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Home My WebLink AboutPermit Building 2005-08-17.'(lFIILII Owner: Address: Contractor TYpe General Electrical Plumbing Status: Issued 225 Fifth Street, Springfield, OR 541.':726-3753 Phone 541-7263676I'ax 541:7 26-37 69 I ns pe ction Line SITE ADDRESS: 187416TH ST ASSESSOR'S PARCEL NO.: 1703252401200 PROJECT DESCRIPTION: Garage conversion Buildin g/Co mbin atio n Permit PERMIT NO: COM2005-00511 ISSUED:08n7t200sAPPLIEDz 0510212005E)GIRESz 0211712006VALUE: $ 27,690.00 Springfield TYPE OF TYPE OF USE: Garage Conversion Remodel Residential ANCIL LEISTER 1511RANCHWOOD EUGENE OR 97401 Phone Number: 541-431-4920 License Expiration Date PhoneContractor OWNER C & S ELECTRIC BQP PLUMBING INC 3849 134320 09/01/2008 03/30/2009 s4l-741-2236 541-343-5748 # of Unib: Primary Occupancy Group: Secondary Occupancy Piimary Construction Type Secondary Construction # of Bedrooms: Street Storm Sewer Available: Special Instruction: R-3 VN # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: oh 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:nla REQUIRED PARKING Total: Handicapped: Compact: Notes: Interior remodel SDC for new bathroom only 5/4/2005 CAS Sidewalk rYPe: setback 5, Downspouts/Drains Curb and Gutter "sqty"(r" Fully Improved Yes DEVELOPMENT INFORMATION PUBLIC IMPRO\TEMENTS 1of 3 a UUN Tr(ALIUK rl\Iil'/ry-I L UILI-rll\ (r Ir\ -r (JILIY!4I! I!!|I'U Frontyard Setback: Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: EIFl r 1t lF\Ullr! IL Status: Issued 225 Ftfth Street, Springfield, OR 541:726-3753 Phone 541-7264676Fax 541:7 26-37 69 I nspe ction Line Building/Co mbination Permit PERMIT NO: COM2005-00511ISSUED: 0811712005 APPLIEDz 0510212005E)PIRESt 0211712006VALUE: $ 27,690.00 Valuation Description Description Estimate Fee Description Plan Review Residential -Mechanical Issuance Fee- + lOoh Administrative Fee + 77o State Surcharge Building Permit Dryer Vent Fixture Minimum/Adj ustment Mechanical Miscellaneous Mechanical PIan Review Residential Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan + l0o/o Administrative Fee + 1oh State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Type of Construction Estimate $ Per Sq Ft Square Footage or muftiplier or Bid Amount $1.00 27,690.00 Total Value of Project Amount Paid Date Paid Value $27,690.00 $27,690.00 Date Calculated 05/19/2005 $69.81 $10.00 $40.20 $28.r4 $241.9s $6.00 $70.00 $6.00 $27.00 $87.61 $45.00 $127.96 $168.28 $14.81 $6.00 $8.10 $5.67 $18.00 $63.00 5tzt05 sn9t05 5/19/0s 5fi9tos 5/19/05 5lt9l0s sngt05 5/19/05 sn9t05 5/19/05 5n9l0s 5/19/05 s/19/05 5lt9l0s sn9l0s 8n7t05 8t17tos 8n7t05 8n7t05 Receipt Number 1200s00000000000549 2200500000000000612 2200500000000000612 2200s00000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200s00000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200s00000000000612 2200500000000000612 2200500000000000612 1200s00000000001196 1200500000000001196 1200500000000001196 1200500000000001196 $1,043.53 Fees Pa Initial Review Planning Review Public Works Review Structural Review 05/03/2005 0s/03/200s 0s/03/2005 0s/03/2005 05/06/2005 05t0412005 05/03/200s 05/r8/2005 APP JB No Planning review required. Interior remodel SDC for new bathroom only 5/4/2005 CAS Approved as noted on plans APP APP APP LLH TAJ CAS To Request an inspection call the 24 hour recording at 72G3769, 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. 2of3 Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-36768ax 541:7 26-37 69 I ns pe ction Line Buildin g/Co mbinatio n Permit PERMITNO: COM2005-00511ISSUED: 0811712005APPLIEDz 0510212005E)?IRES: 0211712006VALUE: $ 27,690.00 Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. 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 certi$ that any and all work performed shall be done in accordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAIICY will be made of any structure without permission of the Community Services Division, Building Safety. I further certiff that only contractors and employees who are in compliance \ilith 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 3 of 3 Date '- l(eoulreo rnsDecuons r 225 Fiftn Street Springfield, Oregon 97 477 541:726-3759 Phone ^iE of Springfield Official Receipt _ z evelopment Services Department Public Works Department 'RECEIPT#: 1200500000000001196 Date: 0911712005 9:12:51AM Job/Journal Number coM2005-00511 coM200s-00s1I coM200s-00s11 coM2005-00511 Description Perm Serv/Fdr 200 amps or less Add, Altei, Extend Circ Ea Add + 7o/o State Surcharge + lUYo Administrative Fee Amount Due 63.00 18.00 5.67 8. l0 Item Total:894.77 Payments: Tlpe of Palment Paid By checkNumDer Auttronzanon Received By Bdch Number Number How Received Amount Paid Check C & S ELECTRIC llh I 1788 By Mail $94.77 Payment Total: $94.77 t :i ,.( I ,i 8/17/2005 lofl 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: COM2005-00511ISSUED: 05/19/2005 APPLIEDz 0510212005 EXPIRES: llll9l2005VALUE: $ 27,690.00 SITE ADDRESS: 187416TH ST ASSESSORTS PARCELNO.: 1703252401200 PROJECT DESCRIPTION: Garage conversion Springfield TYPE OF WORI(: Garage Conversion TYPE OF USE: Alteration/''-' l 3N: Oregon lawrequlresyouto fi i'i.rvv rules adopted by the Oregon Utility Residential flr-431-4e20Owner: Address: Contractor Type General Electrical ANCIL LEISTER l51l RANCHWOOD EUGENE OR 97401 AF e52-001-0010 )!11. /ou may obtain copies olthg rules by n Utility Notification License Expiration Date Phone 3849 09/01/2008 541-741-2236 Contractor OWNER C & S ELECTRIC # 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: 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 nla Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo oflot Coverage: REQUIRED PARI(NG Total: Handicapped: Compact: Fully Improved Yes Sidewalk Type: Downspouts/Drains: Setback 5' Curb and Gutter Notes: Interior remodel SDC for new bathroom only 5/4/2005 CAS Paee I of3 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: COM2005-00511ISSUED: 0511912005 APPLIEDz 0510212005EXPIRES: 11/1912005VALUE: $ 27,690.00 Description Estimate Type of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 27,690.00 Total Value of Project Amount Paid Date Paid Value $27,690.00 $27,690.00 Date Calculated 05/19/2005 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7oh State Surcharge Building Permit Dryer Vent Fixture Minimum/Adj ustment Mechanical Miscellaneous Mechanical Plan Review Residential Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan Total Amount Paid $69.81 $10.00 $40.20 $28.14 $241.95 $6.00 $70.00 $6.00 $27.00 $87.61 $4s.00 $127.96 $r68.28 $14.81 $6.00 512105 5n9t05 5i19105 5/r9105 5/19/05 5n9t05 5lt9l0s 5n9t05 5n9t05 5n9t05 5/19/05 s/l9/0s 5/19/05 5n9t05 5n9105 Receipt Number 1200s00000000000549 2200500000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200s00000000000612 2200500000000000612 2200500000000000612 2200500000000000612 2200s00000000000612 2200500000000000612 2200500000000000612 $948.76 Fees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 05/03/2005 05/03/2005 05/03/2005 05/03/2005 05/06/2005 05t04t2005 0s/03/2005 05/18/2005 APP JB No Planning review required. Interior remodel SDC for new bathroom only 5/4/2005 CAS Approved as noted on plans APP APP APP LLH TAJ CAS 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. Pase 2 of 3 L Valuation Descriotion l(eourred lnsDectrons l 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: COM2005-00511ISSUED: 0511912005APPLIED: 0510212005 EXPIRESz llll9l2005VALUE: $ 27,690.00 Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. 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 Springlield 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 of and the approved set of plans will remain on the site at all times during zao{ Owner or Signature Date Pase 3 of3 I \ -I JOURNAL OR JOB NTIMBER: NAME ORCOMPANY: LOCATION: TAXLOTNT]MBER: DEVELOPMENTTYPE: NEW DWELLING UNITS I. STORMDRAINAGE CITY OF SPRNGFIELD SYSTEMS DEVELOPMENT ,RKSHEET coM2005-0051I Ancil Leister 1874 16th St 1703252401200 SINGLE FAMILY RESIDENCE 0 BUILDING SIZE (SF, O LOT SZE (SF): STORM SYSTEM 0 DIRECTRUNOFF TO CITY t. tr\,PERVIOUS S-F. I o.oo x x x x x x x COST PER S.F $0.310 COST PER S.F $0.310 COST PER DFU $24.04 $18.28 NUMBER OF UNITS 0 NTA4BER OF LINITS 0 ADM.FEE RATE sYo CIIARGE $o.oo DISCOUNTRATE 50o/o $0.00 DISCOTINT $0.00 ROUTED TO DRYWELL DESIGNED AND CONSTRUC ED TO CITY STANDARDS x ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER- CIry A. REIMBURSEMENTCOST: x ITEM 2 TOTAL - CITY SANITARY SEWER SDC s296.24 3. TRANSPORTATION A. REIMBT'RSEMENT COST: NUMBEROFDFU's 7 B. IMPROVEMENT COST: NUMBEROFDFU's 7 ADT TRIP RATE 9.57 B.IMPROVEMENT COST: ADT TRIP RATE 9.57 SLTBTOTAL $296.24 ITEM 3 TOTAL - TRANSPORTATION SDC A.COST: NUIIAEROFFEUb_ 0 B.IMPROVEMENT COST: NUMBEROFFEUb 0 MWMC CREDIT TF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS I, 2, 3, & 4) x x COST PER TRIP $r 8.30 COST PER TRIP $80.72 $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 x x x $ 14.81 TOTAL SANITARY ADMINISTRATION FEE: TOTAL Cheryl Slaymaker 5/4/200s IMPERVIOUS S.F 0.00 $0.00 $168.28 s127.96 $0.00 $0.00 $0.00 $0.00 14.81 $31I.05 1070 1091 1092 1093 1094 1 055 r 054 I 056 1079 a rqoo() &rI]Fa o rq& 078 COST PER FEU- $82.03 COST PER FEU $86531- PREPAREDBY DATE TOTAL SDC CI{ARGES CHARGE DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FDflURES x UNIT EQUIVALENT: DRAINAGE FXTURE LINITS FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL NO. OF FXTURES UNIT DRAINAGE FIXTURE LINITS 0 2 2 1979 FXTURE TYPE MISCELLANEOUS DFU TYPE NT]MBER OF EDU'S TOTAL DRAINAGE FIXTT'RE UNITS *EDU lsa toa BEFORE'1979 1979 I 980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 t992 NEW OLD mit set at 1 67 CREDITFORLAND VALIIE / IOOO $0.00 x CREDITRATE $5.29 20 NTWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT E,LGIBLE FORANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALI.IE / IOOO CREDIT RATE $0.00 x $5.29 TOTALMWMC CREDIT 1993 1994 1995 1996 1997 1998 1999 $0"05 0 0 3 0BATHTUB DRINKINGFOUNTAIN 0 0 1 0 0FLOORDRAIN003 3 0INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 000bINTERCEPTORS FOR SAND / AUTO WASH / ETC. 2 000LAUNDRY TUB 0 0 3 0CLOTMSWASHER/MOP SINK 0006CLOTTIESWASHER- 3 ORMORE (EA) 12 000MOBILE HOME PARK TRAP (1 PER TRAJLER) 000IRECEPTOR FOR REFRIG / WATER STATION / ETC. 3 000RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 2 21SHOWER, SINGLE STALL 0002SHOWE& GANG (NUMBER OF TMADS) 0 3 00SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0002SINK: COMMERCIAL BAR 2 210SINK: WASH BASIN/DOUBLE LAVATORY 0010SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0005T]RINAL, STALL/WALL 0600TOILET, PUBLIC INSTALLATION 3031TOILET,PRTVATE INSTALLATION 7 CREDIT RATE/$I,OOO ASSESSED VALUE YEAR ANNEXED $0.00 0 2000 200 1 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 Construction Contractors Board Permit #: Address: -o 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: ryslgtg"ry Issued Date:ia Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not Itcensed with the Construction Contraitors 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, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement wtll befiled with the permit- Fill in the appropriate blanks and initial boxes I and 2, mdeither box 3A or 38: tr2. I own, reside in, or will reside in the completed structure' I understand that I must become licensed as a constnrction contractor if the strrcture is sold or offered for sale before or on completion. tr 3A. My general contractor is (ccB #)(Narne) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Constnrction Contractors Board. OR 38. I will be my own general contractor. 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 conkact with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the rurme of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information on the reverse side of this form.Notice to Construction (White copy to issuing 5 I Property_owner. doc 06-0 I -04 permitfile, pink copy to applicant.) 2oa otW JActing as Your own General contractor? INFORiNATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES If you are acting as your own contractor to conskuct a new home or make a substantial improv-ement to an existing structure, you can prevent rnany problems by being aware of the following reqponsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "errployer" and the conftactors you conkact lrith will be .'employees', if you u$e contractors not licenged with the Construction Conkactors Board to do labor in conskucting or to assist in the construction or improvement of a residential structure. As the e.mployer, you must comply with the fotlowing: Oregon's lVithholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actuatty wittrtrota the tax &om your employees. For more inf*rmation, call the Department cf R"evenue at 503-378-4g88. Un*mplayrnent Insurance Tax: As an employe4 you are required to pay a tax for rxremployment insurance purpos# on the wages of all employees. For more information, call the Oregon Empioyment Department at 503-94V-1488. The Oregon Business ldentification Number (BII.{) is a combined number for both Oregon Withholding and Unemployment lnsurance Tax. To file for a BIN, catl 503-945-8091 or wwx,.dor.state.or.qs/forms,pay.himll for the appropriate forms. i Workers' Compensatio:r Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain wotkers' conlpensation insuralce for yow employees. If you fail to obtain workersi compensation iRsurance, you could be subjeci to penalties and be liabie for all-claim costs if one of your employees is rnjuieA on rhejob. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 5S3-947-78 15. U.S. Internal Rcvenue Service: As an employer, you must withhold federal inco,me tax from efftplolrces' *ugr} You will be liable for the tax paymant even if you didn't actually withhold the tax. For a Federal EIN nurnber, call the IRS at i-8m-8294933 br visit their web site at $$/lryJls.ggv Other Responsibilities and Areas of Concerns Cods Cornpliance : As the permit holder for this project, you are respcnsible feir resolving any failure 'to meet code rtqu,r.{93.:qnts tlat rnay be brought to your attention ihrough inspections. Liability and Property Damage rnsurance: Contact your insuranoe agent to coverage for accidents and omissions such as falling tools, paint over spr4y, water wqr[th4t must te redone . - \' : ' .\ C tli'_r' .- ,',- . i I i, .r)' Time: Make sie you hlve sufficient time to supervise your employees. ,\ Expertise: Make sure you iirV*'ihe skills to act as ybur own geneiai conhactoi,'to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perfbrm the required inspections. If you have additional questions cail the Construction Contractors Board (503-3734621) or write the agency at PO Box 14140, Salern,{)R 97309-5052. :. ir .;ir.ijir ,.,.) C Property_ovner.doc 06-0 I -04 see if you have adequate instirance '' damage &om pipe punctures, fire or NOTE: Tttis lnformatign Natice t9 Properly Owners abaut Construction Responsibilities was developed by theConsfruc,bn Qontractors Board in accordance with ARS 7A1.055(5J, passed by the lggg Aregon L,egistiture. 225 Fifth Street ,Sprirtgfield, Oregon 97 47 7 541-726-3759 Phone Cr', of Springfield Oflicial Receipt L elopment Services Department Public Works Department RECEIPT #: 2200s00000000000612 Date:05/19/2005 ttz47:24ttiil'I Job/Journal Number coM2005-0051I coM2005-00511 coM2005-0051I coM2005-0051I coM2005-0051l coM2005-0051I coM2005-0051I coM2005-0051I coM200s-00s1I coM2005-00511 coM200s-0051I coM2005-00511 coM200s-00s1I coM2005-00511 Description Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Plan Review Residential Fixture Sanitary Sewer - lst 50 Feet Vent Fan Dryer Vent Miscellaneous Mechanical Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 7%o State Surcharge + l0% Administrative Fee Amount Due 168.28 127.96 14.81 24t.95 87.61 70.00 4s.00 6.00 6.00 27.00 6.00 10.00 28.14 40.20 Item Total:$E7E.95 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard ANCIL D LEISTER nJm 019s20 019520 In Person Payment Total: $878.9s -sffi :r 5/19/200s Page I ofl .allrottrta ,l LEISTER CONSTRUCTION 1511 RANCHWOOD DRrVE EUGENE, OREGON 97401 March 16,2006 City of Springfield Development Services Department 225 5th Street Springfield, Oregon 97477 RE: Job/Journal Number coM2005-00511 [Job Address - tg7416th st] Dear Sirs. Jttil !s to inform you^that the undersigned has this date obtained his General Contractor [residential] license from the oregon Construction Contractors E]oard. My licensenumber is 169097. with an effective date of 03/ 1612006. It is now my intention to offer for sale the proper{y at 1874l6th Street this date. Please attach this notification to my file. Thank yoq Sincerely, Ancil D. GENERAL