HomeMy WebLinkAboutPermit Building 2003-03-12Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Buildin g/Combination Permit
PERMIT NO: COM2003-00093ISSUED: 0311212003APPLIED: 0212012003EXPIRESz 1010712003VALUE: $ 34,000.00
SITE ADDRESS: 2166 YOLANI),\ AVE
ASSESSOR'S PARCEL NO.: 170324' ' ')300
PROJECT DESCRIPTION: Bedroonr .r studio Addition
Owner: LONGKENNETHWJR& BARBARA
Address: 2166 YOLANDA SPRINGFIiiLD OR 97477
Contractor Type
Architect
General
Electrical
Owner
Contractor
RICHARD Z!'''i
KENNETH L(,,
KENNETH L'
LONG KEN)'
in
Springfield TYPE OF WORJ(: Bedroom
TYPE OF USE: Addition Residential
Date Phone
741-2995
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
rrJr'tW
I Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
465R-3
\"l
T1,pe of fleat:
\\lltcr Type:
Itange Type:
Energy Path:
Electric
Path I
27.{\t)
11.{'l
64.r t
Ove
,'BA
44.
l' rt
'2, otll$J
C
IT'-'']ll'lto
D
AYP ERIOD.60.
Partial!r' Irrrpro,
F,r
Sidewalk Type:
Downspouts/Drains:
C ... I-I'.ACTOR INFORMATION
Notes:
Paee I of3
Curb and Gutter
I
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00093ISSUED: 0311212003
APPLIEDz 0212012003EXPIRESz 1010712003VALUE: $ 34,000.00
Description
Dwellinss
Type of Construction
V Wood Frame
$ Per Sry Ft Square Footase
$7{.60 456.00
Total Value of Project
U;pm-t
Value
$34,017.60
$34,017.60
Date Calculated
02t20t2003
Ailt0urrt l''i:l Date Pai Receipt Number
2200200000000000s0s
1200200000000000812
1200200000000000812
12002000000000008r2
1200200000000000812
1200200000000000812
1200200000000000812
1200200000000000812
12002000000000008r2
1200200000000000812
1200200000000000812
1200200000000000812
2200200000000000720
2200200000000000720
2200200000000000720
2200200000000000720
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ l0Yo Administrative Fee
+ 77o State Surcharge
Building Permit
Fixture
Minimum/Adj ustment Mechanical
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - lst 50 Feet
Vent Fan
+ l0Yo Administrative Fee
+ 77o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
si..lr. i
$10.('r)
$4u., t
$28.q:
$277.0s
s70 (")
2t20t03
3lt2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3tr2l03
3lt2t03
3n2t03
4t9t03
4t9t03
4t9t03
4t9t03
$le
$5':
sr
$-t-r
s.')r ,l
Initial Review
Planning Review
Public Works Review
Structural Review
02124t2003
0212412i;t 3
03/03/2003
0212412003
't 116/2003
: )7 t2003
'/0.1/2003
',,t0712003
APP
DON
APP
APP
RJB
EMM
DJW
TCM
To Request an inspection call the 2l
will be made the same working 1!q,.', i
day.
I Footing: After trenches are ex(",.
2 Foundation: After forms are c
3 Post and Beam: Prior to floor i
4 Floor Insulation: Prior to deck'
5 Shear Wall Nailing: Before co,
,rcording at726-3769. All inspection requested before 7:00 a.m.
'1)ns requested after 7:00 a.m. will be made the following work
tlunsstig l
'':,,r tr) concrete placement.
't',.'l.irtg.
,,, 1.;111 filrish rnatcrirls
'( ctl.
.'tl lr',' '
.rrli,
Paec 2 of3
)
I
I
,)
I
,I
5
,I
il
'L^ n*-tie*s t
-
Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
S4l -7 26-37 69 Inspection Line
PERMIT NO: COM2003-00093ISSUED: 0311212003APPLIEDz 0212012003EXPIRES: 1010712003VALUE: $ 34,000.00
6 Framing Inspection: Prior to c, .' ) : .!r' i, il rough in inspections have been approved.
7 Wall Insulation: Prior to cover.
8 Ceiling Insulation: Prior to cor', '.
9 Drywall: Prior to taping.
10 Final Building: After all require ti irrsr,,','':r,rrs havc been requested and approved and the building is complete.
11 Underfloor Plumbing: Prior to ir rttl:,r ,'r ' :'tlecking.
12 RoughPlumbing: Priortocovcr :'r,l i i .iirrg rctluiredtesting.
13 Underfloor Drain: Prior to co\'( r' ,r' . , 'rcnt ol'concrete.
14 Shower Pan. Prior to covering :, I i , 's rcrprired testing.
15 Final Plumbing: When all plr' ' ,',,""'!cte.
16 Rough Mechanical: Prior to (
17 Final Mechanical: When all lr' :. '. ,r li is cornplete.
18 Rough Electric: Prior to Covc:
19 Final Electric: When all electri. \\ ' ' i. r'ottrtrlt'tc.
20 Final Electric: When all electri, rr -u '.'te.
2l Underfloor Mechanical. Prior ' , ,' , o , , ing and including required testing.
22 Rough Gas: After line is instn' ' t irrg and capped if not attached to an appliance.
23 Final Gas: When all gas work
By signature, I state and agree, that !
information hereon is true and corrr
the Ordinances of the City of Sprinr.l
that NO OCCUPANCY will be madc
I further certify that only contractors
I further agree to ensure that all rerpr
street, that the permit card is locaterl
times during construction.
Owner or Contractors Signature
It
': ,"i,rcd the completed application and do hereby certify that all, r '\' t h at any and all work performed shall be done in accordance with
r, : r,l ,lrc State of Oregon pertaining to the work described herein, and' ' :'c rr it hout permission of the Community Services Division, Building Safety.r r r r'€ in compliance with ORS 701.005 will be used on this project.
lcqucsted at the proper time, that each address is readable from the
l" 'rerty, and the approved set of plans will remain on the site at all
Date
Pase 3 of3
J
4/9/2003
2:06:00PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #: 22002000000000 007 20
Date: 0410912003
I
rl
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ lYo State Surcharge
+ l0o Administrative Fee
Payments:
43.00
15.00
4.06
5.80
Line Item Total:$67.86
Type ofPayment Paid By Received By Check Number Confirm No How Received Amount Paid
CreditCard KENETH LONG djb 000040 009342 In Person 67.86 )
Total:$67.86
Page I of I cReceipt.rpt
as submitted has the tollowing
nol require specific land use
225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (34PfgrOL3689
Zoning Le6*E LE CT RI CAL P E F.III IT AP P LI CATI A N
CityJobNumber Loyq ?A:3.- OAO,] oate Date
Authonzed Signature
LiLEI
./
LO CA'TI O N O I; I NSTAL LAT'I A Nfrat CG t l.nr/^ lrt -
3.
O()3OC
200 Amps or less
201 Amps to 400 Amps
601
-e$N
\(\{$e Amps
to 600 Amps
Over 600 Amps or 1000 Volts see "B"
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit e"
Each Additional Circuit or with
Service or Permit
Limited
7o/o State Surcharge
l0% Administrative Fee
TOTAL
LEGAL OESCzuITTON
l7 O3 Z't"t S
ALD L c-r(z+.*:fs
A. Ncrv llcsidcntial - Singlc on Multi-F anr!11' per dnelling 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 $s0.00
B. Services or Feetlers - Installation, Alterations or Retrocation:
401 Arnps to 600
$ 63.00
$ 75.00
$ r 25.00
$ 163.00
$37s.00
$ 50.00\r.)
Relocation
v
JOB DESCRIPTION $ 106.00
$ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
n/,q qlL.Electrical Contractor
Address
,
City
11
Phone
Supervisor License Number
Expiration Date
aB
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name
Address Jf tc G v,€, -1'zrr7r.
$ 50.00
$ 69.00
$ 100.00
t
.--).
J
a-n
o
.5
-{-o
5
"$t0h
oc)il
J\
-Each lnstallafiorr
City @zu $ 50.00
s s0.00
$ 25.00OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
56. OO
,toG
5-84
bTsLInspection Request: 726-3769
Shared Drive(T:)/Building Fonns/Electrical Pennit Application I -03.doc
+ lq/,2
COMPLE'I'E
(' i 't'c*
C $rpu-,-,n- 2 ?\J-
6-, 5., uin-,'z- ,1r^7lc / 1 a t
6 B-Jrro,.- En=-{ c-'L'|zt ( Ezc-7+'2'/> t / a L'
oe
@
6 J* J,'u / ta L-
'1_//c' r'2n5
livk l>l)-4-,,",* ) *J-J,".1 4-z l(c-L
Construction Contrac,-rs Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-3784621
Web Address: www.ccb.state.or.us
Statement: lnformation Notice to Property Owners
About Gonstruction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not
licensed with the Construction Contractors Board to sign the following statement before a building
permit can be issued. This statement is requiredfor residential building, electrical, mechanical and
plumbing permits. Licensed architect and engineer applicants, exempt 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 and2, and either box 3,{ or 38:
(r
K,
I own, reside in, or will reside in the completed structure.
I understand that I must become licensed as a construction contractor if the structure is sold or
offered for sale before or on completion.
3A,. My general contractor is
(Name)(ccB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
OR
(3B. 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 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.
of permit (Date)
Permit #: ( .O tU Z ') - OC(:1 3
Address: 2t 6 A-J*
Issued by:\(Date: () Y O 9 01,
prop-own.doc 05122100
(White copy to issuing agency permitfile, pink copy to applicant.)
6
T
Status: Issued
225 Fifth Street, SpringfieH, OR
541:726-3753 Phone
541-726-3676Eax
541:7 26-37 69 Inspection Line
OF'S
Buildin g/C omb in ation Permit
PERMIT NO: COM2003-00093ISSUED: 031t212003APPLIEDz 0212012003E)GIRESz 0911212003VALUE: $ 34,000.00
SITE ADDRESS: 2I66YOLANDA AVE
ASSESSOR'S PARCEL NO.: 1703244300300
PROJECT DESCRIPTION: Bedroom & studio Addition
Owner: LONG KENNETH WJR& BARBARA
Address: 2166 YOLANDA SPRINGFIELD OR y7477
Bedroom
TYPE OF USE: Addition Residential
License Expiration Date Phone
741-2995
Springfield TYPE OF
Contractor Type
Architect
General
Owner
Contractor
RICHARD ZINK
KENNETH LONG
LONG KENNETH W JR & BARBARA
C ONTRACT OR INF ORMATI ON
NG INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
27.00
11.00
64.00
T8,lt8F;"'-
-
AUtt'
44.00
60.00
Partially Improved
No
REQUIRED PARKING
Total:
Handicapped:
Compact:
Curb and Gutter
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees
Paved Ilrive Rqd:
o/o of Lot Coverage:
AT'I-ENTIO
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport:
Sq Ft Other:
Impervious Surface Area:
I
R-3
VN
Electric
Path I
Urban Fringe
29.00
I
:F \F1
les
NC t fortl
You m
2-001
calling the
0r the rules b)
he telephonenurnberfortheOregon LJtititl, r,lotiiication
Cente
LRMi{1-0010th;.ough OAB 95
ay obtain coples
center. (Note:t
r rs 1-900-3:i
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Notes:
c'
I of 3
46s
Status: Issued
225 Fifth Street, Springfield, OR
541126-3753 Phone
541-726-3676 Fax
541:7 26-Y 69 Inspection Line
Buildin g/C ombination Permit
PERMIT NO: COM2003-00093ISSUED: 0311212003APPLEDz 0212012003
E)PIRBS z 0911212003VALUE: $ 34,000.00
Valuafion Descrintion
Description
Dwellings
Type of Construction
V Wood Frame
$ Per Sq Ft Square Footaqe
$74.60 456.00
Total Value of Project
Value
$34,017.60
$34,017.60
Date Calculated
02t20t2003
Fee Description
PIan Review Residential
-Mechanical Issuance Fee-
+ l0o/o Administrative Fee
+ 7oh State Surcharge
Building Permit
Fixture
Minimum/Adj ustment Mechanical
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - lst 50 Feet
Vent Fan
Total Amount
Amount Paid
$180.08
$r0.00
$40.60
$28.42
$277.05
$70.00
$39.00
$s9.00
$6.s1
$130.28
$14.00
$6.00
$860.94
Date
2t20103
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
3n2t03
Receipt Number
2200200000000000s05
r200200000000000812
12002000000000008r2
12002000000000008r2
12002000000000008r2
1200200000000000812
1200200000000000812
1200200000000000812
1200200000000000812
1200200000000000812
1200200000000000812
1200200000000000812
Plan Reviews
Initial Review
Planning Review
Public Works Revierv
Structural Review
02t24t2003
02t24t2003
03/03/2003
02t2412003
02126t2003
02t27t2003
03/03/2003
03t07t2003
APP RJB
DONE EMM
APP DJW
APP TCM
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.
1 Footing: After trenches are excavated.
2 Foundation: After forms are erected but prior to concrete placement.
3 Post and Beam: Prior to floor insulation or decking.
4 Floor Insulation: Prior to decking.
5 Shear Wall Nailing: Before covering sheathing with finish materials.
6 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
7 Wall Insulation: Prior to cover.
8 Ceiling Insulation: Prior to cover.
9 Drywall: Prior to taping.
:ecrf red Insnections
2of3
rees rato
311212003
ll:52:19AM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 12002000000000008 12
Date: 0311212003
1ne Items:
Job/Journal Number Description Amount Paid
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
coM2003-00093
Plan Review - Planning
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Building Permit
Fixture
Storm Sewer - lst 50 Feet
Vent Fan
-Mechanical Issuance Fee-
Minimum/Adj ustment Mechanical
+ 7%o State Surcharge
+ l0o/o Administrative Fee
Payments:
59.00
130.28
6.51
277.05
70.00
14.00
6.00
10.00
39.00
28.42
40.60
Line Item Total:$680.86
Tlpe of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
000016CreditCardKENNETH LONG lkw
Page I of2
012787 In Person 680.86
cReceipt.rpt
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENI VIIORKSHEET
JOURNAL OR JOB NUMBER: Com2003-00093
NAME OR COMPANY:Ken & Barbara Long
LOCATION:2166 Yolanda
TAX LOT NUMBER:r 7032443-TL00300
DEVELOPMENT TYPE:
NEW DWELLING UNITS 0 BUILDING SIZE (SF) O LOT SIZE (SF):0
a
E]
t-.1oU
&HFa
()
E]il
1070
109t
l@2
1093
t@4
1054
1055
1054
1056
to79
1078
I. STORM DRAINAGE
DI RECTRUNOFFTOCIryI rMPERVious s,F.
| 462.00
STORM SYSTEM
x CHARGE
$130.28
RUNOFF ROUTED TO DRYWELL AND CONSTRUCTED TO CITY STANDARDS
x COST PER S.F.
$0.282
x DISCOUNT RATE
5OVo
DISCOUNT
$0.00
ITEM 1 TOTAL. STORM DRAINAGE SDC I $130.28
COST PER S.F.
$0.282
S.F.
0.00
A.COST:
x COST PER DFU
$22.09 = I $0.00
B.IMPROVEMENT
x COST PER DFU
$ 16.79 = | $0.00
ITEM 2 TOTAL. CITY SANITARY SEWER SDC $0.00
NUMBER OF DFU's
0
NUMBER OF DFU's
0
3. TRANSPORTATION
A. REIMBURSEMENTCOST:
ADT TRIP RATE
9.57
NUMBER OF UNITS
0
x COST PER TRIP
$ r 6.81
x NEW TRIP FACTOR
1.00 = f T0.00
B.IMPROVEMENT
x NUMBER OF UNITS
0
x COST PER TRIP
$74.17
x NEW TRIP FACTOR
r.00 = I $0.00
ITEM 3 TOTAL. TRANSPORTATION SDC $0.00
ADTTRIP RATE
9.57
A. REIMBURSEMENT COST:
NLIMBER OF FEU's
0
x
= | $0.00
B. IMPROVEMENT COST:
NUMBER OF FEU's
0
x
= I $0.00
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =
= I $0.00
= I $0.00
COST PER FEU
$332.86
COST PER FEU
$34.83
i0.00
SUBTOTAL (ADD ITEMS t, 2, 3, & 4)$r30.28
5. ADMINISTRATIVE FEE:
SUBTOTAL
r 30.28
x ADM. FEE RATE
57o
CHARGE
$6.5 r
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
I 6.51
l-$0.00
Steve Templin 3t3t2003
PREPARED BY DATE
TOTAL SDC CHARGES
x
4. SANITARY SEWER - MWMC
DRAINAGE FIXTURE UNIT CALCULATION TABLE
NUMBER OF NEW FXTURES X UNIT EQUIVALENT = DRAINAGE FXTURE UNITS
(NOTE: FOR REMODEIS, CN-CUL{TE ONLY THE NET ADDITIONAL FXTURES)
DRAINAGE
FIXTURE
UNITS
NO. OF FIXTURES
NEWFIXTURE TYPE OLD
UNIT
EQUIVALENT
0 0 3 0
0 0 1 0DRINKING FOUNTAIN
FLOOR DRAIN 0 0 3 0
0 0 3 0INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.
FOR SAND / AUTO WASH / ETC.0 0 6 0
0 0 2 0LAUNDRY TUB
CLOTHESWASHER 0 0 3 0
0CLOTHESWASHER - 3 OR MORE 0 6 0
0 0 12 0MOBILE HOME PARK TRAP PER
REFRIG / WATER STATION / ETC.0 0 1 0
0 0 3 0RECEPTOR FOR COM. SINK / DISHWASHER / ETC.
STALL 0 0 2 0
0 0 2 0OF
KITCHEN 0 0 3 0
SINK: COMMERCIAL BAR 0 0 2 0
0 0 2SINK: WASH BASIN/DOUBLE LAVATORY 0
SINK:BARLAV 0 0 1 0
STALL/WALL 0 0 5 0
PUBLIC INSTALLATION 0 0 6 0
PRIVATE INSTALLATION 0 0 3 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
0
TOTAL DRAINAGE FD(TURE UNITS
+EDU lsa toa dwell unit set at [67
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
CREDIT RATR$I,OOO
ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
0
0
1979
CREDIT FOR LAND OF APPLICABLE)
VALUE/ IOOO
$0.00
CREDITRATE
$4.92x I so.oo
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE/ IOOO CREDITRATE
$0.00 x $4.92
TOTALMWMC CREDIT I $o^oo
BEFORE I979 $4.92
1979 $4.92
l 980 s4.83
r98l 94.77
t982 $4.64
1983 $4.47
1984 $4.30
I 985 $4.09
r986 $3.78
1987 $3.41
I 988 $2.98
1989 $2.s2
l9m $2.06
l99l $l.64
1992 $1.4s
r 993 $r.3 r
t994 $r.13
1995 $0.97
t996 $0.82
1997 $0.63
r998 $0.41
t999 $0.22
2000 $0.04
20
Status: Issued
225 Fifth Street Spring{ield, OR
541:726-3753 Phone
541-726-3676 Fax
541:7 26-37 69 Inspection Line
OFS
Buildin g/C ombin ation Per mit
PERMIT NO: COM2003-00093ISSUED: 0311212003APPLE,Dz 0212012003E)PIRESz 0911212003VALIIE: $ 34,000.00
10
I1
t2
t3
t4
15
t6
t7
18
19
20
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.
Underfloor Drain: Prior to cover or placement of concrete.
Shower Pan. Prior to covering and including required testing.
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.
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 certiS 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
hereiq and that NO OCCUPANCY will be made of any structure without permission of the C-ommunity Services Division,
Building Safety. I further certif 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 of the property, and the approved set of plans will remain on the site
at all times 3 o
Owner or Signature Date
llvo ?
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