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Building/Combination Permit
PERMIT NO: COM2009-00996ISSUED: 0710712009APPLIEDI 0710712009
EXPIRES: 01/1312010
VALUE:
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 Inspection Line
SITE ADDRESS: 858 S 46TH ST
ASSESSOR'S PARCEL NO.: 1802051205100
PROJECT DESCRIPTION: Install Air Conditioner
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Addition
Phone Number: 541-746-0644
Expiration Date
04tr4t2010
03t0712010
Residential
Phone
541-,134-5600
541-988-s674
Owner:
Address:
Contractor Type
Electrical
Mechanical
THOMPSON CARL
858 S 46TH ST
SPRINGFIELD OR 97478
Contractor
DOUG PALMER ELECTRIC LLC
CHARLES ISAAC OSGOOD
License
I 81 465
168942
TION
BUILDING IN
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
:
Frontyard Setback:,
Side I Setback: ,
I
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
1 Overlay Dist:
, '# Street Trees Rqd:
Paved Drive Rqd:
uh 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
I!,$#f,,1ftgllg
REQUIRED PARKING
Total:
Handicapped:
Compact:
ALL
ORK
\S N01
\I\l
Street Improvements:
Storm Sewer Available:
Special Instruction:
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PUBLIC IMPROVEMENTS
Notes:
Pase I of3
oon la rv reqttires
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Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 Inspection Line
PERMIT NO: COM2009-00996ISSUED: 0710712009APPLIED: 0710712009
EXPIRES: 01/1312010
VALUE:
Description Type of Construction $ Per Sq Ft
or multiplier
Square Footage
or Bid Amount Value Date Calculated
Total Value of Project
Fee Description
+ l2o/o State Surcharge
+ 57o Technology Fee
lst Appliance
Heat Pump
+ lzoh State Surcharge
+ 57o Technology Fee
Add. Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid Date Paid Receipt Number
1200900000000000782
r200900000000000782
1200900000000000782
1200900000000000782
1200900000000000799
1200900000000000799
1200900000000000799
I 200900000000000799
$1r.52
$4.80
$79.00
$17.00
s7.32
$3.0s
$s5.00
$6.00
7t7t09
7 t7 t09
7t7t09
7 /7 t09
7n3t09
7/13t09
7n3/09
7n3t09
Total Amount Paid $183.69
To Request an inspection call the24 hour recording at 726-3769. All inspections 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 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.
Fees Paid
Plan Reviews
red Insnections
Pase 2 of 3
Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
Buitding/Combination Permit
PERMIT NO: COM2009-00996ISSUED: 0710712009
APPLIED: 0710712009
EXPIRES: 0l/1312010
VALUE:
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 Sal'ety.
I further certify that onty 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
Pase 3 of 3
225 Fifth Street
Springlield, Oregon 97 477
541-726-3759 Phone
Cifv of Springfield Official Receipt
[ ;lopment Services Department
Public Works Department
RECEIPT #: 1200900000000000799 Date: 0711312009 ll:47:03AM
Job/Journal Number
coM2009-00996
coM2009-00996
coM2009-00996
coM2009-00996
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 57o Technology Fee
+ l2o/o State Surcharge
Amount Due
5 5.00
6.00
3.05
7.32
Item Total $71.37
Payments:
Type of Payment Paid By Received By
Check Number
Batch Number
Authorization
Number How Received Amount Paid
ONLINE CHGS ONLINE PERMIT CHGS KR ONLINE DOUG Online
PALMER
ELECTRIC
$71.37
Payment Total:$71.37
cReceint I Page I of I 711312009
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