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Home My WebLink AboutPermit Building 2006-04-24Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line CITY F Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006 APPLIED: 0312012006 EXPIRES: 0112512007VALUE: $ 35,343.00 SITE ADDRESS: 247 l0TH ST ASSESSOR'S PARCEL NO.: 1703351419700 PROJECT DESCRIPTION: Addition to existing single family residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-543-7714Owner: Address: Contractor Type General Electrical MERLE STENSGAARD 247 IOTH ST SPRINGFIELD OR 97477 Contractor KIVIL CUSTOM CONTRACTORS INC OWNER License 168596 Expiration Date 02nst2008 Phone 541-942-3857 CONTRACTOR INFORMATION )RMATION # 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: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: %" of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 357 Setback 5' Curb and Gutter R-3 VN Wall Heat Path I nla REQUIRED PARKING Total: Haridicapped: Compact: 11.00 Fully Improved Yes Sidewalk Type: Downspouts/Drains: Notes: Storm drainage piped into existing to curb flace 3127106 CAS DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Pase I of3 rLr+). D Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006APPLIED: 0312012006 EXPIRESz 0112512007VALUE: $ 35,343.00 Description Dwellinss Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 357.00 Total Value of Project Amount Paid Date Paid Value $35,343.00 $35,343.00 Date Calculated 03t20t2006 Fee Description Plan Review Residential -Mechanical Issuance Fee- + lOoh Administrative Fee + 87o State Surcharge Building Permit Fixture Minimum/Adj ustment Mechanical Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan + l0oh Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + l0oh Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Receipt Number r 2006000000000003 l s 2200600000000000504 2200600000000000504 2200600000000000s04 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 1200600000000000950 1200600000000000950 I 200600000000000950 12006000000000009s0 1200600000000001 142 1200600000000001 142 l 200600000000001 142 I 20060000000000r 142 $187.69 $10.00 $40.38 $32.30 $288.7s $70.00 $39.00 $133.49 $175.49 $22.12 s133.40 $6.00 $5.20 $4.16 $43.00 $9.00 $19.50 $15.60 $6.00 $189.00 $1,430.08 3t20t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24/06 4t24t06 4t24t06 4t24t06 6t23t06 6t23t06 6t23t06 6t23t06 7t26t06 7t26t06 7t26t06 7t26t06 Plan Reviews Initial Review Planning Review Public Works Review Structural Review 03t2u2006 03t2u2006 03t2U2006 03t2u2006 03t29t2006 03t27t2006 APP APP APP LLH TAJ CAS No Planning issues. Storm drainage piped to existing to curb face 312712006 CAS 03t2u2006 04n4t2006 0K RJB 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 Valuation Descrintion F ees raro I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006 APPLIEDz 0312012006 EXPIRESz 0112512007VALUE: $ 35,343.00 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. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor 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. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Electric Service: Approval required prior to utility company energizing service. 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, thaittre permit card is located at the front of the properfy, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pase 3 of3 Date o0, -: __! Kequlreo rnsDecuons I Cik' of Springfield Official Receipt L .rlopment Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone RECEIPT#: 1200600000000001142 Date: 0712612006 9:25:50AM Job/Journal Number coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10%o Administrative Fee Amount Due 189.00 6.00 I 5.60 19.50 Item Total:$230. I 0 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check KIVIL CUSTOM CONTRACTORS ddk tt42 In Person Payment Total:$230.10 $230. r 0 cReceinl I Page I of I 7t2612006 CITY OF SPRINGFIELD, OREGON SPEI LDL -1-D? -Z,oz>Q * UJ 225 FIFTH STREET o SPRINGFIELD, OR 97477 o PH:(341)72G3753 o FAX: (Yl)72G3659 E LECTRICAL PERMIT APPLICAru ON City Job Number f a,pt?-<> o L -C>O 32 1 Date 1. LOCATIONOFINSTALI-ATION 3. COMPLETE FEE SCTTEDULE BELOW IZt1-7 lO+t S+ LEGAL DESCRIPTION A. New Residential - Single or Multi-Family per dwelling unit. Service Includedl?o3s s/Y | ?zoo JOB DESCRIPTION l- Serc ' ro* Su,s ,/Z Permlts "/. nor-tr"n.r/ro,u ana expt/trwork ls not started withln 180 days of issuance or lf work is Suspended for 180 days. 2. OoNTRACTOR TNSTAT,LATTON ONLY Electrical Contractor Address Phone Supervisor License Number fuv n $tT Expiration Date V Constr. Contr. Number Signature of Supervising Electrician Owners Name S'rf r^ Address Zq1 City 5?,-\ phone S{3 - -77r OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners 1000 sq. ft. or less , Each additional 500 sq. ft. or 6. t /c-* i l\portion thereof City B. Services or Feeders - Installation, Alterations or Rplocation: 2ooAmpsorless 3 $63.00 1t^7 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts 5375.00 Reconnect Only $ 50.00 C. Temporarl'Services or Feeders Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 6e.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts sec "8" above. D. Branch Circuits ! ,h New Altemtlon or Extenslon Per Panel !- One Circuit Each Additional Circuit or with Service or Feeder Permit C E. Miscellaneous (Service/foeder not included) -Each Installation V Pumo or irrisation $ 50.00 - Sign/Outline Lighting $ 50.00 Limited EnergyiResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Elettrlc Permit Inspection Fee is $45.00 * Surchrrges I qf I tLo l?fo Zjo ,O Each Manufact'd Home or Modular Dwelling Service or Feeder 4, SUBTO:TAL OF ABOVE 8% State Surcharge l0% Administrative Fee TOTAL $106.00 $ 19,00 $s0.00 s 43.00 /$ 3.00 La 0+L \ Inspectlon 126-3769 Sharetl Drive(T:)/Building Forms/Electrical Permit Application l -06.doc r\^ Expiration Date Construction Contractors Board Pennit u,Cr5ffUzr:.{e - OO3Aq Address:?qt tM Issued by:Date:1 a Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exernpt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, alnd either box 3A or 38: W 1. I own, reside in, or will reside in the completed structure. n 2. I understand that I must become licensed as a construction contractor if the stucture is sold or offered for sale before or on completion. 3,{.. My general contractor is (Name)(ccB #) I will instuct my general contactor that all subcontractors who work on the stnrcture must be licensed with the Constnrction Contractors Board. OR 38. I will be my own general conffactor.{ If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the 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. 6 -a-oL of )@ate) (Ilhite copy to issuing agency permitfile, pink copy to applicant-) Property_owner.doc 06-0 1 -04 700 Summer St I\tE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 50Ba7E462l WebAddress:!gry.gs1!g!g Acting as hur Own General Cdmtractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CON$TRUCTION RESPONSIBILITIE$ Ifyou are existing structur:e E mployer Responsibilities You will, in mqst instances, be ruled to pe an "employer" and the contractors you contract with will be "employees" if you lrse con$acto(s not licensed with the Constructi.on Contactors Board to do labor in constructing or to issist in the constuction or ipproypgpnt qf.a.resi{qntial stuctgr:e. Aq lhe employer, you-mus{ comphr with thb-fottowing: Oregon's WiltnotAing Tax Law: As an employer, you must withhold income taxes fromtitrployee w€es at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Departrnerrt of Revenr.le at 503-3784988. { ' Unemployment fnsurance Tax: As on employer, you are required to pay a tax for rmenrployment insurance purposesi on the wages of all employees, For more information, call the Oregon Employment Departmental503-947-1488. The Oregon Business Identification Number (BII.{) is a combined number for both Oregon Wit}rbolding and Unernployment Insurance Tax. To file for a BlN, call 503-945-8091 or w-ww.dpr.Slalp.qr.udfo ls y. for the appropriate forms. W'orkers' Compensation Incurance: As an employer, you are subject to the Oregon Workers' Cornpensation Law, and must obtain workers' compensation insurance tbr your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable far all claim costs if one of your employees is injured on the job. For more informatioa, call the Workers' Compensation Division at the Deparlment of Consumer and Business Services at 543-947 -7 815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax'from employees' wages. r' You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, eall the IRSafT:80tr-82949t3 or visit their web site at luurujtl&y ; Other Responsibilities.and Areas of Concerns .r Code Compliance: As the permit hclder for this project, you are responsible for resolving any failure tii meet code requirements that may be brought to your attention through inspections. Liability aud Propertf Dainage Insuradif: ' Contact your insrtrance agent tb see'if you fravd'adtQu?tC ifisrlance coverage for accidents and omissions such as falling tools, paint over spray, water damage, from pipe punctures, fire or work that must be redqre. -. =,. . ,',,,,.r)--i i-- ' .- ^; ,\ .1 " :i , ,'..\ - .-.,..r. ::.i ,. 'r .- Time: Makesureyouhavcsufficienttimetosuperviseyouremployees. ,.. ,.__ .: . :,,'.,'\,; i Expertise; Make sure you'have the skills to ict as your own general contractor, to coordinate the work of rough-in and finish hades, and to notifu building officials as the appropriate times so they can perform the required inspections. lf you have additional questions call the Construction Contractors Board {5A34784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property-owner. doc 06-0 I -04 NOTE: This tnformation Notice to Praperty Awners about Construction Responsibi/ilr'es was dovelaped by the Construction Contractors Eoard in accordance with ORS 701.055(51, passed by the 1989 Aregon Legislature. Construction Contractors Board Permit #: CO\42OO6-. :29 700 Sununer St I\E Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us Address:247 l}th Street, Springfield Oregon Issued by:David Bowlsbv Date: 06 /2312006 Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. Tltis statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38: N @ 1. I own, reside in, or will reside in the completed structure. tr 2. I understand that I must become licensed as a construction contractor if the shrrcture is sold or offered for sale before or on completion. f 3A. My general contractor is (Name)(ccB #) I will instrrct my general contractor that all subconffactors who work on the strrcture must be licensed with the Construction Confractors Board. OR tr 38. I will be my own general contactor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the 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. @ate) Property_owner.doc 06-0 I -04 of copy to issuing agency pennitfile, pink copy to applicant.) Acting as Your Own General Contractor? INFORMATION NOTIGE TO PROPERTY OWNERS ABOUT CONSTRUCTION RE$PON$IBILITIES If you are existing structure, E mployer Responsibilities Youlg! inmgsf inggqgg;, f" ry1"19 f an l'employer" and the contractors-r9}3oa!act.5:$ yltt lil,eq1l9ry,.*t.,1f you u.e contraclors "otliee"ieO wXnliamnetru"{i,on Conkactors Board to do laborin conltmcting oitn assist in the tonstr*ction or improrement of a residential sEucture. As the employer, you must comply with the follon'ing: Oregon,s Withhdlding Tax Law: As an employer, you must withhold income taxes from employee wages at the time **pioy"". are paid. *ou will be liable for the tax payments even if you don't actually withhold the tax from your "*ptoy".r. For more information, call the Dcpartmart of Rerrenue at 503-378-4988' \.J Unemployment Insurance Tax: As an employet, you are required topay a tax for unernploymert insuranee purposft: on the wages of all employees. For more information, call the Oregon Employment Department at 503-94?-1488. 'i., The Oregon Business Identification Number (BN) is a combined.srnber. for both Qregoa Withholding and Unemployment lnsurance Tax. Tc file for a BIN, cali 503-945-8091 or wwu,.dor.state.or.us/forqspay.htmll for the Workers, Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must oitain workers' compensafion insurance for yow employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your #mployees is injured on the job. For more information, call the Workers' Compensation Division at the Departma* of Consumer and Business Services at 503-947-78 1 5. U.S. Internal Revenue Service: As an employer, you must withhold federal incorhe tax from ernployees'wages' you will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the lRsqm,l:i880r8294933 ot visit' their uryb ttte ttmruiiis'eav Other Responsibilities and Areas of Concerns Code Compliance: As the perrnit holder for this project, you are responsible for resolving any failure to meel code requirepentsthatmaybebroughttoyourattentionthroughinspecticns'. Liability and ?roperfy Damage fnsurance: Contact your insurance agent to see if you have adequate insurrhce "ro.rug" for accidJnts and omissions such as falling tools, painl over spray, water damage from pipe punctures, fire or rvork that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you havb the itittg to act as your owrr general contractor, to coordiiiate the work of rough-in *J finirtr trades, and to notifu building officials as the appropriate times so they can perform the required inspections' If you have additional questions call the Construction Contractors Board (503-3784521) or write the agency at PO Property_owner. doc 06-0 I -04 I fVOff, This tnformation Notice to Property Or,vners about Construction Responsibitities was devetoped by the I I Construction Contractors Eoard in accordance with ORS 701.A55$), passed by the 1989 Oregon Legislature. I C'TYOFSPR'NGFJE OREGON siPRIItlGFTELD D EV E LO P M E NT S E RVI C ES D E PA RTM ENT July 12, 2006 Merle Stensgaard 247 l}th Street Springfield, Oregon 97477 Sincerely ty Division Encl. 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-366e www. ci. s p ri n gf i eld. or. u s Enclosed is a form from the State of oregon construgtign contractors Board that we neglected to have V* lo*pf.te and sign"when you obtained your permits on June 23rd' 2006 for the irnprovements to your residence ui Zql lOth Street, Springfield' Oregon' Please fill in the appropriate "boxes" and sign and-date the form' Please keep the pink copy for you, re"o.d, ind return the white Jriginal form to me in the enclosed self stamped envelope at your earliest convenience' Thank you, and if you have any questions, please feel free to phone me at 726-3753. N '-rlo&ac// SPl{TTTGFIELP ZON INITIALS DATE SOURCE r^ 225 FIFTH STREET o SPRINGFIELD,OR97477 o PH:(541)726-3753 o FAX: (54I)726-3689 ELECTRICAL PERMIT APPLICATI ON City Job Number Date l. LOCATION OF INSTALLATION 3. CAIWPLETE FEE SCHEDITLE BELO\tlh /- <3,< 27dO LEGAL DESCRIPTION JOB DESCzuPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. OONTRACTOR INSTALLATIAN OIVIy Electrical Contractor Address Phone Superwisor License Number Expiration Date Constr. Contr Signature of Supervising Electrician Owners Name Address 247 h S-. OWNER INSTALLATION 50t The installation is being made on property I own which is not intendeci for sale, lease or rent. Owners Signature: A. Nerv Residential - Single or l\'Iulti-Fanrilv pcr 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 $ 106.00 $ 19.00 $s0.00 B. Services or Feeders - Installation, Alterations or Relocation ciry 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over"l 000 Arppsi Volts Reconnect Onty - E. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 63.00 $ 75.00 $ l2-5.00 $ 163.00 $37s.00 $ 50.00 C. Temporary Scrvices or Feeders Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circrrits n,* ^illl,ftil,Lr or*J13 rh,ari$Ahg,. n, xH,fifii,i::T,ff'ffiIfxi+1i*fi;, ?s * lrisceltaneous (Service/feeder not,l*fi&[Eru"ach Installation $ s0.00 $ s0.00 $ 2s.00 $ 4s.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. SLBTOTAL OFABOW 8% State Surcharge l0% Administrative Fee TOTAL .r-\ N),tb zo s6Request: 726-3769 Shared Drive(T:)/Building Forms/Elcctrical Per:nit Application l -06.doc z/ :OREGON civ flft Pn.," Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006APPLIED: 0312012006 EXPIRESz 1211412006VALUE: $ 35,343.00 SITE ADDRESS: 24710TH ST ASSESSOR'S PARCEL NO.: 1703351419700 PROJECT DESCRIPTION: Addition to existing single family residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-543-7714Owner: Address: MERLE STENSGAARD 247 IOTH ST SPRINGFIELD OR 97477 I1.00 Expiration Date 02n5t2008 eouires You to le 1( Contractor Type General Electrical # 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 KIVIL CUSTOM CONTRACTORS INC OWNER License 168596 Phone 541-942-3857 R-3 VN # of Stories: I Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: on Utll ter is 1-800-332 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 357 Wall Heat Path I nla REQUIRED PARKING Total:Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: tlnrl 0l t6qr cl j llt). J, 0 NOONVEV Uld SIHI Fully Improved yes Sidewalk Type: Downspouts/Drains: Setback 5' Curb and Gutter Notes: Storm drainage piped into existing to curb face 3/27106 CAS CONTRACTOR INFORMATION DEVELOPMENT INFORMATI( Page I of3 )Ol€ )tel Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006 APPLIEDz 0312012006 EXPIRESz 1211412006VALUE: $ 35,343.00 Description Dwellinss Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 357.00 Total Value of Project Amount Paid Date Paid Value $35,343.00 $35,343.00 Date Calculated 03t20t2006 Fee Description Plan Review Residential -Mechanical Issuance Fee- + lloh Administrative Fee + 87o State Surcharge Building Permit Fixture Minimum/Adjustment Mechanical Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan + l0o/o Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid $187.69 $10.00 $40.38 $32.30 $288.7s $70.00 $39.00 $133.49 $175.49 s22.12 $133.40 $6.00 $s.20 $4.r6 $43.00 $9.00 3t20t06 4t24t06 4t24t06 4124t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 6t23t06 6t23t06 6t23t06 6t23t06 Receipt Number 1200600000000000315 2200600000000000504 2200600000000000s04 2200600000000000s04 2200600000000000s04 2200600000000000504 2200600000000000s04 2200600000000000s04 2200600000000000s04 2200600000000000504 2200600000000000504 2200600000000000504 r2006000000000009s0 1200600000000000950 1200600000000000950 1200600000000000950 $1,199.98 tr'ees Peid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 0312u2006 0312u2006 03t2u2006 03t2u2006 03t29t2006 03t27t2006 APP APP APP LLH TAJ CAS No Planning issues. Storm drainage piped to existing to curb face 312712006 CAS 03t21/2006 04n4t2006 0K RJB 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. Pase 2 of3 Reouired fnsnections M r:?; Valuation Descrintion 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: COM2006-00329ISSUED: 0412412006APPLIED: 0312012006 EXPIRES: 1211412006VALUE: $ 35,343.00 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. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor 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. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Rough Electric: Prior to Cover 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 Page3 of3 ***?I 225 Fifth Street Springfield, Gregon 97 477 541-726-3759 Phone ' of Springfield Oflicial Receipt Development Services Department Public Works Department RECEIPT #: 1200600000000000950 Date: 0612312006 tr:22:424M Job/Journal Number coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + l0o Administrative Fee Amount Due 43.00 9.00 4.16 5.20 Item Total:$61.36 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check KIVIL CUSTOM CONTR DJB 1116 In Person Payment Total: $61 .36 -$6-i-36-'' cReceint I Page I of I 6/2312006 atililn[in3 F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006APPLIED: 0312012006 EXPIREST 1012412006VALUE: $ 35,343.00 SITE ADDRESS: 247 lOTH ST ASSESSOR'SPARCELNO.: 1703351419700 PROJECT DESCRIPTION: Addition to existing single family residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-543-7714Owner: Address: Contractor Type General Electrical MERLE STENSGAARD 247 IOTH ST SPRINGFIELD OR 97477 ._<o44) Contractor KIVIL CUSTOM CONTRACTORS INC MY ELECTRICIAN INC License 168596 87s06 Expiration Date 02n5t2008 tu20t2007 Phone 541-942-3857 541-729-1454 CONTRACTOR INFORMATION )RMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Street Improvements: Storm Sewer Available Special Instruction: 11.00 Fully Improved Yes Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: r Lot Size: Sq Ft lst Floor: Wall Heat Sq Ft 2nd !'19o1:, Sq Ft Basement: Sq Ft Garage/Carport Path I Sq Ft Other: nla Occupant Load: 357 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Setback 5' Curb and Gutter Notes: Storm drainage piped into existing to curb face 3/27106 CAS DEVELOPMENT INF( Paee I of3 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Status Issued 225 Fifth Street, Springfield, OR 541-726,3753 Phone 541-726-3676 Fax 541-7 26-37 69 [nspection Line CITY Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006APPLIED: 0312012006 EXPIRES: 1012412006VALUE: $ 35,343.00 Description Dwellings Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 357.00 Total Value of Project Amount Paid Date Paid Value $35,343.00 $35,343.00 Receipt Number 12006000000000003rs 2200600000000000504 2200600000000000504 2200600000000000s04 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 2200600000000000504 Date Calculated 0312012006 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/o Administrative Fee + 87o State Surcharge Building Permit Fixture Minimum/Adjustment Mechanical Sanitary Sewer - [mprovement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan Total Amount Paid $187.69 $10.00 $40.38 $32.30 $288.75 $70.00 $39.00 $133.49 $175.49 $22.12 $r33.40 $6.00 3t20106 4t24106 4t24t06 4t24t06 4t24t06 4t24t06 4t24/06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 $1,138.62 Epps Peid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 03t2u2006 03t2u2006 03t2u2006 03t2u2006 03t2912006 03t27t2006 APP APP APP LLH TAJ CAS No Planning issues. Storm drainage piped to existing to curb face 312112006 CAS 03t2u2006 0411412006 0K RJB 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. Post and Beam: Prior to floor insulation or decking. Floor lnsulation: Prior to decking. red Insnections Pase 2 of3 Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line CITY F Building/Combination Permit PERMIT NO: COM2006-00329ISSUED: 0412412006 APPLIEDz 0312012006EXPIRES: 1012412006VALUE: $ 35,343.00 Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor 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. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover 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. zt-3,1i-OG Owner or Co a Signature Date Paee 3 of3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2006-00329 NAME OR COMPANY Merle LOCATION 247 loth st TAXLOTNI.IMBER:170335t419700 DEVELOPMENT TYPE:SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 0 7206 I. STORMDRAINAGE DIRECT RTINOFF TO CITY STORM SYSTEM COST PER S.F $0.323 COST PER S.F $0.323 COST PER DFU $2s.07 $19.07 NUMBER OF UMTS 0 NUMBER OF UMTS 0 ADM. FEE RATE 5% BUILDING SIZE 357.5 CTIARGE $133.40 DISCOT]NT RATE 5lYo LOr SZE (SF): DISCOUNT $0.00 IMPERVIOUS S.F 0.00 NUMBEROFDFU's 7 B. IMPROVEMENT COST: NLIMBER OF DFU's 7 ADTTRIP RATE 9.s7 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 STIBTOTAL s442.38 IMPERVIOUS S.F. X 413.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS x x x x x x x x ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER. CIry A. REIMBURSEMENT COST: $133.40 ITEM 2 TOTAL - CITY SAIIITARY SEWER SDC $308.98 3. TRANSPORTATION A. REIMBURSEMENT COST: xx xx COST PER TRIP $ 19.09 COST PER TRIP $84. l 9 $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - M'WMC A. REIMBURSEMENT COST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NLIMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REYERSE) MWMC ADMIMSTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS 1,2,3, & 4\ 5. ADMINISTRATIVE FEE: $0.00 $442-38 CHARGE $22.12 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRAN SPORTATION ADMINISTRATION FEE : COST PER FEU $82.03 $175.49 $133.49 $0.00 $0.00 $0.00 s0.00 t2 .00 $464.50 1070 1091 1092 1093 1094 1054 105 5 1054 l0s6 a lr1n O & rI]Fa sl& COST PER FEU $865.31 TOTAL SDC CHARGES x Cheryl Slaymaker 3/2712006 PREPAREDBY DATE DRAINAGE FXTURE UNIT CALCULATION TABLE NUMBER OF NEW FXTURES X UNIT EQUTVALENT: DRAINAGE FD(TURE LTNTTS FOR CALCULATE ONLY THE NET ADDITIONAL NO. OF FXTURES UNIT FIXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FD(TI]RE UNITS lsa toa mit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAINAGE FD(TURE TINITS 0 2 2 1979 *EDU BEFORE 1979 $5.29 $5.29 $5.1 I $s.12 $4.98 $4.80 $4.63 $4.40 $4.O7 $3.67 $3.22 $2.73 $2.25 $1.80 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 CREDITFORLAND flF APPLICABLE) 1979 I 980 t98l 1982 1983 I 984 1988 1 989 1990 l99t 1992 1993 't994 1995 1996 1997 1998 1999 2001 VALTIE / IOOO $0.00 CREDIT RATE $5.29xI 985 1987 1986 CREDTT FOR TMPROVEMENT (lF AITER ANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0-05 0030BATHTUB 0010DRINKING FOUNTAIN 0003FLOORDRAIN 3 000INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 6 00INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0020I-ATINDRY TTIB 3 000CLOTI{ESWASHER / MOP SINK 0 6 00CLOT}IESWASIIER - 3 OR MORE (EA) 00120MOBILE HOME PARK TRAP (1 PER TRAILER) 0001RECEPTORFORREFRIG / WATER STATIONi ETC. 0 3 00RECEPTOR FOR COM. SINK / DISHWASHER i ETC. 2021SHOWER SINGLE STALL 0002OFGANG 3 000SINK:COMMERCIAL/RESIDENTIAL KITCTMN 0 2 00SINK: COMMERCIAL BAR 2102SINK: WASH BASINIDOUBLE LAVATORY 1 000SINK:SINGLE LAVATORY/RESIDENTIAL BAR 0 5 00URINAI. STALL / WALL 0006TOILET, PUBLIC INSTALLATION 3103TOILET, PRTVATE INSTALLATION 7 CREDIT RATE/$1,OOO ASSESSED VALI]E YEAR ANNEXED s0.00 0 00 2000 TOTAL MWMC CREDIT 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C'' of Springfield Official Receipt L,, elopment Services Department Public Works Department RECEIPT #: 2200600000000000504 Date: 0412412006 l:5E:06PM Job/Journal Number coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 coM2006-00329 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Vent Fan M inimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 8% State Surcharge + l0%o Administrative Fee Amount Due r33.40 t7 5.49 133,49 22.12 288.7s 70.00 6.00 39.00 10.00 32.30 40.38 Item Total:$9s0.93 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check KIVIL CUSTOME CONTRACTING,INC NJM I 069 In Person Payment Total: $950.93 $950.93 cReceintl Page I of I 412412006 *F*UaSFl*l..s