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HomeMy WebLinkAboutPermit Building 1999-03-31OTT OF SPruNGFIEIT', SPFI]TTGFIELD *tlily" P'arDE\ o;#nil,'-biit.,".p;'ffid#.;;ili:"i::;-*'-o" irob N,rnber : ":"".:":,,f1#$ffirDrvrsroN rnspec,i.:':i::, Assessors l,tap #: L7O2L9O0 Tax Lot #: 03200 Lot: 32 Block: Subdivision: AMBLESIDE Page 1 990315 1 26 -37 59 7 26 -37 69 PH Owner: GREY LARKIN Address: 41892 N. RIVER DRIVE Describe work: s/F RESTDENCE Phone #: 36'7-a6a\ City/State/zip: SWEETHOME OR, 9'7386 NEW General-: Plumbing: Electrical: ConEracEor GREY LARKIN 0072942 PO BOX 33524 SEATTLE WA 981330524 MIDWAY PLUMBING OOO4587 2428 SE THREE LAKES RD ALBANY OR 97 c/r rr,ecrRrc 0054468 PO BOX 1586 ALBANY OR 973210000 Const. Contractor #Expiree os/1,0/ee o7 /2s / eB oe/Ls/eB Phone 357-1518 928 -7 927 967 -8627 QUAD AREA: 3RNC OCCY GROUP: R3 HEAT SOURCE: G OFFICE USE -- LAND USE: 1111 CONSTR. TYPE: VN INSUL PATH: P1 # OF BLDGS # OF BDRMS SQ FOOTAGE 1 3 246L To requests an inspection, call- the 24 hour recording at 725-3769 A11 inspectlons requested before 7:00 a.m. wil-l be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS TEMPORARY POWER FOOTING - After trenches are excavated. FOT NDATfON - After forms are erected but ITNDERFLOOR PLUMBING - Prior to insulation or decking ITNDERFLOOR DP-AfN - Prior to cover or placement of concrete ITNDERFITOOR MECHANICAL - Prior to insul-ation or decking. POST AIiID BEAM - Prior to f loor insul-ation or decking. INSULATION - Floor; prior to decking Wa11/Ceiling; Prior to cover WATER LINE - Prior to filling trench. SAIiIfTARY SEWER IINE - Prior to filling trench. STORM SEWER LINE - Prior to filling trench. ROUGH GAS - after line is instal-l-ed and capped if not attached to an appliance ROUGH PLIIMBING - Prior to cover. ROUGH IIIECIIAIIICAL - Prior to cover. ROUGH ELECTRICAL - Prior to cover. SHEAR WALL NAITING - Before covering sheathing with finish materials. FR.AIIING - Prior to cover. fNSULATION - Fl-oor; prior to decki-ng Wal1/Ceiling; Prior to cover DRYWALL - Prior to taping. cAS SERVICE - After line is installed and line has been connected to a minimum of one appllance. Pressure Lest done at this point.. ELECTRICAIJ SERVICE - Must be approved to obtain permanent power. CURBCUT - After forms are erected but prior to placement of concreLe. SIDEWALK - After excavation is complete, forms and sub-base material in pJ-ace. it4frF"[" prior ton$baBlBt b ?illBHE;"i'.' utln Fr 3T iIONED FOR .fob Number: 990315 CITY OF SPruNGFIELT', Page 2 FINAL PLITMBING - When all plumbing work is complete. FfNAL MECHANICAL - When all mechanicaf work is complete. FINAL ELECTRICAL - When all- electricaL work j-s complete. FINAT BUILDING - When all required inspections have been approved and the buil-ding is complete. Lot Faces: S Topography: 2 Lot Type: INTERIOR N Lot Sg. Ft.: Total Helght: W 11 7280 25 .5 Lot Coverage: 20 Z Solar Approved: Y 58 Setbacks s 19 E 7House Garage ftem Main Garage Total Value Building Permit Fee Surcharge/aamin TOTAL FEE --- BUILDING PERMIT --- Square Feet x 2020 44]- $/Square Feet 69 .64 18.34 (A) Value 140,673.00 8, 088 . 0o L48 ,7 5l . OO 543 .2s 43.45 s85 .71 --- PLIN{BING PERMIT Item Residential- Bath (s) Plumbing Permit Surcharge/admin TOTAI, CHARGE 3 Fee 1,92 .50 L92 .50 15.41 207.9L(c) --- MECHANICAL PERMIT --- Furnace Exhaust Hood Vent Fan Wood Stove/ Insert /Fireplace Unit Dryer Vent, GAS PIPE/WATER HEATE Mechanical Permit fssuance surcharge/admin TOTAI, PERMIT 3 5.00 4.50 9.00 4.50 3.00 5.00 32.00 10.00 2.55 (D)44.55 .-- MISCELLAI{EOUS PERMITS --- surcharge/admi-n Sidewalk Curb Cut CITY SDC TEMP, ELECT, WILLA]VIALANE TOTAL MISCELLANEOUS PERMITS 0.00 14.05 L4.95 2 ,485 .06 43 .20 1, 000 . 00 3,557 .26(E) 4 ,396 .44(Excluding Electrical ) unless otherwise noted --- TOTAL AMOI'NT DUE --- (A, B, C, D, and E combined) SPRINGFIELD c o CITY OF SPilNGFIELD, .Tob Number: 990315 Page 3 BUILDING VAIJUE, PLA}I CHECK A}.ID BUILDING PERMIT --- This permit is granted on the express condition that the saj-d constructi-on shaII, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisi-ons of said ordinances. Plan Check Fee: 353.11 Date Paid Received By: Plans Reviewed By: AL WARD Date Building Site Reviewed By: BOB BARNHART Receipt. Number: 03309903/oe/ee 03/3t/ee AAf- --- ADDrrroNAr, coMMENTS F-€EPERATE PERMIT IS REQUIRED DRIVEWAY REQUIRED TO BE PAVED 1 STREET TREES REQUIRED By eignature, I aEate and agree, that I have carefully examined t.he completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shaI1 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 wit.hout. permission of the Community Services Division, Buildi-ng Safety. I further certify LhaE only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that a1l- required inspections are request,ed at the proper time, that each address is readab1e from the street, that the permit card j-s located at the front of the property, and the approved set of plans will remain on the si at alf times dur ing construction. 7- 7/-27 ignat Date --- VALIDATION --- 03tjj {Receipt Number: Date Paid: Amount Received: Received By: hlqtTIILw SPllIT{GFIELD Willamalane Park & Recreation District Job. No- PHoNE: 561-\B STATE: D,sr ztP TBBG SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME:G ADDRESS:qt?.,q 'C\. R,**.. LOCATION OF PROPOSED BUILDING SITE: Street Address:*J 1- DEVEL9PMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelting r A. Single-Family Detachecr single Family home Manufactured home not in a park NO. OF UNITS \x $1,000 per unit = S [C t v-r Tt B. Single-Family Attached NO. OF UNITS X $924 per unit = $ C. Multi-Family Apartment NO. OF UNTTS X $692 per unit = $ D. Manufactured Home park NO. OF UNITS X $699 per unit = $ WILLA,MALANE SDC $ 2. sDc cREDlr (if appricabre) sDC-payer must furnish proof of Wllamatane Credit approvat. See SDC Credit Wotksheet. $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ Plat Name:Tax Lot Number: O C,?2 Services City of Springfield Department 1_, Date L7r JOURNAL OR JOB NO.%oz'. ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPIUITNT CHARGE WORKSHEET Lurk-**- ZzXz j3P"v Sr DEVELOPMENT TYPE 5F NAME OR COMPANY LOCATION BUILDING SIZE OT SiZ Ft. 1. lQ(zi) + IMPERVIOUS SQ. FT rQ 2. SANITARY SEWER-CITY Z + bo^ €r" @)a- t zt(zt) +95+ X $0.227 PER SQ. FI . $M2,b5 s lreNO. OF PFU'S (See Reverse Side) 3. TRANSPORTATiON NO OF UNITS X TRIP RATE X COST PER TRIP I X t.or x$475.32 x $475.32 4. SANITARY SEWER-MWMC A. REIMBURSEMENT COST: NO. OF FEU'S I X 211,4+PER FEU B. IMPROVEMENT COST: NO. OF FEU'S X 25,2OPER FEU MI^IMC CREDIT IF APPLICABLE (SEE REVERSE) MWI'IC ADMINISTRATIVE FEE 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) X .05 Vsv SDC Coordinator ATTACH'A. t^lPD TOTAL-MWMC SDC g 3tz .to * SUBTOTAL (ADD ITEMS 1,2,3 & 4)$ ZZUG1L X X $47.14 PER PFU r3t $.o-7 $ s 2]1 .# $ 2F.20 $ 10.00 $ u83+ T0TAL SDC $24U.,OG oate:alEzf 3L FIXTURE UNIT CALCULATION TABLE: Number of New Fixtur^ X unit Equivalent : Fixture Units. (NOTE: For remodels, calculate only ^ NET additional fixtures) NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS Bathtub. Drinking Fountain.... Floor Drain. lnterceptors For Grease/Oil/Solids/Etc................. lnterceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher...... -T- Clotheswasher - 3 Or More............ Mobile Home Park Trap (1 Per Trailer)...... Receptor For Refrigerator/Water Station/Etc Receptor For Commercial Sink/Dishwasher/Etc..-T- (- -T- --E- Shower, Single Stall...... Shower, Gan9......,.. Sink: Bar, Commercial, Residential Kitchen Toilet, Private....... Miscellaneous: TOTAL FIXTURE UNITS 2 1 2 J 6 2 6 b 1 3 2 1 2 2 1 6 L Urinal, Stall/Wall Wash Basin/Lavatory, Sin91e........... Toilet, Public lnstallation.. /Head 4 Z4 CREDIT CALCULATION TABLE: Based on assessed value calculate credits S. Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) x$ (Rate X Assessed Value)x$ (Rate X Assessed Value) CREDIT TOTAL $ Year Annexed Rate per $1,OOO Assessed Value Year. Annexed Rate per $1,OOO Assessed Value $1.98 1.55 1.15 o.96 o.B3 o.67 o.52 o.38 o.21 1 'i', ,1 1 1 1 989 1 990 1 991 1 992 1 993 994 9.95 996 997 1979 or before 1 980 1 981 1982 1 983 1 984 1985"i'-,"'- 1 986 1 987 1 988 $4.27 4.14 4.12 3.99 3.83 :3.68 3.48 3.18 2.82 2.42 RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating PurPoses Onlyl Residential 0.4 Commerica|......................... 0.9 lndustrial:.. ......... o 5 Governmenta1...................... 0.5 FIXUNIT.WPD TMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT t , I ll lll lf improvements occurred after annexation date in table, SPFlINGF!ELO approvel ADLZoning Dale YN lT st{Al-l- t:xPlPE rtr?u PERHIT APPLICATION s300. $ ao. .-rn I l\lr\f ' t-Ule nirlrr'- BI,E TRICAL )TSPRINGFIELD, OREGON 97477 INSPECf,ION REQUEST: 726-3769 rTNDoNED FORcitY Job Nunb ",7703/5OFFICE: 726-3759 , : r*ti.), 3. COHPLETE FEE SCEEDULE BELOV ON1 I,EGAL DESCRIPTION 00 JOB the Permi ts areif vork i sno of issuance or 180 days. or 2. COMRACTOR INSTALT,ATTON ONI,Y Electrical Contractor Address Ci ty e i trPervisor Li e Number Expiration te Cons t r tr. Number Exp tion Date ture of Supervising Electrician 0vners Name 4Ray heL..t) Address furq z f /,,teP fuar/e Ci ty Ca J Phone*/'3t7'/kt OVNER INSTALI.,ATION The installation is being made on property I ovn vhich is not intended for sa1e, Iease or rent. ignat DATE: A B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only C 200 amps"or 201 amps to Over 401 to Over 600 amp s Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Hanuf'd Home. or Hodular Dvelling Sertice or Feeder s 8s.00 $ 1s.00 s 40.00 LOCATIONLZ? Z oF3rjHlALLg# Sum o t z$ 40.00 s ss.00 $ 80.00 see rrBil aE6TE- amps Ies 400 600so 00 00 00 00 00 00 s s0. $ 60. s100. s130. Temporary Services or Feeders Installation, Alteration or Relocation ampsr 1000-liio-ITs D. Branch Circuits Nev, Alteration or Extension Per Panel One (Ci rcui t $ 35. OO Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. HisCellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0utIine Lighting_ Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL e.o)l, L) $40 $40 $20 $36 {ct 00 00 00 00 RECEIVED I C 5 l3 z-o This permit is required for any site activity in the flood plain and everywhere site alteration consists of flfty (60) cublc yards of material or moro and/or if a dralnageway ls affected, wlthin City llmits and t Thls Slde To Be Fllled Out hV Appllcant ''rl'.' "-x4al Permit Explratlon 32 N. Sprlngfleld, OregonSlte Address: Date of Appllcatlon Property Owner Phone: ?b1-lb ag Clty JournalnumberappllcabloLandUseApplication Tax Lot:3 rc12-n-+3tr uGB Tax Map tr tr o € a,EXCAVATION, Project Su GRADING, Address tr HLL, ou !( tr tr tr tr tr ADDITIONAL INFORMATION, DRAINAGE, POLLUTI ON AND EROSION CONTROL PLAN SOILS & GEOLOGY PLAN, REPLANTING PLAN PROJECT SUPERVISOR:I PHONECOMPANY NAME: STATE STATE crw CITY AD ADDRESS PROJECT SUPERVISOR: COMPANY STATE: , ZIP:- OFFICE PHONE- FAX- MOBILE PHONE:-, EMERGENCY PHONE: Reglstration NAME PROJECT Explratlon Date: PHON I undcr.trnd thrt l. or my .ucco$ora may have future planr for my propcrty- whlch may bc antlo-lpatcd. or qnantlc-lpatcd-at .itrliiimi. I undcrctand that such tutura ilans may requlre permlts ahd dcvllopcmcnt approvalq [rgm thc Clty- of 9prlng{ela. i unOirctanO that notwlthstandlng any a'pproval oi this Larid and Dralnagc.Ahcratlon-Pcrml! lLPAn, dlat Et the time of 6p;liCia19| of iuturc pcrmlu or aiprovali'the CIU may revlew and reconrlder all actlonr-whlch I or.my cucceggorc have uhEcrtrken ocnuant lo thlc LDAP. I understand that the CiW may ac a conditlon of any ftfirrc approva!, rcqulre Ste undolnb, chinglng, or modlficatlon of any actions which I hive thdertakcn a! r rcsuh of the Chy'e approval of thit LDAP. Bri clsnaturc, I rtrto lnd agrec, that I haVe carefully examined the completed applicatlon and do heraby certify that all lnforfration hereln ls truc and conect, and I further'certify that any and all work performcd thall be donc in accordance whh the Ordinanceg of the City of Springfield, applicable'City Standard speclflcations and Drhwlngd, and tho laws of the StEtc of Oregon pertal4lng 1q iho w<irk d-escrlbeil-herein. I fuither certlfy thEt only coqgactor and employees who are ln compllance wtth ORS 7Ol .066 wlll be used on thls project. Thc Oty may lnrpcc{ thc work ritc described in thla pormit at any tim6 durlng r onr yrrr pcrlod foilowlng thc rccolpt by thr Chy of nbtlcd of complctlon of thc doscribod work and epccify, at thc Clty'r rolc darccratlon, lny addltlonal rcctoration work rdquircd to rcturn thc rite to a standard acceptable to tho City. Thc pcrmlttec wlll bc notlfled ln wrhing of any work rcqulrcd and wlll havc thlrty (30) daye from tho dltc of thc notlcc to oomplctc thc work. Work not oompleted !t thr ond of thd ilrlrty deyr wlll bc pcrfiirmed by the Clty and the corts wlll bc blllcd to th. pcrmlttcc. I furthcr lgrcc to cnlurc that atl rcqulrcd lncpcctlons Ero rcquostod at thc propcr tlmc, that proicct addrcac lc rcadable from tho ltrcot, End thc approved let of plans will remain on the sita at all tlmea durlng conctruatloh. Slsnrtnre orc 5441 344q,. FErl M,t!o- Zo -lF M, IIJ = lJJ U Z -l M,o oZ cZ 5 E, lrJz =o trtha z,o Lktr rU5 oz 5 aF2 trJ =I c) koul TE5alrl CE (r, z 5 =U'zoo CEo o EFzoo az 5.L tx cc:l lIL tx cc:fka(, U) eullua\-/Arilt l/;.{-%osls ty of Springfield "+i "Yr&.ih' 2-a and land of tr @ wtr Date:FLOODWAY, FEMA Community Panel No. DSWETI.AN Descrl FEMA Community Panel No.:FLOOD PLAIN, Zone: DRAINAGE, El Storm, O Culvert, El Natural $20.00 030.0o $40.00 940.00 For thE first 10,000 oublo yardr, plut $20.00 for each additlonal 10,000 anblc yarde or fraction thereof. $220.00 For the first 100,001 cubic yards, plus $20.00 for each addltlonal 1O.OOO cublc yards or fraction ther6of. $340 For the first 200,001 cublc yarde, plus 96.00 for each additional 1O,OOO crrbld yardc or fraction thereof. $30.00 $3O.OO For the first 100 cublc yards, plus $14.00 for each additlonal 100 cubic yards or fr€stion thereof. $ 1 56.00 For tho first 1 ,000 cublc yards, plus $12.00 for each additlonal 1,000 crblc yardr or fractlon ther6'cif. $264.00 For the first 1O,O0O cublc yards, plua $54.00 for each additional 10,000 cublc yards or fraqtion thereof. $750.00 For the first 100,001 cublc yards, plus $30.00 for each additional 1 0,000 cublc yards or frastlon thereof. Received By: Dato:+4\e Date: J' )5-'t'' ?q/ e-!r Receipt no,TTiffil Date PA Yb 100,001 To 200,000 2OO,OO1 CUBIC YARDS OR MORE Giading Permit fee: Recoived by: 30:Plan Check Fee: Estimated PLAN CHECK FEES: UP TO 1OO CUBIC YARDS 101 TO I,OOO CUBIC YARDS 1,001 TO 10,000 cuBrc YARDS 10,000 To 100,000 cuBtc YARDS GRADING PERMTT FEES: UP TO lOO CUBIC YARDS 101 TO 1,000CUBICYARDS 1,OOl TO lO,OOO CUBTC YARDS 1O,OOO TO 1OO,O0O CUBTC YARDS 10o,ool To 2oo,ooo Receipt No: Date: Dateng E] Maintenance: tr Buitding: Date: Date: Date Permit Number lssued by:Date: DatePlannlng: Date: Dete Malntenance: Building: FEI M IJJo- Zo =rv --t I.JJFJ IIJ U Z EI Mo cZ nZs land an{ Drainage. activity.as outlined in this permit has boon completed ln accordance with the provisions ofthis perrhit. !=end^Efd_D_f-a.[qgge_a-qtiypty a-s-oqtlined in this permit has not beon complet€d in accordancewltn Ine provrslons oI tnrs permlt. tr Land and Drainage activity was performed prior to application for this permit. Accepted by: Date: tr tr uI()z F(L lJloo 1/6/1998 lTOcv ( q -\- ul CI z rEo is Side To Be Fill Out By City.Std.tf" lrl IIJl.l. U'zo 6zoo o TU =ut r,utf U,zo 1,-o UJ(L U'z Reqrrirarl Flnal lnspeetions.' Date trPR-08-1999 1,21t5 Greg Larkin PO Box 2041 Corvallis, OR 97339 Fax Cover Sheet K_3,INC. April 8, 1999 Tom Springfield Building Dept Greg P.@1. DATE: TO: FROM; TIME: 11:02 AM PHONE: FAX: RE:Compaction testing Number of pages including cover sheet: 3 Tom, The following pages ?!.re copies of the compaction testing results for 2282 33rd Street. If you have any questions, please contact me at 740-4370. RPR-AB-1999 L2t 1,6 MORTIER ENGINEERING,P.C. I245 PEARL STREET EUGENE, OREGON 97401 PHONE (541) 484-9OeQ'FAx (s41) 464'68s9 April 1, 1999 Greg Parlarkin PO Box 2041 Corvallis, OR 97339 Very trulY Yours, UC Emite Mortier, P-E. K-3' INC.P.A2 STBUCruRAL BUILOING DESIGN O FIBE PROTECTION coDE CONSULTANT e PLAN CHECKING CONSTRUCTION INSPEfiION RE:?.8^33rrtSt..SPringfreld'o&CompaotiouTest.w'o.#I1710TJM As you requested, a compaction inspection of the gravel under the proposed foundation has beeu performed on rhis ,ilfi;;;*1i"1 1"i tlie consfrrction involvirrg foundations for the proposed residence, Jhs gxsavation invorved th";'i;;u"t or.t 1/2" rninus crushcd rock. The compacted surface of the cnrshed rock is "d"quati for a foundation bearing capacity of 1000 psf' The unclcrlying soil conditions, site drainage arrd foundation were not deiigncd or reviewed by Mofiier Engineering, p.C. fil;;*pr"tion of1n" gi*a surface is greater than 95% of a standard proctor' p"r-n sftubegg-qr. (See attached sheet') I hope you find this report adequate.for your Purpose€ at lhis time' Pleasc contact me if you havc Iiuther questions' Th";,k you for this opportunity to be of servicc' 1 ECIWmm N{ORTIER ENGINEERING, P.C. RPR-88-1999 12tt7 -+€:€€x4€€z 1245 PEARL STREET EUGENE, OREGON trru{O PHONE (s{t) .0tt'9080 r FAx (541) 484-6859 Wet wcight Dry weight Notes: K_3, INC P. 03 STRUCTURAL BUILDING DESIGN T FIRE PROTICTION coDE CONSULTANT O PI-A^I CHECKING CONSTRUSTION INSPECTION FIELD UNIT WEIGHT. SAND CONE METHOD Per ASTM D 1556 TEST NUMBER: ,I DATEoFTEST: +/t/11 w'o.# ! il'l 0--Fln rESr LocArloN: I rESr tt, f) M ,,M^rE;m?r'o%?-i;"fJ ;,Lfu.i*, . I ," Mina.g Ctu,skel 9p UNIT WEIGHI.OF S^ND I.JSID FOR TI"IIS SAMPLE r iyfr'{l Suor ,/ [0'15,5 .7. p,(:;arrd) '7ZCpp voLUME oF coNE (V') = o'0389 ft^3 FIELD TEST DATA lnitial Weight oF Jar I Sand (W,) Weight of Jar + Sand a{ter test (W) Volume of hole. W,--VY, - V, = Vz P, Weight of soit samPle (WJ = Moist unit weight of soil P. = Jds = v2 Motsture contertt of samPle' tnr6 = (wqioht moist) - (we-!Et!Cry) X 100 (weight drY P* Dry Unit Weigh of Soil Po = 1 + Wo,6 100 MotsruRE coNTENr c weight of jar net weight a 0t5 2o 1,5o.., '1,'/^ WWW TOTAL P.A3 13 sr"f l^ 1f ,f !a Ia SI'TIINGFIELD 1. LOCATION OP D./h./* 4 qqo*S eirr {t l,o( wblAao225 ErFTE STREET 0 SPRTNGFTELD, OREGON 97 411 INSPECTION REQUEST: 726-3769 OFPICE: 726-3759 st o DESCRIPTION Lo+ 32 JOB DESCN.IFTION BLE TRICAL ?ERHIT APPLICATION City Job Number ?4o 3/ f COHPLBTE FBB SCMDULE BELOV Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cost 3 A tToz $!,!. I n eu)srR L000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf,d Home or Iling Sum $ 8s.oo w@ $ ls.oo qS.hO $ s0.00 $ 60.00 $100.00 $130. 00 s300.00 $ 40.00 Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 3_ ffiffttpBi" THEPERMIT2. COI.ITRACTOR INSTALLATION ONIY B. S Electrical contractor G{E E te*r icJnc Re Address g Phone 51il'qb7-8 bz7 supervisor License Ntimber AqSZS Expiration Date t0- {-q? Constr Contr. Number q2Be Ins Expiration Date Signature of Supervising Electrieian 201. ANYl PERIOD 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -60L amps to i.000 amps- over 1000 amps/vorts -Reconnect 0n1y C. Temporary Services or Feeders .AIte:.vreUU fi1 Owners Name L Address +/ tE 4ua Ozc PE Ci ty Phone 7/7-/t /r OIJNER INSTALLATTON The installation iproperty r own vhiforsale, .Lease or Ovners Signature: Date Limj ted Ene rgy/Conn SIETOTAI.0F ABow5,f State Nev, Alteration or Extension per panel One Ci.rcui t Each Additionar $ 35'oo Circuit or vith Serviceor Feeder permit $ 2.00 ration li igiy;1i-,or Relocation uires yori i.,by the o reUo$i {4CI,,00 aE6F Utitiry nstallation aneous (Service/f eeder not included) irrigation $ 4o.oo0utI ine tigh - rlng $ 40.00ted Ene rgylRe _s DATE: $ 20.00 $ 36.00 '0, RECET B Authonzed Signature 5 TOTAL Surcharge lilct.(o -t-qq ENOT Rox .'rv fr(txny follow rules 0vera00& D. Branch ts