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Home My WebLink AboutPermit Building 2004-04-19Status 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: COM2004-00207ISSUED: 0411912004APPLIED: 0212012004 EXPIRESz 1011912004VALUE: $ 15,066.00 SITE ADDRESS: 864 S 34TH PL Springfield TYPE OF WORK: Garage ASSESSOR'S PARCEL NO.: 1802062105610 TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace burnt garage and related interior repair of sheetrock. Issued electric 041304 db. Temp power; Demolish burned garage Owner: CHRIS HANNESON Address: 864 S 34TH PL SPRINGFIELD OR 97478 Contractor Type General Electrical Contractor RAY SHARP CHRISTENSON ELECTRIC INC License 60926 458 Expiration Date 06t0u2004 05t0u2007 Phone 541-345-2279 541-688-6121 # of Units: 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: # of Stories: Height of Structure Type of Heat: Water Type: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: R-3 VN Range Tvne: rneilPifrfifr-N-r lollow rul w reSfE$Pu$l6arPort the ds$tflttHititYION:Oregon la' es adopted bY 620 Thos e rut Jgg1gripg fr6face Area: PARKING 26.00 16.00 34.00 overtav(U$il^'Q the * streeir[Rhtr{Si Paved Drive Rqd: Yo ofLot Coverage: cen'ter. (N the Oregon UtilitY I',!otifiOatsr, acc-2id4\Handicapped: Compact: 2t.60 Sidewalk Type: :- r .QOO- 0.00 ifli-#$1d$:niftrffffBr lLYT[]B'^V Fid'bo PUBLIC IMPRO Notes: Pase 1 of3 m IrUrLUrl.\(, ll\It ltUYlAIll-l\ | 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: COM2004-00207ISSUED: 0411912004APPLIEDz 0212012004EXPIRES: 10/1912004VALUE: $ 15,066.00 Description Garage Tvpe of Construction Garage $ Per Sq Ft Square Footage or multiplier or Bid Amount $24.30 620.00 Total Value of Project Amount Paid Date Paid Value $15,066.00 $15,066.00 Date Calculated 0312612004 Fee Description + lOoh Administrative Fee + 77o State Surcharge Temp Power 200 amps or less + llYo Administrative Fee + 7Yo State Surcharge Demolition Plan Review Residential + l0o/o Administrative Fee + 77o State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl500 + l0%o Administrative Fee + 7o/o State Surcharge Building Permit Total Amount Paid $5.00 $3.50 $s0.00 $4.50 $3.15 $45.00 $100.23 $12.s0 $8.7s $106.00 $19.00 $1s.42 $10.79 $154.20 $s38.04 2t20t04 2t20t04 2t20t04 2t26t04 2t26t04 2t26t04 3t26104 4n3t04 4n3t04 4n3t04 4n3t04 4n9t04 4figt04 4n9t04 Receipt Number 2200400000000000163 2200400000000000163 2200400000000000163 220040000000000018r 220040000000000018r 2200400000000000181 1200400000000000390 1200400000000000472 1200400000000000472 1200400000000000472 1200400000000000472 r200400000000000498 1200400000000000498 1200400000000000498 E'pps Pqid Plan Reviews Initial Review Planning Review Planning Review Public Works Review Structural Review 03t29t2004 03t2912004 APP LLH 03129t2004 WE Height of garage is not listed and no scale indicated to determine height of structure. Called Ray Sharp to get the height of garage so I could figure the solar setback. Left message 4107 tara Height is OK - about 14' Garage to be located in the same location as the demo'ed burned garage. No SDC's. No plan review comments. Engineered building. 04t07t2004 03t29t2004 04t07t2004 04t02t2004 APP APP TAJ VRJ 03t29t2004 04t09t2004 APP RJB 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. Paee 2 of3 \ Valuation Descrintion 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: COM2004-00207ISSUED: 0411912004APPLIED: 0212012004EXPIRES: 10/1912004VALUE: $ 15,066.00 2 Temporary Electric: Approval required prior to Utility Company energizing pole. I Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. 3 Shear Wall Nailing: Before covering sheathing with finish materials. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 5 Drywall: Prior to taping. 6 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 7 Final Building: After all required inspections have been requested and approved and the building is complete. 8 Rough Electric: Prior to Cover 9 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 Owner or Date Page 3 of3 T Kequrreo rnspeetlons l 225 Fifth Street Springfield, Oregon 97 477 541-7?6,3759 Phone ^ity of Springfield Official Receipt -,- evelopment Services Department Public Works Department RECEIPT #: 1200400000000000498 Date: 0411912004 8:17:37AM Job/Journal Number coM2004-00207 coM2004-00207 coM2004-00207 Description Building Permit + 1Yo State Surcharge + l0%o Administrative Fee Amount Due 154.20 10.79 15.42 Item Total:$180.41 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check RAY SHARP CONST INC djb 7072 In Person $180.41 Payment Total : -Si8o.-IT' 4fi9t2004 Page I of I ltrfla**D 225 FIFTH STREET . SPRIIYGtr'IELD, OR 97477 o pH:(S4t)726-3753 E LECTRI CAL P E RMIT APP LI CATI ON City Job Number (Dlyl . 21t6,[-gt:]t1 Dare + as submitted has the tollowing r FAXo(5"€)4116 -gS$9not require specific land use ap\oval. Zoning LD(z 0 \ $ 106.00 $ 19.00 $s0.00 /o(r* lq u" 1. HIS PE 3. A. B. C. SH iro ut't ED AY fu04 s 3f+ +h JOB orsczupttoNt Electrical Contractor LEGAL DESCRIPTIONlytttDt">l 6* t O Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 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 Installation, Alteration or Relocation 200 Amps or less ORK N01 see "B" above. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ur res you $ 50.00srisil$irv Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 u I $ 63.00 $ 75.00 $ r2s.00 s163.00 s375.00 s s0.00 $ s0.00 s 69.00 $ 100.00 s 43.00 $ 3.00 Address l)A 3 belh e-l )pt *(- City trL*r.e-bk'trt > IPhone Supervisor License Number z 15q \ Expiration Date 0 0 Constr. Contr. Number Expiratiou Date 3 CE: 't c0MI,[ENC 0 of Supervising Electrician 180 D Owners Name ANY CAu"s lJ tl n Y1e s.or.J Address Vo'l S Z I pl E. ; : $ 25.00 e 7Yo State Surcharge l0% Administrative Fee TOTAL s 45.00 Inspection Fee is $45.00 * Surcharges /2t 7'f/zf tq6z:Inspection Request: 726-37 69 \$qn Shared Drive(T:/Building Fonns/Electrical Permit Application I-03.doc ---_---- / / City n OWNER INSTALLATION The installation is being made is not intended for sale, lease or rffiO.You center'calling the Owners Signature:the.-".:. {number tor 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 PERMIT NO: COM2004-00207ISSUED: 0212612004APPLIEDz 0212012004EXPIRES: 10/0912004VALUE: $ 15,066.00 SITE ADDRESS: 864 S 34TH PL Springfield TYPE OF WORK: Garage ASSESSOR'S PARCELNO.: 1802062105610 TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace burnt garage and related interior repair of sheetrock. Issued electric 041304 db. Temp power; Demolish burned garage Owner: CHRIS HANNESON Address: 864 S 34TH PL SPRINGFIELD OR 97478 Contractor Type General Electrical Contractor RAY SHARP CHRISTENSON ELECTRIC TNC License 60926 4s8 Expiration Date 06t0u2004 05t0u2007 Phone s4t-345-2279 541-688-6121 CONTRACTOR INFORMATION BUILDING INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Special Instruction: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Dist: Rqd Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN 620 26.00 16.00 34.00 REQUIRED PARKING Total: Handicapped: Compact: 21.60 Sidewalk Type: Downspouts/Drains: NOTICE: THIS PTNUIT SHALL EXPIRE IF THE WORK NUTHONIZTD UNOER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. DEVELOPMENT INFORMATION Notes: Pase I of3 X1 Rqd: 1d1$ 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: COM2004-00207ISSUED: 0212612004APPLIED: 0212012004EXPIRES: 10/0912004VALUE: $ 15,066.00 Plan Reviews Description Garage Fee Description + l0o/o Administrative Fee + lYo State Surcharge Temp Power 200 amps or less + l0Yo Administrative Fee + 1Yo State Surcharge Demolition Plan Review Residential + l0Yo Administrative Fee + 7oh State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl500 Total Amount Paid Tvpe of Construction Garage $ Per Sq Ft Square Footage or multiplier or Bid Amount $24.30 620.00 Total Value of Project Amount Paid Date Paid Value $15,066.00 $15,066.00 Date Calculated 03t26t2004 $5.00 $3.s0 $s0.00 $4.50 $3.15 $45.00 $100.23 $12.50 $8.7s $106.00 $19.00 $3s7.63 2t20t04 2t20t04 2t20t04 2t26t04 2t26t04 2t26t04 3t26104 4n3t04 4tr3t04 4n3t04 4n3t04 Receipt Number 2200400000000000163 2200400000000000163 2200400000000000163 2200400000000000181 2200400000000000181 2200400000000000181 1200400000000000390 1200400000000000472 1200400000000000472 1200400000000000472 1200400000000000472 Feos Paid Initial Review Planning Review Planning Review Public Works Review Structural Review 03t29t2004 03t29t2004 APP LLH 03t29t2004 WE Height of garage is not listed and no scale indicated to determine height of structure. Called Ray Sharp to get the height of garage so I could ligure the solar setback. Left message 4107 tara Height is OK - about 14' Garage to be located in the same location as the demored burned garage. No SDC's. No plan review comments. Engineered building. 04t07t2004 03t29t2004 04t07t2004 04t02t2004 APP APP TAJ VRJ 03t29t2004 04t09t2004 APP RJB 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. Paee2 of3 Vatuation Descrintion I Building/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: COM2004-00207ISSUED: 0212612004APPLIEDz 0212012004EXPIRES: 10/0912004VALUE: $ 15,066.00 Reouired Insnections 2 Temporary Electric: Approval required prior to Utility Company energizing pole. I Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. 3 Shear Wall Nailing: Before covering sheathing with finish materials. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 5 Drywall: Prior to taping. 6 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 7 Final Building: After all required inspections have been requested and approved and the building is complete. 8 Rough Electric: Prior to Cover 9 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 Pase 3 of3 __I L 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone rrty of Springfield Official Receipt _ .velopment Services Department Public Works Department RECEIPT #: 1200400000000000472 Date: 0411312004 1:51:43PM Job/Journal Number coM2004-00207 coM2004-00207 coM2004-00207 coM2004-00207 Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + lYo State Surcharge + l0% Administrative Fee Amount Due 106.00 19.00 8.75 12.50 Item Total:$146.25 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard LARRY CHAPMAN djb 000353 042625 In Person Payment Total: $146.2s -SIItsF 4n312004 Page I of I almtarl,D Buildin g/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00207ISSUED: 0212612004APPLIEDz 0212012004 EXPIRESz 0812612004 VALUE: SITE ADDRESS: 864 S 34TH PL ASSESSOR'S PARCEL NO.: 1802062105610 PROJECT DESCRIPTION: Temp power; Demolish burned garage Owner: CHRIS HANNESON Address: 864 S 34TH PL SPRINGFIELD OR 97478 Springlield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential Contractor Type General Electrical Contractor RAY SHARP CHRISTENSON ELECTRIC INC License 60926 4s8 Expiration Date 06t0U2004 05t0u2007 Phone 541-345-2279 541-688-6121 BUILDING INFORMA' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: .)reooo law requlres you tu -: . ArrENrroi^""';Ht, in" o,"son Utilitv Noteslollqvvrutes^ad?XJ"i.9'r"11i";if ;r.;-fJ 1"3'if$ i3 ir;-q' ; ;;* 31 3,tl ; *' " =' r 0 e o . vo u. 1ay................;;;.' i N " i ", t h e t e I e p h o n e calling,n" t..uJ[,"Jon'u,',,rvlotitication nUmber {or tf .- r oirl-ee 2-.1'.".,+4\.}[m15$*$'nffiiffi'l.5' Sidewalk Type: Downspouts/Drains: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Pase I of3 L(,I\I Building/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: COM2004-00207ISSUED: 0212612004APPLIEDz 0212012004 EXPIRESz 0812612004 VALUE: Description Type of Construction Fee Description + l0oh Administrative Fee + 77o State Surcharge Temp Power 200 amps or less + l0o/o Administrative Fee + 7%o State Surcharge Demolition Total Amount Paid Total Value of Project Date Paid 2t20t04 2t20t04 2t20t04 2t26t04 2t26t04 2t26t04 Value Date Calculated Receipt Number 2200400000000000r63 2200400000000000163 2200400000000000163 2200400000000000181 2200400000000000181 2200400000000000181 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $s.00 $3.50 $s0.00 $4.s0 $3.15 $45.00 $111.15 Fees Paid Plan Reviews 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. I Temporary Electric: Approval required prior to Utility Company energizing pole. 2 Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Rpnrrirpd Insnpefinns Paee 2 of3 :!tL Valuation Descrintion I Building/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: COM2004-00207ISSUED: 0212612004APPLIEDz 0212012004 EXPIRESz 0812612004 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 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 ,r/re/+ 7Owner or Date Pase 3 of3 )lllN(i I; It1 LD. C)Rf:GON P -O2Feb-24- 04 03 z 48P 225 FI]'TH STREET o SPIIII{GFIELD,OR 9747l, o PH:(3f1P263?53 r FAX: (54tpZG36Ul DEMOLITION PERIVI IT APPLICATI ON 1;PEI''{G*':'LCI & Address: Structure to be Demolishedl Job Nurnber: il a U?e The applicant is hereby notified thatany redevelopment of the subject site must complyu'ith all of the applicable laws, codes, ordinances, polices and plaus in effect at the time the redevelopment proposal is accepted as complete for Cit-v teyiew. This would include cnrection of substandard conditions associated with the prsent development. Examples of such srrrections may include modification of inadequate drainage facilities; compliance n'ith building set- backs from property lines; eorrection ofsubstandard sidewalks and street impro'ements, including driveway width and placement; and other corrcctions rvhich may be necessary to cumply with existing development standards. Furthermore, if an existing use is demolished or othen*'ise removed prior to the development of the proposed use, then the sy'stem development charge credit for the previously existing use shall expire t!r,o years after the date of issuancc of the demolition peryit or other removal of the previously existing use. (springiield Municipal Code g.+16(r)). My signature below indicates that I have read and understand the above conditions relating to the demolition of the aborae mantioned structure. <,Z- Datc I CI[Y OT. Feb-24-O4 03:49P 225 T'IFTH STREET T SPRINGFIELD,OR97477 o PH:(54I[26-37SJ r F.AX: (5,f 1)7263639 P-()3 Date: tpatr{3FIGLO o2 & Address:5, S./ru- Propcrty Ovmer Signaturel Job Numben: Your dernolition permit is currently being processed.. There ma1,be a slight delay, of :lP.to , rn'o.rking days for small structures, due to the time requiied t" *ii"",tfrehlstory ot the structure to determine if it needs to be docurnented before demolition.This documentation is for archival purposes ohly and vvill not affe"t ifrrlr.iting ofthe dernolition pcrmit. If the structure is very large or complicated t[;, "----- documentation process n-ray qke up to a maximuir ora *o'rr.inta;i.' Documentation rvill.consist-of photographing the building, takiig rri*osu,-rents and making scaled drawings. The docuurenfutio; will be unaEitat<eriUy tlre City at no cost !o you. Documentation is hing done on all structures dated prior io r94o ihat may have hi-storie importance to the City's del'elopment. THIS DOCUMENTATION WILL NOT IMPEDB T}IE DEMOLIIION PROCESS. fui age cut-offof r94o was ehosen because this is the date that the National parla **if and lte Springlield Development Code use to determine potential historic significance. {.you y-ould Pr+rlo coryPlete this documentation yourself you must provide the clty r"ith the_following inforrnation: r) black and wtrite photographs of each elevation, a floor plan with measurements, and z) a set of etevati,in drarn,ings with measurements. Thank 1'ou for your patience. [Srant the City of Springfield perrnission to enter my property to complete documentation plior to the rcquested demolition of the struchrre Iocated at: d( / CITY OF' SPRINGT'IELD. OREGON 225 Fifth Street ': Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Date: 45.00 3. l5 4.50 Item Total:$52.6s coM2004-00207 coM2004-00207 coM2004-00207 Demolition + 7Yo Slale Surcharge + llYo Adminiskative Fee Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check RAY SHARP CONST INC dlm 7066 In Person Payment Total: s52.65 $52.65 FD-o16 FIRE DAMAGE REPORT OR ELECTRICAL HAZARI) Q,4'00701 TO: FROM: SUBJECT: Building Department Springlield Fire Department Structural Damage to Building Date: 2 -Ly'_ a '/ Address or location of building <i bL1 S o*|L 3 at'-Pl Name of Owner C 1", Type of Building P-.-lr cQ.-.-o @welling, Store, Warehouse, etc.) Estimated value of building $/3O. rd .: Estimated loss to building $D Date of fire Location of damage to building C) (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire ".{ u)t (B Additional pertinent information Lu' urned rafters, Beams, Joists, t Electrical Hazard. (Wiring, Outlets, etc.) CC V:\FD_FORMS\FD{16 FIRE DAMAGE REpORT.doc Signed '2O. <) (2 ,7*.r-r^<- 225FIFTHSTREET . SPRINGFIELD, OF.97477 o PH:(541)726-3753 oF "S3S{Afrd388fotELECTRICALPERMIT APPLICATION Zoning City Job Number COY4 7oo1-OOZD7 ,ur"oZ ZO orl a^t" 1. \ LEGAL DESCRIPTIONLZI C,SC(D JOB Permits are non'-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Conhactor Address l)A k City -\/,-e- Phone b?t'bt>l Supervisor License Number Expiration Date 0.1 Constr. Conff. Number c Expiration Date of Supervising Electrician 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 aa?? as submitted has the following require specific land use 3-o $ 106.00 $ 19.00 $50.00 1Ht $12s.00 s37s.00 $ 50.00 so.oo ,52 0z 69.00 100.00 $ 43.00 $ 3.00 s s0.00 $ 50.00 s 25.00 07) 357 5?D gx 4 sr **e<- t- J A. B. 9<,n""-t Drr *t 200 201 401 601 NDER 1000 Amps C Over 1000 Amps/Volts Reconnect OnlY Installation,lo Owners Name C*ffr,s .:^ { -QflO- Address Ciry rrb Phone5? OWNER INSTALLATION The installation is being made on Property I own which is not intended for sale, lease or rent. Owners Signature: Zb\ .S )Li' One Cfteat^ Each Additionai Circuit or with Service or Feeder Permit Pump or irrigation Sig:r/Outline Lighting Limited EnergyiRes idential 7oh State Surcharge l0% Administrative Fee TOT^{L 4 LE. Limited Energy/Commercial S 45'00 lVlinimum Electric Permit Inspection Fee is $45'00 * Surcharges Inspection Request: 726-37 69 4. Shared Drive(T:)/Building Fonns/Electrical Permit Application 1-03.doc C hr-r stustut (2e<> $ 7s.00 c6rtp #J9t ' 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00207ISSIIED: 0212012004APPLIED: 0212012004EXPIRES: 08/2012004 VALUE: SITE ADDRESS: 864 S 34TH PL ASSESSOR'S PARCEL NO.: 1802062105610 PROJECT DESCRIPTION: Temp power Owner: CHRIS HANNESON Address: 864 S 34TH PL SPRINGFIELD OR 97478 Springlield TYPE OF WORK: Electrical Work Onty TYPE OF USE: New Residential LicenseContractor Type Electrical Contractor CHRISTENSON ELECTRIC INC 458 Expiration Date 05t0u2007 Phone s41-688-6121 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 \rN # of Stories: Height of Structure Type of Heat: Water Type: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area:1 $ Per Sq Ft or multiplier AR Square Footage or Bid Amount REQUIRED PARJflNG Total: Handicapped: Compact: \ Type: Total Value of Project Page I of2 Description Type of Construction Value Date Calculated Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: %6 of Lot Coverage: \attJ Valuation Description I Range ,t Building/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: COM2004-00207ISSUED: 0212012004APPLIEDT 0212012004EXPIRES: 08/2012004 VALUE: Fee Description + l0Yo Administrative Fee + 7oh State Surcharge Temp Power 200 amps or less Total Amount Paid Amount Paid $5.00 $3.s0 $s0.00 $58.50 Date Paid 2t20t04 2t20t04 2t20t04 Receipt Number 2200400000000000163 2200400000000000163 2200400000000000163 Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Temporary Electric: Approval required prior to Utility Company energizing pole. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pase 2 of 2 tiees ratfl I Keourreo Inspectlons 225 Fifth Street Springfield, Oregon 97 477 541-72G3759 Phone City of Spr:ingfield Official Receipt Development Services Department Public Works Department #: ZZUU4UUUUUUUUUUUI6J Date: OZl2Ol20O4 Z:14:03PM 3.50 5.00 50.00 Item Total: coM2004-00207 coM2004-00207 coM2004-00207 + 7o/o State Surcharge + l0% Administrative Fee Temp Power 200 amps or less Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard CHRISTENSON ELECTRIC djb 000303 056215 In Person Payment Total: ss8.s0 -$ffio-- $s8.s0 FD-o16 FIRE DAMAGE REPORT OR ELECTRICAL HAZARI) TO: FROM: SIJBJECT: Building Department Springfield Fire Department Structural Damage to Building Date: 2 -Ly'_ O '/ Address or location of building ,-rJ-L 3 -/tn izlt,/ S Name of Owner C L", Type of Building P-,-ii ,Ln ^ -u @welling, Store, Warehouse, etc.) Estimated value of building $/3O c s)C Estimated loss to building $'2o, o <2o Date of fire Location of damage to building (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire ".{ lL)L (B Additional pertinent information L...,, urned rafters, Beams, Joists, "lo-,.n-o-rz- Electrical Hazard (Wiring, Outlets, etc.) CC V:\FD_FORMS\FD{t6 FIRE DAMAGE REpORT.doc 'Signed I