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Permit Building 2013-8-16
SPRINGFIELD 225 Fifth St ' s CITY OF SPRINGFIELD Springfeld,OR 97477 • Phone: 541-726-3753 c' OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01470 www.springfield-or.gov - permitcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 08/16/2013 EXPIRES: 02/11/2014 STATUS DATE: 08/16/2013 APPLIED: 06/28/2013 • SITE ADDRESS: 6364 Femhill CT,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702343404400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New single family residence OWNER: THOMAS WALTER CUSTOM HOMES LLC Phone Number: 541.683.6355 ADDRESS: 2863 RIVERWALK LOOP EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor STEVEN EDWARD HAUCK II CCB 147618 04/30/2015 541-221-2665 Plumbing Contractor T 8 S PLUMBING INC CCB 186903 • 06/01/2015 541-915-1000 General Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 Mechanical Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 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 t°^TICE: oved. ATTENTION: Oregon law rnrndrns "^u to Tu col dlPf"54�Rti1 EXPIRE IF I RE Wo -- follow rules adopted by the Oregon Utility t to ll{�I�f�t�nl HIS PERMI7 I$ NOT • Plo . cwtion Centel. Tiruse ruses are set forth fit'IN n APIDOWED FOR in OAR 952-001-0010 through nAR os2001 19zohn�ui�tbner 0090. You may obtain copies of the rules by CC1iing tiles Bunter. (ivuie. the 1:elepr- -v 1430 Insulation Wall Wall Insulation: Prior to cover. number for the Oregon Utility Nntfiref;on 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. Center is 1-800-332-2344). 1460 Insulation • 1520 Interior Shearwall Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior Shearwall 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. • Springfield Building Permit 8/16/2013 9:30:55AM Page 1 of 2 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Spnngfield,OR 97477 Phone: 541-726-3753 'OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01470 www.springfieldor.gov permitcenter springfield-or.gov 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. 1190 Retaining Wall 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. 8�1612-a?t6 Owner or Contractor Signature Date • °"/-7 2'3' • Springfield Building Permit 8/16/2013 9:30:55AM Page 2 of 2 SPRINGFIELD- -- CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 { e 541-726-3753 OREGON 811-SPR2013-01470 www.springfieldor.gov 6364 Fernhill CT permitcenter @spnngfield-or.gov RECEIPT NO: 2013001780 RECORD NO:811-SPR2013-01470 DATE:08/16/2013 jet Cod Ilal[o1'I,b ff ,j,t •" biE rIMI ._:-:=?T -:"ACCOUNT.CODElTRANSiCODE; , idAMOUNT.(n Curb Cut/Driveway 1st Cut 201-00000-428060 1141 102.00 Encroachment 201-00000-428060 1143 280.00 Plan Review Adjustment-Residential 224-00000-425602 1061 -1,320.80 SDC:Administrative Fee-MWMC Regional Wastewater SDC 611-00000-426604 1189 10.00 SDC: Improvement-Transportation SDC 447-00000-448027 1174 955.32 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 1,423.97 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,333.70 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 719.50 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 262.11 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 2,917.55 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 108.14 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 493.92 SDC:Total Sewer Administration Fee 719-00000-426604 1175 217.08 SDC:Total Storm Administration Fee 719-00000-426604 1180 60.67 SDC:Total Transportation Administration Fee 719-00000-426604 1190 60.87 Second Permit Discount 201-00000-428060 1148 67.00 TOTAL DUE: 7,691.03 l PAYMENT TYPEz .PAYOR","CASFE R:'d ARSON Z _ -C-OMMENTS ,n age i� � - AMOUN T PAID _ $�Tfr'.. Check THOMAS WALTER CUSTOM HOMES 7,691.03 11801 TOTAL PAID: 7,691.03 • • SPRINGFIELD---- CITY OF SPRINGFIELD h xWa;a p 225 Fifth St u:El TRANSACTION RECEIPT Spnngfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01470 www.springfield-or.gov 6364 Fernhill CT permitcenter @spnngfield-or.gov RECEIPT NO: 2013001783 RECORD NO:811-SPR2013-01470 DATE:08/16/2013 -I . 4ON.: 4IAat. k ,,s& "s t`,L,riC , rACCOUNTACODERRANSCODE •kL L< 'AMOUNTiDUEL ' Address Assignment,each new or change 224-00000-425602 1020 42.00 Planning-Major Review-City 100-00000-425002 1231 211.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 247.60 SDC: Compliance Cost-MWMC Regional Wastewater SDC 444-00000-426607 1113 22.61 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 58.34 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 76.64 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 291.14 Structural Building Permit Fee 224-00000-425602 1002 2,426.20 Structural Plan Review Fee Residential 224-00000-425602 1061 1,577.03 Technology fee(5%of permit total) 100-00000-425605 2099 145.86 Willamalane fees-Single family detached 821-00000-215023 1074 3,410.00 TOTAL DUE: 8,508.42 parAl!MEWriT:Y,PagnP,AYORAS1il�s ERlitARSOR I<' �:a: COMMENSSx� a° rgWORM?MOUNTRAID ar Credit Card THOMAS WALTER CUSTOM HOMES 8,508.42 03556G TOTAL PAID: 8,508.42 • • SPRINGFIELD -°- CITY OF SPRINGFIELD 225 TRANSACTION RECEIPT gfeIE `OR97477 Ste- "' OREGON 541-726-3753 811-SPR2013-01470 www,springfeld-or.gov 6364 Fernhill CT permitcenter @springfield-or.gov RECEIPT NO: 2013001388 RECORD NO:811-SPR2013.01470 DATE:06/28/2013 Sti:t=ip t"i ! _= ?_ °. I:ACCOUNT'CODE/TRANSCODE -_Uc AMOUNT DUET: Structural Plan Review Fee Residential 224-00000-425602 1061 1,320.80 6ry - TOTAL DUE: 1,320.80 a PAYMEN-TT IT PAYOR erirli :o6ww OMME AMOUNiPAID 3 ✓(:^:bTig Credit Card thomas walter 1,320.80 08149z TOTAL PAID: 1,320.80 • Structural Permit Application SPRINGFIELD £DEPARTMENT US ONLY,-, ONLY,; vi a .$24:4+i x'4Y r.w.M11,4R111 t,t°e .M< , t i s ,t»ci 1 r . cmwoF SPRH cIFll D F n l 't.{ 24-k(T �c -s3.`rc t...... -_ ,.a�REGOl�Div:»; v'.�..v'D...� «... S'„-,.s,. S ''^ Permit no SI-5--__ O I -I 7 gb 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 ° OREGON Date: 4,72/f/� 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. ?.5. , OCALiGOVERMENT- APPROYA;( (; fig g .., lgZ l;. _FESCHEDULE ' __r * 3 4: This project has 5nal land-use approval. - Tit-Valuation'iuformat ou 7:1 . � ' s i ,"t Signature: - Date: (a)Job description TJ e°""^ lir e 5��.. III V This project has DEQ approval. Occupancy fL3 v` 5 Signature: Date: r7 / /5 6 G Zoning approval verified: ❑Yes ❑No - Construction type: . V 1, I p U^� Property is within flood plain ❑Yes ❑No Square feet: 3,�d�E /�p 8/ / = '/ g, „` 4dATEGORY OF CONSTRUCTION,`, , r g"? Cost per square foot: i Residential ❑Government ❑Commercial Other information: ;KfAi FJ,OB,SITE-,INFORMA`TION`-/'AND LOCATI`ON`z , Type of Beat: Job site address: (,36 9 Fun 17;It (o Energy Path: -Z rf� 4 .�y " f/r City: cpc 00,5 Y■L14 State: 04, ZIP: .1r+ ew ❑alteration ❑addition e Subdivision: M.3JXc in ,ate. Lot no.: 33 (b)Foundation-only permit? ❑Yes -g No ! Reference /70z St Taxlo[ oyyoo Total valuation $ - ,`��. y , __ j' * . 5 arm tdu 1 C ��'� ., _�t'�'� . ..,PROPE1R—TY_OWNEIR2,U..:'-' , .°., �,7 .< .°2:_Buddmg,fees-* .rc. ;?:-,";T.^' , n '��.,�'�, ..,z -,'t ,.. . Name: vN o \Cr C✓i5 forr■` /40/Ytt.S (a)Permit fee(use valuation table): $ Address: 21“3 R vewa[ h G P q (b)Investigative fee(equal to[2a]): $ City: f U a one. State: 42 ZIP: / )tq el i (c)Reinspection($ per hour): $ ✓ - 6 3 `f : �/-6gj- 3.3„2 3 (number of hours x fee per hour) C Phone: �t,.t[- G3 .t ax. ( /� �ni I tom-, (d)Enter 12%surcharge(.12 x[2a+26+2c]): $Zq�� E-mail: �pM L IA if lid,j" h y1+G j' (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3`:Plan review;fees v,r.;'tt ti4,,:c Fe?� hh ,_sarc �-l n (a)Plan review(af/°x permit x fee[2a1): permit e $+ o�+- -1y J 03 Sign here //V'/�'(,1-- (b)Fire and life safety(40%x permit fee[2a]): $ l r ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): S me or a member of my immediate family,and is exempt from licensing 4-:,Miseellan`eo s fees-r „ice .; 4` u x v'.`1 `,'_, requirements under ORS 701.010. (a)Seismic fee, l%(.01 x permit fee[2a]): $ ':CONTRACTOR INSTALLATION _ s4 r', o i i ..ri ',.W,}., . �- (b)Technology fee,5%(.05 x permit fee[2a]): $ Business name: - TOTAL fees and surcharges(2e+3c+4a+4b): S//9/3"-<,1 Address: City: State: ZIP: Phone: - - Fax: - - E-mail: CCB license no.: Print name: Signature: SUB-CONTRACTORINFORMATION Name CCB License# Phone Number Electrical Plumbing Mechanical willarnalane deb Park and Recreation District / Job. No. 5-1T h70 PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 NAME: A,j li✓mni c.. PHONE: 0.5 (O?SS ADDRESS: 22-4,3 eziv ZA1CL.PCITY: Lt4 7 STATE: 9740/ 0/ LOCATION OF PROPOSED BUILDING SITE: Street address: (0364 11441/f224. a- Plat name: 4;J-y� 13 Tax Lot Number: l212 3y1/4.7y 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS • X $3,410 per unit= $ 2Y/C) 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 Of applicable.SDC payer must furnish proof of credit approval.) ($ ) 3. TOTAL PARK AND RECREATION SDC ASSESSED $ • /a City of Springfield Date of building gP ermit submittal City of Springfield Date of building permit issuance ' SPRINGFIELD - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 r* 6' itf' il Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01473 v .spnngfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued • ISSUED: 08/16/2013 EXPIRES: 02/11/2014 STATUS DATE: 08/16/2013 APPLIED: 06/28/2013 SITE ADDRESS: 6364 Fernhill CT,Springfield,OR 97477 SCOPE: Plumbing Only ' ASSESOR'S PARCEL NO: 1702343404400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New single family residence • OWNER: . THOMAS WALTER CUSTOM HOMES LLC Phone Number: 541-683-6355 ADDRESS: 2863 RIVERWALK LOOP EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor T 8 S PLUMBING INC CCB 186903 06/01/2015 541-915-1000 Mechanical Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 General Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 INSPECTIONS REQUIRED 4 Inspections 3130 Footing/Foundation Drains 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. nn77��r�, quires you to 3200 Sanitary Se4JArl:: Sanitary Sewer Line: Prior to filling tren w rub lladorte'1 F-es�n<?f1rP nn I ltilIt 3315 Water r S PtRMI I- SHALL EXPIRE IF THE WORK follow rubs ente.e / a 0 y I „ Notification Center. Those rules are set forth ZED UNDER I HIS RERIVIINSe�ljp : Prior to fining trendR.OAR 952-001-UUtt througn OAR 902-0 1- 3400 Storm-Sewer. divinFNICED 0 D000. You rF12y obtain reining of the rules by R IS AGANDO 3500 Rough Pldmbirtg DAY PFRIn """yh�fl�rltbing: Prior to cover and incl���j�gj�����lg. (Note: the teleph:::;Y, 3999 Final Plumbing D Final Plumbing: When all plumbing wot(� g1°n�ille.the Uregon unlit lvuuii�auun Center is 1-ann-339-9344). 3440 Culvert/Catch Basin 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 6)4 construction. n Owner or Contractor Signature Date • Springfield Building Permit 8/16/2013 9:20:39AM Page 1 of 1 SPRINGFIELDmaimy CITY OF SPRINGFIELD • rca$" 225 Fifth St ry, TRANSACTION RECEIPT 5pnn911e19,0R 97477 OREGON 541-726-3753 811-SPR2013-01473 vw.springreld-or.gov 6364 Fernhill CT permitcenter @spnngfield-or.gov RECEIPT NO: 2013001782 RECORD NO:811-SPR2013-01473 DATE:08/16/2013 DESCRIPTION :' ? . : _ ._: ACCOUNT CODE/TRANS CODE't4S. -_tk AMOUNT DUE ''£d Each Additional Bath 224-00000-425603 1005 104.50 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 70.50 Technology fee(5%of permit total) 100-00000-425605 2099 29.38 1�. TOTAL DUE: 687.38 PAYAAENT,-W P,AY,ORrNEASlilltraisig rota COMMENTS' x. : AMQUNT;PAID Credit Card THOMAS WALTER CUSTOM HOMES 687.38 03556G TOTAL PAID: 687.38 • • Plumbing Permit Application DEPARTMENT USE ONLY SPRINGFIELD CITiL•OF SPRINGFIEL- OREGON Permit no.: 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work.Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ''c:LOCAL LGOVERNMENT. AP.P,ROVALx> l.':€kid&,t', s.. ".z.- •#. , ','^FEEI,`SCHEDULE, ° ,; Zoning approval verified? ❑ Yes ❑No u, v}ar r ` ` 1 r t' r v '€Descnptlon 1/44.: . �t t, y 4Cast +slicost � Sanitation approval verified? ❑ Yes ❑No `New residential ""f' `"i' "` '-„-ea::. cost New residential CATEGORY„OF”CONSTRUCTION } `r;i '1'x'71; 1 bathroom/1 kitchen(includes:first ❑Residential ❑Government ❑ Commercial f 00 feet maker, underfloor lines, hose bibs, ice maker, underfloor low point $262.00 $ 4'7 JOBr,SITE 1NEORMATION. AND LOCATIONv;Ee drains and rain-drain packages) Job site address: 63114 Ft(t\ t1 N Gov Y‘c 2 bathrooms/1 kitchen $411.00 $ e State: ZIP: 3 bathrooms/1 kitchen $483.00 $ City: $ iC s�Ile'c�G\Ot a Each additional bathroom(over 3) $104.50 $ Reference: J Taxlot.: Each additional kitchen(over 1) $104.50 $ iffy r v ,t Y.(DESCRIPTION•`'OF•-WORK;- ; + �;t.Y1i,"ae'#xs`�`--_ Residential fire sprinklers(includes plan review) .0 to 2,000 square feet $80.00 $ . 2,001 to 3,600 square feet $128.00 $ ;'l, ` :,ti PROPERTY'1liOINNER' kx t�.f:.-i' ftk "e. 3,601 to 7,200 square feet $192.00 $ Name: ENO\\CS CNS\oA'� L'16"IhtiS 7,201 square feet and greater $255.00 $ pp ) Manufactured dwelling or pre-fab(circle one) Address: Ig r,3 'VU via L • Connections to building sewer and $80,00 $ . City: E` 'w State: pp_ ZIP: 9`1H01 water supply Commercial,industrial,and dwellings other than one-or Phone:ci1-/g3--r 6; 55 Fax:541-6 3- -3313 two-family E-mail: / bM( WGIfdcvCTOMv^o Minimum fee - $80.00 $ P'lGS•LO M Each fixture $21.00 $ This installation is being made on residential or farm property owned by me or a member of my immediate family, and is Miscellaneous fees exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line $83.50 $ Signature: _ Each fixture,appurtenance,and piping $21.00 $ ` ,l>v :.'}CONTRACTOR'‘I/NSTALILATION Vr 'i' s Storm water retention/detention facility $21.00 $ Business name: f'-t'S Y b Vt M Is q Irrigation systems $21.00 $ J Piping or private storm drainage Address: systems exceeding the first 100 feet $21.00 $ City: State:State: ZIP: Specialty fixtures $21.00 $ 11 cc -Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone:94-WS t 0 0 0 Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) $80.00 $ CCB license no.: BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no.: ;Medical gas plpmg 3 d if ul r'* _,-:; 3 Minimum fee $ Print name: - Enter value of installation and equipment$ . Enter fee based on installation and equipment value. $ Signature: 3-AI; dt?'1 t 'APPLICQNT-,'!4USE `''' MiWetg J ;?JS _fir `�"`��' (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ 440-2500-1(4/1/2013/COM) SPRINGFIELD 225 Fifth St �a = CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 O0.EGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01472 www.springfield-or.gov permitcenten@spingfield-or.gov PROJECT STATUS: Issued ISSUED: 08/16/2013 EXPIRES: 02/11/2014 STATUS DATE: 08/16/2013 APPLIED: 06/28/2013 • SITE ADDRESS: 6364 Fernhill CT,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702343404400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New single family residence OWNER: THOMAS WALTER CUSTOM HOMES LLC Phone Number: 541-683-6355 ADDRESS: 2863 RIVERWALK LOOP EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 General Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 INSPECTIONS REQUIRED Inspections 2140 Pellet, Gas, Fireplace or Wood Wood Stove: After Installation. Stove 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 requipQ ' �and;upped if not attached to an appliance. follow rUICC Oregon law reonires }'0,00.0t. NOTICE: gas ent P 0 by the Oregon Utlty 2995 Final I HIS P Final Gas: When all as work is completktotitication Center ThoCC rules are set forth PERMIT SIIALL EXPIREndl'Mecil When all mechanical In OAR e4�1-0010 throu 2999 Final rs�crRq �ZED UNDER THIS PERMIT IS NOT t5�a�imay obtain copies oitherul y rou COMMEN E�� ((�1RR ''ee ��ppn� C t e By signature, I,state�n @d"reLr'th�t'11feV@ �u�y-®ic�iOiRed the completed application amiphij C1at(btate: the taileph;• information hereonis't e4�nR iS Oand I further certify that any and all work performed shall be on Pa bfi[enge`tyli jtthia. tifica te-) Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work det'a HeereAr8otid3�t-D�&44). 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. • lick73 /16 (2.0 '3 Owner or Contractor Signature Date Springfield Building Permit - 8/16/2013 9:23:43AM Page 1 of 1 $ SPRINGFIELD -- - CITY OF SPRINGFIELD 225 Fifth St r OREGON TRANSACTION RECEIPT Springfield.OR 97477 541-726-3753 811-SPR2013-01472 www.springfield-ar.gov 6364 Fern hill CT permitcenter©springfield-or.gov RECEIPT NO: 2013001781 RECORD NO:811-SPR2013-01472 DATE:08/16/2013 jo1X Y�;71 Adlo ranlI¢ P.. '' 1__L '�1Vtrt 3 -ACCOUNT:CODE/TRANS CODEfiZIM‘ VAMOUNRDUEI 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 Listed Fireplace 224-00000-425604 1006 42.00 Range hood/other kitchen equipment 224-00000-425604 1006 14.50 Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 60.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 3120 Technology fee(5%of permit total) 100-00000-425605 2099 13.00 TOTAL DUE: 304.20 F;1xPAYMENTAYP.EtWBAY_OR casrnErin=ora.*,�� - .COMMENT&; `< ,_:�IMPMOUNTiPAID .,,. - - Credit Card THOMAS WALTER CUSTOM HOMES 304.20 03556G TOTAL PAID: 304.20 • • Mechanical Permit Application DEPARTMENT USE ONLY , - kSr •SSP...}."a.. y rvSb_-9 ,.1&+.=1 'Ri•,v '(i1: ryrypY 5PR""ansLfl CITY.O S 'PRIl__ GEIEL IUREGON TID Permit no.: 9+t7kub4.rvr Rui.rX�rtd>:2-�"a«'�'SM'h F � 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 ♦ FAX(541)726 3689 N M..�_ .-' gdY Date: This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. '', „' CATEGORY,'OF •CONSTRUCTION, �' .a,x, I ' FEE SCHEDULE { k Residential ❑Government ❑Commercial Residential xx r4 { Qty r t east a ,y cost]..; .5`JOB SITE INFO RMATIONANO<LOCATIONr .x First Appliance 580.00 $ C Job site address: b 3�Y ran t-i It £0.'• Furnace/burner including ducts and vents City State: Q ZIP: Up to 100k BTU/hr. $18.50 $• Over 100k BTU/hr. $22.00 $ Reference: Taxlot Y r ? w%k DESCRIPTION OF,WORK;.asix y;-, Heaters/stoves/vents .M. - Unit heater $18.50 $ Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ ( ] > � = refrigeration unit or r cooling system/ $80.00 $ ? i t _ kPROPRT ',OtWNER sa • 0r absorption system Name: 66\e! tkS1\cm DUNS Evaporated cooler $14.50 $ / Vent fan with one duct/appliance vent I $10.00 $ Address: Z $t S F-YvGf WaNkk LP City: EYl`9,cm, State:0 ZIP: 914°1 Hood with exhaust and duct $14.50 $ 7 Floor furnace including vent $80.00 $ Phoney ) -(�q3- 52)c5 Fax:94)-633- 33 2 3 Gas piping E-mail: -ion,e we,If U(✓c}-or'' i1 pfy1,a5.(Arn One to four outlets $7.50 $ This installation is being made on property owned by me or a Additional outlets(each) $4.50 $ member of my immediate family, and is exempt from licensing Air-handling units,including ducts requirements under ORS 701.010. Up to 10,000 CFM $12.00 $ Signature: Over 10,000 CFM $22.00 $ gaitONTRACTORIINSTALLATIONi r s s Compressor/absorption system/heat pump Business name: MA4tsi$1 t S Up to 3 hp/IOOk BTU $18.50 $ Up to 15 hp/500k BTU $32.00 $ Address: Up to 30 hp/1,000 BTU $47.50 $ City: State: ZIP: Up to 50 hp/1,750 BTU $62.50 $ Phone: - - Fax: - - Over 50 hp/1,750 BTU $104.50 $ E-mail: Incinerators Domestic incinerator $22.50 $ CCB license no.: CommercaIJ ha" w ,_ =I>' Print name: Enter total valuation of mechanical system and installation costs$ Signature: Enter fee based on valuation of mechanical system,etc. $ NMlscellan o s fees 1 Items !Cost Total:? L .w -.ate,,.�.3 ' �2 m.}+i�:�>• 2... .ea ecost», Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(1) - $80.00 $ 4443rd.° v r ,APPL=ICANT USEa ` t, ' x y r� 'k7� (A)Enter subtotal of above fees(or enter set minimum fee of $80.00) - $ (B)Investigative fee(equal to[A]) - $ (C)Enter 12%surcharge(.12 x[A+B]) $ (D)Seismic fee, 1%(.01 x[A]) $ (E)Technology Fee(5%of[A]) $ 440-2545-J(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ SPRINGFIELD H 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 3Nt Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01471 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/16/2013 EXPIRES: 02/11/2014 STATUS DATE: 08/16/2013 APPLIED: 06/28/2013 SITE ADDRESS: 6364 Fernhill CT,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702343404400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New single family residence OWNER: THOMAS WALTER CUSTOM HOMES LLC Phone Number: 541-683-6355 ADDRESS: 2863 RIVERWALK LOOP EUGENE OR 97401 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor STEVEN EDWARD HAUCK II CCB 147618 04/30/2015 541-221-2665 Plumbing Contractor T&S PLUMBING INC CCB 186903 06/01/2015 541-915-1000 General Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 Mechanical Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 INSPECTIONS REQUIRED Inspections 4000 Temporary Power Service 4225 serviueenteler THE WORK ATTFAITION: Ot '-- ;c„ ,�yu;res you to 4500 Rough;EBcp Mlt SHALL EXPIRE E��$.� T Prior to Cover follow rules adopted by the Oregnn I Utility 4999 Final`s'Iec�riIAI�ILED UNDER T i u�llit� ion center. Those rules are set forth nnwENCED OR IS.ABANDONED t ic: When all electrical work i 52-001-0010 through OAR 952-001- V FR (fin 0090. You may bta� By signature, I state and agree,`thalt�l Piave carefully examined the completed application ar fl r Ertl ma opies of the rules by information hereon is true and correct,and I further certify that any and all work performed F��rr e}n%) dprd�Lr1��evitl Retelephti Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work d"° d & SLIPS MaikONotification OCCUPANCY will be made of any structure without permission of the Community Services DivisiorY Ij re iif%Prtarr'ua7'344). 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. . Ae_ '.) ..-.. I t 8/(e)(2e)t3 Owner or Contractor Signature Date Springfield Building Permit 8/16/2013 9:35:06AM Page 1 of 1 • SPRINGFIELD- CITY OF SPRINGFIELD L v .11 AsitN,-` 225 Fifth St �o EGON . TRANSACTION RECEIPT 5pdn0919,0R97477 541-726-3753 811-SPR2013-01471 www.springfeld-or.gov 6364 Fernhill CT permitcenter @springfield-or.gov RECEIPT NO: 2013001784 RECORD NO:811-SPR2013-01471 DATE:08/16/2013 ..w _ _ ,t_,�.., f. ,�, DESCRIPTION'�°��!7tuPa��r`1 .�,'�s�a��•°si`�t�-�.:?�s'� .+tACCOUNTkCODE/TRANS CODE.u.�.,,..:AMOUNT,DUE.' Each added 500 sq.ft or portion 224-00000-426102 1004 220.00 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 52.38 Technology fee(5%of permit total) 100-00000-425605 2099 21.83 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 510.71 JIPAYMENTiY EJl.lir:PAYOR-?casiHIEa`:EJritti ON ;41.50 S& _' FS 1Y AMOUNT'PAID , .44I, :i j Check THOMAS WALTER CUSTOM HOMES 510.71 11802'2 //�2' 'TOTAL PAID: 510.71 Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD w+r......y .F?p ,vim":) ^'. 'Fi"} 'i.G-'t 7ag84 irriC 'T r. b+�'' 1 :.€7:IT!OF SPRINGFIELD°' 0 REg-6 - 6 7 - /tL/7 / i.,z -z. .:& 5-ea° ^,',.—",�".�w"`s,'c3',ke3. xS u ^ ,w'6::.. `•'l'fk+.e..i r., 0 Permit no.: ? / 225 Fifth Street•Springfield,OR 97477♦PH(541)726 3753*FAX(541)726-3689 t� '` �%OU Date: 6(2,,V,)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. :.` < ;LOCALCGOVERNMENV*PPROVAL, E`- ,. „ r .2' -_,7 FA::' fi' rFEE, SCFIEDULE' emugliiiA,,,i't ' � `" t "t` "' '- ' :y st - Zoning approval verified? ❑ Yes ❑No Vu "b r ih spechons pen ltem O Qty' +„Co 39t414; CATEGORY,*OF,'. CONSTRUCTION z.' Residential,per unit,service included Residential ❑Government ❑Commercial 1,000 sq ft.or less(4) / $147.50 $/i/) .73 je; JOB,;SITE INFORMATION'AND' LOCATION:;; -, s Job site address: £3 6i-1 N'\\ Co t',f\ Each additional 500 sq.fr.or portion 1 $ 27 50 $ Fan thereof 726 City: S?-0nctJJ.Qt.,\A State:02 ZIP: Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ 'r WilDESCRIPTIONt,ti ELMO RK:'., t„ {'ate dwelling service or feeder(2) i Services or feeders: installation, alteration,relocation l�I O— I9c F 41 '`sr-.e FY..112,_ 200 amps or less(2) $ 89.00 $ "f ` '?, tr 'P..ROPERTYIQWNER Xr ' x ,,`==,?iM 201 to 400 amps(2) $ 104.50. $ Name: V.t $rr bAs\ocn Horn Q S 401 to 600 amps(2) $174.00 $ Address: '1,8t, 3 4 s\Jertrjci 1 L p 601 to 1,000 amps(2) $225.50 $ City: ti/>✓ State: O . ZIP: i ya I Over 1,000 amps or volts(2) $516.00 $ Phone: 914)F 6 3 55 Fax:511 613- 3313 Reconnect only(2) $ 69.00 $ E-mail: Al�m� V [e/Lv�r� Temporary services or feeders: installation, alteration, relocation ry 0MSS .[UM This installation is being made on residential or farm property 200 amps or less(2) I $ 69.00 $65 owned liy 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 479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above ?,..I`r'", g-lriCONTRACTOR-4INSTAItL''ATION -,"«"Cci g;;: Branch circuits:new alteration, extension per panel Business name: 5-1-evc.. AG U G k a.Fee for branch circuits with purchase of a service or feeder fee: Address: (a, 'Idle X1341 0��� Each branch circuit $ 6.50 $ City: Spr�,F'c Ip State: Ott. ZIP: /'T'/7l b.Fee for branch circuits without purchase of a service or feeder fee: Phone:yt[-VT] 1,1,S S Fax:S`j-741 - I08s First branch circuit(2) $ 60.50 $ E-mail: S IEvE, ffnu a Cpr•,CHST. i'ket Each additional branch circuit $ 6.50 $ CCB license no.: &r-432 C BCD license no.: P176/9 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 3s7 7 St1..,'' Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: /GuE /MIX k_ Each sign or outline lighting(2) $ 69.00 $ skur S / Signal circuit or a limited-energy panel, Signature of signing supervisor: �/ alteration,or extension(2) $ 80.00 $ i Each additional inspection:(1) $80.00 , $ (A) Enter subtotal of above fees $ /Y� 5j (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $ f� (C)Technology Fee(5%of[A]) $ ,, 231 TOTAL fees and surcharges(A through C): $9252Z 440-2584 4(4/01/2013/COM)