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HomeMy WebLinkAboutPermit Building 2013-9-26 SPRINGFIELD - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 { t Phone: 541-726-3753 •" OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01882 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 STATUS DATE: 09/26/2013 APPLIED: 08/22/2013 SITE ADDRESS: 4034 Stellar WAY,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1802061417700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-Single family residence-lot 15 Golden Eagle . OWNER: MIKE BLANKENSHIP CORP Phone Number: 541-912-4582 ADDRESS: 8063 THURSTON RD SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor DOUGS PLUMBING INC CCB 110163 11/24/2013 541-688-3385 GERARD ELECTRIC (C)Electrical Cont 20-2840 07/01/2014 541-741-2596 Mechanical Contractor COMFORT FLOW HEATING CO COB 460 06/27/2015 541-726-0100 General Contractor MIKE BLANKENSHIP CORP COB 78966 01/09/2014 541-746-0194 • INSPECTIONS REQUIRED Inspections 1020 Zoning Setbacks 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. 1170 Post&Beam Post and Beam: Prior to floor insulation or decking. 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. 1520 Interior Shearwall Shear Wall Nailing: Before covering sheathing with finish materials. • 1530 Exterior 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. 1999 Final Building Final Building: After all required inspections have been requeste�l�and&approye.{i�arrdyOU t0 the building is complete. H I[I�rules vi follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth NOTICE: in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by Springfield Builydl 1g iRIZED UNDER THIS PERMIT IS N3/n46/zo,3 9:52:00AM calling the center. (Note: the tale hone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notlt� &t1t9h2 Center is 1-800-332-2344). ANY 180 DAY PERIOD. SPRINGFIELD 225 Fifth St ' ' _- 'f, CITY OF SPRINGFIELD Springfield,OR 97477 ` Phone: 541-726-3753 .OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01882 www.springfield-or.gov •permitcenter @springfield-or.gov By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections re requested at the proper time, that each address is readable from the street,that the permit card is located at the front a property, and the approved set of plans will remain on the site at all times during construction. Abl 1(k°(i) Owner or Contractor Signature Date Springfield Building Permit 9/26/2013 9:52:00AM Page 2 of 2 SPRINGFIELD CITY OF SPRINGFIELD • �- .•R... 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-01882 www.springfield-or.gov 4034 Stellar WAY permitcenter @springfield-or.gov RECEIPT NO: 2013002149 RECORD NO:811-SPR2013-01882 DATE:09/26/2013 DESCRIPTION ACCOUNT CODE/TRANS CODE __'; _AMOUNT DUE ;I Address Assignment,each new or change 224-00000-425602 1020 42.00 Planning-Major Review-City 100-00000-425002 1231 211.00 Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 114.10 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 1,671.36 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 - 1,448.64 • SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 556.44 SDC: Reimbursement-Transportation SDC 446-00000-448026 1173 538.41 SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 3,424.32 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 114.41 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 382.65 SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 79.78 'SDC:Total Sewer Administration Fee • 719-00000-426604 1175 254.78 SDC:Total Storm Administration Fee 719-00000-426604 1180 46.95 SDC:Total Transportation Administration Fee 719-00000-426604 1190 125.03 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 142.92 Structural Building Permit Fee 224-00000-425602 1002 1,191.04 Technology fee(5%of permit total) 100-00000-425605 2099 61.65 Willamalane fees-Single family detached 821-00000-215023 1074 3,410.00 - _"__" -__-- --- --"--_--- --"--- �_---- TOTAL DUE: 15,810.29 ' AMOUNT PAID . ' LPAYMENT TYPEPAYOR casRieR:.ILArssoR..' COMMENTS_. ,, ',.x: , AMOUNT �.�__ ._. s Check MIKE BLANKENSHIP CORP 15,810.29 14807 TOTAL PAID: 15,810.29 • SPRINGFIELD--, CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 g 541-726-3753 OREGON 811-SPR2013-01882 www.springfeld-or.gov 4034 Stellar WAY permitcenter @springfield-or.gov RECEIPT NO: 2013001841 RECORD NO:811-SPR2013-01882 DATE:08/22/2013 DESCRIPTION %Th t-$ ".L i. it rE °'XACCOUNTYeOD En'RANS"CODEm1*: u` 'AMOUNT:DUE r Structural Plan Review Fee Residential 224-00000-425602 1061 774.18 TOTAL DUE: 774.18 P.AYMENTTYPE� , PAYOR cASHIEri:oeowL'se q aCOMMENfopr: - '� ,+“ ,-,'1�sy.�;-��¢MOUN7gPAID._.mss, "�j:�= s Check MIKE BLANKENSHIP CORPORATION - 774.18 14706 TOTAL PAID: 774.18 Structural CfllY31 Permit Application); SPRINGFIELD-- DEPARTMENT'USE ONLY°'- ss. it7 ,:-. Tis-SPRINGFIELD OREGON-, ; ;�' `k _ ;, Q6�f 225 Finn Street Springfield,OR 97477 PH(541)726-3753 FAX(541)726-3689 ';OREGON Permit no.5 3 ' / Q (i Date: 3/7 03 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. r t ,:,:COCAL1,GOVERNMENT°APPROVAL .,P ew -1 e'I.t x FEE SCHE5:01C- I , t. tall This project has final land-use approval. 2"''a" '+a -- 's Y 1. Valuahoninformati(iu.i Wa� ��_�` e'�* �� "�'_ Signature: Date: " s-r��` � '''"� (a)Job description: 51'-• a f'+4�)y This project has DEQ approval. / 1 a""�.C Signature: Date: Occupancy 43 N Zoning approval verified: ❑Yes ❑No .Construction type: ✓t) Property is within flood plain: ❑Yes ❑No Square feet: / S 7 g/ 70 f im- , r' 16"ATEGORYAF,�CONSTRUCTION� t ; rr`,-,' ' Cost per square foot: / Residential ❑Government ❑Commercial Other information: . (y;:t4s:rll WUOB SITE;INFORMATION'.AND ;LOCATION zT'r„L: ,,,a Type of Heat: Job site address: t'/> V 1/7%.-46-M 14 �I Energy Path: City S le� I State: l0/L.- ZIP: I7y 2 new ❑alteration ❑addition Subdivision:6pq)44„/ 4 5&. Lot no.: / - (b)Foundation-only permit? ❑Yes �No S t 3? Reference f 8oL -1 Il Taxlot / 7`f Total valuation s I I 7-' "� Ritgl.-re ...nti- '.''701€OPERTY 511\-Q k .-::'c '{,.rs-,.r r -r... ._��, ,�z- .�� .,. a. . i- ..�.�:° �;- .:,rv',?m. 2kBuddmg fee`s �i �� �1evamw v' Name: it l ) /16 Q (a)Permit fee(use valuation table): $ //? Address: a 063 n s�,c j (b)Investigative fee(equal to [2a]): $ City: S e State:(2. ZIP: 7'J7d' (c)Reinspection($ per hour): �Y+//_9/Z.. VJ--� (number ofhduraxfee per hour) $ Phone: Z Fax: - - E-mail: Ili 4 i mu gG J'-Zn (L nif[_`Csi■_. (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ /7 2 `? 2._ (e)Subtotal of fees above(2a through 2d): $ L Building Owner or Owner's agent authoriz.:g this application: x "'""i'° �'-?-" r 'r ,,;4 . -, K 3._Plan review fees sx.r^'��«' ` fi';- 'av r� ,±<y.._a�-�--_.;;-:/� (a)Plan review(65%x permit fee[2a]): s 77 Sign here: �� (b)Fire and life safety(40%x permit fee(2a]): $ i ❑This'rim don being made on residential or farm property owned by (c)Subtotal of fees above(3a and 36): $ me or a member of my immediate family,and is exempt from licensing wr-- - 3)t „..„ 4:iMiscellanequs fees *-`;_ „„+ ,a ' ,'� requirements under ORS 701.010. „``2;$` . ?'"CONTRACTOR INSTALLATION �;:] s ,R: ±. (a) Seismic fee, 1%(.O1 x permit fee[2a]): $ § ''''1' (b)Technology fee,5%(.05 x permit fee[2a1): $ S - Business name: 5-441.2.. Pita-Lim_ Address: TOTAL fees and surcharges(2e+3c+4a+4b): $ 2,(‘:77 .7___° City State: LH': Phone: - - Fax: - - E-mail: - CCB license no.: Print name: Signature: aila CON gitP_RIINF„ORMATION- = Name CCB License# Phone Number Electri %e elbl ✓& if fir • Plumbing ' ( Mechanical CV A1------7-7/4 SPRINGFIELD - 225 Fifth St t. 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—SPR2013-01884 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/2612013 EXPIRES: 03/25/2014 STATUS DATE: 09/26/2013 APPLIED: 08/22/2013 • SITE ADDRESS: 4034 Stellar WAY,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1802061417700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-Single family residence-lot 15 Golden Eagle OWNER: MIKE BLANKENSHIP CORP Phone Number: 541-912-4582 ADDRESS: 8063 THURSTON RD SPRINGFIELD OR 97478 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06/27/2015 541-726-0100 General Contractor MIKE BLANKENSHIP CORP CCB 78966 01/09/2014 541-746-0194 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 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= r e property, and the approved set of plans will remain on the site at all times during construction. 9/u //) Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: '"`"'s Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AU( THORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by calling the center. (Note: the telephone • Springfield Baba'dg aNCED OR IS ABANDONED FOR 9/26/2013 9.49.z,AM number for the Oregon Utility Notification 1 of 1 ANY 180 DAY PERIOD. Center is 1-800-332-2344). SPRINGFIELD CITY OF SPRINGFIELD i,A ..+a... 225 Fifth St �tl, TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-01884 www.springfield-or.gov 4034 Stellar WAY permitcenter©springfield-or.gov RECEIPT NO: 2013002146 RECORD NO:811-SPR2013-01884 DATE:09/26/2013 (DESCRIPTION ``_ '. _ - - �.�.„ACCOUNTCODE/TRANS CODE___`._ r ,AMOUNT_DUE__;) 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 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 23.76 Technology fee(5%of permit total) 100-00000-425605 2099 9.90 TOTAL DUE: 231.66 ' --AMOUNT PAID . ,_-PAYMENTl'YPE- PAYOR;.. CASHIER:JLARSON - COMMENTS . : — _ ;1 Check MIKE BLANKENSHIP CORP ��------�_�.� --231-.66� -__. 14807 TOTAL PAID: 231.66 • • • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Il.,r-,( Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2 01 3-01 8 83 www.springfield-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 STATUS DATE: 09126/2013 APPLIED: 08/22/2013 SITE ADDRESS: 4034 Stellar WAY,Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802061417700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ELE-Single family residence -lot 15 Golden Eagle OWNER: MIKE BLANKENSHIP CORP Phone Number: 541-912-4582 ADDRESS: 8063 THURSTON RD SPRINGFIELD OR 97478 L CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone GERARD ELECTRIC (C)Electrical Cont 20-284C 07/01/2014 541-741-2596 General Contractor MIKE BLANKENSHIP CORP CCB 78966 01/09/2014 541-746-0194 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 insp.:ions are requested at the proper time,that each address is readable from the street,that the permit card is located at the f ••t of the property, and the approved set of plans will remain on the site at all times during construction. • 41( fo Owner or Contractor Sign- ure Date • • • ATTENTION: Or law requires -w to NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are setforth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952_001- 0090. You may obtain copies of the rules ne by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telep ANY 180 DAY PERIOD. number for the Oregon Utility Notification • Center is 1-800-3 32-2344). Springfield Building Permit 9/26/2013 9:54:37AM Page 1 of I • SPRINGFIELD CITY OF SPRINGFIELD _1 zzs Finn St TRANSACTION RECEIPT Springfied,oR97477 tool 541-726-3753 OREGON 811-SPR2013-01883 www.springfield-or.gov 4034 Stellar WAY permitcenter @springfield-or.go, RECEIPT NO: 2013002147 RECORD NO:811-SPR2013-01883 DATE:09/26/2013 'DESCRIPTION-- ACCOUNT CODE/TRANS CODE___ • AMOUNT DUE..~ 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 IPAYMENT TYPE_ PAYOR CASt1IER:JLARSON , .COMMENTS - AMOUNT PAID , Check MIKE BLANKENSHIP CORP 349.83 14807 TOTAL PAID: 349.83 • • Electrical Permit Application �, - DEPARTMENT VSE ONLY SPRINGFIELD� �1 -4f:r e ---€ e ate era..:g tristi .e.z-fie r s s-x F .ysi .„e a G r0 y4 -WY ORSPRINGET�LD OREGON C 3 /��� it-4 a —7-. =..ss. , " ?? a IT.:44---'s ."- . p --,'W1 Permit no.:c9 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: 61/2z((-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. ;- ) ',LOCALGOVERNMENT;APPROVAL ::; '; .r...'.. 'FEE,, SCHEDULE . , '-, Zoning approval verified? ❑ Yes ❑No „Number of ins ections per item -Cost .Total „.`CATEGORY=='OF'CONSTRUCT,ION p P O .',' QtY ea. cost;.,' Residential,per unit,service included: ❑ Residential ❑Government ❑ Commercial 5 v 1,000 sq.ft.or less(4) / $147.50 $ JOB:SITE 'INFORMATION;:AND„LOCATION .;;, — 1/ Yoh-C/ - Each additional 500 sq. ft.or portion $ 27.50 Job site address: J thereof - j $ �i City: State:State: ZIP: Limited energy(2) J $ 35.00 $ Reference:, Qt?( -7 Taxlot.rn-200 Each manufactured home or modular $ 69.00 $ _, dwelling service or feeder(2) , ; DESCRIPTION OFli WORK;;` .a. �. / "Rhe /„Ln., , '& -�-i^e, ./Z n- Services or feeders: installation, alteration,relocation W v u-d (U', �°U/�'�_ 200 amps or less(2) $ 89.00 $ a'A:aiu I k.' PROP.,ERTY:;OINNER .... 201 to 400 amps(2) . $ 104.50 $ Name: S[ pv' "-' '7 4334,7 401 to 600 amps(2) $174.00 $ Address: DWS /2_)zD4/ 601 to 1,000 amps(2) $225.50 $ City: 1.0r2_O State:on-- ZIP:9A9617 Over 1,000 amps or volts(2) $516.00 $ Phone: '7� Reconnect only(2) $ 59.D0-72--- - / Z Fax: - - $ 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 $6 7 owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(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 n N";t palCONTRACTOR=INSTALL'ATION.1 - Branch circuits:new alteration, extension per panel Business name: G f11 c a Fee for branch circuits with purchase of a service or feeder fee: ro,.-G! / )ecI �'go/ [ are P Address:jy$� tia.c7i a ces 10 i,- go Each branch circuit $ 6.50 $ City:S D ie.t N� _pi a[CLl State:©?. ZIP: 7'771 b.Fee for branch circuits without purchase of a service or feeder fee: Phone: /`-4 -/ 71/_2_$y' Fax: - - 79---2S C .4' First branch circuit(2) $ 60.50 $ E-mail:✓ Each additional branch circuit 5 5.50 $ CCB license no.: 8 7 Ris BCD license no..2-0-2 24C Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 36 5c/S Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: 'Goa. /t ,t,ile tom— Each sign or outline lighting(2) $ 69.00 $ Signature of signing su ervisor:/ \,t Signal circuit or a limited-energy panel, $ 80.00 $ gntng P - t 0 -1'v�Y� alteration,or extension(2) Each additional inspection:(1) $80.00 $ -* c: .APPLICANt USE i '^*,,. (A) Enter subtotal of above fees . (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $ '3 S l (C)Technology Fee(5%of[A]) $ /Y .J TOTAL fees and surcharges (A through C): $rc((G 13 440-2584-3(4/012013/C0 • Electrical Permit Application DEPARTMENT USE ONLY ;: ; 5.4 y,& L ",tiiir/`--!•r�[i'J". s-4.- 4 <.�14.ett^�.f "?�3i ^zCr -oi T, r$i- . SPFi1NGF1ElG CTT cOVISPRING. IELD;- GREG' N-."`-� 1 /' :rs .4 ..,`1, „?: `* 14,7 1442 mss.-: �'* 4,z• Permit no.: J ) �l� 5 �) a; - 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: r°,7; 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. 'ic „LOCAL QVERNMENTiAPPRovAL, atP =s!ll, _`.^?, T FEE(rSCHEDUL'Et,a. `1K a ` „ `; �x,� a4, , . 9 r•ag i` n f+M1 a. ' t'P' m� Y' COSt`141 ,w{Total • Zoning approval verified? D ❑ No +Number of inspections per item O .,, Qty ;,i-- r,=! a .x-0..w is? J,,cost_ x aCATEOORY,,; OF,XONSTRUCTION Fdg Residential,per unit,service included: Residential ❑Government ❑Commercial / .; 1,000 sq. fr.or less(4) / $147.50 $ (�5) : , JOBS!SITE i NF.ORMATIONt•,AND:�LOCATION , ;_ Job site address' hereof additional 500 sq. fr.or portion /Q 3 v V> zc. -y $ 27.50 $,(rZ S City: 5pu f) State: �� ZIP 5 7'Y 7> Limited energy(2) $ 35.00 $vv Reference Taxlot Each manufactured home or modular / � ��7��� dwelling service or feeder(2) $ 69.00 $ '?114) ,W1:,p E CRIP< ION,OFk WORK` :iii °5r` : 2 g ( ) vvl Le `, /„ . pr it rT��� ,/�� Services or feeders: installation, alteration,relocation 11/07/L hr /" 200 amps or less(2) $ 89.00 $ Val"§ 3PROPERTY DWNER .-;. h 4 exa 201 to 400 amps(2) 1 $ 104.50 $ Name: ,//C a..c(.../.., p 401 to 600 amps(2) $174.00 $ Address: 206,7 'T/q—4(es 1--i 6,6 601 to 1,000 amps(2) $225.50 $ City: Fz,..0 State:PL___ ZIP.7c.-7a Over 1,000 amps or volts(2) $516.00 $ Phone: - - 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) I $ 69:00 $ �j`°O , 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 479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above .' ',j CONTRACTOR FINSTALL'ATION., t'ky?33t'X.," ,c,k). Branch circuits:new, alteration, extension per panel Business name: ewi0,.-05•-c jeer>7:".( 1 I(a.__.a TJ a.Fee for branch circuits with purchase of a service or feeder fee: •. Address:' 54/ N4 1 (le..-ti( i• gd - Each branch circuit $ 6.50 $ Citys D h)N5 f a t State:O2 ZIP:9-17y 7'J b.Fee for branch circuits without purchase of a service or feeder fee: Phone:s/ -4 -/ '75/,_2.$? Fax: - - 7�/�-�(9' First branch circuit(2) $ 60.50 $ E-mail: // Each additional branch circuit S 6:50 $ CCB license no.: 8 7/'5 BCD license no.1-0-2. g�[C Miscellaneous Sees:service or feeder not included Signing supervisor's license no.: J ' 'C/S Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Ga.'—ti /14_1/el.— Each sign or outline lighting(2) ,. $ 69.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisor. �MSI-/�_ alteration,or extension(2) $ 80.00 $ Each additional inspection:(1) $80.00 $ _ (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) . $ 2-- 5 (B)Enter 12%surcharge(.12 x[A]) - $ 7 - (C)Technology Fee(5%of[A]) $ 'c` /�_5—. TOTAL fees and surcharges(A through C): $ 17 . 440-2584-1(4/01/2013/COM) . -SPRINGFIELD --- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 ifr.satir Phone: 541-726-3753 •-• OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01885 www.springfield-or.gov permitcenter@springfield-or.gov • PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 STATUS DATE: 09126/2013 APPLIED: 08/22/2013 SITE ADDRESS: 4034 Stellar WAY,Springfield,OR 97477 SCOPE: Plumbing Only ASSESORS PARCEL NO: 1802061417700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-Single family residence-lot 15 Golden Eagle OWNER: MIKE BLANKENSHIP CORP Phone Number: 541-912-4582 ADDRESS: 8063 THURSTON RD • SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor DOUGS PLUMBING INC CCB 110163 11/24/2013 541-688-3385 General Contractor MIKE BLANKENSHIP CORP CCB 78966 01/09/2014 541-746-0194 INSPECTIONS REQUIRED Inspections 3130 Footing/Foundation Drains 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. 3450 Drywell/Soakage Trench Drywell: Engineered Drywell is Required. 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3999 Final Plumbing Final Plumbing: When all plumbing work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the permit card is located at the front o property, and the approved set of plans will remain on the site at all times during construction. '7/2'6/f • Owner or Contractor Signature • . Date a .r on law requires you to ,"1tA .r• t `': e°d by 4I; Oregon Utility NOTICE: r Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK• n�. �G� ;OtfiroughOAR952001- AUTHORIZED UNDER THIS PERMIT IS NOT oo Y�bbIricopiesoftherulesby COMMENCED OR IS ABANDONED FOR � 4- (Note: the telephone n 141. `Spegon Utility Notification ANY 180 DAY PERIOD. Springfield Building Permit 43004.32-2344). 9/26/2013 9:47:15AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 1 •,. >- 225 Fifth St ( �. TRANSACTION RECEIPT SpringfielcIOR97477 ,F `SAY 541-726-3753 OREGON 811-SPR2013-01885 www.springfield-or.gov 4034 Stellar WAY permitcenter @springfield-or.gov RECEIPT NO: 2013002148 RECORD NO:811-SPR2013.01885 DATE:09/26/2013 [DESCRIPTION ;ACCOUNLCODEITRANSCODE,_` .. .AMOUNT-DOE ..; Drywell 224-00000-425603 1005 21.00 One or Two Family Dwelling with Two Bath 224-00000-425603 1005 411.00 Sanitary sewer - 224-00000-425603 1005 83.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 71.88 Technology fee(5%of permit total) 100-00000-425605 2099 29.95 Water Line 224-00000-425603 1005 83.50 TOTAL DUE: 700.83 ,,„PAYMENT TYPE _ _RAYON_ CASHIER:JLARSON _, _ , COMMENTS - AMOUNT PAID `€ Check MIKE BLANKENSHIP CORP 700.83 14807 TOTAL PAID: 700.83 •