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Permit Building 2013-9-19
• SPRINGFIELD 225 Fifth St • ' -cam CITY OF SPRINGFIELD Springfield,OR 97477 " o OREGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01858 www.springfield-or.gov permitcenter@springfield-or.goy PROJECT STATUS: Issued ISSUED: 09/19/2013 EXPIRES: 03/18/2014 STATUS DATE: 09/19/2013 APPLIED: 08/20/2013 SITE ADDRESS: 186 65TH PL,Springfield,OR 97476 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702344201100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: STR-Addition OWNER: HELVIE JOHNS 8 PHYLLIS M Phone Number: 541-870-6308 ADDRESS: 2255 STOLTZ HILL RD • LEBANON OR 97355 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JEFFREY DAVID GRAHAM CCB 189615 04/01/2014 541-653-9523 General Contractor PROSOURCE CONSTRUCTION LLC CCB 199150 02/27/2015 541-731-7988 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. 1220 Underfloor framing t0 i�U 1410 Underfloor insulation ' 'N cequrPQO(1u t..1 ttt 1420 Insulation vapor ieOte9Pd\ the�s a1 e 5G2p0t' 1430 lnsulatia 54i ,1 pe5CP 1-0�nhhGOPgh eilin'4Xsu�f1� Prior to cover. NO0 a. r,F2 00A-`-' ,aP:r", 9 m' 1530 Exterior ah eliOU C aa;1/0A C• nt01�ut1^1t�.3�a1• 1999 Final Buildinstat\\C 'o trot tt\e 9 t-g00"o Final Building: After all required inspections have been requested and approved and SuCC'betGeOtet 19 the building is complete. •By signature. I state and agree,that I have carefully examined the completed application and do hereby certify thatall .,,,-w`O.,-,4.,. information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance wiittrthAt gtV'n \.,\Q Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and °ati('�Jbb-��t� OCCUPANCY will be made of any structure without permission of the Community Services Division, Building SafPt , lvtlk V`l'IcQ� - " certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this proof' t. a.c * to ensure that all required inspections are requested at the proper time, that each address is r� ble f ggtlt}hC" �, +CU's permit car. scaled at the front o the property, and the approved set of plans will remairi1th E Att\t al1�S dt+ construction � C�\\ N rr\t GQOV U Q�0�a ��g Owner or -t ractor Signature Date �N Springfield Building Permit 9/19/2013 9:52:19AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD kril 225 Fifth$t tom TRANSACTION RECEIPT Spdngfield.OR97477 ( OREGON 541-726-3753 811-SPR2013-01858 www.springfield-or.gov 186 65TH PL permitcenler @springfield-or.gov - RECEIPT NO: 2013001808 RECORD NO:811-SPR2013-01858 DATE:0 812 0/2 01 3 a 10 a ., ;x:_tfl , ::w_.?:i 3 `TC3 1__iZ::`' ACCOUNT CODE/TRANSiCODE . —..t. 4:.AMOUN7; x1 Structural Plan Review Fee Residential 224-00000-425602 1061 287.14 TOTAL DUE: 287.14 ,y m s n+[kR ,. 1.14541F4,241_@' e' t AMOUNT PAID 1 S� ,_,ter n -,PAYMENT TYPE _'PAYOR,;._,:CASHIER:DEIOWLSBYt„.,;Iii.b, :COMMENTS . .�s,I r„ `�:<, Check prosource construction Ilc 287.14 552 TOTAL PAID: 287.14 SPRINGFIELD i CITY OF SPRINGFIELD 4.4 Ass-. 225 Fifth St ii4's1-c` 6�oH TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 811-SPR2013-01858 www.springfield-or.gov 186 65TH PL permitcenter@springfield-or.gav RECEIPT NO: 2013002069 RECORD NO:811-SPR2013-01858 DATE:09/19/2013 DESCRIPTION _ ACCOUNT CODE/TRANS-CODE _.AMOUNT DUE Planning-Minor Review-City 100-00000-425002 1231 119.00 . Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 18.40 SDC: Improvement Cost- Local Wastewater 443-00000-448025 1184 487.48 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 155.13 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 998.76 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 106.68 SDC: Total Sewer Administration Fee 719-00000-426604 1175 74.31 SDC: Total Storm Administration Fee 719-00000-426604 1180 13.09 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 53.01 Structural Building Permit Fee 224-00000-425602 1002 441.75 Technology fee(5%of permit total) 100-00000-425605 2099 22.09 TOTAL DUE: 2,489.70 , PAYMENT TYPE - -PAYOR- , CASHIER oBOwLSBY COMMENTS " '-' AMOUNT PAID - _c,,,,:', . .f Check prosource construction Ilc 2,489.70 _m-- 2630 TOTAL PAID: 2,489.70 • Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY � o p G i. .. as o . . w` Permit no.: s/3 'O I O S 225 Fifth Street•Springfield OR 97477•PH(541)726-3753•FAX(541)726-3689 Es.... Date: Viol; This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days o if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Plumbing This project has final land-use approval. SP (7f243M0A Qw nth t e I CS/ 61C I/105 3, 6152 3 Signature: Date: Mechanical This project has DEQ approval. Signature: Date: Zoning approval verified: ❑Yes ❑No FEE SCHEDULE Property is within flood plain: ❑Ycs ❑No 1.Valuation information �f..� CATEGORY OF CONSTRUCTION (a)Job description: AN"y7;00 1Jd Residential I Government I Commercial Occupancy c 11�G L 6 c A M t Ly JOB SITE INFORMATION AND LOCATION Construction type: Sob site address: 12b ( S ? V L.-- Square feet: 3&E City: S@ 21 J.xjy i cl p State: 02 I ZIP:61 Cost per square foot: 4 1\Q i Subdivision: I Lot no.: Other information: Reference: '7 b Z._39 lit t I Taxlot: C f/ 6 O Type of Heat: E L zT .1 C. C.AteT T PROPERTY rOWNER Energy Pam: Name: Val IN nV IG ❑new ['alteration )]addition Address: &St Y L (b)Foundation-only pemnit? ❑Yes No City SQ a.(1`l`cI ' 1) State: 0R- I ZIP: q7 I 4o S LI I, 570 m 630 Total valuation:• S 'T ' Phone: Fax: - - 2.Building fees E-mail: ry (a)Permit fee(use valuation table): S '9 1/( /✓ Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to[2a]): S (c)Reinspection(S per hour): (number of hours x fee per hour) S Sign here: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): S 57 o/ ❑This installation is being made on residential or fans property owned by me or a member of my immediate family,and is exempt from licensing (e)Subtotal of fees above(2a through 2d): S requirements wider ORS 701.010. 3.Plan review fees (/ /L/ CONTRACTOR INSTALLATION , \ (a)Plan review(65%x permit fee[2a]): S 2 a a_ Business name: Q(LO .Z.)Q.cli �'rfLOCi i O{v (b)Fire and life safety(40%x permit fee[2a1): $ Address: K4C4 O_ i S-n. !' (c)Subtotal of fret above(3a and 3b): S City: Q6 pJt I State: O(�- I ZIP: q-j4OZ 4.Miscellaneous fees Phone:SIii-5c6 ci 337 I Faxe11- 06, .5( f0 I (a)Seismic fee. 1%(.01 xpermmit fee[2a]): S qq E-mail:ele `p (' (b)Technology fee.5%(.05 x permit fee[2a1): S O_ CAMM?'fetpQ I Qfosook.l_O �L(1.Co/A �� CCB license no.: 14-1 150 TOTAL fees and surcharges(2c+3c+4a+4b): S _ -- Print name: (._ik -t' ✓l ///III t Signature: ‘. V 4,1I SUB TRACTOR INFORMATION Name CCB License a Phone Number Electrical LyN04 'C14ta12-IC- IO2-3110 51-11'12bii9 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-SPR2013-01860 www.springfield-or.gay perm itcenter @springfield-or.gay PROJECT STATUS: Issued ISSUED: 09/19/2013 EXPIRES: 03/18/2014 STATUS DATE: 09/19/2013 APPLIED: 08/20/2013 SITE ADDRESS: 186 65TH PL,Springfield, OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702344201100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: PLM-Addition OWNER: HELVIE JOHNS 8 PHYLLIS M Phone Number: 541-870-6308 ADDRESS: 2255 STOLTZ HILL RD LEBANON OR 97355 ' CONTRACTOR INFORMATION II Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JEFFREY DAVID GRAHAM CCB 189615 04101/2014 541-653-9523 General Contractor PROSOURCE CONSTRUCTION LLC CCB 199150 02/27/2015 541-731-7988 INSPECTIONS REQUIRED i • Inspections 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. 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 i • - -d at the front of the property,'and the approved set of plans will remain on the site at all times during construction. I I O�,kO Owner or Colt la!*Gea•Ose' u`.rec' ore Date P���i eSGen`0010- p\e 0%eopti aK\ot` NOo. i‘p° 0IV ke'° ore•. .1 N ` oK\\\O (0---mail 0 \o�\) \\23Aa1 AO (SS OP .IoO oer Ce9 0332 .jt �� 10Q1:3 �r Ire 1.00 r0e�t Garret\S Q\. Q�� �p� O • S�`P\F�SOP*OOH Springfield Building Permit 9/19/2013 9:53:56AM •` O�j'wO Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD h' EGON CCi.- 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01860 •www.springfield-ar.gov 186 65TH PL permitcenter©springfield-or.gov RECEIPT NO: 2013002070 RECORD NO: B11-SPR2013-01860 DATE:09/19/2013 .AC000NTLCODE/TRANS,C"ODE AMOUNT DUE_, Shower/Shower pan 224-00000-425603 1005 ' 21.00 Sink/basin/lavatory 224-00000-425603 1005 42.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.08 Technology fee(5%of permit total) 100-00000-425605 2099 4.20 Water closet 224-00000-425603 1005 21.00 TOTAL DUE: 98.28 ,w I PAYMENT TYPE PAYOR' CASHIER:IDBOwLssY °y COMMENTS AMOUNT'.PAID Check prosource construction Ilc 98.28 2630 TOTAL PAID: 98.28 • • Plumbing Permit Application DEPARTMENT USE ONLY �.a SP8INGFIELO W SIP R<<Ill\`GI pLI); CIRI.GOV` '<` Permit S/�- /J O 225 Fifth Street •Springfield,OR 97477• P11041)726-3753 •FARO-I0726-3689 ]OREGON 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 ISO days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No Description IQty.I east Total Sanitation approval verified? ❑Yes ❑No New residential _ CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(iuchrdes,first MO feer of raien!sever lines,hose je Residential ❑Government ❑Commercial bibs. ice maker.underfloor low-paint 5262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 2 bathrooms/I kitchen $411.00 $ 1� (oS In Mfr 3 bathrooms/I kitchen $483.00 $ City: F Vp State: 0{L ZIP: GIU SQ Each additional bathroom(over 3) S104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK ,,./ Residential lire sprinklers(includes plan review) App 5*Nou- ,CL 1 A 2 5,,. is \i I Tpl lien 0 to 2,000 square feet $80.00 $ -To 'Io m e ►Q-bb t T10 -_S 2,001 to 3.600 square feet $128.00 $ PROPERTY OWNER 3,601 to 7.200 square feet $192.00 $ Name: 'I)V STt to ��w t(J 7,201 square feet and greater $255.00 $ pp Manufactured dwelling or pre-fob(circle one) Address: I gb (0 5 Y t- Connections to building sewer and $80.00 $ y C FLA� 0 � q L-7g water supply City: Jt`�• State: ZIP: 1� O Commercial,industrial,and dwellings other than one-or Phone: 'iI 7Q b7)c' Fax: - - two-family E-mail: Minimum lee ` ( 580.00 S Ole This installation is being made on residential or farm property Each fixture `-'t 521.00 5 owned by me or a member of my immediate family,and is Miscellaneous fees exempt from licensing requirements under OAR 918-695-0020. 100.stout,sewer,water line $83.50 $ Signature: Each lixture.appurtenance.and piping $21.00 S CONTRACTOR INSTALLATION ,\ Storm water retention/detention facility $21.00 S Business name: (.tiosi 'ae $oN`-taxitl-O S Irrigation systems $21.00 S Piping or private$loon drainage $21.00 S Address: (06S CC r- t- ST . $j •F systems exceeding the lied 100 feet City: eiC-petsa State: Oa.— ZIP: 01-1402 Specialty fixtures $21.00 $ -/ ` , Reinspection(no.of hrs.x tee per hr.) $80.00 $ Phone:�L�l S q 7j?22 FaxS �\ b',Xj ath_ Special requested inspections(no.of $80.00 $ E-mail: Com ontyctadt®Ko3co rune-630n,CAJn hrs.x fee per hr.) CCB license no.: Nei I co I BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no.: I 6is- 4i) ( tPa\M Medical gas piping Minimum fee $ Enter value of installation and equipment$ . Print name: 1_,, •f - Ab �( �"r a Enter fee based on installation and equipment value. I $ ; Signature: �'J won_.„ APPLICANT USE (A) Enter subtotal of above fees $�. (Minimum Permit Fee$80.90) 07((1 (11)Investigative fee(equal to[Al) $ (C)Enter 12%s rcharge(.12 x[A+BI) $WHO (U)Technology Fee(5%of[AJ) S 20 TOTAL fees and surcharges(A through D): S �- r 1 I 1 440-2500-3(4/112013/COM) SPRINGFIELD - • 225 Fifth St 4 CITY OF SPRINGFIELD Springfield,OR 97477 -tvt Phone: 541-726-3753 '' ` OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01859 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/19/2013 EXPIRES: 03/18/2014 - STATUS DATE: 09/19/2013 APPLIED: 08/20/2013 SITE ADDRESS: 186 65TH PL,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702344201100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: MEC-Addition OWNER: HELVIE JOHN S 8 PHYLLIS M Phone Number: 541-870-6308 ADDRESS: 2255 STOLTZ HILL RD LEBANON OR 97355 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor . JEFFREY DAVID GRAHAM CCB 189615 04/01/2014 541-653-9523 General Contractor PROSOURCE CONSTRUCTION LLC CCB 199150 02/27/2015 541-731-7988 INSPECTIONS REQUIRED Inspections 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 I.:-t-d at the front of the preperty, and the approved set of plans will remain on the site at all times during construction. ia/O- �/a' Q - Eg - 7,o o (-3 Owner or Cry. actor Signature Q�\,teso�\)\N�o,v, Date <e re0 se\ p1" o0\a�\Oee sale 952oso„l : : O 'edb�)sero\zOPP e��\dce X10 O� C(t"t oe GgOpe p°rc •e oz ..\( a\o� icy 4\\' O . r IA No\\\ P9���a,,z0\e,,e9o0 332.2 P e c 3 0 �c i (<-, OP. c O .�o O o " 009°\\\O to,\fie"\s 1" ' \ p' 00 ,,,,es Oe0 \'' co �� 000 c��0�' C2 y,ca Springfield Building Permit 9/19/2013 9:56:00AM Page 1 of 1 SPRINGFIELD-_. CITY OF SPRINGFIELD =f a A . n— 225 Fifth St :, j (O EGON TRANSACTION RECEIPT Springfield.OR 97477 541-726-3753 811-SPR2013-01859 www.springfield-ar.gov 186 65TH PL pennitcenter@springfield-or.gov RECEIPT NO: 2013002071 RECORD NO:811-SPR2013.01859 DATE:09/19/2013 IDESCRIPTION _ _ �- _- _ ACCOUNT CODE/TRANS CODE ______AMOUNTDUE I First Appliance Fee 224-00000-425604 1006 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 • 3.92 TOTAL DUE: 93.52 LPAYMENTTYPE • _ PAYOR CASHIER:DBOWLSBY .- ___COMMENTS_-, _. _ „_,._r AMOUNT PAID-y_ ___°A Check prosource construction llc 93.52 2630 TOTAL PAID: 93.52 SPRINGFIELD CITY OF SPRINGFIELD ______..ii i.t, -siltr. 225 Fifth St _C - � `IONEGON TRANSACTION RECEIPT 54�Zf5e13703 97477 811-SP R2013-01859 wwwspringfield-or.gov 186 65TH PL permitcenter @springfield-or.gov RECEIPT NO: 2013002072 RECORD NO: 811-SPR2013-01859 DATE:09/19/2013 [DESCRIPTION _ : . _ :ACCOUNT CODE/TRANS CODE . ." .AMOUNT DUE_- .f Technology fee(5%of permit total) 100-00000-425605 2099 0.08 ------- �— --- -� - - - --- TOTAL DUE: 0.08 j__.PAYMENT_TYPE___;,PAYOR__CASHIER:DBOWLSBY ____;___COMMENTS_ 2 - -. __v_ AMOUNT PAID V .i Cash PROSOURCE CONSTRUCTION LLC 0.08 TOTAL PAID: 0.08 •