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Home My WebLink AboutPermit Building 2004-08-09Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004EXPIRES: 03/1012005VALUE: $ 16,860.00 SITE ADDRESS: 2266 5TH ST ASSESSOR'S PARCELNO.: 1703262104500 PROJECT DESCRIPTION: Addition to existing SFR Owner: CUMMINGSBRUCED&pA Address: 2266 NORTH 5TII ST SPRINGFIED OR 97477 Contractor Springfield TYPE OF WORI(: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-912-0954 CONTRACTOR INFORMATION Contractor Type General Electrical SWAN Expiration Date 04t24t2005 04t23t200s Phone 541-896-9470 541-729-6s70 Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo oflot Coverage: I 13.00 Wall Heat Path I nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: 150 \S1 # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 21.00 0.00 Street Improvements: Storm Sewer Available: Special Instruction:Storm drainage shall be Notes: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Description Type of Construction Pase 1 of3 Value Date Calculated # of Units: Primary Occupancy Group: FIELD Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax S4l-7 26-37 59 Inspection Line PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004EXPIRES: 03/1012005YALUE: $ 16,860.00 Bid Amount Dwellinss Use Bid Amount V Wood Frame $r.00 3,000.00 $92.40 150.00 Total Value of Project Date Paid $3,000.00 $13,860.00 $16,860.00 07n6t2004 06t30t2004 Amount Paid Receipt Number 1200400000000001009 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 1200400000000001334 1200400000000001334 1200400000000001334 1200400000000001334 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/o Administrative Fee + 77o State Surcharge Building Permit Dryer Vent Fixture Minimun/Adj ustment Mechanical Plan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet + l0o/o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid $90.09 $10.00 $26.60 $18.62 $162.00 $6.00 $14.00 $39.00 $5.07 $103.26 $135.84 $14.13 $43.s0 $45.00 $7.s0 $s.2s $12.00 $63.00 6t30t04 8t9104 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 9t10t04 9n0t04 9n0t04 9n0t04 $800.86 Fees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 07t0u2004 07t02t2004 07t02t2004 07t02t2004 07n5t2004 07t06t2004 APP APP APP LLH TAJ MS 71612004 - As per discussion ilapplicant on71612004 @ 5:00 PM, there will be one toilet, one shower, and one sink located in the new addition. SDC charges were made accordingly. - MS 71612004 - Storm drainage shall be directed to existing. - MS 0710212004 07n6t2004 APP DLM To Request an inspection call the24 hour recording at 726-3769. AII 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. Paee 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004 EXPIRES: 03/1012005VALUE: $ 16,860.00 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. 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. 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. 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. 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 Paee 3 of3 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ^ity of Springfield Oflicial Receipt revelopment Services Department Public Works Department RECEIPT#: 1200400000000001334 Date: 0911012004 e:52:10AM Job/Journal Number coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + ljYo Administrative Fee Amount Due 63.00 12.00 5.25 7.50 Item Total:$87.7s Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard ANTONEELECTRIC djb 390972 InPerson $87.75 Payment Total: -58ffi 911012004 Page I of I KTTrc SFEIfiIGFITLD City of Springfield Development Services Deparfrnent Community Services Division, Building Safety 541-725-3759 Phone 541-726-3676Fax August 1,2005 CUMMINGSBRUCED&PA 2266 NORTH 5TH ST SPRINGFIED, OR 97477 Date Permit Issued:81912004 Permit Number:coM2004-00796 Location:2266 5TH ST Project Description:Addition to existing SFR Dear Permit Holder: Recently, our office sent you a letter notiffing you that your permit(s) was about to expire. Because you did not contact us to request an inspection or to call us to veri$r that progress has continued to be made on the project, your permit(s) has expired. This letter is a reminder that the above referenced permit(s) expired on7llll2005. Please contact our office at Springfield City Hall, 225 Fifth Street, Springfield, Oregon between 8:00 a.m. and noon or between 1:00 p.m. and 3:00 p.m. Monday through Friday, excluding holidays prior to continuing work on your project. There are additional permit fees that are due in order to complete your project. Lisa Hopper Building Safety Supervisor City of Springfield 225 Fifth Street, Springfi eld, OR 97 477' 511-726-3759 Phone 541-126-3676Fa;x June 30,2005 CUMMINGSBRUCED&PA 2266 NORTH 5TH ST SPRINGFIED OR 97477 Job Number: Location: coM2004-00796 2266 5TH ST Project:Addition to existing SFR Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at2266 5TH ST which is set to expire on 7llll2}O5. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notiff you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do not request an inspection prior to the expiration dpte, your permit(s) will expire and additional permit fees will be required in order to complete your project' If you have any questions, please feel free to phone me at 541-726-3790. Sincerely, Lisa Hopper Buiiding Safety Supervisor I U)$, 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: E LECTRI CAL P ERM IT AP P LI CATI O N Ciry Job Number (tYfi Ze<-,tl - UO 7 tr G Dare 1. LOCAT'ION Ob- INS'I'ALIAT'ION SCHEDLiLE 2766 s+k >'|- LEGAL DESCzuPTION JOB DESCzuPTION ?rlC /(-1124^'1 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. .,CONTRAC'TOR Electrical Contractor Address City Phone A.Nerv Residelrtial - Single 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 \ $106.00 $ 19.00 $s0.00 $ s0.00 $ 69.00 $ 100.00 $ s0.00 s 50.00 $ 25.00 s 45.00 Fee is $45.00 * Surcharges Alterations or Relocation : I ..2/ /-,'-. $ 63.00 Supervisor License Nunrber Expiration Date O Constr. Contr. Number tq;4 30dExpiration Date Signature of Supervising Electrician In 20r Amps Amps $ 75.00 $ 125.00 s163.00 $375.00 $ s0.00 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Voits see "B" above. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 1 bJ $\o \hs c \' \e D. E. ownersNu*"Er vLc{ e'^^.^t s Address Z266 5+t\ >T City SFrI Phone OWNER INSTALLATION The installafion is being made on properfy I own which is not intended for sale, lease or rent. Owners Signature: 7%o State Surcharge 10% Adminisffative Fee TOTAL /Z 7{ 5z'aeg7?f Pump or S Limited Minimum Inspection Request: 726-37 69 4. Shared Drive(T:)/Building Fonns/Electrical Pennit Application l-03.doc o 3. Services or Feetlers Installation ABOW 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: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004EXPIRES: 03/1012005VALUE: $ 16,860.00 SITE ADDRESS: 2266 sTH ST ASSESSOR'S PARCEL NO.: 1703262104500 PROJECT DESCRIPTION: Addition to existing SFR Owner: CUMMINGSBRUCED & pA Address: 2266 NORTH sTH ST SPRINGFIED OR Springfield TYPE OF WORI(: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-912-0954 Contractor Type General Electrical # of Units: Primary Occupancy Secondary Occupancy 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: Notes: SW di\ne of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 21.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo ofLot Coverage: 0.00 Storm drainage shall be directed to -MS $e $ Per Sq Ft or multiplier License 113128 145436 Expiration Date 04t24t2005 04t23t2005 Phone 541-896-9470 s4t-729-6570 1 13.00 Wall Heat Path I nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 150 !.$ Sidewalk Type: Downspouts/Drains: PARI(NG Square Footage or Bid AmountDescription Type of Construction Pase I of3 Value Date Calculated \) Valuation Description I UI' V I1,L(JTIVII],N T TN T' UI(IYIA I IU1\ I FIELD Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004 EXPIRES: 03/1012005VALUE: $ 16,860.00 Bid Amount Dwellinss Use Bid Amount V Wood Frame $3,o0o.oo $13,860.00 $16,860.00 0711612004 06t30t2004 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0%o Administrative Fee + 7%o State Surcharge Building Permit Dryer Vent Fixture Minimum/Adj ustment Mechanical PIan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet + l0oh Administrative Fee + l0o/o Administrative Fee + 77o State Surcharge + 1Yo State Surcharge Add, Alter, Extend Circ Ea Add Fixture Perm Serv/Fdr 200 amps or less Total Amount Paid $1.00 3,000.00 $92.40 150.00 Total Value of Project Date Paid 6t30t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 8t9104 8t9t04 8t9t04 8t9t04 9n0t04 9fiot04 9n0t04 9lt0t04 9n0t04 9n0t04 9lr0l04 Receipt Number 1200400000000001009 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000r98 3200400000000000198 1200400000000001336 1200400000000001334 1200400000000001336 120040000000000r334 1200400000000001334 1200400000000001336 1200400000000001334 Amount Paid $90.09 $10.00 $26.60 $18.62 $162.00 $6.00 $14.00 $39.00 $s.07 $103.26 $13s.84 $14.r3 $43.s0 $4s.00 $4.20 $7.s0 $2.94 $s.2s $12.00 $42.00 $63.00 $850.00 tr'ees Peid Plan Reviews Initial Review Planning Review Public Works Review 07t0u2004 07t02t2004 07t02t2004 0710212004 07n5t2004 07t06t2004 APP APP APP LLH TAJ MS 71612004 - As per discussion w/applicant on71612004 @ 5:00 PM, there will be one toilet, one shower, and one sink located in the new addition. SDC charges were made accordingly. - MS 71612004 - Storm drainage shall be directed to existing. - MS APP DLMStructural Review 07t02t2004 07n6t2004 Page 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004 EXPIRES: 03/10/2005VALUE: $ 16,860.00 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. 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. 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. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to coyer or placement of concrete. Rough Plumbing: Prior to cover 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. 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 l/ro/o? Owner or Date Pase 3 of3 Keourreo Inspectrons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone -rty of Springfield Official Receipt --,evelopment Services Department Public Works Department RECEIPT #: 1200400000000001336 Date: 0911012004 11:41:10AM Job/Journal Number coM2004-00796 coM2004-00796 coM2004-00796 Description Fixture + 7o/o State Surcharge + l0% Administrative Fee Amount Due 42.00 2.94 4.20 Item Total:$49.14 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard BRUCE CUMMINGS djb 113625 In Person Payment Total: $49. l4 -$Ef4- 9/1012004 Page I of 1 itltHatr.a t{ tEo -i e:t- ('l t t'r n 5l z o fi fr Lr U tr (.i C E z o{ I o g -1lrl Z ^t - ,..i.-j ..i , . r'J ,'r U' 'ii 'i ." ..^,'' f.ll 'j.- -1 .;r 'T" T ::i:iv. ,. !|. ||| )t' :'i-i ;rli* L. \- '-!-,-./ ** *' i -l: rj ';r'ri = ,.: Jr: d r'd l:t ' 'r-t.-. .r/:l- t: !, -* {:n=a k\.-..,1: r \fl a ", !".: t | .r- -:t 'al\J -.''r"J li!. t' 7 n r1 U:;: }:1._' r:.: _ft.grlj a rJ u) -'- '-:; ':,- lt?r- \il t .'\it* I tr'!.LJ {'\t-i LT; fli, P€'Ir't'Aui G\Z \ 1b\ It r5{tNl. 4 tt lX*rr..l fou sf4tb{ Natt filebu- @, Ey,+{iu u I,lcw- farexp€ $,tf't}V1 {e'tt t+ ,{ W*u- d,l'54)^Jb Lwmtt 6 t IU 0d , ll $u .-)' ? io /\u o Zo '// ?i ;./ I Ffr"l ? 4 @@ 1 I \0rrlut i:n^r D*wtUJ*-I /r"= z I cF. SCrt LA = A }. \ F\n '.'1,, Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004 EXPIRESz 0210912005VALUE: $ 16,860.00 SITE ADDRESS: 2266 sTH ST ASSESSOR'S PARCEL NO.: 1703262104500 PROJECT DESCRIPTION: Addition to existing SFR Owner: CITMMINGS BRUCE D & PA Address: 2266 NORTH sTH ST SPRINGFIED OR 97477 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-912-0954 Contractor Type General Electrical Contractor SWAI\I DOOR INC AI\TONE ELECTRIC Expiration Date 04t24t2005 04t23t2005 Phone 541-896-9470 54t-729-6570 ffi # 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: NOTICE: THIS PERMIT # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VN I 13.00 Wall Heat Path I nla NTION: O REQUIRED PARI(NG Total: Handicapped: Compact: 150 21.00 Paved Drive Rqd: o/o of Lot Coverage: rules a dopted b regon law requlres youto0.00 Storm drainage shall be directed to ryJJ#gBEf D Cii i\,,1t'riE NC ED Square Footage or Bid Amount DEVELOPMENT INFORMATION ANY 1BO DAY Paee 1 of3 Value Date Calculated UIL l.I\ I (,-TUVIA l. IIJI\ I License tt3t28 145436 Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00796ISSUED: 0810912004 APPLIED: 06/3012004 EXPIRESz 0210912005VALUE: $ 16,860.00 Bid Amount Dwellings Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10Yo Administrative Fee + 7o/o State Surcharge Building Permit Dryer Vent Fixture Minimum/Adjustment Mechanical Plan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Total Amount Paid Use Bid Amount V Wood Frame $1.00 3,000.00 $92.40 150.00 Total Value of Project Date Paid $3,000.00 $13,860.00 $16,860.00 07tr612004 0613012004 Amount Paid Receipt Number 1200400000000001009 3200400000000000198 3200400000000000198 3200400000000000r98 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 3200400000000000198 $90.09 $10.00 $26.60 $18.62 $162.00 $6.00 $14.00 $39.00 $s.07 $103.26 $135.84 $14.13 $43.s0 $4s.00 6t30t04 8t9t04 8t9t04 8t9t04 8t9104 8t9t04 8t9t04 8t9t04 8t9t04 8t9t04 819104 8t9t04 8t9t04 8t9104 $713.11 tr'ees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 07t0u2004 0710212004 07t0212004 07t02t2004 07fis12004 0710612004 APP APP APP LLH TAJ MS 71612004 - As per discussion dapplicant on71612004 @ 5:00 PM, there will be one toileto one shower, and one sink located in the new addition. SDC charges were made accordingly. - MS 71612004 - Storm drainage shall be directed to existing. - MS 0710212004 0711612004 APP DLM To Request an inspection call the24 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Paee 2 of3 Reouired Insnections F Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00796ISSUED: 0810912004APPLIED: 06/3012004 EXPIRESz 0210912005VALUE: $ 16,860.00 Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. 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. 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. 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. Final Mechanical: When all mechanical 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 Springfietd 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 Page 3 of3 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 3200400000000000198 Date: 0810912004 1l:06:33AM Job/Journal Number coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 coM2004-00796 Description Storm Sewer - lst 50 Feet Dryer Vent Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- Plan Review Residential + 7o/o State Surcharge + l0% Administrative Fee Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Amount Due 45.00 6.00 39.00 10.00 5.07 18.62 26.60 43.50 135.84 103.26 14.r3 162.00 14.00 Item Total:$623.02 Paymin-s: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check BRUCE CUMMINGS lkw 4023 In Person $623.02 Paym ent Total : -5623.-67 8/912004 Page I of I ry,r JOL]RNAL OR JOB NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET Bruce 2266 Street 17032621 Tax Lot 04500 SINGLE FAMILY RESIDENCE 0 BUTLDTNG SrZE (SF) 0 LOT SrZE (SF):0 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I rMPER\ToLJSSR xl-T5ddo- IMPERVIOUS S.F 0.00 NUMBER OF DFU's 6 B. IMPROVEMENT COST: NUMBER OF DFU's 6 COST PER S.F $0.290 COSTPER S.F $0.290 COST PER DFU s22.64 COSTPERDFU $t7.21 NTIMBER OF UNITS 0 NUMBER OF UNITS 0 ADM. FEE RATE 5% CHARGE $43.50 DISCOUNTRATE 50% $43.s0 DISCOI.INT $0.00 x x x x x x x x ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: ITEM 2 TOTAL - CITY SANITARY SEWER SDC $239.10 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE 9.57 B. IMPROVEMENT COST: ADTTRIP RATE 9.57 SUBTOTAL $282.60 xx xx COST PER TRIP st7.23 COST PER TRIP s76.01 $0.00 NEWTRIP FACTOR 1.00 NEWTRIP FACTOR 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER- MWMC A. REIMBURSEMENTCOST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NLIMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL. MWMC SANITARY SEWER SD( : SUBToTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEE: $0.00 $282.60 CHARGE $ r4.13 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Matt Stouder 8/t012004 COSTPERFEU s314.63 $0.00 $0.00 I I $296.73 1070 1091 t092 1093 1094 1055 1056 t079 1078 aHAo O &r!tr U) r r'l r!& 1IE COST PER FEU s2t4.23 PREPARED BY DATE TOTAL SDC CHARGES x DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OFNEW FD(TURES x UMT EQUTVALENT: DRA]NAGE FXTURE UNITS FOR CArcULATE ONLY TI{E NET ADDITIONAL NO. OFFIXTURES LINIT FIXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NLIMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS rsa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAINAGE FIXTURE UNITS 0 *EDU BATHTUB 0 0 3 0 DRINKING FOTJNTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 o 0 LALINDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTORFOR REFRIG/ WATER STATION/ ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWER, SINGLE STALL 1 0 2 2 SHOWER, GANG TNI.JMBER OF HEADS)0 0 2 0 SINK: COMMERCIAURESIDENTIAL KITCHEN 0 0 3 0 SINK: COMMERCIALBAR 0 0 2 0 SINK: WASH BASIN/DOLIBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 1 URINAL, STALL/WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 1 0 3 3 6 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 0 0 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE/ IOOO $0.00 CREDITRATE s5.04x I so.oo CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/ IOOO CREDITRATE $0.00 x $5.04 TOTAL MWMC CREDIT I so.oo BEFORE 1979 $5.04 1979 $5.04 1980 $4.95 198 I $4.88 1982 $4.75 1983 $4.58 1984 $4.41 1985 $4.20 1986 $3.88 1987 $3.50 1988 $3.07 1989 $2.60 1990 $2.14 l99t $1.71 1992 $r.52 1993 $1.38 1994 $r.19 1995 $1.03 1996 $0.87 1997 $0.68 1998 $0.46 1999 $0.27 2000 $0.09 2001 $0.04 l-o-