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Home My WebLink AboutPermit Building 2007-11-30 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 www.ci.springfield.or.us November 30, 2007 Brian Frechette 408 Palomino Street. Eugene,~egon 97401 Dear Mr. Frechette: On September 13,2007, our office issued pen:i1its for the conversion of your existing garage to a single family residence located at 4184 Camellia Street, Springfield, Oregon. . While calculating the fees for that permit, the plan reViewer neglected to include the Willamalane Park and Recreation District Fee of $2,303.00 and the addressing fee of $35.00, leaving a balance due of$2,338.00 for this project. I am enclosing a copy of the permit that was issued and a copy of the original receipt for your reference. Please pay the amount due prior to requesting your final inspections for this project. I have enclosed a prestamped envelope for your convenience if you wish to make payment by mail, or you are welcome to make payment in person at our office. Our office hours are 8:00 a.m.- noon and from 1:00 p.m. - 3:00p.m:Monday through Friday. I sincerely apologize for any inconvenience this may cause you~ If you have any questions; please feel free to contact eIther the plans examiner, Don Moor~ at 726-3623, or me at 726-3790. . Sincerely, .~. Lisa Hopp~r Community Services Building Safety. cc: Don Moore '\ 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line lnf>.. K\:L). \ t'~ , . SITE ADDRESS: 4~AMELLIA ST ASSESSOR'S PARCEL NO.: 1702323303402 SCAN~ED CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 Status Issued Springfield TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Garage conversion Owner: FRECHETTE BRIAN J Address: 1876 HEITZMAN WAY EUGENE OR 97402 I CONTRACTOR INFORMATION I Contractor Type General Mechanical Plumbing Contractor OWNER OWNER G & C VENTURES LLC License Expiration Date Phone 157056 .11/03/2007 541-544-5258 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 2 # of Stories: 2 Lot Size: Height of Structure: 21.00 Sq Ft Ist Floor: Type of Heat: Wall Heat Sq Ft 2nd Floor: Water Type: Electric Sq Ft Basement: Range Type: Electric Sq Ft Garage/Carp'ort U to Energy Path: nent P~t!l.ON~~fftla\" requtres VOUtiUty Sprinkled Building: ". blfifl' ~ Th-~~blJdh\t: Oregon h fnnqw rules auup ~;'aB are set 1o~ I DEVELOPMENT INFORMA Tr0N~~~~.oo1I.oo10'throUgh ~:e~;\I~ . . ;:0 YoU may obtam.~"'~~~G Overlay Dist: calimg the cent~~ 6~~"ty NotificatiOn 4 # Street Trees Rqd: swmber tor the 18 1 . t\~). Paved Drive Rqd: Center Compact: % of Lot Coverage: R-3 VB Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I NOTICE: ' THIS PERMrrSHAll EXPIRE If THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: Downspouts/Drains: Notes: Page 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Gara2:e Conver. Gara2:e $ Per Sq Ft or multiplier $76.00 Square Footage or Bid Amount 929.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $70,604.00 $70,604.00 09/11/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $323.98 9/11/07 1200700000000001181 -Mech Iss 2+ Appliances- $40.00 9/14/07 1200700000000001197 + 10% Administrative Fee $74.44 9/14/07 1200700000000001197 + 5% Technology Fee $43.02 9/14/07 1200700000000001197 + 8% State Surcharge $59.55 9/14/07 1200700000000001197 Building Permit $498.43 9/14/07 1200700000000001197 Dryer Vent $7.00 9/14/07 1200700000000001197 Exhaust Hoods $10.00 9/14/07 1200700000000001197 Fixture $16.00 9/14/07 1200700000000001197 Fixture $80.00 9/14/07 1200700000000001197 Minimum/Adjustment Mechanical $26.00 9/14/07 1200700000000001197 Plan Review Minor - Planning $116.00 9/14/07 1200700000000001197 Sanitary Sewer - 1st 50 Feet $50,00 9/14/07 1200700000000001197 Sanitary Sewer - Improvement $244.85 9/14/07 1200700000000001197 Sanitary Sewer - Reimbursement $322.00 9/14/07 1200700000000001197 SDC MWMC Administration $10.00 9/14/07 1200700000000001197 SDC MWMC Improvement $961.52 9/14/07 1200700000000001197 SDC MWMC Reimbursement $91.61 9/14/07 1200700000000001197 SDC Sanitary/Storm Admin $46.89 9/14/07 1200700000000001197 SDC Transpo Admin $87.50 9/14/07 1200700000000001197 SDC Transpo Improvement $862.25 9/14/07 1200700000000001197 SDC Transpo Reimbursement $195.48 9/14/07 1200700000000001197 Vent Fan $7.00 9/14/07 1200700000000001197 Water Line - 1st 50 Feet $50.00 9/14/07 1200700000000001197 Total Amount Paid $4,223.52 I Plan Reviews I Plannin2: Review 09/11/2007 09/11/2007 APP T AJ MDR density allows an additional unit. 4 off street parking spaces are required and shown on the plot plan. Public Works Review Structural Review 09/11/2007 09/13/2007 09/11/2007 09/13/2007 APP EW APP DLM Pa2:e 2 of 3 CITY OF SPRINGFIELD - Building/Combination Permit Status Issued PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Reauired Insoections I Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover, Final Building: After all required inspections have been requested and approved and the building is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. 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 of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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 Contrafu'rs Signature 9~fi7 (/ Date Pal!e 3 of 3 Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: CO/A;'\ ?-O -.) ( - 013 g V Lf ~ (AlA/' t={ ~ 9i 4\~~ ~+- 7/;'I~7 / Address: Issued by: Date: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. 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 befifed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: yr). ~. I own, reside in, or will reside in the completed structun~. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. / OR ~ 3B. I will be my own general contractor. . If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 6. -, /" Z::d 0~7 (Signature ~rmit applicant) , (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc . 06-0 1-04 T' ~ .".. - A~tj~'g ~ts'Y-our/Own General Contractor? " \ ',\ ' ~. '. , . , " '. J ' . '.' , ,. "INFORNiATIQNJ\IOTiCE TO PROPERTY OWNERS AS'OUT..C()NSTRUCTiON R.ESPONSiBllITIES' ,", , '\ ... ~ ", \: \ \. ".", "\' \ NOTE: This Information Notice to Property Owners about Construction' Resp~n~iblliiies .was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer Re~polIJlsi/b)iliti~~ , You wjll, in most in;rances, be ruled to be an "employer" a~d the contractors you contract with' will be "employees" if you l,lse contractors not licensed with the Construction Contra.ctors .Board to do labor in constructing or to assist in the " " .' . ,. ". .! ,.' construction Qr improvement of a residential.stru,ctur~. As the employer, yo~ muBst comply with the following: ." ." . , . Oregon's Withholding Tax Law: As an employer: you must withhold 'income taxes from 'employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees_ For more information; ~all the Department of Revenue at 503~378-4988. '. " , . Unemployment Insurance Tax: As an employer~ you are required.to pay a tax for unemployment insurance purposes. on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number, for. both Of~gonWithholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \v'\vw.dor.state.or.us/formsoav.htmll for the appropriate forms. WorKers' Compensation Hnsnrance: As an employer, you are subject to the Oregon ,Workers' Compensation Law, and mu~t obtain w.orkers' co~pensation insurance for your empI,oyees. If you fail to obtain workers' cVJJJpensat10n insurance, you could be subject to penalties and be liiiblefof'lill claih1 costs'ifone Of yo'ur employees is injured on the job. For more information, call the Workers' Compensation DiVision'at the'Department of€onsurner'andBusiness Services at 503-947-7815. .... U.S. ][]:utemallRevenllle Service: As an employer, you must withhold'feder-al income tax iYul-il1emplojees' 'wages;'~','- You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-49330r-.visit their'web site atil.'\'\vw.irs.ZQY. . , . OilhteR" Re~poIDlSi'lblni'lI:nes. anclAreas lOf. ClOlIJl(CeilIJls Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. . ."t Liability and Property Damage' In~nnrance: Contact YOi.lrinsurance agent to see' if y'bu have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone,., -: \",.. ". - '....::; - ~ Time: Make sure you.have sufficient time to supervise your employees.. . Expertise: Make sure you have'the skills to ~ct as yo~r own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner. doc 06-01-04 225 Fifth Street Springfiel'd, Oregon 97477 541-726-3759 Phone Ci f Springfield Official Receipt Dhdopment Services Department Public Works Department Job/Journal Number COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-0 1384 COM2007-01384 COM2007-0 1384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 CO M2007 -01384 COM2007-01384 COM2007-01384 COM2007-0 1384 COM2007-01384 COM2007-01384 Payments: Type of Payment Check cReceintl RECEIPT #: 1200700000000001197 Date: 09/14/2007 Description Plan Review Minor - Planning Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Building Permit Fixture Water Line - 1st 50 Feet Sanitary Sewer - 1st 50 Feet Vent Fan Exhaust Hoods Dryer Vent Minimum/Adjustment Mechanical -Mech Iss 2+ Appliances- Fixture + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BRIAN FRECHETTE CORP Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1001 In Person Payment Total: Page 1 of I 11 :38:03AM Amount Due 116.00 322.00 244.85 195.48 862.25 91.61 961.52 10.00 46.89 87.50 498.43 80.00 50.00 50.00 7.00 10.00 7.00 26.00 40.00 16.00 43.02 59.55 74.44 $3,899.54 Amount Paid $3,899.54 $3,899.54 9/14/2007 , / IimmlliilG1I1lI~ /- ,..... ,r _f} G~) 6\D'~ ~nZ:~~ '" Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lin3r M.V / U~ SITE ADDRESS: ~ CAMELLIA ST ASSESSOR'S P AReEL- NO.: 1702323303402 SCANi~ED Springfield PROJECT DESCRIPTION: Garage conversion Owner: FRECHETTE BRIAN J Address: 1876 HEITZMAN WAY EUGENE OR 97402 " \~CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General OWNER Electrical SPRINTER ELECTRIC INC. 174458 02/20/2009 541-521-9058 Mechanical OWNER Plumbing G & C VENTURES LLC 157056 11/03/2007 541-544-5258 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: R-3 VB 2 2 21.00 Wall Heat Electric Electric nent Path n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: 4 Handicapped: Compact: ATTENT\ON: Orego~ ~a~;:~t ~~pti~J~PROVEMENTS I Street Impr~~ft6W..ieS adopt\hJse rules are set forth Sidewalk Type: 1ifi~~tiqn Center. hOAR 952-001- NOTICE Storm Sew~Wv~~~~_001-001 0 throu.9 f the rules by : Downspouts/Drains: Special Inst~o~ff.nyou may obtain C~f~~~h~ telepho~e THIS PERMIT SHALL EXPIRE IF THE WORK caning the center. (~n Utility NotificatIOn AUTHORIZED UNDER THIS PERMIT IS NOT Notes: number for the.O~~~OO_332-2344). COMMENCED OR IS ABANDONED FOR Center IS ANY 180 DAY PERIOD. Pal!:e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Garaee Conver. Garaee Fee Description Plan Review Residential -Mech Iss 2+ Appliances- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Dryer Vent Exhaust Hoods Fixture Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - Ist 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Vent Fan Water Line - Ist 50 Feet + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Residence Wiring 1000 Sq Ft Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09111/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 I Valuation Description I $ Per Sq Ft or multiplier $76.00 Square Footage or Bid Amount 929.00 Value Date Calculated Total Value of Project $70,604.00 $70,604.00 09/11/2007 ~ Amount Paid Date Paid Receipt Number $323.98 $40.00 $74.44 $43.02 $59.55 $498.43 $7.00 $10.00 $16.00 $80.00 $26.00 $116,00 $50.00 $244.85 $322.00 $10,00 $961.52 $91.61 $46.89 $87.50 $862.25 $195.48 $7.00 $50.00 $11.70 $5.85 $9.36 $117.00 9/11/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 10/23/07 10/23/07 10/23/07 10/23/07 1200700000000001181 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 3200700000000000697 3200700000000000697 3200700000000000697 3200700000000000697 $4,367.43 I Plan Reviews I Paee 2 of3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plannine: Review 09/11/2007 09/11/2007 APP TAJ MDR density allows an additional unit. 4 off street parking spaces are required and shown on the plot plan. 09/11/2007 09/11/2007 APP EW 09/13/2007 09/13/2007 APP DLM Public Works Review Structural Review To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. ReQuired Insoections . Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. 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 of 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 Contractors Signature Date Pae:e 3 of 3 .City of Springfield Electrical Authorization To Begin Work E-mailedTo:Sprinter5c@yahoo.com Receipt # ,EC519126 10/22/20075:50:08 PM Check on status of permit By Phone: (541)726-3753 or Email: permitcenter@ci.springfield.or.us [X] ] or 2 family dwelling D Multi-family D Commercial/ Industrial 11,000 sq. ft. or less I Ea addl 500 sq. ft or portion I-Limited energy, residential (with above SQ. ft.) I-Limited energy, multifamily I residential ~with above sg. ft.) . . 1':S.e~if~~;Q~~f~?;rs::!i!I!~ti6D';~li~r~~id~~~~(~i tei?~~,~,~;rt:::;;l:; I 1200 amps or less I 120] amps to 400 amps I 140] amps to 599 amps I $11700 $117001 I I I I Job no.: I Job address: I City/State/ZIP: SPRINGFIELD, OR 97478-5951 I Suitelbldg.lapt.no.: I Project name: Cross street/directions to job site: I Subdivision: I Tax map/parcel no.: 1702323303402 1 Lot no.: 1200 amps or less 1201 amps to 400 amps /401 amps to 599 amps Contractor has made the existing garage into a living residence that will have it's own service, A Fee for branch circuits with above service or feeder fee, each branch circuit B. Fee for branch circuits without service or feeder fee, first branch circuit; each addl branch circuit I Name: Jeremy Cooper 1 Phone: (541) 743-1213 I Email: Sprinter5c@yahoo.com I Fax: (541) 895-2207 I Service reconnect only Each manufactured or modular dwelling, service and/or feeder Pump or irrigation circle I Sign or outline lighting Signal circuit(s) or limited- not offered online at this jurisdiction energy panel, alteration, or extension, 'EI. Iic. no.: C256 I CCB Iic. no.: 174458 I Business Name: SPRINTER ELECTRIC INC 1 Contact: Jeremy Cooper jAddress: 82924 FLORENCE AVE I City/State/ZIP: CRESWELL OR 97426 IPhone: (541)7431213 I Fax: (541)8952207 1 Email: Sprinter5c@yahoo.com I Metro Iic. no.: 541743-12]3 I City lic. no.: Creswell I Supervising electrician's lic. no.: 1871 S I Supervising electrician's name: DAVID GADOMSKI I I I · City Of Springfield Subtotal $11700 I State Surcharge (8% of permit fee) $9.36 I City Of Springfield fees. $17.55 I TOTAL PERMIT FEE $143.91 I 10% Local Admin Fee; 5% Local Technology Fee Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed within one business day, with instructions on how to schedule your inspection. NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained. The local building department may determine that an Authorization To Begin Work is null and void if it does not meet applicable land use laws and local ordinances. This Authorization To Begin Work must be posted at the job site until replaced by a Permit. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01384 COM2007-01384 CO M2007 -01384 COM2007-01384 Payments: Type of Payment ONLINE CHGS cReceintl RECEIPT #: Description Residence Wiring 1000 Sq Ft + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ONLINE PERMIT CHGS 3200700000000000697 C ')f Springfield Official Receipt Dt:l'elopment Services Department Public Works Department Date: 10/23/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received DDK Page 1 of 1 ONLINE SPRINTER Online ELECTRlC Payment Total: 9:08:40AM Amount Due I 17.00 5.85 9.36 11.70 $143.91 Amount Paid $143.91 $143.91 10/23/2007