The URL can be used to link to this page

Home My WebLink AboutPermit Building 1997-11-13gTTOFSPFIINGFIELE' h, RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIEI,D COMMI'NITY SERVICES DIVISION BUITDING SAFETY Page 1 .fob Nnmber: 97L302 225 North Fifth Street Springfield, oR 97477 Location of Proposed Work: 975 SITNSET DR Assessors i,tap #: 17033411 Lot: 19 Block: Office lnspection Line 726 -37 59 726 -37 69 Tax Lot #: Subdivision: 05 319 FERNCREST Owner: LARRY SMITH Address:. 6829 E COURT Describe Work: S.F. RESIDENCE Phone #: 725-9839 city/state/zip: SPRTNGFIELD, OREGON 97478 NEW General: Plumbing: Mechanicaf: Electrical ContracEor SMITH HOMEBU]LD 0059135 2295 ARTHUR CT EUGENE OR 974O4OOOO DOUGS PLUMBING 0039016 29503 Awbrey Ln Eugene OR 974029635 BEYMERS HEATING OOO4483 300 River Rd Eugene OR 974040000 CITY VIEW ELECT 0026518 PO BOX 70393 EUGENE OR 974010000 -- OFFICE USE Conat. Contsractor #Expires 02/Ls/e8 02 /22 / e8 1-L/L4/e7 02 /L3 / e8 Phone 725 - 9839 588-338s 588 - 5004 687 -L292 QUAD AREA: 1RNW # OF UNITS: 1 CONSTR. TYPE: VN SECONDARY HEAT: HP INSUL PATH: P1 To request an inspection, A11 inspections requested be inspections requested after LAND o$ E 140 # OF BLDGS: 1 OCCY GROUP: R3 HEAT SOURCE: FE RANGE: E recording al 726-3759. will be made the same working daY, # 00 a.m. oo a.m. wifl be made the following work day --- REQUIRED INSPECTIONS --- SITE - To be made after excavation but prior Eo setting forms. FOOTING - After trenches are excavated. FOITNDATION - After forms are erected but prior Lo concrete placement. ITNDERFLOOR PLITMBING - Prior to insulation or decking. INSULATION - Floor; prior to decking wa]I/ceiling; Prior to cover SLAB - To be made after all inslab building service eguipment, conduit piping, and other equipment items are in place but prior to concreLe SPECIAL ROUGH PLI,}TBING - PTiOT TO COVET. ROUGH ITTECIINiIICAL - PTiOT TO CO\/CT. ROUGH ELECTRICAL - Prior to cover. ELECTRICAL SERVICE - Must be approved to obtain permanent power. SHEAR WALL NAILING - Before covering sheathing with finish materials. FRAIr{ING - Prior to cover. INSULATION - Floor; prior Eo decking Wa11/Ceiling; Prior to cover DRYI'IALL - Prior to taping. SfDEWALK - After excavation is complete, forms and sub-base material in place. CURBCUT - After forms are erected but prj-or to placement of concrete. FINAL PLITMBING - When all plumbing work is complete. FINAL MECIIAIiIICAL - When aLL mechanical work is complete. FINAL ELECTRfCAL - When all electrical work is complete. pRE BACKFILL: To verify site is clean of debrig prior to final grading and backfill. SPl.Ii.GF!ELD Job Number: 97L302 dTTOF Page 2 FINAL BUILDING - When all reguired inspections have been approved and t.he building is complete. Lot Faces: W Topography: 30 Solar Approved: Y House Garage Lot Sq. FE.: 5120 Total Height: 15 Lot Type: INTERIOR Setbacks SWE 52710 10 Lot Coverage: 35 ? Setbk From NPL: 5 N '7 Item Main Garage Total Value Building Permit Fee Surcharge/admin TOTAL FEE --- BUILDING PERMIT --- Square Feet x 1550 472 $/Sguare Feet 54 .55 L6.27 (A) Vafue 106,589.00 7,679.O0 114, 358.00 455.75 37.34 504.09 PLIIMBING PERMIT --- Item Residential Bath(s) LESS PERMITS ISSUED Plumbing Permit Surcharge/admln TOTAL CIIARGE ) Fee 150.00 -75.00 85.00 5.80 91.80(c) --- MECHANICAI, PERMIT --- Furnace Exhaust Hood Vent Fan Wood Stove/I,nsert / Fireplace Unit Dryer Vent Mechanical- Permit Issuance surcharge/edmin TOTAI, PERITIIT 1 5 4 3 15 3 31 10 ) 00 50 00 00 00 50 00 53 (D)44 .03 --- MISCELLAT{EOUS PERMITS --- Surcharge/admin Sidewalk Curb Cut CITY SDC WILLAIVI,i{U\NE SDC TEMP ELECT. LAND & DRAINAGE ALT TOTAL MISCELTAI'IEOUS PERMITS 0.00 25.00 14.80 2,375.76 1,000.00 43.20 44 .00 (E)3 ,502 .7 5 (Excluding Electrical ) unless otherwise noted --- TOTAL A}TOI'NT DUE --- (A, B, C, D, and E combined)4 , L42 .68 SPiI!iIGFIELD Job Number: 97L302 OTTOF Page 3 --- BUII,DING VAI.UE, PI,NiI CHECK At{D BUILDING PERMIT --- This permig is granted on the express condition that the said construction shal-l-, i-n all respects, conform to the Ordinance adopted by the City of Springfield, includi-ng the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any ti-me upon violation of any provisions of said ordi-nances. Plan Check Fee: 27L.70 Date Paid Received By: Pl-ans Reviewed By: DON MOORE Date Building Site Reviewed By: LISA HOPPER oe/03/e7 LL/t2/e7 Receipt Number: 27286 --- ADDITIONAL COMMENTS --- PATH 1; SEPARATE ELECTRICAL PERMIT IS REQUIRED CUT SLOPE MITIGAT]ON IS REQUIRED TO PREVENT EROSION OR SLOPE FA]LURE DRIVEWAY REQUTRED TO BE PAVED 2 STREET TREES REQUIRED By signature, I state artd agree, that I have carefully examined the completed application and do hereby certify that al-} information hereon j-s true and correct, and I further certify t,hat any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and Lhe Laws of the State of Oregon pertaining to the work described herein, and thaE NO OCCUPANCY will be made of any structure without permission of Lhe Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with oRs 701.055 will be used on this projecE. I further agree Eo ensure that all reguired inspections are requested at the proper Eime, Ehat each address is readable from the street, Ehat the permit card is located at the front of the property, and the approved set of plans will remain on the site at aII times during construction. //,r42 Eure ;^E---'Z---7 DATION --- Receipt Number: Date Paid: Amount Received: Received By: ti tl --'/un frK $Willamalane Park & Recreation District Job. No. PHONE: $ SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME: ADDRESS: LOCATION OF PROPOSED BUILDING SITE: Street Address: Plat Nam ype ons are on the A. Single-Family Detached Single Family home NO. OF UNITS Manufactured home not in a park X $1,000 per unit = $,00 srArE:0(2- z,r,tF.l--- Tax Lot Number:1 (Check appropriate dwelling(s). SDC calculations and dwelling t back.) q 1 NO. OF UNITS C. Multi-Family Apartment NO. OF UNITS X $692 per unit $ D. Manufactured Home Park NO. OF UNITS X $699 per unit WILLAMALANE SDC 2. SDC CREDIT (if applicable) SDC-payer must furnish proof of Wllamalane Credit approval. See SDC Credit Worksheet. B. Single-Family Attached X $924 per unit 3. TOTAL WILLAMALANE NET SDC ASSESSED (af SDC reduced for Credit) pment $ $ $ $ t 9o \000,00 City of Springfie epartment Date ,6 =E_,9L JOB N0. 77t:<.^ ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE [^/ORKSHEET NAME OR COMPANY ARPY 1n r Ttl LOCATION DEVELOPMENT TYPT . Ft. 1 . STORM DRAI I.IAGI x $0.226 PER SQ. FT. $ *i63,7t 2. SANITARY SEi\rER-CITY NO. OF PFU'S X $.16. 86 PER PFU s 64. . 48 (See Re'rerse Side) 3. TRANSPORIATiON NO OF UNITS X TRIP RATE X COST PER TRIP 4. SANITARY ST./{ER-MbJMC Du'1N0. 0F +tt# S r x s472.49 $ 477,4 x s472.49 x $472.49 X ztt,tcPER FEU + $10 M[,JI.4C/ADM 7gg $ '287,7c X t.o I X X q s MI^JMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMiNISTRATIVE FEES BASE CHARGE (SUBIOTAL ABOVE) X .05 $-toq.5Z TOTAL.MWMCSDC $ I7E,zZ SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ Z, Z62 ,63 D/., $ t t3.73 -76 x peu Pevrse oPta*t7 SDC Coordi nator Date:q-q-?7 ToTAL SDC $ Zr3 7s. BUILDiNG SIZE: LOT SIZE SQ IMPERVIOUS SQ. FT.2,7 IE t a an I tr,rfll- tJlYl a rvHL\r\JLH I l\JlY I HI.LE. NumDer or i\ew Ftxtr,'os X Unlt Equivalent = Fixrure Units (NOTE: For remodels, calculate on FIXTURE TYPE Bathtub...... Drinking Fountain.... Floor Drain................. lnterceptors For Grease/Oil/Sol ids,rEtc lnterceptors For Sand/Auto WashiEtc Laundry TubiClotheswasher... Clotheswasher - 3 Or More.... Mobile Home Park Trap (1 Per Trailer). Receptor For Refrigerator/Water StationiEtc........ Receptor For Commercial SinkiDishwasher/Etc.. Shower, Single Sta|1................ Shower, Gan9......... Sink: 8ar, Commercial, Residerrtial Kitchen.......... Urinal, Stall/Wall Wash Basin iLavaloty, Single....... Toilet, Pubiic lnstallation. Toilet, Private....... ,e NET additional fixturesl NUMBER OF UNIT NEW FIXTURES EOUIVALENT FIXTURE UNITS 2 1 2 3 6 2 6 6 1 3 2 i /Head 2 2 1 6 4 Miscellaneous: TOTAL FIXTURE UNITS l8 CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in rable, calculate credits s 3,1a x$I o4,{3 L Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) 27, S-90 (Rate X Assessed Value)X$ (Rate X Assessed Value) CREDIT TOTAL S ) Dc/,4'4 Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $ 1,0OO Assessed Value pbC i-g7g or before 1 980 1 981 1 982 1 983 1 984 1 985 1 986 $3.97 - 3.89 3.83 3.70 3.55 3.39 3.20 2.91 ("1 987 1 988 1 989 1 990 1 991 1 992 1 993 1 994 1 995 1 996 D2.5e} 2.17 1.73 1.31 o.92 o.74 o.61-o.45 o.31 o.'17 RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) Fesrdeniiai Commerical....... lndustrial........... Governmental.... ...... 0.4 ..... o.9 05 ..... o.5 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT 2- 2- 7 2 2- 3 I{GFTELE'R.ESIDENTIAL PERMIT APPLICATION lnspections: 726.3769 Office:726-3759 LOCATION OF PROPOSED WOFIK: JOB NUMBER 225 Fifth Street Springfleld, Oregon 97477 TAX LOT:f),/.o 4 /2 ? 7/3r ^ ASSESSORS MAP: LOI - BLOCK:SUBDIVISION: PHONE: 5a)STATE:ZlPi 72 CITY: -?93? ADDRESS: OWNER: REMODEL ADDITION DEMOLISH OTHERt/ DESCRIBE WORK: NEW ELECTRICAL: ADDRESS EXPIRES ,11 PHONECONTRACTOFI'S NAME GENERAL: PLUMBING: CONST. CONTRACTOR '' - OFFTCE USE - LAND USE: WATER HEATER: FLOOD PLAIN * OF UNITS: QUAD AREA: * OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: # OF BDRMS: - OCCY GROUP: * OF STORIES: ZONING CODE: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. will be made the followlng work day. REQUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to cover. Flnal Plumbing - When alt plumbing worl( is complete. E Slto lnspectlon - To lre madc after excavatlon, but prior to settlng forms. Underslab Plumblng/ Electrlcal / Mechanlcal - Prlor to cover. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng, Foundatlon - After forms are erected but prlor to concrete placemont. Underground Plumblng - Prior to fllllng trench. Underlloor Plumblng / Mechanlcal - Prlor to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulation - Prior to decklng. Water Llne - Prlor to filling trench. Rough Plumbing - Prlor to cover. Rough Electrical - Prior to cover, Electrical Servlce - Must be approved to obtaln permanent electrlcal power. Flreplace - Prlor to faclng materlals and framing lnsp. n Framlng - Prlor to cover. WaltlCelling lnsutallon - Prlor to cover, l--l Drywall - Prlor to taplng. Wood Stovo - After lnstallation lnsert - After flreplace approval and lnstallatlon of unlt. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Drlveway - After excavation is complete, forms and sub-base material in place. Fence - lVhen coi-rrpleted. Street Trees - When all requlred trees are planted. Finat Electrlcal - When all electrical work ls complete. Final Mechanical - When all mechanical work ls complete. Flnal Buildlng - When all required lnspectlons have been approved and bullding is completec,. Other MOBILE HOME INSPE TIONS [-_l Blocking and Set.Up - When ail - blocklng ls complete. Xl;:Xry sewer - Prior to rrrrrns K,"r:"J;.sewer - Prior to rllllns X Plumbing Connections - When home has been connected to water and sewer. Electrical Connecllon - When blocking, set-up, and plumblng lnspections have been approved and the home is connected to the servlce panel. Final - After all required inspectlons are approved andporches, sklrting, decks, and ventlng have been lnstalled. K ?71?a MECHANICAL: BANGE: tl tl E E E E il E :1 ' fi' Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterior - Corner - Panhandle !: - Cul-de-sac (.IS THE PROPOSED WORK TN THE. HISTORICAL DISTRIGT, OR ON THE HISTORICAL REGISTER? - lf yes, this appllcatlon must be slgned and approved by the Hlstorlcal Coordinator prlor to permit issuance. APPROVED: P.L.HSE GAR ACC' N S E VALUE (A) Total Value Building Permit Fee State Surcharge Total Fee ,4 x $/sQ. FT. BUILDING PERMTT ITEM SQ. FT. Main Garage Carport AND BUILDING PERMIT Thls permit is granted on the express condition that the said construction shall, ln all respects, conform to the Ordlnance adopted by the City of Springfleld, includlng the Development Code, regulating the construction and use of bulldings, and may be suspended or revoked at any tlme upon violation of any provisions of said ordinances. Receipt Number:- Plans Reviewed By Date BUI LDI NG LUE,LAN CHECK Plan Check Fee: Date Paid Received By SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home 7,fn S)f r L?-f /- * (c) 8( oo FT, ?O 3o L)- 2-i FEE N. Lf FT. FT.o PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permlt lssuance State Surcharge Totat Permit MECHANICAL PERMIT Furnace Exhaust Hood By slgnature, I state and agree, that I have carefully examlned the completed application and do hereby cerilfy that all lnformatlon hereon is true and correct, and I f urther cerilly that any and all work performed shall be done in accorr1ance wlth the Ordinances of the City of Sprlngfleld, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCY will be made of any structure wlthout permission of the Building Safety Divislon. I further certify that only contractors and employees who are In compliance with OFIS 701.0S5 wiil be used on thls proiect. I {urther agree to ensure that all requlred lnspections are reguested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln /o 7 Slgnature Date on the site at all ti ring constructlon MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolitlon State Surcharge Total Mlscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A,B,qQandECombined)_g/.r % VALIDATION: RECEIPT NUMBER DATE PAIT) AMOUNT RECEIVED RECEIVED BY +.\ ., 't gop€R./o.R. lt oaEL fr PF Sil'r t ?l t3o z- q7 5 9an$Ef i1 r=! tditriI rl- i/ 3T€€ L tlDf sroJ of iL" c.aocl'Et€ od€E- OF€^) utl 6- -4 e, : I, Atfg{iol fl nIlx Lli (n -1n1 Frtra.t+< t e'r€ 0' q" .f(..rlftt arER eO.\fCti?E S tff&)atl7 /A; 4 figS 7/A4J 'to^,c*"r5 (1..o *ot *} ta' Dxvn r! ?*,larE?.ou€a troD rTf,rit sTuo eo G,)n6t- l, ai i:'.1 +t ':DL-rrg-l i r-- r:.1 'f, !=' ,/, {/F/q8 I1"1,l NJr UJu)(D F LT $3 1I F'r(€ EO4 ---l lr 7 ,'l-'_:t!E :L 4: lD ,ll:1l -EEtE-7BEtr.r :FOl'l : Pan,rgs,,-rc =Oll SiS:E'. Larry Smrtn Smith Hrn€burldere lnc 682e E Ct. $pringfiald, OR 97478 Fax and Ph 726-9938 FHDNE I{N, H+i i PATiE E1 tlpr'. E4 1'flE l1:f,rint't Ff y\ff r-*-,v/,-/r, Supcrior Flreplrct Far 9014E5-78S0 lrlt:$fnlly $helly Thr dly d Springfitld inspector* ,-fiderutand thr Cidewails rfi quectio{r as rliustreterj in the dlegrrm do not confonft to ycur rpeciflcstlons es lrt'tsd on p*g€ 18 the Faragraph betow Figure 55 Plcrfe fl6te ther6 sidewsllr Bre fion.cambirsliblr- $inctrely Affi-?,#*,4 Lerry Smith $mith Homrilrilders lnc SF GFIELO 'he :onintr and rpproval. doee nd r€qulre sPecillc hnd use (N0ile[: INSPECf,ION OFPICE: 7 1. LOCATI 26-37s9 IJGAL DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI..ATION ONLY Electrical Contractor ,&,5k {t,'c- eaaress f-0 Bon ?aao ( e, Ci ty Phone -6s7 Supervisor License Number 3a .s Expiration Date Constr Contr. Number 75?/c Exp iration Date 6 Signature of SuPervising E1ect rician 6f Ovners Name Address A Ci ty %ro Ynone 7' "7f,37 OVNER INSTALI.ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: unhodzed THIS PEHMIT SHALL EXP'RE,FTHE WORKAUTHOR'ZED UNDER TH'S PERMII ISNOI ELECTRICAL PERHIT APPLICATIoN FOB CitY Job Nunber 3. COHPI..ETE T'EE SCEEDTIIJ BELOV ON OT INSTALI,ATION A. Nev Residential-Single or Multi-Family Per dvelling unit. Service Included: aJ JOB DESCRIPTION Items Cost / $ Bs.oo A g ls.oo $ 40.00 Ee-s 1000 sq.ft. or less Each additional 500 sq. ft or portion t hereo f Each Manuf'd Home. or Modular Dvelling Service or Feeder B. Servi.ces or Feeders Installation, Alterations or Relocation: c E Sumrc 34q2 200 amps or less 20L amps to 400 amps -401 amps to 600 amps - 601 amps to 1000 amPs- Over 1000 amps/volts - Reconnect OnlY Temporary Services or Feeders Insiallation, Alteration or Relocation 200 amps"or less 201 amps to 400 anPs - Over 401 to 600 amps - Over 600 amPs or 1000 volts D. Branch Circuits s s0.00 s 60.00 $100.00. $130.00 $300.00s 40.00 00 .00 .oo ee (Btr aEE s $ $ s $ $ $ $ 40 55 BO Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 3s.00 s 2.00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0utIine Lighting- Limited EnergY/Res - Limited EnergY/Comm 40.00 40.00 20.00 36.00 atoSUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.strative Fee -TOTAL U r' ctTY oF.sPEl OBEGO'U RECEIVED 5 / 5.- , iJ I BY: EfrANCH EI,JGINEEF ING;18-97 9:42AId; 5417460389 =>503 726 3683; 3'1 {_J 5r.l,Srneer. 5prirr'.Jfrr:trl . Llnegon 31 a7 ? t5411 746 t )b37 Fex t54 -11 746-OaJBS Branch Engineenlng .j.om i"iarx Builrling Safet.Y Divislon(:ity ol SPringfield ? )-5 N - 5th .St-reet ,'jpr- artgf i e1tl , Oregon 97 47'l iir::New for resiclence at 975 Sunset BIvd, Springfreld Smi th Homeburlders. i)ear Mr ^ I"lat x : I am respondirrg to your reglle5t tor a staternent regardrng srrrl ability Of construct-ion at t,he site referenced above. t pertormerl .t site visit at the resrdence descrrbed above- Al I toot ings have been engineerecl fot the proposed St.ructure. As Yurr may note In my engineering report dated 9-18-97, all footlngs irre t-r-r be place-d on 6" of granul.ar f ill-, Compact-ed to 928 reiat ive ccrmpaction (modified proctr:r) - If this requrremerrt is satisf ieti, rhis site is suitable f or the construct-ion of a foundatiorr. fA,l €"5":c-2;'7 iien€: Fabr i cant 1l-l'l-9 1'Rr.NIPt" )UIATIt.lN UIVIL SL,RVfYlNrl 225 FIFTE STREET SPRTNGFTELD, oREGoN 97417 INSPECTION REOUEST: 726-3769 OFFICE: 126-3759 rtN r'.rO 1. LOCATTON OF INSTALLATION77f,Szu.se7 ON Permits are non-transferable and expire i.f vork is t-tot started vithin 180 days of issuance or if vork is suspended for 1.80 days. 2. CONTRACTOR INSTALI,ATION ONLY Electrical Contractor Supervisor License Number Ar Exoiration Date SPr iit--lEl*l) CAL PERHTT APPLICATION 200 amps or less 201 amps to 400 amps -401 anps to 600 amps _ 60L amps to 1000 amps_ Over 1000 amps/volts Reconnect Only b Nunber COHPLETE FEE SCEEDULE BELOV Nev Residential-Single or Multi-Famil-y per dvelling unit. Service fncluded:ftems Cost 1"000 sq.ft. or less Each add i. t i onal 500 sq. ft or portion t hereo f Each Manuf'd Home. or Modular Dvelling Service or Feeder $ 8s.00 s ls.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: ln OL 3 A Add res s_ Ci ty-- Phone B C D E s s0.00 s 60.00 $100.00 s130. 00 $300.00 $ 40.00 s 40.00 $ ss.00 $ 80.00 see rrBtr $ 2.00 Sum aEove ln-ooExoi::ation Date Constr Contr. Number Signature of Supervising Electrician 0vners Name Address Z?ZT € C? Ci ty ,5/16 02 Phone 2ea ?937 O\INER INSTALLATION 200 amps''or 1 201 amps to 4 0ver 401 to 6 0ver 600 amps ess 00 amps 00 ampsor tOo0-vo[s The installation is be proper tY I ovn r+hi ch i for sale, lease or ren Ovners Si DATE: RBCEI Nev, Alteration or Extension Per Panel One Circui t Each Addi tionaf Circuit or vith Service or Feeder Permit $ 3s.00 SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL Miscellaneous (Service/feeder not included) -Each instal-lation Pump or irrigation $ 40.00 t iilited Energy/Res - $ 20.00 ing SN made on ot intended 5 r( L( LtRECEIVED B Temporary Services or Feeders Installation, Alteration or Relocation sr .GFI€LO ELECTRICAL PERHIT Job Nu.mber COHPTJTE FEE SCEEDTILE BELOV Nev Resj.dential-Single or Hulti-Family per dvelling unit Service Included: I tems 1 TI F TNS \qffihi'iffK11l'r fuiluz\ rzrT Permits are non-transferable anU expireif vork is not started vithin 1B0 daysof issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI..ATTON ONLY ctricaL Contractor Add s Ci ty Ph Supervisor cense Nu r Expiration Dat Constr Cont r. Uu* o{(.\Y Expiration Signature of Ovners Name %F 225 FIFTE STR.EET SPRINGI'rELD, OREGON g INSPECf,ION REQIIEST: OFFICE: 726-3759 ,lA: W#iitr*'n natui6 3 A 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Hanuf'd Home. or Hodular 'Dve11ing Sertice or Feeder Services or Feeders Installation, Alterations or Relocation: Cos t s 85.00 s 1s.00 s 40.00 s s0.00 s 60.00 $100.00 s 130. 00 s300.00 s 40.00 Sum aEove B D. 200 amps or less 201 amps to 400 amps -401 amps to '600 amps -601 amps to 1000 amps_ Over 1000 amps/volts Reconnect On1y 200 amps''or less -l201 amps to 400 amps over 401 to 600 amps -Over 600 amps or 1000 volTs Branch Circuits Temporary Services or Feeders Installation, Alteration or Relocation $ 40.00 s ss.00 s 80.00 see (Brt 40.00 40.00 20.00 36.00 oO, 4D__ Ad Ci ALTATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. Ovner Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/OutIine Lighting- Limited Energy/Res . Limited Energy/Comm 5. SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee.TOTAL dre s Phone s s $ $ DATE: RECETVED tu - ,-tn*rl$l C. F I ) Springfi Oregon 97477 . Devetopmerlt City of eld,itt{oaB.D services225 Fifth Streer, Springfield, Address Propsrty Owner PhonE: : Zlo 37 Tax Lot:?3/ Slte Address tr Springflold, Oregon Jo. No. of us land use UGB Tax Map N @1,,,, e ouantltY-, Source Locatio Profect W-excAVATroN, ou G RA t:DIN Ou Phone Destlna Suppller Address EI- t"-,l-LrN Fggrlr:!-Qaraou^antrtv of materiar, propertv rines and descrrotlot number. Sl ""r'0"%.i.;p'ij;ili'g,,tp$i3.i1iis.1ll[iiii1e,ffi 1a;.;i-i!ffi ts'n]]ltT.'^' tr tr tr tr E DRAINAGE, POLLUTTON AND EROSTON CONTROL PLAN cRoss sEcTtoNs, ADDTTIONAL INFORMATION, SOILS & GEOLOGY PLAN, REPLANTING PLAN STATE PHON STA PHONE CITY CITY ADDRESS COMPANY ruArUC PROJECT SUPERVISOR: COMPANY NAM PBOJECT SUPEBVISOR: ADDRES EMERGENCY PHON PHON tr IP:- OFFICE PHoN MOBILE PHONE ADDRESS: Explratlon Date: CITY: CONTRACTOR NAME: STATE: .Z PROJECT SUPERVISOR: Registratlon Number: Fr EuIII A. z orF u lJJFJ oz LU U zr u,o oz J z o E a 5o g u. E u,o o 6 I 8y rlonature. I rtatc and lgree. thtl I hrvc carctully cxamlned thc completcd rppllcrtlon rnd do hereby certlly that alllnlormatlon hcrcln lr rue aid loniit. rno t-tririirii'cliiliy-iiiiti',iir-ni'i'"riilork'performed_shar bc done rn accordancc wlththc ordinancot ot tht cltv ol. sprlnsiiilq;!iliid;.bio airi 'si;;d;A.6iilili.ilonr rnd D,wlnsr, lnd rhr laws ot rho srrr! or3iif"d^rilS,,,18Er,t1ii"ryi,,:j:#l:rrl"i:Xir. r iunrii? ;;;i'r,/ i[.r';;ivl?nracio,i ;;;i;;i-r6;]ci.wr,.,i i,iin ;ft;ii;;;' l[i!i'i[i!i'li8iilJ,l!,#1it1:'q'.',Eif'.TJLll':ff'Ji'"'.',,fll lill..f,:,r,1" !. ono v.rr perrod ro,ov r;qil;ii.i,i'iitiinl-rii',i[i.ro iliiirairaiEiipildri ro rni ciri. irrc i:diit;".ilfi,tTlf,i,,,,llifg,,i,1.r,,l","fifir]rJfip]rflo:l( i:i.Xll,iil.r:llyJ:fLiill'Si,?:li1;:";1,,1";igiif,.Ell,;lj"rglL:,J:'uffdHi'#;ifi3itT;, ,r,; ai';iih;iifi; arc rcqucttcd at thc propcr tlme, thrt prolcct on thc rttc .t lll tlmca durlng conrtruitloh. rddrcss lc readable from Slgnrturo thlt rll planr tcmaln Date - .:'d ration tal-zEI E-&U Hl- uol-U dFzoU 4utz Bo ' ut ts : zo l- u,lrtt-J oz -l I tr w- tr WETLANDS, Descrlption_ FLOOD PLAIN, Zonet (=- , FEMA Community Panel No. FLOOOWAY, FEMA Community Panol No.: _, Date E storm, E Ditch, O culvert,A DRATNAGE, $20.00 $30.00 e40.00 $40.00 For the lirst 10,000 cublc yards, plus C20.00 for cach oddltlonal 10,000 cublc yards or fraction thereof. 1220.00 For the flrut 100,001 cublc yrrdt, plua t20.00 for each additlonrl 10,000 cublc yards or fracrlon thsreof. t340 For thc llrst 200,001 cublc ygrds, pluc 16.00 for cach additionol 10,000 cublc yards or fractlon theroot. 930.00 $30.00 For the first 100 cublc yards, plus t14.00 for oach eddltioncl '100 cublc yords or fraction rheroof. tl50.00 For the liret 1,000 cubla yarda, plus 912.00 for each Edditlonsl 1,000 cublc yards or fractlon thsr€of. t264.00 For tho lirut 10,000 cublc yordr, plus t54.00 lor each addltlonol 10,000 cublc yards or fraction thereol. 9760.00 For the flrst 100,001 cublc yards, plus 930.00 lor each additional 10,000 cubic yards or fraction thereof. Date: EO +<- Date:Recelpt Date Plan Check Fee Estlmated Volume 1.001 TO 10,000 cuBlc YARos 10,000 To 100,000 cuBtc YARDS 100,001 To 2q0,000 Becelved by: Becelpt: Grading Pormlt fee: Received GRADING PERMIT FEES: UP TO lOO CUEIC YARDSl0l To 1,000 cuBtc YABos PLAN CHECK FEES: UP TO lOO CUBIC YARDS 101 TO 1,000 cuBtc YARDS 1,001 To 10,000 cuBtc YARos r0,000 To 100,000 cuBrc YARDS 100,001 To 200,000 200.00r cuBrc YARos oB MoRE n ET w tr Date: Malntenance: PI 2 DateEngineering Bullding:Date: Date FI =d, TU O- zc IF d, LUFJ oz LJ.I U z I tro oz J Permit Number Date:lssued by Final lnspeetlons.. Malntenance: Date Date: Planning: Engineerlng: Building: .Date Date .i!'..; ;.:..ti i:, ll, a .l i,..,.i.'*.iI utEIu- o'rI Bu,l ll,c,//, ,n; -