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HomeMy WebLinkAboutPermit Building 2013-9-4 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 cc-lea Phone: 541-726-3753 k *N OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01637 went.springfieldor.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/04/2013 EXPIRES: 03/02/2014 STATUS DATE: 09/04/2013 APPLIED: 07/19/2013 SITE ADDRESS: 246 S 70TH ST,Springfield,OR 97478 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702353305902 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-New SFD OWNER: CHANEY NICHOLAS - Phone Number: 541-722-9481 • ADDRESS: 2222 11TH ST SPRINGFIELD OR 97477 _ CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08)01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 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 rnnuires you 10 cr. r rr Gea .. the Oregon Uoury. 14)?O TnsulatIntll VaDor�Barrier " t:! " 1 altuirtr.�+ -,Y .. t fnrttl 1 Olnsulation(Walter. Those lu■ca t In Insulation: Prior to cover. NOTICE:Inh OAR 952 _ a4o.hs�u�atiorinCeilirrg�t�jli copies of the rUlc Afrig Insulation: Prior to cover. THIS �{PERMIT'SHALL L EXPIRE IF THE WORK 15201 terior,Sheartv"alllr fly o�l;ility Nctific•Shear Wall Nailing: Before covering PSflEatNP WrtcQnfSM1'fr(�[�FiZoIS PERMIT IS NOT CC",IMENCED OR IS ABANDONED l'OR 15301 Extenoc�r'Sl ea-1 iwall 1_�yp�.3'2 2:SG`t)• ANY 1R11 f1AY PFRIOD- �r 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. 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. • Springfield Building Permit 9/4/2013 2:21:38PM Page 1 of 2 • SPRINGFIELD 225 Fifth St " CITY OF SPRINGFIELD Springfield,OR 97477 t w Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01637 www.springfieldor.gov permitcenter @springfield-or.gav 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 • ^n r.V +. b •.rr�' -. U?7? Springfield Building Permit 9/4/2013 2:21.38PM Page 2 of 2 SPRINGFIELD CITY OF SPRINGFIELD r t ,:„,-, j 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 4,REGON 541-726-3753 811-SPR2013-01637 www.spnngfield-or.gov 246 S 70TH ST permitcenter©spnngfieldorgov RECEIPT NO: 2013001950 RECORD NO:811SPR2013-01637 DATE:09/04/2013 DESCRIP.T ON . , tPT tne'-:,,,_ mftkin .L-:J 01VIIV 0 0 : 'RANS.CODE T 3,(Ci?",,j'st'AMOUNT DUET,j Address Assignment, each new or change 224-00000-425602 1020 42.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 79.45 SDC:Administrative Fee-MWMC Regional Wastewater SDC 611-00000-426604 1189 10.00 SDC:Compliance Cost-MWMC Regional Wastewater SDC 444-00000-426607 1113 22.58 SDC: Improvement-Transportation SDC 447-00000-448027 1174 1,962.23 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 1,601.72 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,448.64 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 797.16 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 538.41 SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 - 3,281.64 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 114.41 SDC: Reimbursement Cost-Storm Drainage • 441-00000-448029 . 1177 548.18 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 79.78 SDC:Total Sewer Administration Fee 719-00000-426604 1175 244.17 SDC: Total Storm Administration Fee 719-00000-426604 1180 67.27 SDC:Total Transportation Administration Fee 719-00000-426604 1190 125.03 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 116.12 Structural Building Permit Fee 224-00000-425602 1002 967.66 Technology fee(5%of permit total) 100-00000-425605 2099 50.48 Willamalane fees-Single family detached 821-00000-215023 1074 3,410.00 TOTAL DUE: 15,506.93 P,AYMEN7.T RT PAYOR cns.l.R...REeo.R- , COMMENTS . ' .._ t A-..,'. d I. :,1 �. .>: . _�„,,. MOUNT F'dID Check CHANEY NICHOLAS 15,506.93 0669100669 TOTAL PAID: 15,506.93 • • • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spdngfield,OR97477 ;IE' 40-F 541-726-3753 OREGON 811-SPR2013-01637 www,springfieldor.gov 246 S 70TH ST permitcenter©springfield-or.gov RECEIPT NO: 2013001955 RECORD NO:811-SPR2013-01637 DATE:09/04/2013 DESCRIPTION. "-eV k s&3 n L 1w+ 1.r`.i.':`ACCOUNT CODEITRANS'CODE :.n: 411 J AMOUNT DUE 3.1 Planning-Major Review-City 100-00000-425002 1231 211.00 TOTAL DUE: 211.00 P.AYMENT;<- E_ : PAYOR CASHIER:KREEDER, COMMENTS AMOUNUPAID Credit Card CHANEY NICHOLAS 211.00 411114 TOTAL PAID: 211.00 • SPRINGFIELD CITY OF SPRINGFIELD ..._ _____Isi - ..de,,,..„ 225 Fifth St TRANSACTION RECEIPT Springfield.OR 97477 E• r,c�a e 541-726-3753 OREGON 811-SPR2013-01637 www.springfield-ar.gov 246 S 70TH ST permitcenter©springfield-or.gov RECEIPT NO: 2013001576 RECORD NO: 811-SPR2013-01637 DATE:07/19/2013•EDESCRIPTION ,_ ' ' ` .,'ACCOUNT CODEITRANS CODE "AMOUNTDUE, - Structural Plan Review Fee Residential 224-00000-425602 1061 628.98 TOTAL DUE: 628.98 L PAYMENT_TYPE_ _ _PAYOR, -CASHIER:CGRRPEhEfq13_,_ -__ COMMENTS - - .AMOUNT PAID -F Credit Card CHANEY NICHOLAS 628.98 288745 TOTAL PAID: 628.98 Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY ' CITY OF SPRINGFIELD. OREGON t Permit no.: Si 3_/637 225 Fifth Street•Springfield,OR 97477•P71(541)72673753•FAX(541)726-3689 • .aREGON Date: -l/ g Jj 3 This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of i4suanc or if work is suspended for 180 days. . LOCAL GOVERNMENT APPROVAL 'FEE:'"SCHEDULE - . _ This project has final land-use approval. 1.Valuation information Signature: Date: (a)Job description: IL S; 4;e, I /1/4'`L ,A__e_ This project has DEQ approval. Date: Occupancy /l� • Signature: )) Zoning approval verified: 111 Yes ❑No Construction type: T I L e t, t N Property is within flood plain: ❑Yes ❑No Square feet: t( S 5 l-t /L109 .CATEGORY OF CONSTRUCTION •,' , Cost per square foot: ❑ Residential ❑Government ❑Commercial Other information: ' ' :JOB SITE.'INFORMATIO,yN� AND_.LOCATION Type of Heat•. F..t-4.S(.e //' 4 P,--r mi) lob site address: Z9 , Sot tR .c4 FRI to Energy Path: City: $erInic;e (Q' State: ZIP: rew ❑alteration ❑addition Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No Reference: 0--Q Z-3S-33 TaxloC S901,, Total valuation: yq DO PRO�PEeRTY. OWNER ' 2:Building'fees / Name: V'v_t_ _ .1' (a)Permit fee(use valuation table): S ��P/bc Address: 2 Z '12 I 7t -C.K_- (b)Investigative fee(equal to[2a]): S City: See:,v C - e I I State: fl 4 ZIP: 9�? (c)Reinspection(S per hour): S Phone: 5 Lf j. -11Z ry' mils/1 Fax: - - (number of hours x fee per hour) i- E-mail: y');t ix0 ico 6 C'-tic f.) < en r.: ],(�qt (d)Enter 12%surcharge(.12 x[2a+26+2c]): q 11� . 'lJ (e)Subtotal of fees above(2a through 2d): $ Building Owner or 0 'Cs agent authorizing this application: ;3�Planireview fees (a)Plan review(65%x permit fee[2a]): $ WriC Sign here: — �— (b)Fire and life safety(40%x permit fee[20: $ to 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 4„Miscellaneous fees , requirements under ORS 701.010. ° -_ (a)Seismic fee, I%(.01 x permit fee[2a]): S CONTRACTOR INSTALLATION'S ze/r /x� ^ (b)Technology fee,5%(.05 x permit fee[2ap: S __/r16�� Business name: `=..') f /761 h TOTAL fees and surcharges(2e+3c+4a+4b): $ Address: City: State: I ZIP: Phone: - - Fax: - - E-mail: CCB license no.: • Print name: , Signature: _-4 ;1-,""`. SUB=CONTRACTORINF.ORMATION ;,. _ . ( Name CCB License# Phone Number J • Electrical ,93—/ V2 - J! Plumbing -r•/6 /�l 3 ( Mechanical - ? S! 3 ('Y l . • Property Owner Statement Regarding Construction Responsibilities • Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: • I own, reside in, or will reside in the completed structure and my general contractor is: • Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. N ; deidLog Print Name of Permit Applicant atur-emit Applicant Date • • Permit# S/3 —/ Y7 /6i /2- loterr /6 `Yr 6f ' Address: 7 2.-9 G S. d :te H ��•'Nidy`i: ceFL41 ate- 9N7 r • Issued by: c77"1// 5 8 5 g • • This Copy for Permit Offices willamalane . Park and Recreation.District Job. No. 513:7637 PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET // Jan. 1-Dec. 31, 2013 NAM E:a' -7Ve- PHONE: 72„..7 - ADDRESS: 22 2- 2— / / CITY: S Pte-y\ STATE. IP: LOCATION OF PROPOSED BUILDING SITE: Street address: 2-rC S - 73 a_ c— Plat name: Tax Lot Number:• /70L 3573 roc-2v 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS / X$3,410 per unit= $ 34/1O 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 (7u/& • City of pri gfiel Date of building permit submittal City of Springfield Date of building permit issuance I SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfeld,OR 97477 ;y{,: kti l - Phone: 541-726-3753• OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01643 www.springfeldor.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 09/04/2013 EXPIRES: 03/02/2014 • STATUS DATE: 09/04/2013 APPLIED: 07/19/2013 SITE ADDRESS: 246 S 70TH ST,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702353305902 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-New SFD OWNER: CHANEY NICHOLAS Phone Number: 541-722-9481 ADDRESS: 2222 11TH ST • SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 • Mechanical Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 r INSPECTIONS REQUIRED I 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. ■ Owner or Contractor Signature ' Date ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK • in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-600-332-2344). Springfield Building Permit 9/4/2013 2:16:40PM • Page 1 of 1 • r • SPRINGFIELD--- CITY OF SPRINGFIELD • 6A"`"., . TRANSACTION RECEIPT Springfield,OR 97477 t 225 Flkh St OREGON N 541-726-3753 811-SPR2013-01643 www.springfieldor.gov 246 S 70TH ST permitcenter©spdngfeld-or.gov RECEIPT NO: 2013001952 RECORD NO: 811 SPR2013-01643 DATE:09/04/2013 D • •' , o ## °.fL .><,'- +5 7St ACCOUNT CODE/TRANS CODE _ `.. - ;;AMOUNT DUE- ) First Appliance Fee 224-00000-425604 1006 80.00 Furnace-up to 100,000 BTU 224-00000-425604 1006 18.50 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 17.16 Technology fee(5%of permit total) 100-00000-425605 2099 7.15 TOTAL DUE: 167.31 PAYMENT eTYPE PAYO1 -04swER:RREEDERR COMMENTS AMOUNT,i... Check CHANEY NICHOLAS 167.31 0669100669 TOTAL/PAID: 167.31 1 • • I, 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-SPR2013-01644 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued - ISSUED: 09/04/2013 EXPIRES: 03/02/2014 STATUS DATE: 09/04/2013 APPLIED: 07/19/2013 SITE ADDRESS: -246 S 70TH ST,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702353305902 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-New SFD OWNER: CHANEY NICHOLAS Phone Number: 541-722-9481 ADDRESS: 2222 11TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 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 tat; tyre 110, l 1"' �� �l p, 0{{'fjkpestlonsSarefregtie'sied.at TFtl.�roper time,that each address is readable from the street,that the•- permit car4 Islo tkat the f font ofithetprdperty Cana{fie tt roved set of plans will remain on the site at all times during construcfeiBtification Center. Those rules are set fort NOTICE: in OP 9 952-001-owl thrnual OAR 952-001- or :i of the rules by THIS PERMIT SHALL EXPIRE W THE WORK art:- u onir_r rr .,re: the telephone y�vf°,d'nRIZED UNDER THIS PERMIT IS NOT Owner or Contractor Signature IPC'" U;;Iity Notification Date COMMENCED OR IS ABANDONED FOR r . .-i �c ' - - ' " '- ANY 180 DAY PERIOD.. • • • Springfield Building Permit 9/4/2013 2:19:10PM Page 1 of 1 • SPRINGFIELD _ CITY OF SPRINGFIELD .t 225 Fifth St kk � TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 oReco+ 811-SPR2013-01644, www.spdngfeld-or.gay 246 S 70TH ST permilcenter©springfield-or.gov RECEIPT NO: 2013001953 RECORD NO:811-SPR2013-01644 DATE:09/04/2013 DESCRIP.TION_ :_ .:•- 1:4 ,ii T„'_..Lthk ..t . ACCOUNTCODE/TRANSCODE''.F'• .R `_ _ tAMOUNT,RV ": One or Two Family Dwelling with Two Bath 224-00000-425603 1005 308.10 TOTAL DUE: 308.10 P YMEN7 isiE FAVOR cas-WriIotigo R' ,COMMENTSI' 7 'AMOUNTYMPWI ir;;;i:wn. Check CHANEY NICHOLAS 308.10 0669100669. TOTAL PAID: 308.10 • • • SPRINGFIELD -- • CITY OF SPRINGFIELD ° • - - kird 225 Fifth St el TRANSACTION RECEIPT Spnngfield,DR 97477 OREGON 541-726-3753 811-SPR2013-01644 www.spnngfield-or.gov 246 S 70TH ST pemiitcenter@spnnggeld-or.gov RECEIPT NO: 2013001954 RECORD NO: 811-SPR2013-01644 DATE:09/04/2013 pot 'git tlM ifigiJ- U : C.,•,";,ft?at% 4t1 _ ;`_rir-ACCOUNT-CODEJT •NS CODE :1 _` J &'AMOUNT DUES One or Two Family Dwelling with Two Bath 224-00000-425603 1005 102.90 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: 172.77 T'PAYMENT.TYPE t.- ;'PAYOR CASHIER:KREEDER 'f:4-rr.,: °COMMENTS,S_t ` ` J:i:At 'P:R:AMOUNT!AID-7:C.S '?t N ` Credit Card CHANEY NICHOLAS 172.77 411114 TOTAL PAID: 172.77 • • 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-SPR2013-01642 • www.springfield-or.gov permitcenter @spri ngfield-or.gav PROJECT STATUS: Issued ISSUED: 09/04/2013 EXPIRES: 03/02/2014 STATUS DATE: 09/04/2013 APPLIED: 07/19/2013 • SITE ADDRESS: 246 S 70TH ST,Springfield,OR 97478 SCOPE: ASSESOR'S PARCEL NO: 1702353305902 TYPE OF STRUCTURE: PROJECT DESCRIPTION: ELE-New SFD OWNER: CHANEY NICHOLAS Phone Number: 541-722-9481 ADDRESS: 2222 11TH ST _ SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER COB 000000 08/01/2025 Plumbing Contractor OWNER COB 000000 08/01/2025 Mechanical Contractor OWNER COB • 000000 08/01/2025 Electrical Contractor OWNER COB 009000 08/01/2025 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 • operty,and the approved set of plans will remain on the site at all times during construction. Gam% : •regon law requires you to /�� Owner or({;pnf1tractoutes adrepteo oy toe Oregon uull Date IV O[Incatlor .center. Those rules are set forth NOTICE: • hi OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain conies of the rules by calling the center. (Note.: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT number for the Orc;,y.1 ' Ii"i.;' ;1004: :tion COMMENCED OR IS ABANDONED FOR Center is t = ' ,, ANY 180 DAY PERIOD. • • Springfield Building Permit , 9/4/2013 2:25:05PM Page 1 of 1 • • ' SPRINGFIELD CITY OF SPRINGFIELD '-� 225 Fifth St �e TRANSACTION RECEIPT Spnngfield,OR97477 ' OREGON 541-726-3753 811-SPR2013-01642 www.spnngfield-or.gov 246 S 70TH ST permitcenter©spnngfield-or.gov RECEIPT NO: 2013001951 RECORD NO: 811SPR2013-01642 DATE:09/04/2013 1e]Co1:71:21AIo1�l Y„_�?�� _-,e,."F,L-5,;.1 , __._j,.2.7-4 .. ,.y L'.4CCOUNT'CODELiRANSioToleM ' :I,.^L°=AMOUNT DUE- Each added 500 sq. ft. or portion 224-00000-426102 1004 55.00 Residence wiring 1,000 sq.ft.or less ” 224-00000-426102 1004 147.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 32.58 Technology fee(5%of permit total) 100-00000-425605 2099 13.58 Temp services 200 amps or less 224-00000426102 1003 69.00 TOTAL DUE: 317.66 O AI'MENTuTYPE; PAY,OR'tl oasniER"�KI° erN COMMENTS ,AMOUNTiPAID Check CHANEY NICHOLAS 317.66 0669100669 TOTAL PAID: 317.66 • • • • Electrical Permit Application DEPARTMENT USE ONLY ` y�eS SPNINGFIELO° rt a::,,:. *L:' ' „�- -w f, , .*.aF,,' 4,°7x'+N'rzw8`» 5,6:4)t hr x3�Yn. t aGITY OF�SPRINGFIEbDPOREGQT ' �-'-- 4 5117—(( cz 2 - ,�.:i r ? ag di.a...,,.."s • , b Permitno.. 4v���',t rEt�;;A '.:3,.. .m.��"i" ,a,�`-.. �.+.., z,ss `'�`3... `m'."='-..s. .-a�z 'tie"u..g.._ 225 Fifth Street♦Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 W 5 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. -5NEOCAL COVERNMENt ARPROVAli5)1{ , 4, ` t, ps-N-,FEE SCHEDULE}, 1at ,a §'i; Zoning approval verified? ❑ Yes ❑No _ nt ', r 11Cost , Total,_\umber of Inspectionsper item(0 Qty: ;, ea cost a; ge„- S1:=CATEGORY?OECONSTRUCTION tL, O Residential,per unit,service included: ❑Residential ❑Government ❑Commercial 1,000 sq.ft.or less(4) $147.50 $/��5� a .,JOBSITE INFORMATION` AND,'L'OCATION„a, is Each additional 500 sq.ft.or portion Job site address: 21/(0 S thereof . $ 27.50 $ 55-05 _4_ 7. I en 5 Qi c/CJ State: 02 ZIP: q $ Limited energy(2) $ 35.00 $ Reference: ✓ I Taxlot.: Each manufactured home or modular $ 69.00 $ W:g4;* jDESCRIP,�TION MO FEW ORK'; *, P'”`;i'> -w dwelling service or feeder(2) C.d'L F�.Sr 4 ./�,_ ,=,t Services or feeders: installation, alteration, relocation [w"`, f W,- 200 amps or less(2) $ 89.00 $ i YW$59.RQPE^RT/Y OWNER S- 201 to 400 amps(2) $ 104.50 $ Name: 1) c � nit._t� 401 to 600 amps(2) $174.00 $ Address: t:G _220_ /g S( ....-- --'7\ 601 to 1,000 amps(2) $225.50 $ City:Cs ECU!) ( State: (17 I ZIP:nj 7y2 2 Over 1,000 amps or volts(2) $516.00 $ Phone: - - I Fax: - - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $�1 5;a 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 479.560(1). ■-. 401 to 600 amps(2) $138.50 $ r. Signature: -- Over 600 amps or 1,000 volts,see services or feeders section above ilcifeiu tC0 NTRACTOR:;INSTAL-LATION z " "!i fix, Branch circuits:new alteration, extension per panel Business name:6i(n/NLYt_____. a.Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit $ 6.50 $ City: - State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $ Si nature of signing supervisor: Signal circuit or alimited-energy panel, - $ 80.00 $ g g g P alteration,or extension(2) Each additional inspection:(1) $80.00 $ t ig..,s „ =at APP,LICANT;'USE,rk,` :v�P+°,hM4Z (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ 2 7(5-6 (B)Enter 12%surcharge(.12 x[A]) - $ �ci (C)Technology Fee(5%of[A]) $ ///$ TOTAL fees and surcharges(A through C): $</7 bf§:_..._ 440-2584-J(4/01/2013/COM)