITE: • Street address: 5 732 %//)!&r Gf� Plat name: •Tax Lot Number: i/YO2 O7// 07/0C 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached --7 NO. OF UNITS / X$3,410 per unit= $ L/w B. Single-Family Attached NO. OF UNITS X$3,385 per unit = $ • C. Multi-Family Apartment NO. OF UNITS X$3,021 per unit= $ r 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 Of applicable. SDC payer must furnish proof of credit approval.) ($ ) • 3. TOTAL PARK AND RECREATION SDC ASSESSED $ _Tc{7U Cam' / / / � ' • City of Springfield Date of building permit submittal 7 z / (3 City of Springfield Date of building permit issuance SPRINGFIELD CITY OF SPRINGFIELD t hit �- zzsR�nnst TRANSACTION RECEIPT Springfield,OR 97477 t` 'EGoN 541-726-3753 811-SPR2013-01155 www.springfield-ar.gov 5739 Ridae CT permitcenter©springfield-or.gov RECEIPT NO: 2013001419 RECORD NO: 811-SPR2013-01155 DATE:07/02/2013 DESCRIPTION_' . AC COUNT aCODEJTRANSACODE,., .AMOUNT.DUE..2 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 PAYMENT TYPES ..;PAYOR CASHIER:CCARPENTER ' _ L. COMMENTS ...... ' , ,' ' +a,AMOUNT PAID " _ Check PROCK LIVING TRUST 317.66 1141 TOTAL PAID: 317.66 • 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-SPR2013-01156 www.springfield-or.gov pe rm itcenter@springfiel d-or.gov PROJECT STATUS: Issued ISSUED: 07/02/2013 EXPIRES: 12/28/2013 STATUS DATE: 07/02/2013 APPLIED: 06/04/2013 SITE ADDRESS: 5739 Ridge CT,Springfield,OR 97477 - SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1802041107100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New single family dwelling,lot 10 Thurston Ridge_SAME AS 4735 Union Terrace OWNER: PROCK LIVING TRUST Phone Number: ADDRESS: PO BOX 114 SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor SUNSET HEATING&COOLING INC CCB 161085 08/14/2014 503-793-3052 L 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. 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. 4nolcc_ 7 -,2- 1_3 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT • 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephorra CO COM 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 7/2/2013 10.21:34AM Page 1 of 1 SPRINGFIELD i CITY OF SPRINGFIELD 6L71.,....\(4.1\14- OREGON TRANSACTION RECEIPT s;�Fifth 97477 541-726-3753 811-5 P R2013-01156 www.springfield-or.gov 5739 Ridge CT permitcenter©springfield-or.gov RECEIPT NO: 2013001418 RECORD NO: 811-SPR2013-01156 - DATE:07/02/2013 iDESCRIPTIONJ__ _ .___-;w , ,_ACCOUNT CODEITRANS CODE ;„ AMOUNT DUE_: 3 First Appliance Fee 224-00000-425604 1006 80.00 Single-duct exhaust(bathrooms,toilet compartments, utility room! 224-00000-425604 1006 30.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.20 Technology fee(5%of permit total) 100-00000-425605 . 2099 5.50 TOTAL DUE: 128.70 LPAYMENT TYPE -PAYOR, CASHIER:CCARPENTER.- _- ' COMMENTS_-„-.;;-„n - -'_ 'AMOUNT PAID” I Check PROCK LIVING TRUST -_ T-- ___..V..__.___._ 128.70 1141 TOTAL PAID: 128.70 • SPRINGFIELD 225 Fifth St 1.• . '_7(,..Eli ___ CITY OF SPRINGFIELD Springfeld,OR 97477 �1� Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01157 . www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/02/2013 EXPIRES: 12/28/2013 STATUS DATE: 07/02/2013 APPLIED: 06/04/2013 • SITE ADDRESS: 5739 Ridge CT,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1802041107100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New single family dwelling,lot 10 Thurston Ridge_SAME AS 4735 Union Terrace OWNER: PROCK LIVING TRUST Phone Number: ADDRESS: PO BOX 114 SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone CUSTOM PLUMBING (PB)Plumbing Co 20-174PB 07/01/2014 541-741-1736 INSPECTIONS REQUIRED II 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. X-4144.It 11 eV L .rte 7-02- I � Owner or Contractor Signature Date ...•,.,.,.- ,•.,.,.,,,,.._a,y..:>..,. ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT In OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR • 0090.ll You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telepho n:, r•• number for the Oregon Utility Notification Springfield Building Piaenterts'1-800432-2344). 7/2/2013 10:19:30AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St `��; TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-S P R2013-01157 www.springfield-ar.gov 5739 Ridge CT pennitcenter @springfield-or.gov RECEIPT NO: 2013001420 RECORD NO:811-SPR2013-01157 DATE:07/02/2013 (DESCRIPTION_ _ __: ACCOUNTCODE/TRANS_CODE . AMOUNT.DUE___! 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 PAYOR CASHIER:.CCARPENTER` . COMMENTS°r ` AMOUNT PAID . ' ' -_ Check PROCK LIVING TRUST 480.87 1141 TOTAL PAID: 480.87