The URL can be used to link to this page

Home My WebLink AboutPermit Building 2013-7-29 -I SPRINGFIELD 225 Fifth St ___t____iii CITY OF SPRINGFIELD springfield,olts7477 kirraer_ces\ Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01423 www.springfield-or.gov permitcenter©springfield-or.gav PROJECT STATUS: Issued ISSUED: 07/29/2013 EXPIRES: 01/24/2014 STATUS DATE: 07/29/2013 APPLIED: 06/27/2013 SITE ADDRESS: 5255 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702283401200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New SDF-Lot 4 Thurston PI-SAMEAS 5211/Lot 1 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 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 SheanvaljNTION: Oregon law requires you to �"JDRK 1999 Final BuildNotification l Center. Those Fl e5B ulaing." all required inspections have`bett requested and agingi*d it NDT in OAR 952-001-0010 through e eW ygoe u3ip ete. SHR1 t- CCnnt ' "t IS IT TNIS 0090. You may obtain copies of the rules by j1HpRIZED UN�S AgpNDONE FOR calling the center. (Note: the teleph::,n, D(�MENpED OR number for the Oregon Utility Notification piv PERIOD. Center is 1-800-332-2344). kw? 180 Springfield Building Permit 7/29/2013 11:15:30AM Page 1 of 2 SPRINGFIELD 225 Fifth St h<� i"°' CITY OF SPRINGFIELD Springfeld,OR97477 \‘...46. OREGON Phone: 541-726-3753 Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01423 www.springfield-orgov permitcenter @springfield-or.gov 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. V 7/24 76 Owner or Contra:tor Signature Date • Springfield Building Permit 7/29/2013 11:15:30AM Page 2 of 2 SPRINGFIELD - - CITY OF SPRINGFIELD %t.1 r� 225 Fifth St I'-‘ OREGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01423 www.springfield-or.gov 5255 HIGH BANKS RD permitcenter©springfield-or.gov RECEIPT NO: 2013001654 RECORD NO: 811-SPR2013-01423 DATE:07/29/2013 ;DESCRIPTION a-' ACCOUNT CODE/TRANS_CODE .; if AMO.UNT-D.UE s Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 60.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 106.66 Technology fee(5%of permit total) 100-00000-425605 2099 46.54 Willamalane fees-Single family detached 821-00000-215023 1074 1,342.44 TOTAL DUE: 1,555.64 - - `-•• L. AMOUNT PAID - _ I j�i?AYNIENT TYPEPAYOR CASHIER:CCARPENTER_� � COMMENTS_;_.-_„- _ - Check DAVIS CONSTRUCTION SERVICES L 1,555.64 2052 TOTAL PAID: 1,555.64 • • SPRINGFIELD - CITY OF SPRINGFIELD rha 225 Fifth St et TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-725-3753 811-S P R2013-01423 www.springtield-ar.gov 5255 HIGH BANKS RD permitcenter©springfield-or.gov RECEIPT NO: 2013001650 RECORD NO: 811-SPR2013-01423 DATE:07/29/2013 DESCRIPTION . -. ACCOUNT_CODE/TRANS CODE AMOUNT DUE_ i Address Assignment,each new or change 224-00000-425602 1020 42.00 Planning-Major Review-City 100-00000-425002 1231 211.00 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 955.32 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 779.80 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,392.04 SDC: Improvement Cost-Storm Drainage 440-00000448028 1176 511.91 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 262.11 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 351.42 SDC: Total MWMC Administration Fee—Local 719-00000-426604 1121 76.64 SDC: Total Sewer Administration Fee 719-00000-426604 1175 118.88 SDC: Total Storm Administration Fee 719-00000-426604 1180 43.17 SDC: Total Transportation Administration Fee 719-00000-426604 1190 60.87 Structural Building Permit Fee 224-00000-425602 1002 888.82 Wllamalane fees-Single family detached 821-00000-215023 1074 2,067.56 TOTAL DUE: 9,500.00 [-PAYMENT-TYPE __. ._. .,. AMOUNT PAID c FAVOR 'CASHIER:ccnRPeN7eR , :;;, COMMENTS „ - I”` ,,_„_._ - I Credit Card CUMMINS INVESTMENTS LLC �� v 9,500.00 m 015866 TOTAL PAID: 9,500.00 SPRINGFIELD CITY OF SPRINGFIELD l� 225 Fifth TRANSACTION RECEIPT Springtield,OR 97477 OREGON 541-726-3753 811-SPR2013-01423 www.spnngfleld-or.gov 5255 HIGH BANKS RD permitcenter©spnngfleld-or.gov RECEIPT NO: 2013001364 RECORD NO:811SPR2013-01423 DATE:06/27/2013 DESCRIPTION MIED€ a riles a..Qi. 'rl .n lnODEITRANS CODE A . } ANIOUNTiDUE-card Same as Plan Review Submittal 224-00000-425602 1060 275.00 TOTAL DUE: 275.00 PAYMENT,TYPE'EZ2PAYOR:` ""`_'"_,sCOMMENTS.it eITIRLIF7:24.16.:..'..'01 PPAID 44aC l r Credit Card CUMMINS INVESTMENTS LLC 275.00 08059D TOTAL PAID: 275.00 • Structural Permit Application SPRINGFIELD OEFARTMNT,IIEONLY Y , ,: ^sib+.!^ntG'' xr, f.s� r n4*' , 2w � " 'IrwnrT,,,,.E t -. +si. -“ ,-vofiir� r -"trococt siuDiwa 0_�_, -t' t'w ) a- - ..i. 1 ' , .mss Permitno 3 —`y/ Z 225 Fifth Street♦Springfield,OR 97477.+P11(541)726-3753•FAX(541)726-3689 OREGON �I/ G �✓ Date: 61 Z73 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. - ;+#`. :.01 LOCA0ILERNMENT AP 3,110. ,-0. -atittA _:• .: - .,FEE*1.46)0±t - >'i"i „_M1.=. This project has final land-use a :. -r- rd•,` _ - - P 7 approvaL :L>PaInat,oamforatioail� '�'-,;,,c' ,s..r `�.c- .. Signature: Date: (a)lob description: 1V ." cf.,' This project has DEQ approval Occupancy 27 Signature: Date: Zoning approval verified: ❑Yes ❑No - Construction type: Vg -_- Property is within flood plain: ❑Yes ❑No Square feet /200 u Jt. • 4'-+°�t; al E60RY O 101 STRUC770 47 *fl- .� Cost per spume foot ential I ❑Government I ❑Commercial Other information: S.,.S JQ6tf51.1MFORMATiblitr NU LOCATION-_s'". 'g_-- TypeofBeat £/4U. )tgiVC Job site address: 5z 5S th 614 (3ANKJ R J Energy Path: nig. OS • City. 5pz.N6rrh.o I State: oA I ZIP: 97g7E thew ['alteration 0 addition Subdivision: 71t.cCr-577w,---r pr,.te r I Lot no.: 1/ (b)Foundation-only permit? ❑Yes ❑No c/ Reference: 170 Et 83 9'I Taxlot Q l ZOO ' Total valuation I S��5!�C abfulTdmgTeesazix': e; . +. ..:r .r.w.x _ ran . Name: Cu.,asr,..y 1NV. l.t.c (a)Permit fee(use valuation table): 5 00 L Address 312.zt oSPOfti LN• (b)investigative fee(equal to pal): S City LESA.✓,wrt State: o I ZIP:€3TISS (c)Reinspection($ per hour): S Phone: 5-1/1 - 2 51; -76.5-0 Fax: - - (number of hours x fee per hour) E-mail: '�£tom,,..,,.,s e Go.,c tit r, ,Jt r (d)Enter 12%surcharge(.12 x[2a+2b+2cn: s /(J6 (e)Subtotal of fees above(2a through 2d): S Building Owner or Owner's agent authorizing this application i3 eeli i ,fees.4ti-n 4!1A1-5`41 ratcSgi ' 'ilia:,: _�q. (a)Plan review(65%x permit fee(2a))1 :77 C SN'^'r -'� Sign here: I , C (b)Eire and life safety(40%x permit fee[?a)): S ❑This inslallat n is being made on residential orfarmproperty owned by (c)Subtotal of fees above(3a and 3b): 5 me or a member of immediate is ex empt from horsing mg 4: -se S s r + ''v =_Itt ii5Ax M. requirements underORS 101.010 . (a)Seismic fee, l%(.01 x pe®t fee[2a)): 5 4:?-2,kli t..K-° iCONTRACTOR INSTALLATION ' '` -% _); (b)Technology fee,5%(.05 xpetn it fee[2aD: 5 '77r' _. Business name: DArA1 cootie+n-c,JJ sf?.ltes ILe I /?�/ Z Address: Si 4 t T 5?cSir TOTAL fees and sarcharges(2e+3e+4a+4b): 5 City. Spytr> State: o,- I ZIP:47473 Phone: 5L{f 4 S 4.a f . Far - - E-mail• DA Msco 3- e 44h-c, torn CCB license no. I G 0314'7 Print name: t Corr DA 41...1 Signature: 44— ‘r\-. - rey u =1"r •e-TO--I F&- -•••ON -.Y_ Name CCB License# Phone Number Electrical 015i510 g Silt MIr 117'70 915-9120 Plumbing ._ Palnsrur pt-t.•r..*l 151275 R5-3-Lg.,7 . Mechanical SvN £T /4v.r-c ' 17170& 9°v8 3r� r willamalane Park and Recreation District • • Job. No. PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 NAME: �.e /i✓,' �/v7/ PHONE: 25- 26' ADDRESS:3/22/ O/'t--e-- STATED ZIP: 1795 • LOCATION OF PROPOSED BUILDING SITE: Street addressfC2-SS4enr'-fieS . Plat name:70/2SY PLIT4 4' Tax Lot Number: /7Di 2-17/ 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached � NO. OF UNITS / X$3,410 per unit= $ 3'1/ 7' 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 $ j /9 City of Springfield Date of building permit submittal . 9' City of Springfield Da of building permit issuance • • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 iji Phone: 541-726-3753 %OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01439 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/29/2013 EXPIRES: 01/24/2014 STATUS DATE: 07/29/2013 APPLIED: 06/27/2013 SITE ADDRESS: 5255 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702283401200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New SDF-Lot 4 Thurston PI-SAMEAS 5211/Lot 1 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. 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. Le , 7/17//3 Owner or orra1{�cg Ea ignature: Date I reQLots y°U-lo OI U 1 1liL. On law °n Utlilty THIS PERMIT SHALL EXPIRE IF THE WORK A�1ENTtONado�ted by t ru�are settorth ries COMMENCED OR ABANDONED FOR NOT NOilcationue1tp01othr°u9t1 oAtFlieSueobY ANY 180 DAY PERIOD. too oRYou may obtitate t6the 400\ Qatt0 the centeOre9°n Utilily Notiflcatton cattln9 1-g00.332 2344) nurnber for the center is Springfield Building Permit 7/29/2013 11:22:53AM Page 1 of 1, • SPRINGFIELD CITY 01:SPRINGFIELD 225 Fifth St `( E�oN TRANSACTION RECEIPT 5pringfieI OR97477 541-726-3753 811-SPR2013-01439 www.springfield-or.gov 5255 HIGH BANKS RD permitcenter©springfield-or.gov RECEIPT NO: 2013001653 RECORD NO:811-SPR2013-01439 DATE:07/29/2013 ;DESCRIPTION ACCOUNT_CODE/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 - . _ .. AMOUNT PAID. _.7.j L_PAYMENT TYPEPAYORcnsweR�ccarsPEyTErs _A_COMMENTS --:• � � � Check DAVIS CONSTRUCTION SERVICES L 480.87 2052 TOTAL PAID: 480.87 • • • SPRINGFIELD 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 It `C,r OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01438 www.springfield-or.gov permitcenter @springfield-or.goy PROJECT STATUS: Issued ISSUED: 07/2912013 EXPIRES: 01/24/2014 STATUS DATE: 07/29/2013 APPLIED: 06/27/2013 SITE ADDRESS: 5255 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702283401200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New SDF-Lot 4 Thurston PI-SAMEAS 5211/Lot 1 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 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 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. 7/1V/3 Owner or Contr ctor Signature Date are set forth ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE.IS P EXPIRE IF THE WORK Notification Center. Those rules AR 952 001 THIS PERMIT SHALL EX in OAR 952-001-0010 throng 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the teleptl;:: ANMMBO DAY PERIOD. ANDONED FOR Center is 1-800 -332-2344y number for the Oregon Utility Notification Springfield Building Permit 7/29/2013 11:20:56AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD , a.. Fifth St ;�c spr TRANSACTION RECEIPT Springtield,d,OR 97477 OREGON 541-726-3753 811-S PR2013-01438 viww.springfield-or.gov 5255 HIGH BANKS RD permitcenter @springfield-or.gov RECEIPT NO: 2013001651 RECORD NO:811-SPR2013-01438 DATE:07/29/2013 tDESCRIPTION_ —� .`.._. ACCOUNT CODE/TRANS CODE ,__-;,_._-AMOUNT DUE First Appliance Fee 224-00000-425604 1006 80.00 Range hood/other kitchen equipment 224-00000-425604 1006 14.50 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 14.94 Technology fee(5%of permit total) 100-00000-425605 2099 6.23 TOTAL DUE: 145.67 )._ PAYMENT TYPE___,. PAYOR_ CASHIER:CCARPENTEER__ - ' COMMENTS ' - _ AMOUNT PAID � Check DAVIS CONSTRUCTION SERVICES L 145.67 2052 TOTAL PAID: 145.67 • • SPRINGFIELD 225 Fifth St _,i ...__... CITY OF SPRINGFIELD Springfield,OR 97477 _i____saii :x `t Phone: 541-726-3753 ONEGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01437 www.springfield-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/29/2013 EXPIRES: 01/24/2014 STATUS DATE: 07/29/2013 APPLIED: 06/27/2013 • SITE ADDRESS: 5255 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702283401200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New SDF-Lot 4 Thurston PI-SAMEAS 5211/Lot 1 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. ltk 7/Z // 3 Owner or Contr ctor Signature Date ATTENTION: Oregon law requires you to .1C : IRE IFTF1EwORY follow rules adopted by the Oregon Utility SHAEE-MS RWI IS NO • Notification Center. Those rules are set forth ".S PERM DNDER PE FOR 0090, You may obtain through copis of the 952-001- rules by y MR1dC D OR IS ABANDONED calling the center. (Note: the teleph...r1e y DAY PERIOD• ,vY i80 number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 7/29/2013 11:17 48AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD W5..- 225 Fifth St � ; TRANSACTION RECEIPT Springheid.OR97477 OREGON 541-726-3753 811-S PR2013-01437 www.springfield-or.gov 5255 HIGH BANKS RD permitcenter@springfield-or.gov RECEIPT NO: 2013001652 RECORD NO:811-SPR2013-01437 DATE:07/29/2013 1DESCRIPTION - ' m -1:,--;-%.' ACC OUNT CODE/TRANS CODE '.. . AMOUNT DULJ Each added 500 sq.ft. or portion 224-00000-426102 1004 27.50 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 29.28 Technology fee(5%of permit total) 100-00000-425605 2099 12.20 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 285.48 LPAYMENT TYPE PAYOR ••CaSRIERi ccaRPERrER. • COMMENTS • - "" .-..' •••••• AMOUNT PAID `. , - Check DAVIS CONSTRUCTION SERVICES L 285.48 2052 TOTAL PAID: 285.48 • Electrical Permit Application = DEPARTMENT USE ONLY SPRINGFIELD 5k4i1-:.u�t+N.tr, : ':...rx*e-+'rte wF'kr iV.-.: *,."z.a :4 `' ' '.c` t „CITaY ®T P INGFICED YOREGG6 x' �-- :z sk r y :5,1Vi,, .;� Permitno.: St3 1L137 225 Fifth Street•Springfield,OR97477•PH(541)726-3753♦FAX(541)726-3689 -.`..'_,. tt,, Date: {O it- 27/ 5 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. LOCAL.GOVERNMENT APPROVAL .,.; ,t FEE. SCHEDULE , Zoning approval verified? ❑Yes ❑No Number'of ins pections per item O Qty Cost ."Total; ' ,.CATEGORY yOF. CONSTRUCTION ,`.r , �. ,�/ Residential,per unit,service included: I-v�Residential ❑ Government ['Commercial JOB,SITE.(INFORMATION i AND LOCATION' 1,000 sq.fr.or less(4) / $147.50 $ Each additional 500 sq.ft.or portion _ Job site address: 52 SS /4-1.6 14- 6,4411c7 124. thereof $ 27.50 $'Z�✓ City: $pgiN6Flu4-o State: 02 ZIP: 1-74-7 ng Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ °="DESCRIPTION,,OF•'WORK dwelling service or feeder(2) Services or feeders: installation, alteration, relocation yew SF/2 200 amps or less(2) $ 89.00 $ ' '. PROPERTY OWNER ' 201 to 400 amps(2) $ 104.50 $ Name: CUMMINS M✓• "C 401 to 600 amps(2) $174.00 $ Address: 3 1221 osp¢s7 Rd. 601 to 1,000 amps(2) $225.50 $ City: LE3pvNOft) State: o/t ZIP: 5 73S Over 1,000 amps or volts(2) $516.00 $ Phone:.g f 2.5-s 2.5-s 265 o Fax: - Reconnect only(2) $ 69.00 $ y E-mail: Temporary services or feeders: installation, alteration, relocation TECvmatgg @. CPmcA 5r , N1'r' This installation is being made on residential or farm property 200 amps or less(2) / $ 69.00 $6 7 owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.5400)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above A CONTRACTOR-INSTALLATION , ,, Branch circuits:new alteration, extension per panel Business name: EA s -sit,E Fax TA1 C lAK • a Fee for branch circuits with purchase of a service or feeder fee: Address: 302S'3 13 o,CA6 E LP. Each branch circuit $ 6.50 $ City: 5 pzt..'6 Ft u-A State: o2 ZIP: 9747 e b.Fee for branch circuits without purchase of a service or feeder fee: Phone:Sy( 9/r 91z g Fax: - - First branch circuit(2) $ 60.50 $ E-mail: go k)qp 1 Lo 'r#ti,e o, (OWN Each additional branch circuit $ 6.50 $ CCB license no.: I i-n'7 o BCD license no.: Miscellaneous fees:service or feeder not included Signing o supervisor's license no.: `I 7'.7S' Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: g2o6ER ktro& Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: n,,, , 9g Signal circuit or a limited-energy panel, $ 80.00 $ Sn g P hf'y�"t`te.7 alteration,or extension(2) Each additional inspection:(1) $80.00 $ s , ,APPLICANT;USE .. ;..;s (A) Enter subtotal of above fees r, (Minimum Permit Fee$80.00) $ G yy (B)Enter 12%surcharge(.12 x[A]) $ G/ 26 (C)Technology Fee(5%of[A]) $ /2 2"--f— TOTAL fees and surcharges (A through C): $2E It? 440-2584-J(4/012013/COM)