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Permit Building 2013-8-27
• 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-SPR2013-01283 wwwspringfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/27/2013 EXPIRES: 02/22/2014 STATUS DATE: 08/27/2013 APPLIED: 06/14/2013 SITE ADDRESS: 5281 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702283401500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New single family dwelling-Lot 7 Thurston PI 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 EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 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 SUNSET HEATING&AIR INC CCB 171706 08/18/2014 541-554-2604 L INSPECTIONS REQUIRED j 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. 1370 Masonry Veneer 1410 Underfloor insulation • 1420 Insulation\Vap 4C&tier rnrvi drop urn I tr1 1430 lnsulationlWatl' PERMIT SHALL EXPIt TH '� �'„`� ••�••• - -�- --- riOniiED UNDER THIS P (tip to cover. follow rules adopted by the Oregon Utility 1440 Insulation Ceiling i s n: Prior to cover. Notification Center. I nose rules are set forth .'1 P.:1„ncn'CED OR IS ARArmu 1 � ��� n nn+ nn1nthrc'” OAP Q52-nn1- 1520 Interior Shearwalln nAY PERIOD. Shear Wall Nailing: Before covering sheathmgwithlfir]ish-mntealajn copies of the rules by 1530 Exterior Shearwall calling the center. (Note: me teleplu/J rinn I bitty Mntifioration 1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made afterAlathingja5 c gn2344). board, interior and exterior are in place, but prior to plastering. 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. Springfield Building Permit - 8/27/2013 10:32:49AM Page 1 of 2 • SPRINGFIELD 225 Fifth St lira: CITY OF SPRINGFIELD Springfield,OR 97477 (` � Phone: 541-726-3753 ` REGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01283 www,$pringfield-ar.gov permitcenter @springfield-ar.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. G k A' g177 113 Owner or Contractor Signature Date • Springfield Building Permit 8/27/2013 10:32:49AM Page 2 of 2 SPRINGFIELD - CITY OF SPRINGFIELD .1 i 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 ` CO'9 541-726-3753 OREGON 811-SPR2013-01283 www.springfield-or.gov 5281 HIGH BANKS RD permitcenter @springfield-or.gov RECEIPT NO: 2013001888 RECORD NO:811-SPR2013-01283 DATE:08/27/2013 iDESCRIPTION ` . - -.,.r„ ` -ACCOUNTCODE/TRANS_CODE___ - AMOUNT_DUE_',J Address Assignment,each new or change 224-00000-425602 1020 42.00 Curb Cut/Driveway 1st Cut 201-00000-428060 1141 102.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 103.65 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 745.89 SDC: Improvement Cost-MWMC Regional Wastewater SDC • 445-00000-448025 1187 1,392.04 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 1,052.35 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 262.11 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 1,528.24 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 108.14 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 722.42 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 76.64 SDC:Total Sewer Administration Fee 719-00000-426604 1175 113.71 SDC:Total Storm Administration Fee 719-00000-426604 1180 88.74 SDC:Total Transportation Administration Fee 719-00000-426604 1190 60.87 Second Permit Discount 201-00000-428060 1148 67.00 Structural Building Permit Fee 224-00000-425602 1002 1,099.06 Technology fee(5%of permit total) 100-00000-425605 2099 8.45 Willamalane fees-Single family detached 821-00000-215023 1074 -938.76 TOTAL DUE: 9,500.00 '°...,PAYMENT„TYPE..__ PAYOR�,_�CASHIER:JLARSON COMMENTS „,„”;'--:,.,' ;_,. .AMOUNT PAID CreditCard CUMMINS INVESTMENTS LLC 9,500.00 005305 TOTAL PAID: 9,500.00 • '' SPRINGFIELD CITY OF SPRINGFIELD .....____iiii :I 1 .ate 225 Fifth St Rol TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01283 www.s96699eld-or.gov 5281 HIGH BANKS RD permitcenter @springfield-or.gov RECEIPT NO: 2013001892 RECORD NO: 811-SPR2013-01283 DATE:08/27/2013 [DESCRIPTION ^� - - _,. m;. . _ACCOUNT CODEITRANS CODE _AMOUNT DUE I State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 131.89 Technology fee(5%of permit total) 100-00000-425605 2099 57.05 Willamalane fees-Single family detached 821-00000-215023 1074 2,471.24 -� - —��— — "------ -- --- — TOTAL DUE: 2,660.18 '^AMOUNT PAID _PAYMENT TYPE:_,,�PAYOR ,_CASHIER:duRSOR ___; ,� � COMMENTS_�;` _�_ _ _ _..�— J Check CUMMINS INVESTMENTS LLC v 2,660.18 2092 TOTAL PAID: 2,660.18 SPRINGFIELD ..... CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-S PR2013-01283 www.springfield-or.gov 5281 HIGH BANKS RD permitcenter@springfield-or.gav RECEIPT NO: 2013001239 RECORD NO:811-SPR2013-01283 DATE:06/14/2013• LDESCRIPTION r ACCOUNT CODE/TRANS CODE ' • ::.AMOUNT.DUE ., Structural Plan Review Fee Residential 224-00000-425602 1061 714.39 TOTAL DUE: 714.39 AMOUNT PAID k .__ PAYMENT TYPE„.....- ,;PAYOR,_ cnsHlER:ccnaPER7ER;„ .-'.....," COMMENTS -.°.,_�... . ,.�.. ..__._ -..._°...__.�-.-�._._..,._ .....:=.:� Credit Card DAVIS CONSTRUCTION SERVICES t 714.39 04163d TOTAL PAID: 714.39 Structural Permit Application .$PRINGdON DEPARTMENT'U SE ONLY;__ -..-._.... cgat-;ggs.9 S)?RTN-HatIskO EGOIfr� - a.ik.:* -S Permit no.c3 72g3 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753♦F AX(541)726-3689 Date: /y/i3 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. .. -�? COCAL�_GOVERNMENT APPROVAL "- - --' - _,;_ ,� FEE SCHEDULE This project has final land-use approval 1 Va[uahonfnfotutahaa r_, Signature: Date: - (a)Job description Hgrbi Jr0 This project has DEQ approval Signature: Date: Occupancy itr/ Zoning approval verified: ❑Yes ❑No - Construction type: "Ig • Property is within flood plain ❑Yes ❑No Square feet /92 Z l/ gd ft. / /4'O G',© Awe- 419= �., sCATEGORY OF.,,CONaTRUC710N Cost per square foot Y/ �73 7 � 2/Residential Residential ❑Government ❑Commercial` Other inforniatiom ,,.,,.J06 SffE,INFORMATIONAND LOCATION _' Type of Heat - - Jobsiteaddress: 5ZS/ R[6st 6,41..g .1 Rd. �,/Energy Path: City 5pez 6nfrn I State: oa ZIP: 97y7B 12 new alteration ❑addition Subdivision 1"jNR5rno,a r Lot no.: 7 (b)Foundation-only permit? ❑Yes ❑No Reference: /7t — 2 F Taxlot O7 Steel Total valuation: $174,33?Z!2 err �z 3 ..:,. a`_•.PROPERT_ OtJNER•4 ---> _ . _. Name: (VM-44„v5 )Ni/. Lr_C (a)Permit fee(use valuation table): ^. - y/b9?Pe Address: 3 12.11 05 p a f7 LN- (b)Investigative fee(equal to[2a]): S- City Lf$4Nmo,-r State: pt ZIP: 4'7?SS (c)Reinspection($ per hour): (number of hours x fee hour) Phone: 5jI - 2Se - 24.5 Fax: - - ( per ) e Co.wt.tr r, rJ t r (d)Enter 12%surcharge(.12 x[2a+2b+2cD: $ 171 l' 8 - (e)Subtotal of fees above(2a through 2d): S Building Owner or Owner's agent authorizing this application: .3PLmrevlewl'ees (a)Plan review(65%x permit fee[2a]): S._7i4 7.7 Sign here: (b)Fire and life safety(40%x permit fee[2a]): $ 1:1 This installau n 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`;Mtscellaneous*'ees j`=-F i z c requirements undu-ORS 701.010. - -• — -- (a)Seismic fee, 1%(.01 x permit fee Rap: S • „�-t� '” � ,_h�iCONTR'ACTOR INSTALLATION .� �•7� (b)Technology fee,5%(.05 x permit fee[2a]): s p 7 Ps Business name: DAJ■ CONS raven,,.) 51.PsJ tel I.Le Address: 5i 4 7 S 5Nt f1 r TOTAL fees and surcharges(2e+3rF4a+4b): 5 2pOD 2-7 City SpF-'-.n State: C& ZIP:4741 73 Phone: 52./ ( -D.4 0 4.2.41''1 Fax.: - - E-mail: PA"iseo 3- e 444-C, Coin CCB license no_: 14.034-1 Print name: S corn— DA vU Signature: ' 44— -- U6;E•N RACTORiINFORMATION--- Name CCB License ft Phone Number Electrical a5T51ng Stfc-Mir � 1��7o 91�9oZ� Plumbing - polctsiQ, p .'.rs CS 27i 41T3 - Ltc17 Mechanical - 5vNkT Nt € U7/7aC 9f.,°, - 51o ) • PZ,willamalane tb Park and Recreation District Job. No. .9/22-015-0(24“ PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET r • Jan. 1-Dec. 31, 2013 NAME: C/(ALwlfrn)4c PHONE: Sill -2g-ZE'S'D ADDRESS: 3 122/ bsret,l JM, CITY:Id,,kfVk n STATE:0( ZIP: 9 • LOCATION OF PROPOSED BUILDING SITE: Street address: 5-2,61 14)5ti 4244s Plat name: I ?"67Z2-6 3 `F Tax Lot Number: 0 /SHOO 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS ( X $3,410 per unit= $ 3� `-f /o 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.) (5 ) 3. TOTAL PARK AND RECREATION SDC ASSESSED. $ 3 LF 10 . / to i I f / 2a 13 City of Springfield Date of building permit submittal City of Springfield Date of building permit issuance SPRINGFIELD 225 Fifth St hir` '°� CITY OF SPRINGFIELD Springfield,OR 97477 (\l� Phone: 541-726-3753 `OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01284 www.springlield-or.gov pennitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/27/2013 EXPIRES: 02/22/2014 STATUS DATE: 08/27/2013 APPLIED: 06/14/2013 SITE ADDRESS: 5281 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702283401500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-New single family dwelling-Lot 7 Thurston PI 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 EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 SUNSET HEATING&AIR INC CCB 171706 08/18/2014 541-554-2604 ' INSPECTIONS REQUIRED Inspections • 4000 Temporary Power Service 4120 UFER Ground 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. • Owneri1CoI 1.CitSignature Date TH S PERMIT SHALL EXPIRE IF THE WORK ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth `?MMENCED OR IS ABANDONED FOR oosO.Y out may obtaontcopies ofthe gu e�by "� Y PERIOD. calling the center. Note: the number for the Oregon telept;:, Center is 1-po_3t2t��34OtlfIcation • Springfield Building Permit 8/27/2013 10:24:39AM Page 1 of 1 •SPRINGFIELD -` CITY OF SPRINGFIELD h4 a....i,j.. 225 Fifth St ° TRANSACTION RECEIPT Springfield,OR 97477 ell EGON 541-726-3753 811-SPR2013-01284 www.springfield-or.gov 5281 HIGH BANKS RD pennitcenter @springfield-or.gov RECEIPT NO: 2013001890 RECORD NO: 811-SPR2013-01284 DATE:08/27/2013 ',DESCRIPTION- _• _ v : ACCOUNTCODE/TRANSCODE ___ AMOUNT;DUE_J 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 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 35.88 Technology fee(5%of permit total) 100-00000-425605 2099 14.95 Temp services 200 amps or less 224-00000-426102 1003 69.00 — -- TOTAL DUE: 349.83 ' - - . AMOUNT j_PAYMENTTYPE . PAYOR CASHIER:JLARSON COMMENTS Check CUMMINS INVESTMENTS LLC 349.83 2092 TOTAL PAID: 349.83 Electrical Permit Application DEPARTMENT USE ONLY _ SPRINGFIELD r - min Pta;lpi Thmil i ®REDO , u a� h t, - S t ` �a7 r �-'�m�`'"�. � �„ +� �` � � Permitno.: �.��� /zit/ r',,'?t.M5'% 225 Fifth Street•Spriagtield,OR 97477•PH(541)726-3753•FAX(54])726-3689 Date: 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 ,'COVERNMENT APPROVAL "` ... ,..:.: e. *i FEE;5OHEDULE4 . :`, , Zoning approval verified? ❑Yes ❑No Number of insnecnons: e�items : Cost Total ...- p, p C}.ri Qty v'( , .'- CATEGORY�'OF.'CON$TRUOT;ION .:::;, ._ , 1E/RResidential,per unit,service included: esidential ❑Government ❑Commercial 1,000 ft or less 4 dOB SITE .INFORMATION. AND LOCATION .c sq. (4) $147.50 $ Each additional 500 sq.ft or portion Job site address: SZ S I /4--1 bH 84.44c1 ?.< thereof -3 $ 27.50 $ City: SpRIN6FISt,+o State: 0 l ZIP: g19-713 Limited energy(2) $ 35.00 $ Reference: Taxlot.: 7 Each manufactured home or modular - t:IDESCRIPTION'OF.. WORK`:= r " dwelling service or feeder(2) $ 69.00 $ AI1:W SFR Services or feeders:installation,alteration,relocation 200 amps or less(2) $ 89.00 $ r k-2, PROPERTY OWNER >; r ` c' 201 to 400 amps(2) $ 104.50 $ . :..tam: Name: Cum•vuM5 /NJ. LLL 401 to 600 amps(2) $174.00 $ Address: 3 I22 I os7psi Rd. 601 to 1,000 amps(2) $225.50 $ City: LESANNo p State: ewe ZIP: 9 735S Over 1,000 amps or volts(2) $516.00 $ Phone:.5YJ 2S8 26SJ Fax: - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation,alteration,relocation TECvMM/NS a ComeAsr . Al Sr This installation is being made on residential 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) property is not intended for sale, exchange, lease, or rent.OAR $ 96.00 $ 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 CONTRACTOR INSTALLATION,`. v4' 7 .:i4' Branch circuits:new alteration,extension per panel Business name: rA STSoo E E E t)e, c .I a.Fee for branch circuits with purchase of a service or feeder fee: Address: 39253 13ostA6E cp. Each branch circuit S 6.50 S City: S pries b Ft 14.A State: cut ZIP: 9-Ni g b.Fee for branch circuits without purchase of a service or feeder fee: Phone:51i J lic' 91z g Fax: - - First branch circuit(2) $ 60.50 $ E-mail: go lc 19(4 e yA tM a Co, Each additional branch circuit $ 6.50 $ CCB license no.: 1 1777 o BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 47)7 5 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: R.06F„/t k,M& Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: ciare'9)4 IL-q Signal circuit or a limited-energy panel, $ 80.00 $ alteration,or extension(2) Each additional inspection:(I) $80.00 $ ,,^- 5.-4L -1 ,T APP;L7CANT,iUSE ' Vein (A) Enter subtotal of above feu �'+�j (Minimum Perm it Fee$80.00) $ Z / pp(�� (B)Enter 12%surcharge(.12 x[A]) • $ 3-rit (C)Technology Fee(5%of[A]) $ /(r 7J TOTAL fees and surcharges (A through C): S 7%' ! ?3 440-2584-1(4/012013/C0M) • SPRINGFIELD 225 Fifth St ` CITY OF SPRINGFIELD Springfield,OR 97477 `la Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2 01 3-01 28 5 www.springfield-or.gov pennitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 08/27/2013 EXPIRES: 02/22/2014 • STATUS DATE: 08/27/2013 APPLIED: 06/14/2013 SITE ADDRESS: 5281 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702283401500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New single family dwelling-Lot 7 Thurston PI 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 EASTSIDE ELECTRIC INC COB 117770 10/04/2013 541-741-1499 Plumbing Contractor JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 DAVIS CONSTRUCTION SERVICES LLC CCB 160347 06/14/2014 541-868-6294 SUNSET HEATING 8 AIR INC CCB 171706 08/18/2014 541-554-2604 INSPECTIONS REQUIRED j 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 locate tent of the property, and the apprdved set of plans will remain on the t all times during 'g � I NTION: Oregon law requires you to construction. THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth / In OAR 952-001-0010 through OAR 952-001- nnnnncplCED OR IS ABANDONED FOR �'(u�/3 In OA You ma o t Ow er or ContractdilSignatlr AY PERIOD. Date calling the center. .(N r:t ue. of thephl by number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 8/27/2013 10:29:52AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 'Kk OREGON TRANSACTION RECEIPT Seri gfield`OR 97477 541-726-3753 811-SPR2013-01285 www.springfield-orgov 5281 HIGH BANKS RD permitcenter @springfield-or.gav RECEIPT NO: 2013001891 RECORD NO:811-SPR2013-01285 DATE:08/27/2013 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 L„PAYMENT_TYPE�PAYOR CASHIER: AMOUNT PAID �_. - COMMENTS - � �� -� Check CUMMINS INVESTMENTS LLC 480.87 2092 TOTAL PAID: 480.87 • • • Plumbing Permit Application DEPARTMENT Litt ONLY ,< SPHINGitELp d*je'° : :Lc"' I �F 7 RINiF�L VECtiN '' Permit no.:C , - � a 225 Fifth Street• Springfield,OR 97477 • P11(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. E'; :LOCAL:GOVERNMENT,.APPROVAL .tt s?r'% - „FEE,SCHEDULE';,A „ i; Zoning approval verified? ❑ Yes ❑No s{ '_/ : +Cos r t Toal':Descnpt]on Qb f '" __rangy '=` ) •• ...r.ea. ;cost.:,;Sanitation approval verified? ❑Yes ❑No New residential <7';;:f.:..:- =CATEGORY OF xCONSTRUCTION` �" t I bathroom/1 kitchen(includes:first ❑Commercial 100 feet ofwater/sewer lines, hose [+residential ❑Government j f $262.00 $ bibs, ice maker, underfloor low-point JOB-SITE INFORMATION .AND'LOCATION;; ''.t.1 drains and rain-drain packages) Job site address: 51 8 I 14i614 &WAe I ga. 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/1 kitchen City: 5 peiNG Fin D , State: p,2 ZIP: 9/y78 Each additional bathioom(over 3) $104.50 $ Reference: Taxlot 7 Each additional kitchen(over I) 5104.50 $ `i 'DESCRIPTION`.`OF WORK' =• �r e Residential fire sprinklers(includes plan review) NE& 5 pg - 0 to 2,000 square feet $80.00 $ 2,001-to 3,600 square feet $128.00 $ P,.ROPERT:IOWNER ;iO r ' i - 3,601 to 7,200 square feet $192.00 $ Name: w„�MtN s 7,201 square feet and greater - $255.00 $ /NV. Li Address: Manufactured dwelling or pre-fab(circle one) '312 Z i ospa h t-N. Connections to building sewer and water supply $80.00 $ Crty: LF$ANac.1 State: m2 ZIP: Q73 SS Commercial,industrial,and dwellings other than one-or Phone: 5-4-f I 3 S$ . 26 SJ Fax: - - two-family E-mail' -. Minimum fee $80.00 $ 1 Eca.wM1N1 e LO-•.c,,r . N1•r• This installation is being made on residential or farm property Each fixture $21.00 $ 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 $ `;CONTRACTOR.'INSTALLATION '`iy.? °'f�i Storm water retention/detention facility $21.00 $ Business name: PgicisioN PL S,8iN6 u•c litigation systems $21.00 $ Piping or private storm drainage Address: SS6 3 S ti,6q f.) 6N. systems exceeding the first 100 feet $21.00 $ City: Evrlewt State: on ZIP: q-,21.01- Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone: Sy) - 953 - 9677 Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) $80.00 $ CCB license no.: 1 5-8 279 BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no =Medical gaspiping'+F .L'i t .r! Minimum fee $ Print name: . To gliv f Enter value of installation and equipment$_. Enter fee based on installation and equipment value $ Signature: ai _ APPLICANT�iUSE' rr* r�^_ w y .�a al;..r � fwd (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(4/12013/COM) SPRINGFIELD- 225 Fifth St ' .� CITY OF SPRINGFIELD Springfleld,OR 97477 ., v Phone: 541-726-3753 "l\OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01286 www.springfeld-or.gov permitcenterQspringfieId-or.goy PROJECT STATUS: Issued ISSUED: 08/27/2013 EXPIRES: 02/22/2014 STATUS DATE: 08127/2013 APPLIED: 06/14/2013 • SITE ADDRESS: 5281 HIGH BANKS RD,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702283401500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New single family dwelling-Lot 7 Thurston PI 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 EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 JOHNS PRECISION PLUMBING LLC CCB 158279 02/04/2014 541-736-8690 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. 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 required testing and capped if not attached to an appliance. 2995 Final Gas Final Gas: When all gas work is complete. 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 pertainin to the- p{ de cribed herein, and that NO Sf t HIV I r midi I,..., . OCCUPANCY will be made of any structure without permission of the Community Services�[7iVi Io� Building°Safety?Ufurtfi0tOU to IL 7 rt C rIn r! H., cer;iiVylq'�itP(�rr�y contractors and employees who"are in compliance with ORS 701vuU5{�altbB�isc��onfthis�ro7ect�?EI�116�j{agr�lllty to ensuViffif all re uitgci s IQtt�r�r� (��r5b proper time, that each RRa sslf5 rccablerfroJn{lie"-st[61€tstflaetbet forth permitlocarB ga3ltA�krp GP fRE ISfo aAbifti approved set of plans II{� °,n-o'ri ts(te a YSfale�Fltftiiu 'g'?952-001- con'stru`dt(SiRIZED UNDER THIS PER IIIIIIS NOT 090. You may obtain copies of the rules by ",OMMENCED OR IS ABANDONED FOR • calling the center. (Note: the telephr. number for the Oregon Utility Notification NY 180 DAY PERIOD. 1 421.1/3 Center is 1-800-332-2344). Jr Owner or Contractor Signature Date Springfield Building Permit 8/27/2013 10:27:15AM 'Page 1 of 1 SPRINGFIELD • CITY OF SPRINGFIELD 225 Fifth St ~`"O OREGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01286 www.springfield-or.gov 5281 HIGH BANKS RD permitcenter @springfield-or.gov RECEIPT NO: 2013001889 RECORD NO:811-SPR2013-01286 DATE:08/27/2013 :DESCRIPTION • ACCOUNT_CODE/TRANS.CODE_ �. . AMOUNT DUES First Appliance Fee 224-00000-425604 1006 80.00 Furnace-up to 100,000 BTU 224-00000-425604 1006 18.50 Gas Piping up to 4 outlets 224-00000-425604 1006 7.50 Range hood/other kitchen equipment 224-00000-425604 1006 14.50 Single-duct exhaust(bathrooms, toilet compartments, utility room: 224-00000-425604 1006 40.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.26 Technology fee(5%of permit total) 100-00000-425605 2099 8.03 TOTAL DUE: 187.79 -P - i '° AMOUNT PAID � AYMENT TYPE ._-,_LLPAYOR CASHIER:uLnRSON COMMENTS � - Check CUMMINS INVESTMENTS LLC 187.79 2092 TOTAL PAID: 187.79 • • • Mechanical Permit Application , DEPARTMENT,USE ONLY •> t ,0 RINMEIaD VAREGON,¢ , i ,..*2, „' N Permit no.: 225 Fifth Street•Springfield,OR 97477• PH(541)726-3753 • FAX(541)726-3689 [? -z, 1 11 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 ` > N " F.EE SCHEDULE LJ Residential ❑Government ❑Commercial ]Residential " <` t` Qty ,Cost , . Total. ,. ,' -- JOB SITE,INFORMATION AND LOCATION ' .. . , First Appliance $80.00 $ lob site address: S 213 I HID/ eaglet ,A Furnace/burner including ducts and vents City: 5p1,N4,1 fc D State: oft ZIP: 97979 Up to IOOk BTU/hr. $18.50 $ Reference: Taxlot.: -7 Over 100k BTU/hr. $22.00 $ 'rDESCRIPTIOM_OF WOR. Heaters/stoves/vents , Unit heater $18.50 $ NEv't 5pr Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ PROPERTY:OWNER , ^'' s` .` i absorption system Name: Cv.r,M/nrJ /NV. Cr.- Evaporated cooler $14.50 $ Address: 31221 (WAS" JPd. Vent fan with one duct/appliance vent $10.00 $ Hood with exhaust and duct City: 1.EP4,4vvory State: p2 ZIP: 97353 Floor furnace including vent $80.00 $ Phone: 5-4/ 2 V0 Za co Fax: - - Gas piping E-mail: TECv-ims. J P ton CAST . Nf r 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 $ .CONTRACTOR=INSTALLATION, t Compressor/absorption system/heat pump Business name: 5u1/051T" 14 vA-C Up to 3 hp/100k BTU $18.50 $ Address: Up to 15 hp/500k BTU $32.00 $ 5729 MA,n, swtftr ga 2/€ Up to 30 hp/1,000 BTU $47.50 $ City: SpRwaFaDn State: OR • ZIP: 979ig Up to 50 hp/1,750 BTU $62.50 $ Phone: Sy I -fj BS - 31 g 1 Fax: - - Over 50 hp/1,750 BTU $104.50 $ E-mail: QRoCL2J 19711 C-' Ao... . cOA, Incinerators CCB license no.: /-7l 7p� Domestic incinerator $22.50 $ Commercial - Printname: g21AN Teo 6YR5 Enter total valuation of mechanical system Signature: and installation costs$ - Enter fee based on valuation of mechanical system,etc. $ Miscellaneous fees ' ' items "-Cost Total Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(1) $80.00 $ • Di "°�fir* s `„APPLICANT?.USE (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]) $ 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $