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Home My WebLink AboutPermit Building 2005-10-07Status: Issued 225 Fifth Street, Springfietd, OR 541:726-3753 Phone 541-72G3676Fa,x 541:1 26-37 69 Ins pe ction Lin e Buildin g/Co mbinatio n Permit PERIVIIT NO: COM2005-01259ISSUED: 1010712005APPLIED: 09/15/2005 E)(PIRESz 0410712006VALUE: $ 17,900.00 SITE ADDRESS: l9l7L7TIJ ST 1919 Springfield TYPE OF ASSESSOR'S PARCEL NO.: 1703252403900 TYPE OF USE: PROJECT DESCRIPTION: Convert Residence to Duplex & add carport at existrg pad Single Family Residence Remodel Residential Owner: Address: WILLIAM ALLEN I9I7I7TIJ STREET SPRINGFIELD OR 97477 Phone Number: 541-747-2161 CONTRACTOR INFORMATION Contractor Type General Electrical # of Unib: Primary Occupancy Group:' Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacla: Street Storm Sewer Available: Special Instruction: Contractor ERIC MATTHEW MASON JOSEPH BUNCH to\o't't o NR {ror) e Expiration Date 09t0st2007 08t2u2007 Phone 54t-607-3141 541-344-874srequ\{ 00 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Path: Sprinkhd Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: nla 7.60 25.00 0.00 3 Yes REQUIRED PARKING Total: 4 Handicapped: Compact: Sidewalk Tvoe: D"**;r,,.i,r*rf.$S[ t - and Gutter AC Mat Yes DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Storm drainage into existing system 9/19/2005 CAS l of 4 Electric CITY OF SPRINGFIEL Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-7263676Fax 541:7 26-37 69 Ins pe ction Line Building/Co mbination Permit PERLIT NO: COM2005-01259ISSUED: 1010712005APPLIED: 09/1512005E)PIRESz 0410712006VALUE: $ 17,900.00 Description Bid Amount Carport Fee Descrintion PIan Review Residential + l0o/o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less + l0oh Administrative Fee + 7%o State Surcharge Addressing Assignment Building Permit Fixture Miscellaneous Plumbing Plan Review Minor - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Sewer - lst 50 Feet Willamalane Attached (duplex) Total Amount Total Value of Project Date Paid Receipt Number 2200500000000001269 2200500000000001318 2200s00000000001318 2200500000000001318 2200s00000000001318 1200500000000001479 r200500000000001479 1200500000000001479 1200s00000000001479 1200s00000000001479 1200500000000001479 120050000000000r479 1200s00000000001479 1200500000000001479 1200500000000001479 1200s00000000001479 120050000000000r479 1200500000000001479 1200s00000000001479 1200s00000000001479 120050000000000r479 1200s0000000000r479 1200s00000000001479 Type of Construction Use Bid Amount Carport $ Per Sq Ft or muhiplier $1.00 $18.00 Square Footage or BftI Amount 8,000.00 ss0.00 Value $8,000.00 $9,900.00 $17,900.00 Date Calculated 09nst2005 09/15/2005 Amount Paid $110.37 $6.90 $4.83 $6.00 $63.00 $27.38 $19.17 $31.00 $169.80 $14.00 $45.00 $8s.00 $s7.21 $75.21 $10.00 $865.31 $82.03 $12.28 $91.63 $805.70 $182.69 $4s.00 $924.00 $3,733.51 9n't05 9t22105 9t22t05 9t22105 9t22tvs t0t7t05 t0t7tos t0t7t05 t0t7t05 t0t7t05 t0t7tos t0t7t05 t0t7t05 t0t7t05 t0t7tos t0t7t05 t0t7t05 t0t7t05 t0t7l05 t0t7t05 t0t7t05 t0t7tos t0t7t05 Eees Paid Plan Reviews APP LLHInitial Review 09n6t2005 09n6t2005 2of4 Valuation Description I CITY F PRIN D Building/Co mbination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:72G3753 Phone 541-726-3676Fax 541:7 2637 69 I nspe ction Line PERMIT NO: COM2005-01259ISSUED: 1010712005APPLIED: 09/1512005E)PIRESz 0410712006VALUE: $ 17,900.00 Planning Review Public Works Review Structural Review 09n6t2005 10/03/2005 APP TAJ Property meets density requirements for MDR district. 3 street trees are required unless already in. Pave first 18r ofdriveway. Storm drainage into existing system 9/19/2005 CAS Plan review is only for the new carport and the lire wall between the dwelling units for conversion to duplex. dlm See documents for Plan review comments. 09t16t200s 09n6t2005 09n9t200s 10t04t2005 APP APP CAS DLM 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. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Firewall: Located and constructed according to plans. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. nsnecfions 3 of 4 PRIN Buildin g/Co mbination Permit CITY F PERMITNO: COM2005-01259ISSUED: 101071200s APPLIED: 09/1512005E)?IRESz 0410712006VALUE: $ 17,900.00 D Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7264676Fax 541:7 26-37 69 I nspe ction Line By signaturer l 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 SpringfieH and the Laws of the State of C)regon pertaining to the work described herein, and that NO OCCUPAI\{CYwill be made of any structure without permission of the Community ServicesDivision, Building Safety. I further certi$ that only contractors and employees who are in compliance with ORS 701.005 will be used on this proiect. 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 b located at the front of the property, and the approved set of plans will remain on the site at all times during construction 0-2 Owner or Signature Date 4of4 L Construction Contractors Board Permit#: cot"tz;,-s- o I 297 Address: l?/7 ?r Issued by:\6 Date: t7*L SI700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:ry$1!41!4q 0 05- Statement: lnformation Notice to Property Owners About Gonstruction 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, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 38: ff, Sz 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. X 3,{. My general contractor is d-tL t/WlEuJ lzsozS: (Name)(ccB #) I will instruct my general conhactor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR tr 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 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. /a -7 ^oJ- o fpermit applicant)@ate) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 IMPERVIOUS S.F 0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENTCOST: COST PER S.F $0.323 COST PER S.F $0.323 COST PER DFU s2s.07 $19.07 NTIMBER OF UMTS I NUMBER OF T]NITS I ADM. FEERATE 5% CTIARGE $0.00 DISCOUNTRATE s0% $0.00 EET DISCOUNT $0.00 CIry OF SPKINGFIELD SYSTEMS DEVELOPMEN JOURNALORJOBNUMBER: CoM2005-0l259revised NAME ORCOMPANY Allen LOCATION:t9t7 l7th st l9l9 TAX LOTNUMBER:1703252403900 DEVELOPMENT TYPE:SINGLE FAMILY RESIDENCE NEW DWELLTNG UMTS I BUILDING SIZE (SF) 0 LOT SIZE (SF) I. STORMDRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM 0 IMPERVIOUS S.F. x 0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CIry STANDARDS x x x x x x x x x ITEM 2 TOTAL. CITY SANITARY SEWER SDC $132.42 3. TRANSPORTATION A. REIMBURSEMENT COST: NUMBEROF DFU's 3 B. IMPROVEMENT COST: NUMBER OF DFU's 3 ADTTRIP RATE 9.s7 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 ST]BTOTAL $2.078.1 5 xx xx COST PER TRIP $19.09 COST PER TRIP $84.1 9 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's I B. IMPROVEMENT COST: NUMBEROFFEU's I MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMIMSTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS I, 2, 3, & 4) 5. ADMIMSTRATME FEE: $957.34 $2,078.15 CHARGE $103.91 TOTAL SANITARY ADMIMSTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Cheryl Slaymaker t0lsl200s 1988.39 $75.21 $57.21 $r82.69 $82.03 $86s.31 $0.00 12.28 $2,182.06 1070 1091 1092 1093 1094 l0s4 1055 1054 1056 1079 1 078 v) 14ao() HFa rI]& COST PER FEU $82.03 COST PER FEU $865.31 PREPARED BY DATE TOTAL SDC CIIARGES DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEWFD(URES x UNIT EQUIVAIENT:DRAINAGEFXTURE UMTS FOR CALCULATE ONLY THE NET ADDITIONAI NO. OF FIXTURES UNIT FXTURE TYPE NEW OLD MISCELLANEOUS DFUTYPE NTA4BER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS lsa toa uit set at 167 NTWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE BEFORE 1979 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 CREDIT FOR LAND (IF APPLICABLE) *EDU DRAINAGE FIXTURE UNITS 0 2 1979 21979 1980 198 I 1982 1983 1984 x1985 1986 1987 1988 1989 I 990 t99r 1992 1993 1994 't995 1996 1997 1998 1999 2001 VALTIE / 1OOO $0.00 CREDITRATE $5.29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1OOO CREDIT RATE $0.00 x $5.29 TOTALIVTWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTIIB 0 0 3 0 DRINKING FOTINTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 b 0 LAUNDRY TUB 0 0 2 0 CLOTI#SWAS}IER / MOP SINK 0 0 3 0 CLoTITESWASHER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWE& SINGLE STALL 0 0 2 0 SHOWE& GANG OTUMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCIIEN 1 0 3 3 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 ,|0 URINAL. STALL / WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 TOILET, PRTVATE INSTALLATION 0 0 3 0 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALTIE 0 $0.00 2000 20 $5.29 $5.1 I $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 i'\'11]; ! i i< /7*4 -:- rzi -" .-: .- "'// THIS INDENTURE t'tADE and entered into this 3ottr - day of July r 19 8t , by andfilr refLrreci toFeiei nabetween as the ran rs, an T0 HAVE AND T0 H0LD the above easenent IN WITNESS WHERE0F, the Grantors above 30rh day of July . '19 V STATE 0F oREGoN ) ,, County , amun pa c0rp0ra oll r in Lane County, L T.T l,$rt{il 0o(}fil.frir to the said Grantee, its heirs and assigns fore'rer. named have heieunto set the'ir hands and seals this 8_1_. SEAL)SEAL) SEAL)SEAL) Oregon, hereinafter referred to as the Grantee. }IITNESSETH In consideration of the acceptance by Grantee and the use or ho'lding of said_easement for pieient or future public use'by Granlee, Grantors hereby grant, bargain, :el.l and convey unto the Grantee, a perpetual Lasemenl 7 feet in width, tog_ether.with.the right to go upo, ruia ease*ent area'hereinafter descr ?l for the purpos-e of constructing, reconstruct- ilg, *ui.taining.nd riing public utilities which may hereafter be installed on the follovt- ing described propertY, to-wit: Beginning at the Southwest corner of Lot 25, R0NALD PARK, as platted and recorded in Book 14, Page 13, Lane County Oregon PIat Records, said point being on the East margin of North 17th Street; thence along said margin North 9L.32 feet; thence Ieaving said margin East 7.00 feet; thence South 91.32 feet; thence West 7.00 feet to the Point of Beginning, in Lane County, 0regon of lrt,"- ) BE IT before me, the unders ly appeared the wi thi n to me to be the i denti t and acknowledged to me IN TESTIMONY I,JHERE0F, I have hereunto set my hand and affixed my officia'l seal the day and year 'last above written. h -93 xp res c Jg E Zdoz-/7 Q-s Ezsa< 'L 814188? PUBLIC UTILITY EASEMENT +{a t.lD 4 Fg 1 OF C/S ED L\c I 225 Fifth Street SpringfielA, Ore gon 97 477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT#: 1200500000000001479 Date: 1010712005 11:56:45AM Job/Journal Number coM2005-012s9 coM2005-01259 coM2005-01259 coM2005-01259 coM2005-012s9 coM2005-01259 coM2005-01259 coM200s-012s9 coM2005-01259 coM2005-01259 coM2005-01259 coM2005-01259 coM2005-01259 c0M2005-01259 coM2005-01259 coM2005-01259 coM2005-01259 cbrrazoos-orzsq Description Addressing Assignment Willamalane Attached (duplex) SDC Transpo Reimbursement SDC Transpo Improvement Plan Review Minor - Planning Building Permit Fixture Storm Sewer - lst 50 Feet Miscellaneous Plumbing + 7Yo State Surcharge + llYo Administrative Fee Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Amount Due 31.00 924.00 182.69 805.70 85.00 169.80 14.00 45.00 4s.00 19.17 27.38 75.21 57.21 82.03 86s.31 10.00 12.28 91.63 Item Total:$3,542,41 Payments: Tlpe of Payment Paid By Received By C[ecFNumEa Batch Number ffi Number How Received Amount Paid Check W PERRY ALLEN djb 1049 In Person $3,542.41 Payment Total: -S5"54-'tZf .l ) t01712005 I of I rlt fi*gaa.s i The tol '"#:nJJ:1"::??,ilffiffi"i1"'; " in 225 FIFTH STREET r SPRINGFIELD, OR97477 ' PH:(541)72 E LE CTRI CAL P ERMIT AP P LI CATI ON City Job Number s- o tzs Date 1.LOC{TION OF INSTALLAT'ION .3 l?r-7 l-7+r^:t- LEGAL DESCRIPTION ?O3ZS L\03 zc'c JOB DESCRIPTION t bo A-P Sbtc c ik Permits are non-transferable and expire if work is " not started within 180 days of issuance or if work is Suspended for 180 daYs. A. Nex Residential - Single or Nlulti-Farnily per drvclling 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 6-3753 o FAX: tilorlzeo ) $50.00 B., Electrical Address r,o,/lona- br City € oa"XLtt t Phone Supervisor License Number Expiration Date i0 -c0 Constr. Contr. Number /{671, i Expiration Date ic -{7 of Electrician 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 Amps/Volts Re6]ec.tr Only Pump or irrigation Sign/Outline Lighting Limited Energy/Residential 7% State Surcharge 10% Administrative Fee TOTAL $ 63.00 $ 75.00 s 1 25.00 $163.00 $375.00 $ 50.00 s 43.00 $ 3.00 $ s0.00 $ 50.00 $ 25.00 ebq -5 C D. Over 600 Amps or 1000 Volts see "B" above. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Owners Name N rl(,*,,,* *( Address t9 la lfi^ City SPFI Phone 7t{7-Z/ OWNERINSTAILATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: E. trIiscellaneous (Service/feeder not included) -Each lnstallation Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is $45'00 * Surcharges 4. SWTOTAL OF ABOVE .' .6?8) Bo7Inspection Request: 726-3769 \\b $ Shared Drive(T:)/Building Fonns/Electrical Permit Application l-03.doc $106.00 $ 19.00 3qrtrHs- tlt by or Feetlers UNDEB TY F PRIN Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERN{IT NO: COM2005-01259ISSUED: 0912212005APPLIED: 09/1512005 EXPIRESz 0312212006VALUE: S 17,900.00 SITE ADDRESS: l9l7L7TIJ ST 1919 ASSESSOR'S PARCEL NO.: 1703252403900 PROJECT DESCRIPTION: Springfield TYPE OF \\/ORK: Sirrsle Family Rcsidence TYPII OF tlSll: llcrnotlel ConvertResidence toDuplex & add carport at eri:t's p:ttl Owner: Address: Contractor Type General Electrical WILLIAM ALLEN I9I7I7TIJ STREET SPRINGFIELD OR 97477 Ilxpirrtion Date 09tt)5t2007 08t2U2007 Il csidcntial P!'r'y,'g 511-607-3141 541-344-8745 Phonc \rrrrrlrcr: 541-747-2161 I ccNTRAcl -iltA l--'-- - Contractor ERIC MATTHEW MASON JOSEPH BTJNCH ELECTRIC INC I-ict ttsc l:50- t; 15676 I BUILDING INFORMI # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Ilt'i' rt { 'rrrt'tttre l-r' - ol' \\': '.'r " : Rartge 1.r ,;' : Energr' l' ' ,'' ' Sprinl<lc,l lluilding: Lot Sizc: St1 l:t lst Floor: Srl lrt 2nd Floor: Sq Ft Bascment: S11 Ft Carage/Carport St1 l:l Othcr: Occtr;l:rrrt l,oad: R-3 u-1 \TN n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: l-DFf r.r. ,, - \t REQUIRED PARIilNG Tot:rl: I ltnrlicapped: Corrrlltct: Crrrb and Gutter 0r'cr'l:tv r':' t' #:, ' t)rrtl! I: : 'r, I -r ' .l gc: fPUnuirl-- AC lllt Yes li \TS ! ' loralk T1,pc: Downspouts/I)ra irr s: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Storm drainage into existing system !/lQTrtttt: 1-' ,. f)'r,,c I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line v c t'[Y oF s P iil N(; 1.': I LD Bu ild inq/Combination Perrnit I'l.l !lN I I't' N ( ISSUUT): AI)I'I,I IiD: I.]x !,t tt t,]S: YJ !.Uli: COr\ 12 00:,-0f 259 09t2u2a0s 09/ l s/200s 03t22t201t6 s 17,900.00 fYlluat;,',r-I' Description Bid Amount Carport Tvpe of Construction Use Bid Amount Carport $PerStl 'l or multi; r sl.!)0 s I s.00 T1t:tl \"r1,,,' 1rf l);r,i,','1 t Amount I'rirl Fee Description Plan Review Residential + l0oh Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid $110.37 $6.90 $4.t].1 $6.0i1 s63.()0 $191.1 0 (' (' ',,1',,,r' :! YrrItrc $8.()0 0.00 s9.e 0 0.00 s r 7.9(x).00 l)ule Cirlculated 09/t 5/2005 09/ l 5/2005 ,t,,irl llr'ccilll Ntrrrrht'r 0 tt 3 It f- r Initial Review Planning Review Public Works Review Structural Review 09n6t2005 09fi6t2005 09n6t2005 09n6t2005 0')i l{ '20(} 0o7 I ,,' /) 00i To Request an inspection call the24 hou;' ' will be made the same working day, inspct day. E Rough Electric: Prior to Cover Electric Service: Approval required prior to 1lrir:t1' 1'1,"" Final Electric: When all elcctrical u'orli is (' ,,'' i' t(!. f).r.r, 1 qrl'.'l I ',.r I '-'t s Sl0t.,,r .' :..: i r: 1,,,f i :: l,r t,r i. r i rrrr q1,\t1,111 t)" ... c(Ittcst0(l l) rrrarlc lhc l' ----------t - r' ,, :. ,.t'r. Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line CI i'Y OIT l)r.^. ' P rl i! r! ipo /COntbiflAt;^n 116.".' !1 I'E:{N I l't N0: CONI2005-01 25) ISSUI:D: 0912212005Al'}l'l.lED: 09/15/2005 EX l'l I{llS: 0312212006\/r\l.Ull: $ 17,900.00 By signature, I state and agree, that I have carcftrlll'cr(r;rri111''' information hereon is true and correct, and I l'"r'tlrlr t' the Ordinances of the City of Springfield and tlte Littt r , that NO OCCUPANCY will be made of any structure u illrr" I further certify that only contractors and emplovecs tvlto :tt'' I further agree to ensure that all required inspections are rt(: street, that the permit card is located at the front of tlte prol'"' times during construction. Owner or Contractors Signature l''r,,t'3 of3 rrissiorr of ll: ':rp!i:rrtcc u i 'l :rt the prol' rrrtl the appr' rril'r'Scrvict's l)it isiorr, litt i,;.,ii:g S:rli'tr'. ;1. l.(!05 rvill lrc rrsc(l orr this pro.jr:ct. tlrut caclr rrtlrlrt'ss is rt.lrd:rlllc I'r'orn lhe ol'lllans rlill l'crrr:rirt on llte site at all m a 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone rity of Springfield Official Receipt ;velopnrent Services Department l'ublic Works Department RECEIPT#: 2200500000000001318 Date: 0912212005 9:16:04AM Job/Journal Number coM2005-01259 coM200s-01259 coM2005-01259 coM2005-01259 Description Perm ServiFdr 200 amps or less Add, Alter, Extend Circ Ea Add + l0% Administrative Fee + 7Yo State Surcharge Amount Due 63.00 6.00 6.90 4.83 Item Total:\80.73 Payments: Type of Payment Paid By I{eceivctl llv ( ircck Number l',',lr Nurrrbcr Authorization Ntttttber lluN llcceived Anrount Paid CreditCard JOSEPH BUNCH ELECT nlnl 0()7-,-r, j'lt()ltc Pal rucnt Total: s8u.73 -iirT 1 9/22/2005 Page I of I aEt-