HomeMy WebLinkAboutPermit Building 2004-09-09Building/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: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004
EXPIRESz 0412612005VALUE: $ 32,000.00
SITE ADDRESS: 544 SPRINGDALE AVE
ASSESSOR'S PARCEL NO.: 1703224205900
PROJECT DESCRIPTION: Bedroom and Bath Addition
Springlield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition Residential
Owner: FLECKJOINT TRUST AGREEMENT
Address: 544 SPRINGDALE AVE SPRINGFIELD OR 97477
Contractor Tvpe
General
Electrical
Contractor
MOIR CONSTRUCTION
EASTSIDE ELECTRIC INC
sU \o
CONTRACTOR INFORMATION
'.1
License
41570
117770
131109
T\1 S\\
Expiration Date
02n4t2006
10t04t200s
08124t2006
Phone
541-3434396
541-915-9828
s41-683-7535
$\i toSTEVEN DOUGLAS 9e\
hNl
g\
Units:of#
GroupOccupancyPrimary
OccupancySecondary
TypeConstructionPrimary
Type:ConstructionSecondary
Bedroomsof#
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
144
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Path:
Sprinkled Building:nla
Overlay Dist:
s.00 # Street Trees Rqd:
49.00
3.00
yes
Storm sewer will hookup to existing.
I
"1tD
u\
h1
Sidewalk Type:
Downspouts/Drains:
Notes:
Pase I of3
ffi.i
N\
\e\
nA\
PARJilNG
Paved Drive
%o of Lot B
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: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004
EXPIRESz 0412612005VALUE: $ 32,000.00
Description Type of Construction
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ l0Yo Administrative Fee
+ 7oh State Surcharge
Building Permit
Fixture
Miscellaneous Mechanical
Plan Review Minor - Planning
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
+ lOoh Administrative Fee
+ 77o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
Total Value of Project
Date Paid
Value Date Calculated
Receipt Number
1200400000000001236
2200400000000001138
2200400000000001138
2200400000000001 138
2200400000000001 138
2200400000000001 138
2200400000000001 138
2200400000000001138
2200400000000001138
2200400000000001138
2200400000000001138
220040000000000r r38
1200400000000001514
1200400000000001514
1200400000000001s14
120040000000000r514
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Amount Paid
$172.48
$10.00
$38.03
$26.62
$265.35
$70.00
$45.00
$s9.00
$18.28
$24.04
$4.94
$56.42
$s.20
$3.64
$43.00
$9.00
8n9t04
9t9t04
9t9104
9t9t04
9t9t04
9t9104
9t9104
9t9t04
9t9t04
9t9t04
9t9104
919t04
10t26t04
10t26t04
t0t26t04
10t26t04
$851.00
['ees Paid
Plan Reviews
Initial Review
Planning Review
Public Works Review
Structural Review
08t2012004
08t20t2004
08t2012004
08t2012004
08t27t2004
08t2412004
SKG
TAJ
MS
08t2012004 09t0712004 APP DLM
812412004 - Storm drainage to
hookup to existing. - MS
See documents for plan review
comments
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.
Page 2 of 3
Renrrirpd Insnecfions
Valuation Descrintion
APP
APP
APP
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Rax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004
EXPIRESz 04126/2005VALUE: $ 32,000.00
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.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
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.
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 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
evelopment Services Department
Public Works Department
RECEIPT #: 1200400000000001514 Date: 1012612004 9:18:35AM
Job/Journal Number
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ 10Yo Administrative Fee
Amount Due
43.00
9.00
3.64
5.20
Item Total:$60.84
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
CreditCard ROGERKING djb 015704 In Person $60.84
Payment Total:
-TGTIdTI
t0/26/2004 Page I of I
SFlllr{cFrELo
si*f?tsrdlslg!-D
225 FIFTH STREET . SPRING.FIELD, OF.g7477 ' PH:(541)726-3753 ' FAX: (54 1)726-3689
E LE CTRICAL P ERMIT AP P LICATION
Date /0-76<>clCity Job Number '6iy7oa q- opao
1 J
I l/\3no
LEGAL DESCRIPTION A.
17c 3 ZZ\Z Ot ZOO service
JOB DESCRIPTION 1000 sq. ft. or
Asl Ll A{-r' t FS Each additional 500 sq.
portion
Permits are non-transferable and expire if work is
' not started within 180 days of issuance or if work is
Suspended for 180 days.
,,
Electrical Contractor
Address X)s3 go1C
City SPFcO rTYzt Phone 7 tl(-/nq Over 1000AmpWolts
Reconnect Only
Supewisor License Number ,1 7) 7s
Expiration Date lo-
ConsE. Contr. Number t7 7 7 0
Expiration Date l0- 0 i- os
Signature of Supenrising Electrician
I
$ 63.00
$ 75.00
sl2s.00
$163.00
s375.00
s 50.00
$ 50.00
-
$ 69.00
$100.00
5Z
s6r7Yo State Surcharge
l0% Administrative Fee
TOTAL
owners Name t/g-\c J.o.^+\ e-^^+5
C.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 or 1000 Volts
D.
u<
s 43.00 t )
. 3 $3.00 7
$ s0.00
s 50.00
$ 2s.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 * Surcharges
Address sY Y 3?A'^J+le
City Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
E.
5zoLInspection Request: 726-37 69
4.
Shared Driv(T:/Building Forms/Electrical Permit Application I {3.doc
\he
7
to
or
or
\l
<
the
the to 600 Amps
New Alteration or
One Circuit
Each Additional
Service or Feeder \$
SLTBTOTAL OF ABOVE
Pump
Limited
Status Issued
225Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004EXPIRES: 03/0912005VALUE: $ 32,000.00
SITE ADDRESS: 544 SPRINGDALE AVE
ASSESSORTS PARCEL NO.: 1703224205900
PROJECT DESCRIPTION: Bedroom and Bath Addition
Owner: FLECK JOINT TRUST AGREEMENT
Address: 544 SPRINGDALE AVE SPRINGFIELD OR 97477
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition Residential
LicenseContractor Type
General
Electrical
Plumbing
Contractor
MOIR CONSTRUCTION
EASTSIDE ELECTRIC INC
STEVEN DOUGLAS
5.00
49.00
3.00
'i{eF\n
41570
Expiration Date
02n4t2006
r0t04t2005
08t24t2006
eq\17770e0J'
J
Phone
s4t-3434396
541-915-9828
541-683-7535o(
# 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:
Path:
Sprinkled Building:nla
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
%o ofLot Coverage:
0 h'(
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Type:
REQUIRED PARKING
Total:
144
hu1
Yes
Storm sewer wiII hookup to existing.\s0
Notes:
Page I of3
*Y
t
jL L
\r
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: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004
EXPIRES: 0310912005VALUE: $ 32,000.00
Description Tvpe of Construction
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Building Permit
Fixture
Miscellaneous Mechanical
Plan Review Minor - Planning
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Total Amount Paid
Total Value of Project
Date Paid
Value Date Calculated
Receipt Number
1200400000000001236
2200400000000001138
2200400000000001 138
220040000000000r138
2200400000000001 138
2200400000000001138
2200400000000001 r38
2200400000000001138
2200400000000001 138
2200400000000001 138
2200400000000001138
2200400000000001138
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Amount Paid
$172.48
$10.00
$38.03
$26.62
$265.35
$70.00
$45.00
$s9.00
$18.28
$24.04
$4.94
$s6.42
8n9104
9t9t04
9t9t04
9t9104
919t04
9t9t04
9t9t04
9t9t04
9t9t04
9t9104
9t9t04
9t9t04
$790.16
Eees Paid
PIan Reviews
Initial Review
Planning Review
Public Works Review
08t20t2004
08/20/2004
08t20t2004
08t20t2004
08127t2004
08t24t2004
APP
APP
APP
SKG
TAJ
MS
Structural Review
To Request an inspection caII the 24
will be made the same working day,
day.
08t20/2004 09t07t2004 APP DLM
812412004 - Storm drainage to
hookup to existing. - MS
See documents for plan review
comments
hour recording at 726-3769. All inspection requested before 7:00 a.m.
inspections requested after 7:00 a.m. will be made the following work
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.
Paee 2 of3
\m L-l
Valuation Descriotion 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: COM2004-01030ISSUED: 0910912004APPLIED: 08/1912004EXPIRES: 03/0912005VALUE: $ 32,000.00
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
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.
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.
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 70f .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 card is located at the front of the property, and the approved set of plans will remain on the site at all
times
Owner or Signature Date
0
Paee 3 of3
qI
225 Fifth Street
Springfield, Gregon 97 477
541-726-3759 Phone
ctty of Springfield Official Receipt
velopment Services Department
Public Works Department
RECEIPT#: 2200400000000001138 Date: 0910912004 10:56:32AM
Job/Journal Number
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
coM2004-01030
Description
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Plan Review Minor - Planning
Building Permit
Fixture
Miscellaneous Mechanical
-Mechanical Issuance Fee-
+ 7Yo State Surcharge
+ l0% Administrative Fee
Amount Due
s6.42
24.04
18.28
4.94
s9.00
265.35
70.00
45.00
10.00
26.62
38.03
Item Total:$617.68
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check MOIR CONSTRUCTION djb 446t In Person $617.68
Payment Totat :
-56115-8-
9t912004 Page I of I
-t
JOURNAL OR JOB NUMBER:
NAME ORCOMPANY:
LOCATION:
TAXLOTNI.]MBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
130
Tax Lot 05900
Addition to SFR
BUTLDTNG SZE (SFl 0 LOT SZE (SF):0 9584
DIRECT RUNOFF TO CITY STORM SYSTEM
RUNOFF ROUTED TO DRYWELL
IMPERVIOUS S.F
0.00
COST PER S.F
$0.310
COSTPERDFU
$24.04
$18.28
NUMBER OF TINITS
0
NUMBER OF TINITS
0
I II\,tPERVIous s.e- xf rsrro
CHARGE
$56.42
AND CONSTRUCTED TO CITY STANDARDS
x DISCOI.INT RATE
5OYo
ss6.42
x
x
x
x
x
DISCOT]NT
$0.00
ITEM I TOTAL - STORM DRAINAGE SDC
A. REIMBT]RSEMENT COST:
NLIMBER OF DFU's
I
B. IMPROVEMENT COST:
NUMBER OF DFU's
I
ADTTRIP RATE
9.57
B. IMPROVEMENT COST:
ADT TRIP RATE
9.57
ITEM 2 TOTAL - CITY SAi\ITARY SEWER SDC
A REIMBTIRSEMENTCOST:
s42.32
COST PER TRIP
$18.30
COST PER TRIP
$80.72
$0.00
NEWTRIP FACTOR
1.00
NEW TRIP FACTOR
1.00
xx
xx
ITEM 3 TOTAL - TRANSPORTATION SDC
4. SANITARY SEWER. MWMC
A.COST:
NUMBER OF FEU's
0
B. IMPROVEMENT COST:
NUMBER OF FEU'S
0
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
SUBTOTAL (ADD ITEMS I, 2, 3, & 4\
SUBTOTAL
$98.74
TOTAL SANITARY ADMIMSTRATION FEE:
TOTAL TRANSPORTATION ADMIMSTRATION FEE:
Matt Stouder 8/24/2004
s0.00
$98.74
CFTARGE
s4.94
x
x
COST PER S.F
$0.310
COST PER FEU
$82.03
Fleck
$56.42
s24.04
$18.28
$0.00
$0.00
$0.00
4.94
$103.68
1070
1091
1092
I 093
1094
1055
1054
1056
1079
1078
a
14
oO
d
E]F
U)
o
rq&
I
COST PER FEU
s865.3 r
ADM. FEE RATE
5%
PREPARED BY DATE
TOTAL SDC CHARGES
x