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Home My WebLink AboutPermit Building 2006-07-05Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 I nspection Line Buildin g/Combination Permit PERMIT NO: COM2005-01439ISSUED: 0710512006APPLIED: 10/1312005EXPIRES: 01/0512007VALUE: $ 380,925.00 SITE ADDRESS: 770 Summit BIvd ASSESSOR'SPARCELNO.: 1703341409100 PROJECT DESCRIPTION: Single Family Residence -lot 33 Springfield TYPE OF WORKr Single Family Residence TYPE OF USE: New Residential Owner: Address: DANIEL BROWN 467 ROAN DR EUGENE OR 9740I Phone Number: 541-484-9407 ires you to License Expiration Date 54806 rl/04t2007 Contractor Type General Electrical Mechanical Plumbin # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms; Frontyard Setback; Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Contractor WOLTER ENTERPRISES INC SUNSET ELECTRIC INC JUNG ENTERPRISES INC CHAPIN ENTERPRISES INC R-3 Fullv Improved yes 07t?712008 tire teiePirdfrA4l2006 Phone 541-954-0471 541 -91 5-4883 541-937-2688 541-485-t 146 1,897 I,751 645 Cdrbside 5' Curb and Gutter I # of Stories: 2 Height of Structure 31.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Energy Path: nent Path Sprinkled Building: nla Overlay Dist: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other; Occupant Load: U VN 4 20.00 r3.00 s.00 32.00 32.00 # Street Trees Rod: pavea ori&C|iltEF: v, riiriuaro,gEat'tt t si I iLL AUTI-IORIZED UI{DER Hillside ) PiRl0i.l. Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: 2 Handicapped: E IF THEWUru(: PERI,4IT IS I{OT Notes: Hillside developement requires storm drainage pressure to be controled @ curb weep hole( no underground main at this location); sanitary connection off Sunset also 3/2012006 CAS DEVELOPMENT INFORMATION Page 1 of5 ; tire center, Building/Combination Permit Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -726-3'7 69 Inspection Line PERMIT NO: COM2005-01439ISSUED: 0710512006APPLIED: l0/1312005 EXPIRES: 01/0512007VALUE: $ 380,925.00 Description Type of Construction A.C. - Residen AC - Residential Dwellings V Wood Frame Garage Garage Fee Description Plan Review Residential + l0oh Administrative Fee + 7%o State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + l0oh Administrative Fee + 8olo State Surcharge 3 Baths One & Two Family Addressing Assignment Appliance Not Listed Appliance Vent Building Permit Curbcut Permit Dryer Vent Encroachment Permit Exhaust Hoods Fixture Furnace - up to 100,000 btu Gas Fireplace Gas Outlets l-4 Plan Review Major - Planning PW Disc - 2nd Permit (Street) Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl500 Sanitarl Sewer - Improvement Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SD(l Sanitary/Storm Admin SDC Transpo Admin Total Value of Project Date Paid $ Per Sq Ft or multiplier $4.00 $96.00 $25.00 Square Footage or Bid Amount 3,648.00 3,648.00 645.00 Value s14,592.00 $350,208.00 $16,125.00 $380,925.00 Date Calculated l0/13/200s I 0/l 3/2005 l 0/1 3/2005 Amount Paid Receipt Number I 20050000000000152 r 2200600000000000836 2200600000000000836 2200600000000000836 220060000000000091 s 220060000000000091 5 220060000000000091 5 220060000000000091 s 22006000000000009r s 22006000000000009r 5 22006000000000009r 5 220060000000000091 5 220060000000000091 5 22006000000000009r 5 22006000000000009r 5 22006000000000009r 5 220060000000000091 5 220060000000000091 5 220060000000000091 s 220060000000000091 5 220060000000000091 s 22006000000000009r 5 220060000000000091 s 220060000000000091 5 220060000000000091 5 220060000000000091 5 220060000000000091 5 22006000000000009 l 5 220060000000000091 5 220060000000000091 5 220060000000000091 s 22006000000000009 l 5 220060000000000091 s 220060000000000091 5 $961.29 $s.00 $3.50 $50.00 $10.00 $220.s9 sr76.47 $306.00 s31.00 $18.00 $6.00 $1,478.90 $80.00 $6.00 $130.00 $9.00 $70.00 $24.00 $15.00 $4.00 $1s0.00 $-30.00 $106.00 $133.00 $57.21 $877.22 $75.21 $1,153.22 $10.00 $865.31 $82.03 $6.62 $201.31 $60.48 10/13/05 6n4t06 6n4t06 6n4t06 7t5t06 7t5t06 7t5t06 7t5106 7tst06 715106 7tst06 715106 7t5t06 7t5t06 715t06 7tst06 7/5t06 715106 7t5t06 7 t5t06 7 t5t06 7 t5t06 715/06 7/5t06 7t5t06 7 t5t06 7 t5t06 7 t5t06 7 t5t06 7t5t06 7 t5/06 7/5t06 7 t5t06 715106 Fees Paid Paee 2 of5 Yaluatiun PeseriBtion ] CITY F PRIN Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 lnspection Line PERMIT NO: COM2005-01439ISSUED: 0710512006APPLIED: 10/1312005 EXPIRES: 01/0512007VALUE: $ 380,925.00 SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Vent Fan Willamalane Single Family Total Amount Paid $80s.70 $182.69 $80.00 $1,259.70 $30.00 $1,o0o.oo s10,710.45 7tst06 7t5t06 7 t5t06 7 t5106 7t5t06 7t5t06 220060000000000091 5 220060000000000091 5 22006000000000009r s 220060000000000091 s 220060000000000091 5 220060000000000091 5 Plan Reviews Initial Review Initial Review Planning Review Planning Review Public Works Review Public Works Review Structural Review 10n4t2005 I 1/03/2005 06t2312006 l0/19/2005 10n412005 Lu04t2005 06t23/2006 10n4t2005 06t23t2006 APP CAS 04t04t2006 04t04t2006 WE JLP t0n4t200s n/09/2005 APP TCM Revised plot plan received and routed to Cheryl Slaymaker and Tom Marx to attach to drawings. Revised calculations meets coverage. Awaiting revised coverage calculations from Monfy. Revised site plan received on l0/28. Coverage OK as long as PWE approves the use ofthe particular pavers. Building and retaining wall moved out of easemant per contractor noted on plans 6/12106; Submittal received 6l14106 denied 6115106 pervious paver submittal needed called Monty 312012006 Storm drainage pressure must be control al curb weep hole per Hillside code. CAS Left msg on Monty Luke's phone machine. PW still needs geotech submittals prior to authorization. Waiting for his submittal.4/4/06 JLP Forwarded to Tom Marx for review I l/3/05 Revised partial building plans submitted 3/16/06 dlm Revisions reviewed 3120106 OK dlm APP APP APP WE LLH LLH TAJ 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. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or lbundation inspection. Reouired Insnections Paee 3 of5 f,Im SPRINGFIE Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -726-37 69 Inspection Line PERMIT NO: COM2005-01439ISSUED: 0710512006APPLIED: 10/1312005 EXPIRES: 0l/0512007VALUE: $ 380,925.00 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. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underground Plumbing: Prior to fitling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Llnderfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover 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. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. 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. Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Ppior to Cover Etectric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. 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. Curbcut - Standard: After forms are erected but prior to placement of concrete. Page 4 of5 h j t L3 Building/Combination Permit Status Issued 225 Fitth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2005-01439ISSUED: 0710512006APPLIED: 10/1312005 EXPIRES: 0l/0512007VALUE: $ 380,925.00 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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 Sal'ety. I further certity 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 is located at the front of the property, and the approved set of plans will remain on the site at all times during Owner or Contractors Signature 6 Page 5 of 5 T { CITY OF SP'{INGFIELD SYSTEMS DEVELOPMEN. ,dORKSHEET JOURNAL OR JOB NUMBER: COM2005-01439 NAMEORCOMPANY Dan Brown LOCATION 770 Summit TAX LOTNUMBER:1703341409100 DEVELOPMENTryPE SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM COST PER S.F $0.323 BUrLDrNG SrZE (SFl 2944 LOT SrZE (SF): CIIARGE $1,259.70 10000 IMPERVIOT]S S.F- 3900.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CIry STANDARDS IMPERVIOUS S.F 0.00 NUMBER OF DFU's 46 B. IMPROVEMENT COST: NLIMBER OF DFU's 46 ADTTRIP RATE 9.57 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 SUBTOTAL $5,23s.87 COST PER S.F $0.323 COST PER DFU $25.07 $r 9.07 NT]MBER OF UNITS I NUMBER OF TINITS I ADM. FEE RATE 50/, DISCOTINT RATE 50Yo DISCOTINT $0.00 x x x x x x x x ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBTIRSEMENT COST: ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBURSEMENTCOST: $2,030.44 COST PER TRIP $ r 9.09 COST PER TRIP $84. r 9 $988.39 xx NEW TRIP FACTOR r.00 NEW TRIP FACTOR 1.00 xx ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENTCOST: Nt 4BER OF FEU's I B. IMPROVEMENT COST: NIA4BER OF FEU's I MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATTVE FEE ITEM 4 TOTAL - MVYMC SANITARY SEWER SDC SUBToTAL (ADD ITEMS 1,2, 3, & 4) 5. ADMINISTRATIVE FEE: $957.34 $5,235.87 CHARGE $261.79 TOTAL SANITARY ADMINISTRATION FEE: TRANSPORTATION ADMINISTRATION FEE: Cheryl Slaymaker 3120/2006 it,259.70 s877.22 $805.70 $82.03 $865.31 $r0.00 201.31 .66 I 070 t09l 1092 I 093 1094 I 054 l 056 078 a rrlooU &rrlFa rl]& I@ COST PER FEU $82.03 COST PER FEU $865.31 PREPARED BY DATE TOTAL SDC CHARGES DRAINAGE FXTURE UNIT CALCULATION TABLE NUMBER OF NEW FD(TURES x UNIT EQUIVALENT: DRAINAGE FXTURE TINTTS FOR CALCUI-ATE ONLY T}IE NET ADDITIONAL NO. OF FIXTURES T]NIT FIXTURE TYPE NEW OLD MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FXTURD UNITS lsa toa unit set at '167 }TWMC CREDIT CALCULATION TABLE: BASED ON COI]NTY ASSESSED VALUE DRAINAGE FIXTURE TINITS 0 2 t979 +EDU BEFORE 1979 1979 1980 1982 1984 1985 1986 1987 1988 1989 I 990 199',I 't992 1993 1994 t995 1996 1997 1998 1999 $s.29 $5"29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $t.oz $3.67 $3.22 $2.73 $2.25 $1,80 IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) 2 l98t 1983 VALUE / IOOO $0.00 CREDITRATE $5.29x CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.e2 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 2 0 3 6 0 0 1 0DRINKING FOUNTAIN FLOORDRAIN 0 0 3 0 0 3 0INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 b 0 LALINDRY TUB 2 0 2 4 CLOT}IESWASHER / MOP SINK 2 0 3 6 0 0 6 0CLoTITESWASHER - 3 OR MORE (EA) MOBILE HOME PARKTRAP (I PERTRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 0 0 3 0RECEPTOR FOR COM. SINK / DISHWASHER / ETC. SHOWER. SINGLE STALL 4 0 2 8 0 0 2 0SHOWE& GANG (NUMBER OF HEADS) SINK: COMMERCTAL/RESIDENTIAL KITCHEN 1 0 3 3 STNK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 2 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 5 0 1 5 URINAL, STALL/WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 TOILET, PRTVATE INSTALLATION 4 0 3 12 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE $0.00 2000 2001 20 CITY OF SPr{INGFIELD SYSTEMS DEVELOPMEN. ,IIORKSHEET JOURNAL OR JOB NUMBER: COM2005-01439 NAME OR COMPANY:Dan Brown LOCATION:770 Summit TAX LOTNUMBER:r 703341 409 r 00 DEVELOPMENT TYPE:SINGLE FAMILY RESTDENCE NEW DWELLING TNITS I. STORM DRAINAGE DIRECT RIINOFF TO CIry STORM SYSTEM COST PER S.F. $0.323 BUTLDTNG SIZE (SFl 0 LOT SZE (SF): CHARGE $0.00 0 0 IMPERVIOUS S.F 0.00 RTINOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F 0.00 NUMBER OF DFU's 3 B. IMPROVEMENT COST: NUMBER OF DFU's J ADT TRIP RATE 9.57 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 SUBTOTAL s132.42 COST PER S.F $0.323 COST PER DFU $25.07 $ r 9.07 NLIMBER OF T]NITS 0 NTA4BER OF TINITS 0 ADM. FEE RATE 5o/o DISCOT]NT RATE 50o/o $0.00 DISCOUNT $0.00 x x x x x x x x ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENTCOST: 3. TRANSPORTATION A. REIMBURSEMENT COST: s132.42 COST PER TRIP $19.09 COST PER TRIP $84. I 9 $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR r.00 xx xx ITE]VI3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER. MWMC A. REIMBURSEMENTCOST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NUMBER OF FEll's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS I, 2, 3, & 4) 5. ADMIMSTRATIVE FEE: $0.00 $132.42 CHARGE s6.62 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TATION ADMINISTRATION FEE: Cheryl Slaymaker 3t20t2006 COST PER FEU $82.03 $0.00 $57.21 $0.00 $0.00 $0.00 $0.00 $0.00 $139.04 1070 l09l 1092 r 093 1094 I 055 1 056 079 078 a rrloo(-) HFa r!& COST PER FEU $865.3 r PREPARED BY DATE TOTAL SDC CHARGES x x ITEM 2 TOTAL. CITY SANITARY SEWER SDC DRAINAGE FD(TURE UNIT CALCULATION TABLE NUMBER OFNEWFXTURES x UNIT EQUIVALENT = DRAINAGE FXTURE LINTTS FOR CALCUI.ATE ONLY THE NET ADDITIONAL NO. OF FIXTURES UNIT FXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FXTURE UNITS lsa toa mi1 set at I 67 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRA]NAGE FIxTURE LIMTS 0 0 1979 +EDU BEFORE 1979 1979 1980 l98l 1982 I 983 I 984 I 985 I 986 1987 I 988 I 989 1990 l99l 1992 1993 1994 1995 1996 1997 1998 t999 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 fi.07 $3.22 $2.73 $2.25 $1.80 VALUE / IOOO $0.00 CREDITRATE $5.29 IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) 0 x $3.67 CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $o.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKING FOLINTAIN 0 0 1 0 0 0 3 0FLOOR DRAIN INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0 0 0 2 0LATINDRY TUB CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASFIER. 3 OR MORE (EA)0 0 b 0 MOBILE HOME PARK TRAP (1 PER TRA]LER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 0 0 3 0RECEPTOR FOR COM. SINK / DISHWASHER / ETC. SHOWE& STNGLE STALL 0 0 2 0 SHOWER, GANG (NIA4BER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCTIEN 0 0 3 0 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 T]RINAL, STALL/WALL 0 0 5 0 TOILET, PUBLIC IN STALLATION 0 0 6 0 TOILET. PRIVATE INSTALLATION 1 0 3 3 3 YE,AR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALT]E 0 2000 2001 225 FIFTH STREET . SPRINGFIELD, OP.97477 o PH:(541)726-3753 o FAX: (541)726-36E9 E LE CTRI CAL P ERMIT AP P LI CATI O N City Job Number Date 1. LOCATION AF INS'TALIAT'ION .:.3 LEGAL DESCRIPTION JOB DESCRIPTION f Permits are 'able and if work is " not started within 180 days of issuance or if work is Suspended for 180 days. 2. 00NTRACTOR Electrical Conffactor Address 4 A. New Residential - Single or Plulti-Farnity per drvelling 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 1 s 19.00 $50.00 B. +aoo ?t, lotpf6'wb06.00$l Relocation: City Phone 200 Amps or less 201 Amps to 400 Amps I 401 Amps to 600 Amps 601 Amps to [000Anrps ,. Over 1000 Amps/Volts Reconnect Only 001- $ 63.00 les tl $ 7s.00 $125.00 $163.00 $37s.00 $ 50.00 )ne ,,on Supervisor License Number Socso S C. Temporary Sen'ices or Feetlers Expiration Date /cv-o t -o? Constr. Contr. Number Owners Name Address P \ city \\blgda=:- Pr,o". Q?B ZSH OWNER INSTALLATION The installation is being made on properry I own which is not intended for sale, lease or rent. Owners Signature: $100.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit Service or $ 3.00 included) -Each lnstalla tiou Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit lnspection Fee is $45.00 * Surcharges Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits $ s0.00 $ 50.00 $ 25.00 $ 4s.00 Z tL State Surcharge l0% Administrative Fee TOTAL <r/t*zgro Inspection Request: 726-37 69 a Shared Driv{T:)/Building Forms/Electrical Permit Application l-03.doc a C O M P LETE T- E E S CII B D LILE BELO'Y ANLY AD-S I t. 401 Amps to 600 Amps Installation, Alteration or Relocation 2ooAmpsorless -L $so.oo 5E 201 Amps to 400 Amps $ 69.00 \ SP lTls_lsl_ $ 43.00 FOR .a ::l, r,. ... Zg,1 225 Fifth Street Springfieldo Oregon 97 477 541-726-3759 Phone c- '' of Springfield Official Receipt r-,velopment Services Department Public Works Department RECEIPT #: 2200600000000000915 Date: 0710512006 8:27:3lAM Job/Journal Number coM2005-01439 coM2005-0 r 439 coM2005-01439 coM2005-0 r439 cloM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-0 r 439 coM2005-0 r 439 coM2005-01439 coM2005-0 r 439 coM2005-0 r 439 coM2005-01439 coM2005-0t439 coM2005-01439 c'oM2005-01439 coM2005-01439 coM200s-0 t 439 coM2005-01439 coM2005-01439 coM2005-01439 coM2005-01439 c()M2005-01439 c()M2005-0 r 439 coM2005-01439 coM2005-0 t 439 coM2005-01439 coM2005-01439 coM2005-0 t 439 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Building Permit 3 Baths One & Two Family Fixture Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets l-4 Appliance Not Listed Gas Fireplace -Mechanical Issuance Fee- Furnace - up to 100,000 btu Curbcut Permit 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 Sanitary/Storm Admin SDC Transpo Admin Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin + 8% State Surcharge + l\oh Administrative Fee Sidewalk Permit PW Disc - 2nd Permit (Street) Encroachment Permit Plan Review Major - Planning Amount Due 31.00 r,000.00 106.00 133.00 r,478.90 306.00 70.00 30.00 6.00 9.00 6.00 4.00 t 8.00 l5.00 10.00 24.00 80.00 1,259.70 I,153.22 877.22 t82.69 805.70 82.03 865.3 I 10.00 201 .3 I 60.48 7 5.21 57.21 6,62 176.47 220.59 80.00 (30.00) r 30.00 150.00 Item Total:$9,690.66 Payments: 'I-ype of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check coMMoN CENTS CONSTR djb I 960 ln Person Payment Total: $9,690.66rc:66- cllcceintl Page I of I 7 t5t2006 rtuilal*,n UfZZON INITIALS DATE SOURCE tl lu M 225 FIFTH STREET o SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATI ON City Job Number -ot4 Date b-t*^ob 3. COXfPLETE FEE SCHEDULE BELOII' A. Nerv Residential - Single or ['Iulti-Family per drvelling unit' Service Included 1000 sq. ft. or less *fi1"1tff:',."":1500 sq' ft' or Each Manufact'd Home or ruroaJffIf,l0hg Serv ice or Feedeffll$ PERMIT SHALL EXPTAE]TTIIE 1.LOCATION OF LEGAL JOB DESCzuPTION Permits are 'ansferable and exPire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . COJVTRA CTOR INSTALLATION ANLYL. Electrical Contractor Grurzx:q1 CL 2oo Arli,Y Jp0'pAY PERI0D. 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 AmpsA/olts Reconnect Only Pump or irrigation Sign/Outline Lighting Limited EnergY'/Residential Limited EnergyiCommercial 1 ,Y/, State Surcharge l0% Administrative Fee TOTAL tr1) $s0.00 $ 63,00 $ 7s.00 $ r 25.00 $ 163.00 s375.00 $ 50.00 s 50.00 s 50.00 $ 25.00 $ 45.00 B. rsA B ANDONED FOR C\-. Address ) ) o 30'tnl-, r Ciry 3 ( phon" ? Strq!? /€ Expiration Date Constr. Contr. Numb"t 5? 8oO 201 Amps Expiration Date Signature of D. owners Name €,1 / n\az-ra< Address 2)O €azzr>,IT E. ,noo" ?{7o?7 / t Installation, Alteration or Relocation 200 Amps or less -a_-$ so.oo 4.@ $ 69.00 Supervisor License Number a5 City 5 OWNER INSTALLATION The installation is being made on properfy I owu which is not intended for sale, lease or rent. Owners C. Temporarv Services or Feedcrs N{iscellaneous (Serviceifeeder uot included) -Each lnstallation Minimumf,lectricPermitlnspectionFeeis$45.00+Surcharges 4. SUBTOTAL OF ABOI,'E .oo W.sb5.@ Inspection Request: 726'3769 Lc0' Ufl il Shared Drive{T:)/Building Fonns/Electrical Pennit Application I -06'doc s,Pr-' .riFlELo . r *,:j .: 1 ,, ,' fufr, ;,,. I J Electrician $ 106.00 '$ '19.00 b-- g sn 225Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C:+y of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 2200600000000000836 Date: 0611412006 l0:46:30AM Job/Journal Number coM2005-01439 coM2005-01439 coM2005-01439 Description + 7%o State Surcharge + llYo Administrative Fee Temp Power 200 amps or less Amount Due 3.50 5.00 50.00 Item Total:$s8.s0 Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check COMMON CENTS CONSTRUCTION ddk 1954 In Person Payment Total: $58.50 $58.50 cReceintl Page I of I 611412006 uneckNumDer Autnortzatron