HomeMy WebLinkAboutPermit Building 2007-2-20
Status
Issued
225 Fifth Street, Springfield, OR
541,726-3753 Phone
541,726,3676 Fax
541,726-3769 Inspection Line
.
. CITY VI' ~rKINuNJ!..LD .
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 08/20/2007
VALUE: $ 249,644.00
SITE ADDRESS: 4155 Glacier View Dr 4157
ASSESSOR'S PARCEL NO.: 1802052204400
Springfield
TYPE OF WORK: Duplex
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Duplex - Glacier View Subd lot 7.
Same as Com2006,00784 4152 Glacier View Dr 4154
Owner:
Address:
Phone Number: 541-840-1138
OK INVESTMENTS LLC
PO BOX 8010
MEDFORD OR 97504
Nn,",^,
,VI;"
, 'Hr .
I CONTAAeTb....u~~vKlyfATION I
-, IJURll '<J11..q~ '
Contractor CO/vt/vtf ED UND i€KOV.ii'E I xpiration Date
MATTHEW KARL OLSIDNy 780 NCED OR ISf I~il(l$ PE: ~HEO'll1007
SOURCE ELECTRICAL INC DA y PER ~~iWJo fl/vtIT I~o 1!008
JET HEATING INC IOfh944 NED FOF/!. li2007
JET MECHANICAL LLC 158633 02110/2008
Contractor Type
General
Electrical
Mechanical
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Phone
54 I ,840- 1138
541-520-6466
503-363-2334
503-363-2334
BUILDING INFORMATION.
2
R-3
U
VN
# ol\~tp'ries: 2 Lot Size:
Ifti!Rl~~f.S/'il.CJ~'Q~ 26.50 Sq Ft 1st Floor:
'J!)~mcofJleiaSaa Wi1~~~Gas Sq Ft 2nd Floor:
:f/ 'tj'l~fPfce Opted b h 6ll~/Jire~q, Ft Basement:
Jo1}j}n e~e,Jolnter. iho~~e~/.iq-egog(ljItJ~rage/Carport
dim. . tf~'4', -OOlOrh" e'Mb:!a" gclJrt(~)her:
") !fpf.ilij$lmJ!u\l/i1litJlf/ C ~gtl'!,)Ao etll!~W1t Load:
Urnh_, Ciltrw. On'ft_ n,g",^ _ 'CI
I DEVELOPr;d~Ni'Jl1iIE~RiiA"FIO~.,: me ru"ie';U 1
!,'S '-81'>"'" ~/flttyf.leI8Phone b, REQUIRED PARKING
vv-a3<. . 'Oti(;.... .
Overlay Dist: -2344) ."""tIOn Total: 4
# Street Trees Rqd: . I Handicapped:
Paved Drive Rqd: No Compact:
% of Lot Coverage: 24.50
6,000
1,024
1,380
448
6
18.00
5.00
5.00
32.00
15.00
I PUBLIC IMPROVEMENTS I
Fullv Improved
Yes
Sidewalk Type:
DownspoutslDrains:
Curbside 5'
To Storm Sewer
Pa2e 1 of4
-;W1i:~"lI'I~~~~}. ,
\ .
.
.
.
Status
Issued
225 Fifth Street, Springfield. OR
541-726-3753 Phone
541,726,3676 Fax
541,726,3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Garaee
Dwellines
Garaee
.
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
2,404.00
448.00
Total Value of Project
l..Fpp< P~irl J
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 08/20/2007
VALUE: $ 249.644.00
Value
Date Calculated
$237,996.00
$11 ,648.00
$249,644.00
06/2912006
06/29/2006
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Same As $ I 00.00 6/29106 1200600000000000992
-Mechanical Issuance Fee- $10.00 2/20/07 2200700000000000219
+ 10% Administrative Fee $195.18 2/20/07 2200700000000000219
+ 8% State Surcharge $144.73 2/20/07 2200700000000000219
3 Baths One & Two Family $612.00 2/20/07 2200700000000000219
Addressing Assignment $62.00 2/20/07 2200700000000000219
Boiler/Comp Up To 100,000 btu $24.00 2/20/07 2200700000000000219
Building Permit $1,053.15 2/20/07 2200700000000000219
Copies - Ea Addtl @ 50 Cnts Ea $5.00 2/20/07 2200700000000000219
Curbcut Permit $80.00 2/20/07 2200700000000000219
Dryer Vent $12.00 2/20/07 2200700000000000219
Exbaust Hoods $18.00 2/20/07 2200700000000000219
Fire SF Fee - Residential $142.60 2/20/07 2200700000000000219
Furnace - more tban 100,000 $30.00 2/20/07 2200700000000000219
Gas Outlets 1,4 $24.00 2/20/07 2200700000000000219
Plan Review Major - Planning $198.00 2/20/07 2200700000000000219
Plan Review Same As $100.00 2/20/07 2200700000000000219
Sanitary Sewer, Improvement $877.22 2/20/07 2200700000000000219
Sanitary Sewer - Reimbursement $1,153.22 2/20/07 2200700000000000219
SDC MWMC Administration $10.00 2/20/07 2200700000000000219
SDC MWMC Improvement $1,730.62 2/20/07 2200700000000000219
SDC MWMC Reimbursement $164.06 2/20/07 2200700000000000219
SDC SanitarylStorm Admin $189.66 2/20/07 2200700000000000219
SDC Transpo Admin $139.14 2/20/07 2200700000000000219
SDC Transpo Improvement $1,611.40 2/20/07 2200700000000000219
SDC Transpo Reimbursement $365.38 2/20/07 2200700000000000219
Sidewalk Permit $80.00 2/20/07 2200700000000000219
Storm Drainage Impervious Area $664.09 2/20/07 2200700000000000219
Vent Fan $36.00 2/20/07 2200700000000000219
Willamalane Attached (duplex) $1,848.00 2/20/07 2200700000000000219
Total Amount Paid $11,679.45
Paee 2 of 4
.
. CITY OF ~rKll~GFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 08/20/2007
VALUE: $ 249,644.00
Status
Issued
225 Fifth Street, Springfield, OR
541,726,3753 Phone
54 I -726-3676 Fax
541-726-3769 Inspection Line
Initial Review
Plan nine Review
06/30/2006
06/30/2006
I Plan Reviews I
06/30/2006 APP
07/19/2006 APP
LLH
TAJ
Survey required because of
minimum side setbacks. Setback
street tree at least 16' for vision
clearance (condition #8 of
subdivision).
SDCs added for two dwelling units.
. Sidewalk & curbcuts added.
LDAP application and permit
required before issuance of Building
permit.
provide truss details and layout
Public Works Review
06/30/2006
07/14/2006 APP
SO
Structural Review
Structural Review
06/30/2006
08/17/2006
08/15/2006 WE
08/1 7/2006 APP
RWC
RWC
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.
I Rpnllirpf'l Tllsnections I
ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut, Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Fou'ndation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
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.
Firewall: Located and constructed according to plans.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Paee30f4
.
. CITY OF SPRIN'-'l'lJ<.LD
Building/Combination Permit
PERMIT NO:' COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 08/20/2007
VALUE: $ 249,644.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54 I ,726,3676 Fax
541-726-3769 Inspection Line
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
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.
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 descrihed 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 readahle 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.
~~
J-;)()-()7
Owner or Contractors Signature
Date
Paee 4 of 4
, CITY OF stiNG FIELD SYSTEMS DEVELOPMEaORKSHEET
JOURNAL OR JOB NUMBER: COM2006-00S13
NAME OR COMPANY: OK INVESTMENTS
LOCATION: 4155 & 4157 Glacier View Drive
TAX LOT NUMBER: 0
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 2 BUILDING SIZE (SF' 0 LOT SIZE (SF):
I, STORM DRAINAGE
o
'1-
1m
11:5
10
I~
m
(3
~
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F, x 1 COST PER S,F, I 1 CHARGE
2056.00 1 $0,323 = 1 $664,09 1
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUS S,F. I x 1 COST PER S.F, I x I DISCOUNT RATE 1 I
1 1 1 $0.323 I 50% 1 = I
DISCOUNT
$0,00
ITEM I TOTAL, STORM DRAINAGE SDC
, $664.09
$664.09
1070
2 SANITARY SEWER, CITY
A. REIMBURSEMENT COST:
1 NUMBER OF DFU's 1 x COST PER DFU
1 46 1 $25,07 51,153.22 1091
B. IMPROVEMENT COST:
1 NUMBER OF DFU's 1 x
1 46 1 $19.07 $877.22 1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $2,030.44
3, TRANSPORTATION
A. REIMBURSEMENT COST:
1 ADT TRIP RATE 1 x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRlPFACTORI
I 9,57 I r 2 I 1 $19,09 1 1.00 1 $365.38 I 1093
B. IMPROVEMENT COST: I
1 ADT TRIP RATE I x 1 NUMBER OF UNITS 1 x 1 COST PER TRIP x INEW TRIP FACTORI
1 9.57 1 1 2 1 1 $S4,19 1 1.00 I $1,611.40 11094
ITEM 3 TOTAL, TRANSPORTATION SDC = , $1,976.78 I
4~ SANITARY SEWER, MWMC
A. REIMBURSEMENT COST:
INUMBER ~F FEU's I x ICOST PER FEU
1 $S2,03 = $164.06 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
i 2 I $865.3 I = $1,730.62 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054
MWMC ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL, MWMC SANITARY SEWER SDC = , $1,904.68
SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , $6,575.99
5 ADMINISTRATIVE FEE:
I SUBTOTAL x I ADM, FEE RATE 1= CHARGE
$6.575.99 I 5% I $32S.S0
TOTAL SANITARY ADMINISTRATION FEE: 189.66 11079
~I
TOTAL TRANSPORTATION ADMINISTRATION FEE: $139.14 11078
Steve Barnes 7/3/2006 TOTAL SDC CHARGES $6,904.79
PREPARED BY DATE
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT ~ DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONLY THE NlIT ADDmONAL FIXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EOUlVALENT UNITS
'BATHTIJB 4 0 3 = 12
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL I SOLIDS / ETe. 0 0 3' = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0
LAUNDRY TIJB 0 0 2 = 0
CLOTIlESW ASHER / MOP SINK 2 0 3 = 6
CLOTIlESW ASHER, 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG / WATER STATION I ETe. 0 0 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC, 2 0 3 = 6
SHOWER. SINGLE STALL 0 0 2 = 0
SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERClAL!RESIDENTIAL KITCHEN 2 0 3 = 6
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
SINK: SINGLE LAVATORYIRESIDENTIAL BAR 4 0 1 = 4
URINAL. STALL/WALL 0 0 5 = 0
TOILET. PUBLIC INSTALLATION 0 0 6 = 0
TOILET. PRIVATE INST ALLA TION 4 0 3 = 12
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 46
-BOU (Equivalent Dwelling Unit) is a discharRe equivalent to a sinRie family dwelling unit (20 DFU's) set at 1671mllons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I---.: YEAR CREDIT RATE/$I,OOO JI
ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 2
I BEFORE 1979 $5,29 (Enter I for Yes, 2 for No)
I 1979 $5,29 IS IMPROVEMENT ELGlBLE FOR ANNEX, CREDIT? 2
I 1980 $5,19 (Enter I for Yes, 2 for No)
I 1981 $5,12 BASE YEAR 1979
I 1982 $4.98
I 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE)
I 1984 $4.63 VALUE /1000 CREDIT RATE
I 1985 $4,40 $0,00 x $5.29 ~ , $0,00
I 1986 $4,07
I 1987 $3,67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
I 1988 $3,22 VALUE / 1000 CREDIT RATE
1989 $2,73 $0,00 x $5,29 0 I
1990 $2,25 I
1991 $1,80
1992 $1,59 TOTAL MWMC CREDIT = $0.00 I
1993 $1.45
1994 $1,25
1995 $1.09
1996 $0,92
1997 $0.72
1998 $0.48
1999 $0.28
2000 $0.09
2001 $0,05
, ..
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225 Fiftb,~treet
. ~ .' .
Sprmgfield, Oregon 97477
541-726-3759 Pbone
SPiftiAINOFlIlU>
· itr'~""'."""--','."'" 'i.,.
-~".,..:... _ _'.' 1
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Cwf Springfield Official Receipt
.opment Services Department
Public Works Department
Job/Journal Number
COM2006,00813
COM2006,00813
COM2006-00813
COM2006,OOSI3
COM2006,OOSI3
COM2006,008 I 3
COM2006,008 I 3
COM2006-008 I 3
COM2006,OOSI3
COM2006,OOSI3
COM2006-00S13
COM2006,OOSI3
COM2006-00S13
COM2006-00S13
COM2006,00813
COM2006-00813
COM2006,008 I 3
COM2006,00813
COM2006,008 I 3
COM2006,00813
COM2006,00813
COM2006,00813
COM2006,OOSI3
COM2006,008 I 3
COM2006-00813
COM2006,OOS13
COM2006,00813
COM2006,OOSI3
COM2006,OOSI3
Payments:
Type of Payment
CreditCard
Check
cReceintl
RECEIPT #:
2200700000000000219
Date: 02/20/2007
Description
Plan Review Same As
Addressing Assignment
Willamalane Attached (duplex)
Fire SF Fee - Residential
Storm Drainage Impervious Area
Sanitary Sewer, Reimbursement
Sanitary Sewer, Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC SanitarylStorm Admin
SDC Transpo Admin
Curbcut Permit
Sidewalk Permit
Plan Review Major - Planning
Building Permit
3 Baths One & Two Family
Furnace, more than 100,000
Boiler/Comp Up To 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
-Mechanical Issuance Fee-
Copies, Ea Addtl @ 50 Cnts Ea
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MATTHEW OLSEN CONSTR
MATTHEW OLSEN
Item Total:
l.:heck Number Authorization
Received By Batch Number Number How Received
djb OS0962 In Person
djb 7056 In Person'
Payment Total:
Page I of2
8:56:42AM
Amount Due
100.00
62.00
I,S4S.00
142.60
664.09
1,153.22
877.22
365.38
1.611.40
164,06
1,730,62
10.00
IS9.66
139,14
SO,OO
SO,OO
19S,OO
1,053,15
612,00
30,00
24,00
36,00
18,00
12,00
24,00
10,00
, 5,00
144,73
195,1S
$11,579.45
Amount Paid
$8,000,00
$3,579.45
$11,579.45
2/20/2007
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
A ,i; 0'
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.
CITY OF ~rK1j~l>FIELD .
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
SITE ADDRESS: 4155 Glacier View Dr 4157
ASSESSOR'S PARCEL NO.: 1802052204400
Springfield
TYPE OF WORK: Duplex
TYPE OF USE: New
PROJECT DESCRIPTION: Duplex - Glacier View Subd lot 7.
Same as Com2006-00784 4152 Glacier View Dr 4154
Owner: OK INVESTMENTS LLC
Address: PO BOX 8010
MEDFORD OR 97504
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
MATTHEW KARL OLSEN
ROBS ELECTRIC INC
JET HEATING INC
JET MECHANICAL LLC
License
116801
156678
3944
158633
# of Units:
Primary Occupancy Group:
Secoudary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
5.00
5.00
32.00
15.00
BUILDING INFORMATION I
2
R-3
U
VN
# of Stories: 2
Height of Structure: 26.50
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path: Path 1
Sprinkled Building: nla
Residential
Phone Number: 541-840-1138
Expiration Date
08/15/2007
08/14/2007
05/31/2007
02110/2008
Phone
541-840-1138
541-686-5444
503-363-2334
503-363-2334
6
I DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
6,000
1,024
1,380
448
1
No
24.50
REQUIRED PARKING
Total: 4
Handicapped:
Compact:
ATTF~mr"" 1">.___.
I PUBLIC IMPROVEMENTS liO::,OW rules adoPi~dby'ih~Vo~~;~t~~.tf
;' ""iI'''O If/cat/on Center Thos I II Y
Street Improvements::: F II I d In OA~ige~alklT~lieo: th e ru es are ~ fO{1.bd
THIS D(;r;n u V mprove 0090 v. - vv -~:J I. rough OAR 9oz!!flJe e 5'
Storm Sewer Available:1lT SHALL EXPIRE Yes Cafi.DS',\!n'Sp"OUWtriliid&:Pies of tlf& llJllffh~ewer
Special Inst'j!MIi'dl.1RIZED UNDER TH. IF THE WORK nu ~g ~he center. (Note: the telephone
LUMMENCED OR IS A IS PERMIT IS NOT m e~ or the. Oregon Utility Notification
Notes: ANY 180 DAY PERIOD. BANDONED FOR enter IS 1-800-332-2344).
Pa~e 1 of4
~WIt"-AI;"~~~'
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Dwellin~s
Gara~e
V Wood Frame
Gara~e
Fee Description
Plan Review Same As
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 80/0 State Surcharge
3 Baths One & Two Family
Addressing Assignment
BoilerlComp Up To 100,000 btu
Building Permit
Copies - Ea Addtl @ 50 Cnts Ea
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Furnace - more than 100,000
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC SanitarylStorm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
Willamalane Attached (duplex)
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
.
.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
2,404.00
448.00
Value
Date Calculated
$237,996.00
$11,648.00
$249,644.00
06/29/2006
06/29/2006
Total Value of Project
F'pp< PiiIIJ
Amount Paid
$100.00
$10.00
$195.18
$144.73
$612.00
$62.00
$24.00
$1,053.15
$5.00
$80.00
$12.00
$18.00
$142.60
$30.00
$24.00
$198.00
$100.00
$877.22
$1,153.22
$10.00
$1,730.62
$164.06
$189.66
$139.14
$1,611.40
$365.38
$80.00
$664.09
$36.00
$1,848.00
$25.00
$12.50
$20.00
$212.00
$38.00
Date Paid
Receipt Number
6/29/06
2120107
2/20/07
2/20/07
2/20/07
2/20/07
2120107
2120/07
2120/07
2120/07
2/20/07
2/20/07
2/20/07
2120107
2/20/07
2/20/07
2/20/07
2/20/07
2120107
2120/07
2/20/07
2/20/07
2/20/07
2120107
2120/07
2120/07
2120/07
2/20/07
2/20/07
2120107
7/23/07
7/23/07
7/23/07
7123/07
7123/07
1200600000000000992
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
Pa~e 2 of 4
.
.
CITY OF SPRINGt< .....LU '
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Amount Paid
$11,986.95
I Plan Reviews I
Initial Review
Plannine Review
06/30/2006
06/30/2006
06/30/2006
07/19/2006
APP
APP
LLH
TAJ
Survey required because of
minimum side setbacks. Setback
street tree at least 16' for vision
clearance (condition #8 of
subdivision).
SDCs added for two dwelling units.
Sidewalk & curbcuts added.
LDAP application and permit
required before issuance of Building
permit.
provide truss details and layout
Public Works Review
06/30/2006
07/14/2006
APP
SB
Structural Review
Structural Review
06/30/2006
08/17/2006
08/15/2006
08/17/2006
WE
APP
RWC
RWC
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.
, Rponirpti In~ne('tions I
ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
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.
Firewall: Located and constructed according to plans.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Pa~e 3 of 4
.
.
CITY OF SPRI!'Iil>J<lJ<..Lu
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Underfloor Plumbing: Prior to insnlation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
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.
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
Pa~e 4 of 4
'({\GVZ", .'1
_ 2-3-~(:)
'Nil'
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~~~
ELECTRICAfr .!~~IT APPLICATION -....
City Job Number l)\ 1'1\ ) Cl71v - fX) ~ \ ~ Date "1 - 6l ~ ~ en
1. ~~'ibCAT.iON OFiNSTfl i"f.'4noN; ~i: ~ t9~@MPiEiE FEE SCHEDVI.:E'!""'-.''',J:t''-w'~li.-';~'''f~n~~;~!f''g~Y~~!i-d1!3
l.fJS?74IS7"=c;.i~'If:~ j't:~v 3. ~~"'_.'"".~...-.. ._-~_--'!!.!!?'=~"""'~Y~3,,~
LEGAL DESCRIPTION
\ 'i50?-- b5 d.d. 0 Lt'iOl)
JOB DESCRIPTION
!,..oJ11L-t!'
~.,. ~Lf!'X
Permits are non-transferable and expire If work Is
not started within 180 days ofissuance or If work Is
Suspended for 180 days.
(T.;'.'."".""""""""'''''->'''''''''~~~''''-,,:v..u!
2. ~~~~~~~~.g~~~~
Electrical Contractor A 6s E/l"'c:,Lrlc JI1C.
Address ';:;tJ &J % d( cf d /
City h/Ciene
'-"
Phone {;, ,f fer') ,/1,/<)
Supervisor License Number
.,./ 7V~S
Expiration Date
//) -/-07
Constr, Contr, Number /5007J>
Expiration Date ,.r -/ r,I- t:' 7
Signature of Supervising Electrician
~~~
Owners Name OIL. :Dv V(7.~ f3,j~ ...Llc...
Addre~~ ex-,~ ~O
City~ tt-IDa.-'D / Phone ~O ' II ::>, g-
tSt2- q,co ~
OWNER INST;L,hION
The inSlanatLion is being made on property I own which
is not intende for sale. lease or rent.
Owners / ature:
{
A. ~'N~"';"Re;ldentia1- si::;li,~tMuid!F~~':' ei"d~~Uin' -'iii1l't>~~
.t... .e~'I;"~"'-'L"" ......".'~_, ~....g__ ~... .1"._ '._,",_._."T;L:~"., Y"p.. _~.,._,"..". <' g,,__, "'.' ,,,r;;'-"1
..,.~ ~"'_""'_" .. .....,-~....._"."'.__..._"..._.. _-<A.._.._~""",_.. _ii:l:l
Service Included
1000 sq. ft, or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
2
Z-
$106,00
ZIZ
s.%
$ 19,00
$50.00
~~~'.."~'1" ,,~'.k~~'I-';':"~:~.-'kJi~r'c-i."f{<!;;.,.t..~~~~iW~~~
B. ~1~itIf.&!b-~r;-f!~2!tll~'!~~~CJJ!t~~~!!~~!:ri~~l~=~~
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpslVohs
RecoDDect Only
$ 63.00
$ 75,00
$125,00
$163.00
$375,00
$ 50,00
....' ...",...,.,.,.l'~~-< .., "~":-"V_'''"--..~,,, ~..,......_..~, ,". ,'e ,". ' ',l'i'_'
C \!T' .,,-<1l!""....~....... S . !t-....-F. :..""-~' ....",:'li).'t,1tl: ~.;,<::,)i.~"" ,t"","fi, .."":' !-'~sil
. !4.~P~.ITk>:.!E':!~cg,!~!ry~~~~'~,;~~:.:~;'-~bk:rt.J;i;: :.,.~('i ~~:~
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
'--"$~"'p-::.::>.", . ~".'R~.-~...."....~.,..t-, "{I'" ~"'~~':->if~.;-'l<7'"':''' .-.;k-' ., <.," ~;'-':il'il.
D. 1r;Br:~ctir.C~rcuits' . Y, ~\ t~tf;i.<;~ '\~~:~"~~Jf(,1~.~>.~~f:ar~~;. :-:;: ~':;':}~!,
1iOI"""-'-=;f"", '._<-' .:.:-J;. ;.s:..,>,_ ~'"",.~.....~-;t.'l<....~.~~,.,.,,,~...:L~,,-, ..f..__",.,,:tM.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 50,00
$ 69,00
$100.00
$ 43,00
$ 3,00
f'}-~>~"~ -,'. '~~<mt-~-,..,..~~~~,..- .....-."I'~~. 1=
E. 11Misceiian~ous (Ser~iceifeedir'iiofili'tiifd~d):",d~h"ih~tau~tiOil'~
~~':i:;::;..,jll':"':;'~. ".... ~l'::~il:il:.llll:l'~.~!,.:l."I~~~~,')l.'t"~~~~;.~::...1t'..::lj;:.:.....:':. ~'-;t ,;,,\i't!ii!..
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50,00
$ 50.00
$ 25,00
$ 45.00
Minimum Electric Permit Inspeetion Fee Is 545.00 + Surcharges
.~,,;. jt ~~~W' I,.. .. .,' '~I.'" "'.' ,:,,_ 'r _ . ~.' ,
4 tSUBToTAL' OF ABOvE'P~~:l ;:;:li0~~.:.'t:,li~l'~I'I: hj,"..
. !.~fSi><;;:-~-;'\' :'..i~..;~.,,' j,,~~-~:tL;~~ ~~~C.-~~:~.....,:_~~...'
Inspection Request: 726-3769
8% State Surcharge
10% Administrative Fee
~% Tee,.! ~
fOtAL
Z5C
I~'~O
-~
as:O'D
&i 301 50
- -
Shared Drive(T:)IBuilding Forms/Electrical Pennit Application 1-06.doc
225, F~ftb' S'treet
Springfield, Oregon 97477
541-726-3759 Phone
:~
Wic.
. of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2006-00813
COM2006-00813
COM2006-00813
COM2006-00813
COM2006-00813
Payments:
Type of Payment
CreditCard
cReceint I
.
RECEIPT #:
3200700000000000492
Date: 07/23/2007
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ROB'S ELECTRlC
Item Total:
Lheck Number Authorization
Received By Batch Number Number How Received
njm
040640 Phone
Payment Total:
Page J of 1
10:02:I3AM
Amount Due
212,00
38.00
12,50
20.00
25,00
$307.50
Amount Paid
$307.50
$307.50
7/23/2007
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
Ail! 0'
~~r' ~/~J
~,~,{1
"'\ -r-'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4155 Glacier View Dr 4157
ASSESSOR'S PARCEL NO.: 1802052204400
Springfield
TYPE OF WORK: Duplex
TYPE OF USE: New
ATTEY\!Ti0f\J' f"'I.~;-.r ' _
I PUBLIC IMPROVEMENTS IfJOtl~.OfY" r~Nes adopi~d' 'bY'tt]~c6~~g~~tOUUt'f~Ot
o Ilcatlon Center Th I , Y
In OAP$iyS!'-tl~1T~6'eo' those rules are set fqr:tb ,
0090 I. rough OAR 9~!tf0'~lde 5
calj.rl'8~h~Oiag'(pjes of tffert1Rffb ewer
mg n e center. (Note' the tele h
number for the. Oregon Utility Notif;~~e
Center IS 1-800-332-2344). Ion
PROJECT DESCRIPTION: Duplex - Glacier View Subd lot 7.
Same as Com2006-00784 4152 Glacier View Dr 4154
Owner: OK INVESTMENTS LLC
Address: PO BOX 8010
MEDFORD OR 97504
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
License
116801
156678
3944
158633
Contractor
MATTHEW KARL OLSEN
ROBS ELECTRIC INC
JET HEATING INC
JET MECHANICAL LLC
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: 2
Height of Structure: 26.50
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path: Path 1
Sprinkled Building: n/a
2
R-3
U
VN
6
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
5.00
5.00
32.00
15.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
, ,""':(lil/1"
Street Improvements:;: F II I
TIi}(' Dr; , u y mproved
Storm Sewer i1~q.i'lafJfJv1IT SHALL EXP Yes
speciallns€ucllJIJRIZED UNDER TH IRE IF THE WORK
OMMENCED OR IS PERMIT IS N
Notes: ANY 180 DAY PER:g~BANDONED FOR or
Pal!e 1 of 4
Residential
Phone Number: 541-840-1138
Expiration Date
08/15/2007
08/14/2007
05/31/2007
02/10/2008
Phone
541-840-1138
541-686-5444
503-363-2334
503-363-2334
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
6,000
1,024
1,380
448
REQUIRED PARKING
1
No
24.50
Total:
Handicapped:
Compact:
4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Dwellinl!s
Garal!e
V Wood Frame
Garal!e
Fee Description
Plan Review Same As
~Mechanical Issuance Fee~
+ 10% Administrative Fee
+ 8% State Surcharge
3 Baths One & Two Family
Addressing Assignment
Boiler/Comp Up To 100,000 btu
Building Permit
Copies - Ea Addtl @ 50 Cnts Ea
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Furnace - more than 100,000
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
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
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
WiUamalane Attached (duplex)
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
2,404.00
448.00
Total Value of Project
~
Amount Paid
$100.00
$10.00
$195.18
$144.73
$612.00
$62.00
$24.00
$1,053.15
$5.00
$80.00
$12.00
$18.00
$142.60
$30.00
$24.00
$198.00
$100.00
$877.22
$1,153.22
$10.00
$1,730.62
$164.06
$189.66
$139.14
$1,611.40
$365.38
$80.00
$664.09
$36.00
$1,848.00
$25.00
$12.50
$20.00
$212.00
$38.00
Date Paid
6/29/06
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
Pal!e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
Value
Date Calculated
$237,996.00
$11,648.00
$249,644.00
06/29/2006
06/29/2006
Receipt Number
1200600000000000992
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
CITY OF SPRINGFIELD -
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Amount Paid
$11,986.95
I Plan Reviews 1
Initial Review
Planninl! Review
06/30/2006
06/30/2006
06/30/2006
07/19/2006
APP
APP
LLH
TAJ
Public Works Review
06/3012006
07/14/2006
APP
SB
Survey required because of
minimum side setbacks. Setback
street tree at least 16' for vision
clearance (condition #8 of
subdivision).
SDCs added for two dwelling units.
Sidewalk & curbcuts added.
LDAP application and permit
required before issuance of Building
permit.
provide truss details and layout
Structural Review
Structural Review
06/30/2006
08/1712006
08/15/2006
08/17/2006
WE
APP
RWC
RWC
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.
lJeouireCUnsnections .
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
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.
Firewall: Located and constructed according to plans.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Pal!e 3 of 4
CITY OF SPRINGFIELD I
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 10/17/2007
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
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.
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
Pal!e 4 of 4
,-, ,',- _ , -. ''', I 9f "'-;""'"
-, :-"~'-~':-:' ..:CITM'IOFrSPRINGFIEtO....O G@N >. ',j.., ,,"-,,
'-",,;ht~:~-7t~~~;\:._, -', . ""''';-*'L ~:.:_ a. " -- _ ,.,' . ,""'" ";~:"'i,." - :'(~'d*i___.-, :~~: ~~..~~{",:
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAfr PERM.IT APPLICATION
City Job Number LQ){'fi ) tTll(P - ('j:J ~ \ ~ Date ., - ~ ~.oJ Of
I. LOCATION OF INSTALLAT10N.;i~:.:d~..:;;f;c;. 3 COMPLETE FEE SCHEDULEBlJLQW
~ J s~/47s7";;~'C;,'--;::;."~:;;:;.'M~~;~ ';",oliO""""'",."",.,,_ .._".,"s"'~"..','_.l"'"C"_ .
LEGAL DESCRIPTION
\ ZO"A 05 d.~O LtL-fOO
JOB DESCRIPTION
w ,a..tr ~'^ 1PL.f!'X
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
-;~,-;-< ',;;<'" " _ "', " :>, ~>""~'-<-fi;". ..,e-::<"{i :' :.-_~"'>(oa~.f'~~<.~':~~i!:f.e;;~~~~
2 'f.;ONTRAc::11. .QRIlYSrAIJ.4!J1()lV.{.)!fE-'f'Jll(
. .~- ii,;:.>", " , '-'-'_'-;"<:>i(.:~; <,~::~_>-, :;,.:-,,;,_;:-: '.:,-j"::,.;.,;:;...~~).,'~ :t,fkJ~::i.:k...~~1.t:1':..~~iftktt~l
Electrical Contractor A 6:s E/c>cl.r/c J/1c..
Address ,;JtJ,&) y c;( f'd /
City h/oe/'Je
J
Phone 61'6 -5Yt/s!
Supervisor License Number
c/ 7~9'S
Expiration Date
//) -/-07
Constr. Contr. Number /56 CJ 7 J
Expiration Date if' -/ 7L' -C.) 7
Signature of Supervising Electrician
~ .r/'~ ~
Owners Name 0 \L :t'1\J ~<t.-~""" a.J'R I \ -l c....
Addre~C\ 0n~ ~\ 0
/
City~_ rl-fua...L:>~\.. / Phone guO '" II ?:> g-
cf2- q,w
OWNER INST A~ nON
/
The installat~~{S being made on property I own which
is not intendi for sale, lease or rent.
Owners Si~6ature;
I
/
I
f
I
I,
A. ,.N~~l-~l~;~"~tial- S~~~~:~~l\{ult;i-famllyper d~elling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq, ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
2
z.
$106.00
ZIZ
36'
$ 19.00
$50.00
~~';~~;';~:, <~~y; ;;::',- , ,'.':.:,:!:i~c..:,.:~~~1::(.:<"-.,~' :,":(;-:'Nt~i:~~~:>0:,'::::':'-'g':?'_}i'i':~;' _'_:- -~-" ',::::::::~} , . .~~>:~
B. ~~f~]g5"'~ecder$_t~~~M:ll~~e~4\~.l~f,~~~,?ns orRclocation:;:,..
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
C.T!:)~poJ;~ryServices. (,II: F~~ders. .
':-,........~"""._ "'~'_'.:'._h ._';'.-','._ ,,"',.\.- .._.:....",~:_...~
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or I 000 Volts see "B" above.
D. ..... Br;chCircuits
New Altcration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 63.00
$ 75,00
$125.00
$163.00
$375.00
$ 50.00
$ 50.00
$ 69.00
$100.00
$ 43.00
$ 3.00
E. ..... Miscellaneous (Scrvice/feedernotinchided) -Ea.ch Installation
;: '-'~>(:, ":<';', ',-,i;:{;:': ..... . ",' -...
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Pcrmit Inspection Fee is $45.00 + Surcharges
Inspection Request: 726-3769
4. SUBTOTAL OF ABOVE
;;..-_~.LL:i ;::;~:.~~:--:,
8% State Surcharge
10% Administrative Fee
S% Tetrf Ft:e
IO'rAL
250
I~ .~o
., (\ /""f"'"t-,
""",",,,,"" . -
as. ()1>
'CbL301: 50
Shared Drive(T:)/l3uilding FonnslElectrical Pennit Application I-06.doc
,
225 Fifth'Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-00813
CO M2006-00813
COM2006-00813
COM2006-00813
COM2006-00813
Payments:
Type of Payment
CreditCard
cReceint I
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
Date: 07/23/2007
3200700000000000492
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ROB'S ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 040640 Phone
Payment Total:
Page 1 of 1
10:02:13AM
Amount Due
212.00
38.00
12.50
20.00
25.00
$307.50
Amount Paid
$307.50
$307.50
7/23/2007
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 04/04/2008
VALUE: $ 249,644.00
SITE ADDRESS: 4155 Glacier View Dr 4157
ASSESSOR'S PARCEL NO.: 1802052204400
Springfield
TYPE OF WORK: Duplex
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Duplex - Glacier View Subd lot 7.
Same as Com2006-00784 4152 Glacier View Dr 4154
Owner: OK INVESTMENTS LLC
Address: PO BOX 8010
MEDFORD OR 97504
Contractor License Expiration Date
MATTHEW KARL OLSEN 116801 08/15/2007
ROBS ELECTRIC INC 156678 08/14/2008
JET HEATING INC 3944 05/31/2008
JET MECHANICAL LLC .__..,I..;;~~egu'res Y01j~0/2008
.A' F';-' J. 9...~! the breguII ~
BUILD' ila.1Q) rules are set forth
I!iiP '~~~_~g~_go1~throu.gh ~e9=~
o~tnw~ptaln ~oil~8 te'e~~est Floor:
T ~~~e cenWrc'U'~t~Not~d Floor:
WaKDmtiOf~or the. Oreggn~3i344)Sq Ft Basement:
Range Typc;enter 18 \-8 ~Iectric Sq Ft Garage/Carport
Energy Path: Path 1 Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
Contractor Type
General
Electrical
Mechanical
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Overlay Dist: Total:
# Street Trees Rqd: 1 Handicapped:
Paved Drive Rqd: No ~act:
% of Lot Coverage: 24'~f -n\~ ~Q\
~. , ~~\~ ~\\ \S
y~n:\,~(',... . ,"IlL'-\. 'y.\% 1>1'.1' r~Q
I PUBLIC IM~ ~Q~" ~'Or-.~t)O~t\J
~\)\ "'CtO 0'" \~. ~'walk Type:
Fully Improved. t'\W"^t:\'I\" Vt."'~.
Yes tv " '\ CO<J O~ Downspouts/Drains:
~Nl
2
R-3
U
VN
18.00
5.00
5.00
32.00
15.00
Phone Number: 541-840-1138
I CONTRACTOR INFORMATION'
Phone
541-840-1138
541-686-5444
503-363-2334
503-363-2334
6,000
1,024
1,380
448
6
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
4
Curbside 5'
To Storm Sewer
Pa2e 1 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Garae:e
Dwelline:s
Garal!e
Fee Description
Plan Review Same As
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 8% State Surcharge
3 Baths One & Two Family
Addressing Assignment
Boiler/Comp Up To 100,000 htu
Building Permit
Copies - Ea Addtl @ 50 Cnts Ea
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Furnace - more than 100,000
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
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
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
WiIlamalane Attached (duplex)
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
2,404.00
448.00
Total Value of Project
~
Amount Paid
$100.00
$10.00
$195.18
$144.73
$612.00
$62.00
$24.00
$1,053.15
$5.00
$80.00
$12.00
$18.00
$142.60
$30.00
$24.00
$198.00
$100.00
$877.22
$1,153.22
$10.00
$1,730.62
$164.06
$189.66
$139.14
$1,611.40
$365.38
$80.00
$664.09
$36.00
$1,848.00
$25.00
$12.50
$20.00
$212.00
$38.00
Date Paid
6/29/06
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
2/20/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
Pae:e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02120/2007
APPLIED: 06/29/2006
EXPIRES: 04/04/2008
V ALU,E: $ 249,644.00
Value
Date Calculated
$237,996.00
$11,648.00
$249,644.00
06/29/2006
06/29/2006
Receipt Number
1200600000000000992
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
2200700000000000219
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
3200700000000000492
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-00813
ISSUED: 02/2012007
APPLIED: 06/29/2006
EXPIRES: 04/04/2008
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
+ 5% Technology Fee
Reinspection Fee Plumbing
$2.50
$50.00
10/5/07
10/5/07
2200700000000001556
2200700000000001556
Total Amount Paid
$12,039.45
I Plan Reviews I
Initial Review
Plannin2 Review
06/30/2006
06/30/2006
06/3012006
07/1912006
APP
APP
LLH
TAJ
Survey required because of
minimum side setbacks. Setback
street tree at least 16' for vision
clearance (condition #8 of
subdivision).
SDCs added for two dwelling units.
Sidewalk & curbcuts added.
LDAP application and permit
required before issuance of Building
permit.
provide truss details and layout
Public Works Review
06/3012006
07/14/2006
APP
SB
Structural Review
Structural Review
06/3012006
08/1712006
08/15/2006
08/17/2006
WE
APP
RWC
RWC
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.
~eouirecUnsDections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
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.
Firewall: Located and constructed according to plans.
Pa2e 3 of 4
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00813
ISSUED: 02/20/2007
APPLIED: 06/29/2006
EXPIRES: 04/04/2008
VALUE: $ 249,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
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.
r
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
ZVIl'\. S ~t!'C..:t"fhAI rc:;e;-
VIA- c c..:H /(!W
Jg
Date
/7-0/
Pal!e 40f 4
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-00813
COM2006-00813
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Reinspection Fee Plumbing
+ 5% Technology Fee
Paid By
MATTHEW OLSEN
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001556
Date: 10/05/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 011147 In Person
Payment Total:
Page 1 of 1
1:50:59PM
Amount Due
50.00
2.50
$52.50
Amount Paid
$52.50
$52.50
1015/2007