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HomeMy WebLinkAboutPermit Building 2013-8-23 • • 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-SPR2013-01457 .www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/23/2013 EXPIRES: 02/18/2014 STATUS DATE: 08/23/2013 APPLIED: 06/28/2013 • • SITE ADDRESS: 4180 Glacier View DR 4182,Springfield,OR 97477 SCOPE: Duplex ASSESOR'S PARCEL NO: 1802052205000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New duplex • OWNER: FOUR OAKS LLC Phone Number: 541-463-1000 ADDRESS: PO BOX 26208 EUGENE OR 97402 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electncal Contractor LYNNS ELECTRIC CO CCB 102316 10/14/2013 541-726-7895 CUSTOM PLUMBING (PB)Plumbing Col 20-174PB 07/01/2014 541-741-1736 Mechanical Contractor COMFORT FLOW HEATING CO COB 460 06/27/2015 541-726-0100 General Contractor MIKE GANSEN CONSTRUCTION COMPANY COB 92159 06/14/2015 541 463-1000 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. 1150 Slab/Flatwork • - Slab: To be made after all inslab building service equipment,conduit piping and other equipment items are in place but prior to concrete. 1160 UFER Ground Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been ATTENTION: Oregon law renuira.q v 7PRf4ved. • 13iRM WaRycArl eppted by the Oregon Utility nt ntinn Oct:r. Th.;;,c i ulo cite set TOrrn 14n �5p 9.ra ]t ro through OAR 952-nnt_ h'OTICF• • 1d�Z'd insulya�t n Valfo4$e7il&r OpieS of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK ra /inn thri �.,.....,. rn _.. 1430-Insulation Wal6 t.•�.�. ty otiiIc' AUTHORIZED UNDER THIS Oregon Utility Notificat tInsulation: Prior to cover. PERMIT IS NOT rir' 1-800-332-2344 Ceiling Insulation: Prior to cover.icuiv hNCED OR is ABANDO 1440 Insulation Ceding �• 9 q NV n NFO FOR 1520 Interior Shearwall Shear Wall Nailing: Before covering sheat inDgAtN ffrfi3{ terials. 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. 1550 Firewall Firewall: Located and constructed according to plans. Springfield Building Permit 8/23/2013 1:19:30PM Page 1 of 2 • 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-SPR2013-01457 www.springfieldor.gov permitcenter @spnngfeld-or.gov 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 construction. dler Owner or Contractor Signature Date • • • • . 4., „ it ' t, . Springfield Building Permit • 8/23/2013 1:19:30PM Page 2 of 2 • • SPRfNGFIELD CITY OF SPRINGFIELD ~`l' 225 Fifth St to EGON TRANSACTION RECEIPT Springfeld,OR 97477 541-726-3753 811-SPR2013-01457 www.springfeld-or.gov 4180 Glacier View DR 4182 permitcenter @springfield-or gov RECEIPT NO: 2013001858 RECORD NO: 811SPR2013-01457 DATE:08/23/2013 )tgl,'L?ra .:,Matat-.�ThfEv,'��`::ACCOUNTCODE/TRANSCODE 4k4`trra'AMOUNT4DUE-0 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 45.22 SDC: Improvement-Transportation SDC 447-00000-448027 1174 1,910.65 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 1,763.02 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 2,784.08 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 810.29 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 524.25 SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 3,612.21 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 216.28 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 556.25 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 152.78 SDC:Total Sewer Administration Fee 719-00000-426604 1175 268.76 SDC:Total Storm Administration Fee 719-00000-426604 1180 68.33 SDC:Total Transportation Administration Fee 719-00000-426604 1190 121.74 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 193.91 Structural Building Permit Fee 224-00000-425602 1002 1,615.90 Technology fee(5%of permit total) 100-00000-425605 2099 80.80 Willamalane fees-Single family attached 821-00000-215023 1074 6,770.00 ky��,;; TOTAL DUE: 21,715.47 pnSP.AYMENTaTYPE,,. PAYOR iri twits a OMMENTS _ , 'a'aa''a,?AMOUNT,PAIDSWi rte- -�,�, Check MIKE GANSEN CONSTRUCTION 21,715.47 023873 COMPANY TOTAL PAID: 21,715.47 SPRINGFIELD CITY OF SPRINGFIELD 4d 225 Fifth St `O EGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01457 www springfield-or.gov 4180 Glacier View DR 4182 permitcenter©springfield-or.gov RECEIPT NO: 2013001381 RECORD NO:811-SPR2013-01457 DATE:06/28/2013 DESCRIPTION »_ _,ACCOUNT CODERRANS.CODEL___ „LAMOUNT,DUE_ Structural Plan Review Fee Residential 224-00000-425602 1061 1,050.34 TOTAL DUE: 1,050.34 t_ PAYMENT TYPE PAYOR CASHIER:DBOWLSeY COMMENTS ';.. '_' - . . AMOUNT PAID --J Credit Card michael gansen J 1,050.34 01888c TOTAL PAID: 1,050.34. Structural Permit Application SPRINGFIELD ;tip EPARTMENT,U$E ONLY � ID f4� eisacITYrOF,4SPRNG OREGOVQk b w '` tt _ o. Permit n : SI -40 I 7 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 _ OREGON Date: 0if/113. This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days f issuance or if work is suspended for 180 days. ,Te �` -.-.LQtAL,:GOVERNid ENT, APPROVAL > , ,w ;r ,, 1]; t,'`'' "i }" FEE,;SCHEDULE x,ar " s, '^z' < Vii. ti ' This project has final land-use approval. 1 Valuation mformation 'r / r,n if,w_� v..,�� Signature: Date: (a)Job description: Gt eLEX This project has DEQ approval. Occupancy 12:-34A,.:Signature Date: 12:-34A,.: Zoning approval verified: ❑Yes ❑No Construction type: / /V iT.S �/7� Property is within flood plain ❑Yes ❑No Square feet: Z S 6 O _/ D o . ....N., ._.,. . ^�`s s;Ui"s,�"s,CATEGORY OF CONSTRUCTION, „f,r.,.z :- �=. Cost per square foot: 1 f(Residential ❑Government ❑Commercial Other information: 2 ..,, r 3,,,,.,r JOBS SITE,JNraiiii ATION"AND LOCATI fO'N`?' ,::_' ."-. Type of Heat: &r-t&---(7,44,04 l I Job site address: �2 V k.° 6 Ia-(ACV (A a.") �Energy Path: City: S0ri42 4€/y) State: 02, ZIP:/7777 -N new ❑alteration ❑addition Subdivision:5f4--'e y/ ()( I Lot no.: 3 (b)Foundation-only permit? ❑Yes ,' io Reference /.4670 s--z.Z Taxlot j560 0 Total valuation:$ _ ' �� + :-w,,�' :f/f��-: PROPERTY::Oy11NER4,'t.. ' #_�/:'/:g4:: xiiiiLldmg,O- . T..f'ski f .,.t r:,i",-,s.`. . `y 3.,.-�:. Name: /A L, (r r4. C-e ,70. 'S ( LC (a)Permit fee(use valuation table): $- Address: //O 4'a, 2t--�2.P4 (b)Investigative fee(equal to[2a]): $ City: (� • State: D _ ZIP:77)10, (c)Reinspection($ per hour): $ Phone: .537 1`6,g-/a0D Faxff -fin —(Cy j/ (number of hours x fee per hour) E-mail: 3 Gr ra.cen l o ryPS.GO (d)Enter 12% surcharge(.12 x[2a+2b+2c]) $ r/ (e)Subtotal of fees above(2a through 2d) $ Building Owner or owner's agent authoriz'i. -'s application: 3.`Plari revte`w:fees -K-te_;;," , x ,r( "r'u"`�s;•:�?: .""rte' 1J (a)Plan review(65%x permit fee[2a]): s /0 St ar' Sign I • (b)Fire and life safety(40%x permit fee[2a]) $ ❑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 t""' ai"S�" e ' r..' - 42�1MtsceBaneoiLS fees , „rs ,,,,, ,„ ,l? 1r, 4_..-; requirements under ORS 701.010. (a) Seismic fee, 1%(.01 x permit fee[2a]): $ ;p i t5 CONT2AC70R*NSTALLATION i , , (b)Technology fee,5%(.05 x permit fee[2aD: S Business name: 65(.;t.,5_, e..., Cok,-c/ TOTAL fees and surcharges(2e+3c+4a+4b): S Address: pee'DX 2Alg7—r� City: C/(�J State: 01C— ZIP?7$o2_ Phone:SSr/ l G3-/o00 FaxSyf 763 -L0o/ E-mail: ryrfkn.944i 5-2.7 @ 9a..r-c P2+-r/t cfr4.t S COP, CCB license no.: 9Z l C/ Print name:% `� � ' Signature: Rf• ifa ft " WW 'r.esuB CONTRACTOR_INFORMAT[ON ` • . Z Nt�r. Name CCB License# Phone Number 64�,Q Electrical G17/S Plurhbing GI)(310VI f u"�(H IiIII- 6E-00 Mechanigal Cad -av fi I'�axl 726 bi to r . P willannalane Park and Recreation District Job. No. 513 -C)/14 S 7 PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET Jan. 1-Dec. 31, 2013 NAME: Fa"'el— CD A" LL. L PHONE: S il-LI 43 a100O ADDRESS:PO 'Was GZOB CITY: el&C-&W ' STATE:Ot ZIP: 9 >k o2 LOCATION OF PROPOSED BUILDING SITE: Street address: y( 8074//14 &f.4crr.L Jis.1 IS IL_ Plat name: Tax Lot Number: /8°1 CI'S a O Sat) 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS X $3,410 per unit = $ B. ' Single-Family Attached NO. OF UNITS X $3,385 per unit= $ 6 7 70 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 $ 6 77 Ur 3 f ,28,70/..3 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 tea- '`-'I Phone: 541-726-3753 *: OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01458 www.springfieldor.gov permitcenter @spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 08/23/2013 EXPIRES: 02/18/2014 STATUS DATE: 08/23/2013 APPLIED: 06/28/2013 SITE ADDRESS: 4180 Glacier View DR 4182,Springfield,OR 97477 SCOPE: Duplex ASSESOR'S PARCEL NO: 1802052205000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New duplex OWNER: FOUR OAKS LLC Phone Number: 541-463-1000 . ADDRESS: PO BOX 26208 . EUGENE OR 97402 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor LYNNS ELECTRIC CO CCB 102316 10/14/2013 541-726-7895 CUSTOM PLUMBING (PB)Plumbing Col 20-174PB 07/01/2014 541-741-1736 Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06/27/2015 541-726-0100 General Contractor MIKE GANSEN CONSTRUCTION COMPANY CCB 92159 06/14/2015 541463-1000 L. INSPECTIONS REQUIRED • Inspections 4000 Temporary Power Service 4120 UFER Ground 4150 Underslab Electric Underslab Electric: Prior to cover • 4220 Electrical-Service 4225 Service or Feeder 4500 Rough Electrical Rough Electric: Prior to Cover 4550 Limited Energy EIS T IJN. fX::--:- ': 1 in 4999 Final Ele r1�ay a1 El t 1 `"�o Oliow rules adopted by theFl7•-w t illMfen all electrical wort. Notification Center. Those rules are set forth T NU TICE: signature, I istat randoagreeUthat-I-ha4O carefully exarmnedQfa4 completed applicatioSAr f(Q ty information her��rronnSii1s truetand�cortectaandLfuifhecceitify1hat brf>»'and all work perforinegOp d� Lc'afia gN�lt� WORK Ordinances of the City of Spriingfeldand thetLaws,of theistatebr Oregon pertaining tolthe prp �€sc i r�nf IaSaMVP/ IS NOT OCCUPANCY w11 bermade of any structure without perniissionrof,the Community Seruceo 1 6sr ANDe 1 7 FOR nwtwtr ui -4 certify that only contractors and employees)who_are_jn compliance with ORS 701.005 will bertied`;6rpEp ct. 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 8/23/2013 1:17:30PM Page 1 of 1 • • f SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfeld,OR 97477 `; OREGON 541-726-3753 811-SPR2013-01458 wvw.spdngfield-or.gov 4180 Glacier View DR 4182 permilcenter @springfield-or.gov RECEIPT NO: 2013001856 RECORD NO: 811-SPR2013-01458 DATE:08/23/2013 " ` M i1 . a fl_ `l_ACCOUNT:CODE/TRANS�CODE Elf- ": ,a*AMOUNT DUE Al DESCRIPTION � �-r , �s�*z._t_ Each added 500 sq.ft.or portion 224-00000-426102 1004 82.50 Residence wiring 1,000 sq.ft. or less ' 224-00000-426102 1004 147.50 Services 200 amps or less 224-00000-426102 1004 178.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 57.24 Technology fee(5%of permit total) 100-00000-425605 2099 23.85 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 558.09 BAYMEN1 ftRE IcnsRiEa:,d° 'OMMEP11 AMOUNTPAIp Check MIKE GANSEN CONSTRUCTION 558.09 023873 COMPANY TOTAL PAID: 558.09 • • SPRINGFIELD°--- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 oae+;oN Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01459 www.sprtngfield-ar.gov • permitcenter©springfeld-or.gov PROJECT STATUS: Issued ISSUED: 08/23/2013 EXPIRES: 02/18/2014 STATUS DATE: 08/23/2013 APPLIED: 06/28/2013 SITE ADDRESS: 4180 Glacier View DR 4182,Springfield,OR 97477 SCOPE: Duplex ASSESOR'S PARCEL NO: 1802052205000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New duplex OWNER: FOUR OAKS LLC Phone Number: 541463-1000 ADDRESS: PO BOX 26208 EUGENE OR 97402 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor LYNNS ELECTRIC CO CCB 102316 10/14/2013 541-726-7895 CUSTOM PLUMBING (PB)Plumbing Ca 20-174PB 07/01/2014 541-741-1736 Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06/27/2015 541-726-0100 General Contractor . MIKE GANSEN CONSTRUCTION COMPANY CCB 92159 06/14/2015 • 541-463-1000 INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: Wien 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. Owner or Contractor Signature Date ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility THIS Notification Center. Those rules are setfort ' AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 in throug cod s OA Re rul ooby COMMENCED OR IS ABANDONED FOR • 0090. You may ANY 180 DAY PERIOD. calling the center. !Note'. „ t oy:ick s number for the Oreg-'1 (,r.nf P" i5 - • Springfield Building Permit 8/23/2013 1:15:13PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St t,t TRANSACTION RECEIPT SpnngfielQOR 97477 OREGON 541-726-3753 811-SPR2013-01459 www.springfieldor.gov 4180 Glacier View DR 4182 permitcenter @spingfield-or.gov - RECEIPT NO: 2013001855 RECORD NO:811-SPR2013-01459 DATE:08/23/2013 II •RI'- i o 'Ii Etirt tlsS!yrl-ai tVAli` 14 ACCOUNT CODE/T- . NS:CODE i'eY.rL'i AMOUNT.DUE` First Appliance Fee 224-00000-425604 1006 80.00 Range hood/other kitchen equipment 224-00000-425604 1006 29.00 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 22.50 Technology fee(5%of permit total) 100-00000-425605 2099 9.38 Water heater 224-00000-425604 1006 18.50 TOTAL DUE: 219.38 . . .�_-...tirt.-..-.- 375ii ATH __...-__........., _ . y-n _ .: �AM9UNTPAI�;n, *k atg �P.AYMENT�IYP..E �'��PAYORF�cgsHlE` wrisoN ° MMENTS --; Check MIKE GANSEN CONSTRUCTION 219.38 023873 COMPANY TOTAL PAID: 219.38 • • 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-SPR2013-01460 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/23/2013 EXPIRES: 02/18/2014 STATUS DATE: 08/23/2013 APPLIED: 06/28/2013 SITE ADDRESS: 4180 Glacier View DR 4182,Springfield,OR 97477 SCOPE: Duplex ASSESOR'S PARCEL NO: 1802052205000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM -New duplex OWNER: FOUR OAKS LLC Phone Number 541-463-1000 ADDRESS: PO BOX 26208 EUGENE OR 97402 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor LYNNS ELECTRIC CO CCB 102316 10/14/2013 • 541-726-7895 CUSTOM PLUMBtNG (PB)Plumbing Col 20-174P8 07/01/2014 541-741-1736 Mechanical Contractor COMFORT FLOW HEATING CO • CCB 460 06/27/2015 541-726-0100 General Contractor MIKE GANSEN CONSTRUCTION COMPANY CCB 92159 06/14/2015 541-463-1000 INSPECTIONS REQUIRED Inspections 3150 Underslab Plumbing Underslab Plumbing: Prior to filling the trench and including required testing. 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. 3411 Preimeter Rain Drains v7101J: Oregon icIW lei tub a r1uu to • 3500 Rough P,11-II�i�T Rougrh Plumbing: Prior to cover and including required testing. n rnM glac arinntPrt by the /re,ron tlrPrf R"�TICE _ 3502 Top OuN3dugp R.lurnhingiter. Those rules are set forth v • ' 3650 Showeri�G(�rlFt y04-l/� -vu u Lill uuyltS�i°wei a- Prior to covering and nc udi PER °I d�I IOL EXPIRE IF IHE WORK frl irh Ynii rim/nhfain rnniP.s of trle rims by i 1m rid LYPt �y"-R THIS ('[KNIT !3 NOT 3999 Final Plumbi? ig the center. (Note: tiF.inalRIurnbing: When all pwmbing�worlf�is� lE�.OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD By signature, I state and-760 -i ave careful y�examined the completed application and do hereby certify tl at 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 •roperty, and the approved set of plans will remain on the site at all times during construction. Owner or Contractor Signature Date Springfield Building Permit 8/23/2013 1:12:38PM Page 1 of 1 • • SPRINGFIELD- CITY OF SPRINGFIELD h'\ OREGON TRANSACTION RECEIPT Springfield,OR97477 811-SPR2013-01460 www.springfield-or.gov 4180 Glacier View DR 4182 permitcenter @springfield-or.gov RECEIPT NO: 2013001857 RECORD NO:811-SPR2013.01460 DATE:08/23/2013 li�Yoi 1F dF tt a :_� j _ `*E, n - * { -' .. 1'ACCOUNT CODE TRANS CODE rya=¢A a T DUE") Dishwasher 224-00000-425603 1005 42.00 Each Additional Bath 224-00000-425603 1005 313.50 Each Additional Kitchen 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 113.16 Technology fee(5%of permit total) 100-00000-425605 2099 47.15 TOTAL DUE: 1,103.31 P VhIEN7aTiYP.E P,AYOR' cASRIER"KraSDR COMMENTS° _ , AMOUNVAID- Check MIKE GANSEN CONSTRUCTION 1,103.31 023873 COMPANY TOTAL PAID: 1,103.31 J dt -�0-1 I t z� v S� IVdj 3 J� aN<,LIrYJF�C�7 CJ Jiod c1VY�r Gr-8� C7 ��-361vn Gtr I ?n4 �=rz s<jr�y l��c-�1is�G :dCJ <azLl s, c�)Ntn�MG Z�n4 dsczid -� JNI rldJoo� l dzin)�r;?Jis -�Ntzl�/9 NI 'A Nd 1`T--niIJS " 0 17 L Qz —11 rl V� �d 9r Y lC) —� 7�F4�N3-1N1v" GtAv I +ES7 -S �c141 3lv❑ L Baa oanoaddy N093HO 6C NUNd§; AID A113 p "IYIOIddb0N10-M 3HL AS 03A021ddV 3H 'i�'HS MO"138 31V0 3H 213 l 1dVf03d N 210 SSNIMVLiO 03AOJddtl 3Hl Ol 30VbN SNOIlVL'3-LlV UO ` S3ONVH0 "lION3d 03210-100 NO C131VOICNI SNOUVa31ltl I M H1lM '03M3IA3i1 N338 3AVIi NO BUH S•LN31N00 3HL a servo N ziz 2 ,'7S ob13 'N f Cr+ 1s3+ sl zSo >`II I GOid3d tda 04l nNti BHN •0� JV 1U Cd ti I 51 HO 0dHN�WWOv ON a I a S(llidd3d SIP1 �30N(1 O�LiuOHlfltl �� zk II dy I Q H C M 3H1 dl �aIdX3 lltlHS 11WH SI I I � I szI to ja wnu auo4da!al uo!;eoypON Ann uo6a�O a41 1 4 g 1 Z ] W a qoN) Ja;uao ay; 6unleo Aq sa!ni 84110 sa!doo „offu!e qo Aew noA '0600-L00-Z5"o jVo g6no1410100 'ZZ ms's -400'Z46 iltlQ ul 4Vo;las ale sant eso41 -Ja;ua0 uo!;eogRON A1!!!in u06ajo aq; Aq poldope sa!n' mono} o; not sal!nbaJ me! uo6a10 1NOIiN3ild �l�I�bd Nc.,Ityr� I � a servo N ziz 2 ,'7S ob13 'N f Cr+ 1s3+ sl zSo >`II I GOid3d tda 04l nNti BHN •0� JV 1U Cd ti I 51 HO 0dHN�WWOv ON a I a S(llidd3d SIP1 �30N(1 O�LiuOHlfltl �� zk II dy I Q H C M 3H1 dl �aIdX3 lltlHS 11WH SI I I � I szI to ja wnu auo4da!al uo!;eoypON Ann uo6a�O a41 1 4 g 1 Z ] W a qoN) Ja;uao ay; 6unleo Aq sa!ni 84110 sa!doo „offu!e qo Aew noA '0600-L00-Z5"o jVo g6no1410100 'ZZ ms's -400'Z46 iltlQ ul 4Vo;las ale sant eso41 -Ja;ua0 uo!;eogRON A1!!!in u06ajo aq; Aq poldope sa!n' mono} o; not sal!nbaJ me! uo6a10 1NOIiN3ild �l�I�bd Nc.,Ityr�