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Home My WebLink AboutPermit Building 2008-6-24 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO. COM2008-00550 ISSUED. 06/24/2008 APPLIED' 04/21/2008 EXPIRES: 12/24/2008 VALUE: $ 98,28000 225 F,fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 806 55TH ST ASSESSOR'S PARCEL NO 1702331201535 Springfield TYPE OF WORK Smgle FamIly ReSIdence TYPE OF USE AddItIOn ReSldenllal PROJECT DESCRIPTION Shop and IIvmg space Owner MAAHS MARK A & TAMARA Address 730 55TH PL SPRINGFIELD OR 97478 Phone Number 541-741-3044 I CONTRACTOR INFORMA TlON I Contractor Type General Electllcal Plumbmg Contractor OWNER OWNER DOUGS PLUMBING INC LIcense ExpiratIOn Date Phone 110163 11124/2009 541-688-3385 BUILDING INFORMATION' # of UOIts Primary Occupancy Group Seconddry Occupancy Group Primary ConstructIOn Type Secondal) ConstructIOn Type # of Bedrooms R-3 U VB # of Stories HeIght of Structure 1800 Type of Heat orced Air Electric Water Type Electric Rdnge Type Electric Energy Path Pdth I Sprinkled BUlldmg No Lot SIze Sq FI I sl Floor Sq Ft 2nd Floor Sq FI Basement Sq Ft Garage/Carport Sq Ft Other Occupant Lnad 584 1,320 REQUIRED PARKING Frontyard Setback 2600 Overlay DlSt Total 2 S,de I Setback 500 # Street Trees Rqd HandIcapped S,de 2 Setback 3000 Paved Drive Rqd ATTENTION Oregon law l'.!llHi~M1(OU to Rearyard Sethack 10 00 % of Lot Coverage follow rules ~ed by the Oregon Utlltty Solar Setbacks 8 50 Notification Center Those rules are set forth ^'I'l...._r- In ()~R Oc,?_nn1_nn1 n throuoh OAR 952-001- THIS' VI;; I PUBLIC IMPROVEME\'IlIPS'1I You may obialn copies of the rules by ,1 17'. PERMIT SHAL Jim9 the center (Note the telephone Streetllmpto':fl'l~t~'N L EXPIR&'llilt/J!Qj,;tllVetL number SJde\f.llI19rl!tpe' Utility NotlflcaliOeurbSlde 5' CmRMc^JI' DER THIS PER "VU!11\ Con'or IS 1-8Clfl-3.32-2344) Sto~m,~ew~"Y~iJ3~ IS,ljR MIT IS 1'JYH DbMlspoutsllTrams To Storm Sewer Speci~J Irl,a()JfJJW1-PERIOtilt~gtJ1~/)'It;WP U E I DEVELOPMENT INFORMATION I Notes Storm 10 deSlgndted sewer Page I of 5 Status Issued 225 F,fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIDe DeSCriptIOn Tvpe of ConstructIOn Dwelhnes Garaee V Wood Frame Gar dee Fee DeSCriptIOn Plan ReView ReSidentIal -Mech Iss 2+ Apphances- + 10% AdmIDlstrahve Fee + 12% State Surchdrge + 5% Technology Fee I Bath One & Two Family BUlldIDg PermIt Curbcut PermIt Dryer Vent Exhaust Hoods Fire SF Fee - Re"dentlal Furnace - up to 100,000 btu MIDlmum/Adjustmenl MechaDlcal Plan ReView Major - PlannIDg ReSidence Wiring 1000 Sq Ft ReSIdence Wiring Ea Addtl 500 Samtary Sewer - Improvement Samtary Sewer - Reimbursement SDC MWMC AdmID'strahon SDC MWMC Improvement SDC MWMC Relmbur>ement SDC SaDltary/Storm AdmID SDC Transpo Improvement SDC Trdnspo Relmbnrsement SDC TransportatIOn AdmID Sidewalk PermIt Storm Dramdge ImperVIous Area Storm Sewer Each Addt1100' Vent Fan Total Amount PaId I Valuation DescrlOhon I $ Per Sq Ft or mulhpher $10500 $28 00 Square Footage or B,d Amount 584 00 1,320 00 Total Value of Project ~PPli',~ Amount Paid $402 06 $40 00 $10988 $12043 $68 93 $16000 $61855 $85 00 $700 $1000 $95 20 $1400 $500 $205 00 $11700 $42 00 $36727 $483 00 $1000 $990 39 $95 35 $15234 $862 25 $19548 $7016 $85 00 $1,44628 $1600 $1400 $6,887 57 Date P did 4/21/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 6/24/08 Paee 2 of5 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00550 ISSUED 06/24/2008 APPLIED 04/21/2008 EXPIRES. 12/24/2008 VALUE: $ 98,280.00 Valne Date Calculated $61,320 00 $36,96000 $98,280 00 04121/2008 04/21/2008 ReceIpt Number 1200800000000000379 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 1200800000000000686 Status Issued 225 F,fth Street, Spnngfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541- 726-3 769 InspectIOn Lme 100tIal RevIew 04/22/2008 PublIc Works RevIew 04/23/2008 PuhlIc Works RevIew 05/01/2008 Planmne: Review 04/23/2008 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO' COM2008-00550 ISSUED. 06/24/2008 APPLIED. 04/21/2008 EXPIRES I 2124/2008 VALUE: $ 98,28000 Plan RevIews I 04/23/2008 04/24/2008 04/30/2008 06/05/2008 APP LLH WE Waltmg for mformatlOn on saOltary & storm for thIS SIte along WIth concrete or gravel dnvewdY Left message for owners on 4/24/2008 Tamara Maahs called on 4-28-2008 and stated they were hookmg up to saOltary & storm sewer, and they dnveway WIll eIther be asphalt or concrete On 4-30-2008 called dnd left msg to call regardmg ISsue WIth SIte plan APP LKW 25' P U E , storm water to desIgnated sewer APP TAJ 1 ThIS IS bemg allowed as dn acces!tory bUlldmg on a lot adjacent to the pnmary dwellIng The pnmdry d"ellmg IS m the same ownershIp and IS on tax lot 817 (dddress 730- 56th Place) As a condItIon of occupancy the owner WIll need to record a deed restnctlOn that requires both parcels to be sold together 2 A shop bUlldmg cannot have cooklOg faCIlities therefore the stove must he removed ThIS IS not to he conSIdered d dwellIng UOlt at thIS time It may be converted to a dwellIng m the future ",th appropnate bUlldmg permIts and SDC lees At that tIme the deed restnctlOn would be VOId 3 The shop bUlldmg does not exceed the square footage of the house or and It IS the same heIght as the house (the house has 1906 sf and the shop IS 1904 sf, thev are hoth 17.5' hIgh) 4 The first 18' of the panhdndle dnve needs to be paved unless It alreddy IS paved Paee 3 of5 CITY OF SPRINGFIELD' Building/Combination Permit . Status Issued PERMIT NO ISSUED' APPLIED. EXPIRES: VALUE' COM2008-00550 06/24/2008 04/21/2008 12124/2008 $ 98,280 00 225 F,fth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Structural RevIew 04/23/2008 06/10/2008 WE DLM ThIS project was placed on Ihe hack burner due 10 unresolved plannmg ISsues until the end of May Met wi owner re lUconslstenclCS ID the plans tbat afffect lateral brJcmg, crawl space heIght, and bUlldmg overhead door heIght Ownel WIll revise drawmgs to correct the problems dlm6/1 1/2008 Structural RevIew 06/23/2008 06/2312008 APP DLM Met WIth owners agam Resolved all Issues See documents for plan review comments 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 IR"OI~ EroslOnlGradmg InspectIOn Pnor to ground dISturbance Jnd after erosIOn meJsures are mstalled SIdewalk - CurbSIde After forms Jre erected but p'lOr to placement of concrete Curbcut - Standard After forms Jre erected but pnor to placement of concrete Ufer Electncal Ground Install ground rod at footing and call for mspectlOn 10 conJunclron WIth footing Jnd/Ol foundation inspectIOn Footing After trenches are excavated FoundatIOn After forms are erected hut pnor to concrete placement Post and Beam Pnor to floor msulatlOn or deckmg Floor InsulatIOn Pnor to deckmg Shear Wall Nadmg Before covenng sheathmg WIth fimsh matenals FrJmmg InspectIOn Pnor to cover and after all rough 10 mspectlOns have been approved WalllnsulatlOn Pnor to cover Drywall Pnor to tJpmg Fmal BUlldmg After all requ,red mspectlOns have been requested and Jpproved and the buddmg IS complete Underfloor Plumbmg Pnor to msulatlOn or deckmg Undertloor Dram Prior to cover or placement of concrete Rough Plumbmg Pnor to cover and mcludmg reqUIred test 109 Water Lme Pnor to filhng trench and mcludmg reqUIred teslmg , Samtary Sewer Lme Pnor to filhng trench and mcludmg reqUired testmg Pal!e 4 of 5 -~~ CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO ISSUED' APPLIED' EXPIRES, VALUE' COM2008-00550 06/24/2008 04/21/2008 12/24/2008 $ 98,280 00 225 Fifth Street, Spnngfield, OR 541-726-3753 Phone 541- 726-3676 Fa< 541-726-3769 InspectIOn Lme Storm Sewer Lme Pnor to filling trench Fmal Plumhmg When dll plumhmg work IS complete Underlloor MechaDlcal Pnor to msulatlOn or deckmg and meludlng required teslmg Rough MechaDlcal Pnor to Cover Fmdl MechaDlcal When all mechaDlcal work IS complete Rough Electnc Pnor to Cover Electnc ServIce Approval required pnor to utility company energIZIng service Fmal Electnc When all electncal work IS complete By SIgnature, I state and agree, that 1 have carefully exammed the completed applicatIOn and do hereby certify tbat all InfOrmdtlOn hereon IS true and correct, and 1 further certIfy that any dnd dll work performed shall he done 10 accordance With the Ordmances of Ihe CIty of Spnngfield and the Laws of the State of Oregon pertamlng to the work descnbed herem, dnd that NO OCCUPANCY will be made of any structure WIthout permIssIOn of the CommuDlty Services DIvIsIOn, Bulldmg Safety I furthcr certify thdt only contractors and employees who are III compliance With ORS 701 005 will he u,ed on thIs project I further agree to ensure Ihat all reqUIred mspectlOns are requested dt the proper time, that each address IS redddble from Ihe street, that the permit cdrd IS located at Ihe front of the property, and the approved set of plans will remam on the site at all times durmg constructIOn ( }(l,V'YI CV\.o.-... 110 C\.. cUVJ..- Lo-at-C8 Owner or Contractors Signature Date Paee 5 of5 (I) Construction Contractors Board 700 Summer St NE SUIte 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address' www ceh state.or.us Penntt# ~ -CJ05':ro Address '/'=)4 CS 73 ~ i / tssne~A ~ - ~ate ~~'l/O~ /u Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires resldentwl constructIOn permit applzcants who are not lzcensed With the ConstructIOn Contractors Board to Sign the following statement before a building pernllt can be Issued This statement IS reqUired for resldentwl building, electrlcal, mechamcal and plumbing penmts Licensed architect and engineer applzcants, exempt from lzcenslng under , ORS 701010(7), need not submit this statement This statement Will befiled With the permit Fill m the appropnate blanks and mltIal boxes I and 2, and eIther box 3A or 3B ~I r~ 2 I own, resIde m, or will resIde m the completed structure I understand that I must become hcensed 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 mstruct my general contractor that all subcontractors who work on the structure must be lIcensed WIth the ConstructIOn Contractors Board OR )ZC 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 mmd and hIre a general contractor, I Will contract With a contractor who IS lIcensed WIth the CCB and will Immediately no1:ify the office Issumg thiS bUlldmg permIt ofthe 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. f {1rUY10JtCA ,,(VitA o..~ lo-d4-0B '---' - (Signature of permIt applIcant) (Date) (White copy to ISSUing agency permit file, pink copy to applzcant) Property_owner doc 06-01.04 Actil!1lg as Y OllllW' Own GeJlJl.teJrall COll1ltractoJr? INFORIVlATION'NOTICE TO PROPERTY OWNERS ABOUT. CO~STRUCTION RESPONSIBILITIES \'-- NOTE ThIs InformatIon NotIce to Property Owners about Construction ResponsIbilitIes was developed by the Construction Contractors Board In accordance with ORS 701 055(5), passed by the 1989 Oregon LegIslature If you are actmg as your own contractor to construct a new home or make a substantial Improvement to an eXlstmg structure, you can prevent many problems by bemg aware of the followmg responsIbilities and concerns Employer Responsibilities You Will, m most mstances, be ruled to be an "employer" and the contractors you contract WIth will be "employees" If ~ you use contractors not hcensed with the Construction Contractors Board to do labor m constructing or to assIst m the construction or Improvement of a resldential structure As the e~ployer, you must cOlpply with the following: .' Oregon's Withholdmg Tax Law' As an emp10yer, you must Withhold mcorhe taxes from employee wages at the time employees are paId You Will be hable for the tax payments even If you don't actually Withhold the tax from your employees For more mformatlOn, call the Department of Revenue at 503-378-4988 . < Unemployment Insurance Tax: As an employer, you are requlTed to pay a tax for unemployment msurance purposes on the wages of all employees For more mformation, call the Oregon Employment Department at 503-947-1488 The Oregon Busmess Identification Number (BIN) IS a combmed number for both Oregon Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or wwwdorstateor us/fonnsoav htmll for the app!Vpuate forms Workers' CompensatIOn Insurance: As an employer, you are subject to the Oregon Workers' CompensatIOn Law, and must obtam workers' compensation msurance for your employees If you fail to obtam workers' compensation msurance, you could be subject to penalties and be liable for all clalm costs If one of your employees IS mJured on the job For more mformatlOn, call the Workers' CompensatIOn DIVISion at the Department of Consumer and Busmess Services at 503-947-7815 U.S. Internal Revenue Service' As an employer, you must WIthhold federal mcome tax from employees' wages I You Will be lIable for the tax payment even If you didn't actually wlthhold the tax For a Federal EIN number, call the IRS at 1-800-829-4933 or VISit theIr web site at v,ww IlS.l!OV . . Other RespoYUsill>mdes almdl Areas of COlllcerlms Code ComplIance' As the permit holder for tlus project, you are responSible for resolvmg any failure to meet code reqUirements that may be brought to your attentIOn through inspectIOns I ' LIabIlity and Prope'rty Damage Insurance: Contact your msurance agent to see If you have adequate msurance coverage for aCCIdents and omiSSions such as fallmg tools, pamt over spray, water damage from pipe punctures, fire or work that must be redone, , \ " Time' Make sure you have suffiCIent time to supeTVIse your employees Expertise Make sure you have the slalls to act as your own general c~ntractor, to coordmate the work of rough-m and fimsh trades, and to notify bUlldmg offic13ls as the appropnate ames so they can perform the reqUired mspectlOns If you have additIOnal questIOns call the ConstructIOn Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 , Pr9perty _owner doe 06-01-04 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET 'I~ IV) ~ o U P:: ~ f-< I~ o ~ COM2008-00550 Maahs, Tamara & Mark 806 55th Street 1702331201535 Single rarmly Rcsldt.ncc I BUll DING SiLl: (Sr 1904 LO I SILL (SI ) 9583 JOURNAL OR JOB NUMBER NAME OR COMPANY LOCA TlON TAX LOT NUMBER J)LVCI OPMCN I I YPC NLW DWCLLING UNll S ISTORM DRAINAGC - DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS SF x I COST PER SF CHARGE 417975 1 $0346 I = 1 $1,44628 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSl RUCTED TO CITY STANDARDS lIMPER VIOUS S F I x I COST PER S F I x I DISCOUNT RATE I I 1 000 1 I $0346 I I 50% ~ I ITEM I TOTAL - STORM DRAINAGE SDC I $1,44628 2 SANITARY SEWER - r.ITY A REIMBURSEMENT COST 1 NUMBER OF DFU's I I 18 B IMPROVEMCNT COST I NUMBER OF DFU's 1 1 18 1 DlSCOUN r $000 $1,44628 1070 x COST PER DFU $26 83 $483 00 11091 x COST PER DFU $20 40 $36727 I 11092 I ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $850 27 3 TRAN~PORTATION A REIMBURSEMENT COST 1 ADTTRIPRATE I x I NUMBCR OF UNITS I x r COST PER TRIP x INCW TRIP FACTORI I 957 I I I I 2043 I 100 $19548 11093 B IMPROVEMENT COST I I ADT TRIP RATE 1 x I NUMBER OF UNITS I x I COST PER TRIP x 1 NEW TRIP F ACTORI I i 957 I I I 1 1 $90 10 I 100 ;;1 $862 25 11094 ITEM 3 TOTAL- TRANSPORTATION SDC = , $1,05773 I 4 SANITARV Sr:WER - MWMC II A REIMBURSCMENT COST I INUMBER OF FEU's I x ICOST PER rEU I I J I $9535 = $95 35 11054 B IMPROVEMENT COST I [NUMBeR OF FEU's I x ICOST PER FEU I I I i $990 39 = I $990 39 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~ I $000 I. J054 MWMC ADMINIS rRATlVE FEE ~ , $10 00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,09574 SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = , $4,450 02 J 5 ADMINIS I RATIVE n:r. ISUBTOTAL x I ADM rLC RA TC I~ CHARGE I $4,450 02 I 5% I $222 50 TOTAL SANITARY ADMINISTRATION FEE 15234 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE $7016 1078 Kaye Wilson 4/24/2008 TOTAL SDC CHARGES =1 $4,672.52 II PRbPARED BY DATE --.. .-. ...---- DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQU1V ALENT - DRAINAGE FlXTURE UNITS (NOTe fOR R[MODEL~ CAI CULATE ONI Y TIIF NET ADDITIONAl FIXTURLS) NO 01' nx I URCS DRAINAGC UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS lEA THTUB 0 -- 0 3 = 0 IDRlNKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC 0 0 3 = 0 I INTERCEPTORS FOR SAND I AUTO WASH I ETC 0 0 6 = 0 !LAUNDRY l1JB 0 0 2 = 0 ICLOTHESWASHER I MOP SINK 2 0 3 = 6 ICLOTHESW ASHER, 3 OR MORE (EAt 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRlG I WATER STATION I ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK I DISHWASHER I ETC 1 0 3 = 3 SHOWER, SINGLE STALL 1 0 2 = 2 I SHOWER, GANG (NUMBhR OF HEADS), 0 0 2 = 0 ISINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 ISINK COMMERCIAL BAR 0 0 2 = 0 I SINK WASH BASINIDOUBLE LA V A TORY 0 0 2 = 0 ISINK SINGLE LA V ATORYIRESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL I WALL 0 0 5 = 0 ITOILET, PUBLIC IN~TALLAlION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER or EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 18 "EDU (EQUlvalen1 Dwellm~ Umt) IS a dlSChar~ eqUlvalentto a smgle falmly dwellmg umt (2? Dms) set at 161. gallons per day - I I- I I I I I I I I II I I I Ii I I I MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE YEAR I CRJ:DlT RATE/$I,OOn! ANNF"XCD . ~SESSED V ALUE.... J BEFORL 1979 -- $5 29 1979 $5 29 1980 $519 1981 $5 12 1982 $498 1983 $4 80 1984 $463 1985 $4 40 1986 $4 07 1987 $367 1988 $322 1989 $273 1990 $225 1991 $180 1992 $1 59 1993 $1 45 1994 $1 25 1995 $1 09 1996 $092 1997 $0 72 1<J<)8 $048 1999 $028 2000 $0 09 2001 $0 05 IS LAND ELGIBLE fOR ANNEXATION CREDIT'> 2 (Enter I for Yes, 2 for No) IS IMPROVEMLNT CLGl8LE FOR ANNEX CREDIT" 2 (Enter I for Yes, 2 for No) BASE YEAR 1979 CREDIT fOR LAND (IF APPLICABLE) VALUE 11000 CREDIT RATE $000 x $529 ~ , $000 CREDIT fOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $000 x $529 ~I 0 TOTAL MWMC CREDIT = $000 I. I I I I I I '1 I I I I I I I I I I I I I J SPR1NOF.IELD _~ ZON \(l. J 1.N.,-,~1 INII~L~ _ ' ~ DAI \\ , ,,~~ SOURC ;:7) Date (P12~ /6 t ~ 225 foll-fll STRll I . SI'Rli\GrILLD, Ol.t 97477 . PH (541)726-3753 . I'A'\ (541)726-3689 ELECTRICAL PERMIl'APPLICATlON Clly Job Number ./!O#f? /'ff) f5 - /)19 fl,)/') JOB DESCRIPTION 1000 sq fI or less A - ~ vi L Each additIOnal 500 sq ft or permlt~~trab~::e~ wo:~:,~ff ~;::~o::::~a::'d Home or not ~tarted '" ItlUI1 180 days of Issuance or If work I~ Modular Dwellmg Service or Suspended for 189",days Feeder L~N OF INSIALLA110N r'/ /r>< C;-c;; /3: ~ p/ , , LEGAL DESCRIPTION / 7 () 2..- ;.? '2, / 2 > n Ie:; s G 2 CONl1<AQ'OR INS1ALLAfION ONLY Electrical Contractor Address / /- /hone Supervisor L71cense Number EXpiration D e CIty Constr Contr Numbcr E\.plratlOn Date Signature of SupervIsing Electnclan Owncrs Name<)JU.,/J:.! (ku.&1!l /tfA-k,fL J} 0 5'5' 71t jJi.., Clly ~A'IMA,Ne!./J Phone 14-1--- 30ff Addrcss OWNER INSTALLATION rhe installatIOn IS belllg made on propcrty I own which IS not Intended for sale, lease or rent Owners Signature Inspcchon Rcquest 726-3769 3 COMPLbl'E [<EE SCHbDULE BELOW A Ne\\ Resldcntlal- SlIlgle 01 Multl-F'.utlll) pCI d\\elhllg III1It Service Included ! 2- $11700 //700 . $2100 42-tHJ $55 00 B Sel vices 01 Feeder' - In~t,lll.ltlOlI, Alter.ltlOlls or Reloc.lhon 200 Amps or less N 0 n la'" req~I"6$l(\ou.to ~JI=NT10 ,rego .. U'I , 20 I Amps to f Wo~'VBles adopterl h.y the Oi'tSgClJl UtIIIt1 40 I Amps t rMt\1!in Center. Those rulBlila~ fOI1l'l 601 Amps tqrj tnDJll.lil,~-001-0010 through 9.1~:b; Over 1000 ,nlIOIh'~P.lJ may obtaul c;utJ.,,~ 1 e~ "'""1""" Note' th C"''' Reconnect OnI9a1ling the center. ( caIit'" number for the Oregon Uttllt Center Is 1-800-332-2344). C Tcmponll y Scn IlCS or Feedel S InstallatIOn, Alteration or RelocatIOn 200 Amps or Icss $ 55 00 20 I Aml1.'i to 400 Amps $ 76 00 40 I A~\o!;nQIil Amps $11000 Over i~'\l\l~ !1i~HflJnI. ~RIft~~~vfHE WORK D Brdll,l;~ If~W~D UNDER THIS PERMIT IS NOT ,;uM ENC'tD OR IS ABANDONED FOR New 1\!tera1W B'A'ii'!1'rnrorf.er Pancl One CirCUIt Each AddItIOnal CIrcuit or with Service or feeder Penmt $ 48 00 $ 400 I -- E M"celldneou, (Servlcc/fceller not IIldudcll)-Edeh Imtalldtloll Pump or lITIgatIOn $ 55 00 Sign/Outline Llghllng $ 55 00 LimIted energy/Residential S 28 00 Limited Energy/Commercial $ 50 00 Minimum ElectriC Permit InspectIOn Fec IS $50 00 + Surcharges 4 /fiqtJv /~.,,~ 15'1'0 rJ.7\ , TOTAL ~/,~-5 Shared Dnve{ J )/BUlldmg Fonns/Eleelncal Pemut AppllcatlO1f 1-08 doc SUlJl01AL OFABOVl, 12% State Surcharge 10% Admllllstratlve rcc 5% rechnology Fee 225 FIfth Street Spnngfield, Oregon 97477 541-726-3759 Phone -~ ~- City of Sprmgfield Offic131 ReceIpt Development ServIces Department Pubhc Works Department Job/Journal Number COM2008.00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008.00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008-00550 COM2008.00550 Payments 1 ype of Payment CredllCard cRecclOt] RECEIPT #. 1200800000000000686 Date' 06/24/2008 Descnptlon Fire SF ree - ResldenlJaI Storm Drainage ImpervIOus Area Sanitary Sewer - Rellnbursemenl Sanitary Sewer - Improvement SDC Transpo ReImbursement SDC Transpo Improvement SDC MWMC Relmbursemenl SDC MWMC Improvement SDC MWMC AdminIstratIOn SDC Sanllary/Slorm Admin SDC Transportalion Admin Sidewalk PermIt Curbcut Permit Building Permit I Balh One & Two Family Storm Sewer Each AddtI 100' Furnace - up to 100,000 btu Venl Fan Exhaust Hoods Dryer Vent -Mech Iss 2+ Apphances- MInimum/AdJustment Mechanical Residence W iring 1000 Sq Ft Residence Wiling Ea AddU 500 Plan RevIew Major - Planning + 5% Technology Fee + 12% Stale Surcharge + 10% Administrative Fee Paid By TAMARA MAAHS Item Total Check Number AuthonzatJon Received By Batch Number Number How Received nJm 02569a In Person Payment Total Page I of 1 2 25 20PM Amount Due 9520 1,446 28 483 00 36727 19548 86225 9535 99039 1000 15234 7016 8500 8500 61855 16000 1600 1400 1400 1000 700 4000 500 11700 4200 205 00 6893 12043 10988 $6,485 51 Amount Plud $6,485 51 $6,485 51 6/24/2008