HomeMy WebLinkAboutPermit Building 2003-10-28Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-726-37 69 Inspection Line
PERMIT NO: COM2003-01080ISSUED: 1012812003
APPLIEDz 10124/2003
EXPIRESz 0412812004YALUE: $ 1,500.00
SITE ADDRESS: 3198 PARTRIDGE WAY Springfield TYPE OF WORK: Interior
ASSESSORTSPARCELNO.: 1703221308900
TYPE OF USE: New
PROJECT DESCRIPTION: Add washer and dryer hookups - in urban growth boundary. Modifying existing
closet for appliances.
Owner: CyNTHIA HOWLAND
Address: 3198 PARTRIDGE WAY SPRINGFIELD OR 97477
PhoneNumber: 541-726-0191
Contractor Type
General
Electrical
Contractor
MARK SANDBERG
LR BRABHAM
Expiration Date
05102t2004
12n8t2004
Residential
Phone
6894370
541-747-6638
License
100778
8699
BUILDIN(
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
VN
REQUIRED PARKING
Total:
Handicapped:
Compact:
NOTIGE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED TOR
ANY 1BO DAY PERIOD.
Sidewalk Type:
Downspouts/Drains:
;
a/.antcr iS
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Notes:
Pase 1 of3
L Ur\ l r(AL l t,K rN rr ut(lvrA _L]LA__.]
Status Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2003-01080ISSUED: 1012812003
APPLIEDT 1012412003
EXPIRESz 0412812004VALUE: $ 1,500.00
Description
Bid Amount
Tvne of Construction
Use Bid Amount
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 1,500.00
Total Value of Project
Amount Paid Date Paid
Value
$1,500.00
$1,500.00
Date Calculated
r0t28t2003
Fee Description
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 7oh State Surcharge
Add, Alter, Extend Circ Ea Add
Building Permit
Dryer Vent
Fixture
Minimum/Adjustment Mechanical
Minimum/Adj ustment Plumbing
Perm Serv/Fdr 200 amps or less
Plan Review Residential
Total Amount Paid
$10.00
$21.30
$14.91
$15.00
$45.00
$6.00
$14.00
$39.00
$31.00
$63.00
s29.2s
10t28103
10t28t03
t0t28t03
10t28t03
10t28t03
10t28103
10t28t03
r0t28t03
10t28t03
10/28/03
10t28t03
Receipt Number
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
1200200000000002376
$288.46
Fees Paid
Plan Reviews
Structural Review 10t24t2003 10t28t2003 APP DLM
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Rough Plumbing: Prior to cover and including required testing.
2 Final Plumbing: When all plumbing work is complete.
3 Rough Electric: Prior to Cover
4 Final Electric: When all electrical work is complete.
5 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
6 Drywall: Prior to taping.
7 Final Building: After all required inspections have been requested and approved and the building is complete.
8 Final Mechanical: When all mechanical work is complete.
9 Electric Service: Approval required prior to utility company energizing service.
Paee 2 of 3
Valuation Description I
Keouired lnsnectlons
Building/Combination Permit
Status Issued
225 F'ifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-01080ISSUED: 1012812003
APPLIED z 1012412003
EXPTRES| 04t28t2004YALUE: $ 1,500.00
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 wiII remain on the site at all
times during construction.
t'\)n gt,1,.
Owner or Signature Date
Pase 3 of3
225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-37 53 r FA)ft (541b)fi106$689'as submitted has
E LECTRICAL P ERMIT AP P LICATI AN zoning, and does not require sPecific
approval Lbl-CityJobNumber CO$\Z.aC;3 -. l) IO8O Date Zoning
1.3.
zea
the tollowing
land use
ri ure
-0
$ 106.00
$ 19.00
i,J
LEGAL DESCzuPTION
l7o3 zz t3 o7?oo
JOB DESCzuPTION
l$ts Q (LL,^r /-s
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
A. New Resideutiat - Single or PIulti-Farrrily per du'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 $s0.00
B. Sen,ices or Feeders - Installation, Alterations or Relocation:
b4a
1
ElectricalContractor L A- BcrtrA^.- _ <200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsA/olts
Reconnect OnlyJ
Signature of Supervising Electrician
Owners Name
Address 3 frA Tarr+v p lUau
t/
Fee
$ 63.00
$ 75.00
s 12s.00
$ 163.00
s37s.00
$ s0.00
' $ 43.00
.00
Address b I Lrle _r t a 5 4reet
City 5p,-, na Fel<l Phorc 71-? : JLl n
Supervisor License Number Ll L!14.5.C. Temporary Services or Feeders
Expiration Date Installation, Alteration or Relocation
200 Amps or less S 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Constr. Contr. Number t6'1a
Expiration Date rzlrz loq Over 600 Arnps or 1000 Volts see "B" above.
13ranch (lircuits
New Alteration or Extension Per Panel
One Circuit
!r**'"T$:ffi::i:"H1,"'*"0 fr $3oo lf
c
x
D.
E.
City ,*Jii-Ttqt
OWNER INSTALLATION
The installation is being made on properly I own which nco pie
4ffi,'mlrfi*ihffi#BT
MiniJUUo
4.7o,@
lYo State Surcharge
l0% Adminisffative Fee
TOTAL
a ra_
?i-24 -Inspection Request: 726-3769
Shared Drive(T:)iBuilding Fonns/Electrical Pennit Application l -03.doc
by ths
5.46
225Eifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Offidial Receipt
Development Services Department
Public Works Department
#: 1200200000000002376 Date: L012812003 9:41:05AM
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
coM2003-01080
Fixture
Minimum/Adj ustment Plumbing
Building Permit
Dryer Vent
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Plan Review Residential
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ llYo Administrative Fee
14.00
31.00
45.00
6.00
39.00
10.00
29.2s
63.00
15.00
14.91
21.30
Item Total:$288.46
Type ofPayment Paid By Received By Batch Number Authorization Number IIow Received Amount Paid
Check CYNTHIA HOWLAND dlm 2s85 In Person
Payment Total:
s288.46
-$28-57-d