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Home My WebLink AboutPermit Building 2008-7-7 -ijF Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00970 ISSUED: 07/0712008 APPLIED. 07/02/2008 EXPIRES 01/07/2009 VALUE' $ 180,83000 225 F,lth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 840 S 31ST PL ASSESSOR'S PARCEL NO 1802062109800 Sprmgfield TYPE OF WORK Smgle FamIly Residence PROJECT DESCRIPTION Smgle famIly residence TYPE OF USE New Res,denhal Owner KAST CONSTRUCTION INC Address 2860 MARTINIQUE AVE EUGENE OR 97408 Contractor Type Gener dl Electrical Mechamcal Plumhmg I CONTRACTOR INFORMATION I Contractor License DJS INVESTMENTS LLC 131714 BOB FISHER ELECTRIC INC 96275 MARSHALLS INC 25790 EUGENE EXCAVATION & PLUMBING INC 138003 BUILDING INFORMA TlON I # 01 Umts' # of Stories I Primary Oc<updncy Group R-3 Height of Structure 2200 Secondary Occupdncy Group U Type of Heat. Forced Air Gas Primal y Construct"fn-Tip~N OregN1Baw tequireSWfil'tDype Gas Secondary ConstructIOn IType:ldopted by the OregREl.!gtlhtype' Gas # of Bedrooms N.ltlflCallon Center ThJlse rules arl!:fil1lg9i1ll1th Path 5 In OAR 952-001-0010 through OA~llTR~1rBUlldmg No f'\(\(V'\ v,.", 1'T'I"'''..c.b1a1n l""nnIPC::: nf thA rillAa', h\l calling the center (Not., NMOOl-M'flNT INFORMATION I number for the Oregon L..!'.." tt. .fll!!!!.. ' Center IS 1-800-332-2344). 13 00 Overlay Dlst 5 60 # Street Trees Rqd 5 60 Paved Drive Rqd 19 40 % of Lot Coverage 188 Frontyard Sethack Side I Setback S,de 2 Setback Rearyard Setback Solar Setbacks I PUBLIC IMPROVEMENTS I Street Improvements Fully Improved Storm Sewer AvaIl:NQT/CE: Yes Special InstructlOnTHIS PERMIT SHALL EXPIRE IF THE WORK Notes Stormwa~~I~9~1Z~~e4~~ THIS PERMIT IS NOT liutv1rVlt~C~D OR IS ABANDONED FOR ANY 180 DAY PERIOD. ExpiratIOn Date 10/09/2008 0l/25/2010 12/23/2009 04/27/2009 Phone 541-485-2655 541-689-7973 541-747-7445 541-988-0868 Lot SIZe Sq Ft 1st Floor 1,523 Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport 475 Sq Ft Other Occupant Load 2 Yes 3970 REQUIRED PARKING Total 2 Handicapped Compact SIdewalk Type Downspouts/Drams Page I of 4 CurbSide 5' Curb and Gulter Status Iss u ed 225 F,fth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Description Type of Construclton A C - Reslden Dwelhn2s Gara2e AC - ReSldenltal V Wood Frame Gara2e Fee DescriptIOn -Mech Iss 2+ Apphances- + 10% AdmmlStraltve Fee + 12% State Surcharge + 5% Technology Fee 2 Baths One or Two Fam,ly AddressIng Ass'gnment Apphance Vent BoIler/Comp Up To 100,000 btu BuIldmg PermIt Curbcut Permit Dryer Vent Exhaust Hoods FIre SF Fee - Resldenltal Furnace - up to 100,000 bto Gas Outlets 1-4 Plan Review Major - Plannmg Plan Review ReSidentIal Samtary Sewer - Improvement SDC MWMC AdmmlstratlOn SDC MWMC Improvement SDC MWMC ReImbursement SDC MWMC Reimbursement SDC Samtary/Storm Admm SDC Transpo Improvement SDC Transpo Reimbursement SDC TransportatIOn Admm Sidewalk PermIt Sto. m Dramage ImpervIOus Area Vent Fan Water Lme - Each AddtlIOO' WIIlamalane Smgle FamIly Total Amount PaId I ValuatIOn D~sC~Il~ti~n I $ Per Sq Ft or mulltpher $500 $10500 $28 00 Square Footage or BId Amount 1,523 00 1,523 00 47500 Total Valne of Project Fp~<. p~ Amount PaId $40 00 $138 67 $15442 $83 69 $280 00 $35 00 $700 $1400 $912 82 $88 00 $700 $1000 $99 90 $14 00 $500 $211 00 $593 33 $483 84 $10 00 $1,00917 $97 90 $636 30 $14485 $888 94 $201 54 $73 29 $88 00 $1,03500 $21 00 $1600 $2,513 00 $9,912 66 Date PaId 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 7/7/08 Pa2e 2 of4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' COM2008-00970 ISSUED 07/07/2008 APPLIED' 07/02/2008 EXPIRES: 01107/2009 VALUE: $ 180,830.00 Value Date Calculated $7,61500 $159,91500 $13,30000 $180,830 00 07/07/2008 07/02/2008 07/02/2008 Receipt Number 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 CITY OF SPRINtJ1'1J'.,LU . Building/Combination Permit Status Issued PERMIT NO. COM2008-00970 ISSUED: 07/0712008 APPLIED. 07/0212008 EXPIRES 0110712009 VALUE: $ 180,83000 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIne I Plan RevIews ~ Structural RevIew 07/07/2008 APP See docnments for plan reVIeW comments Plannm2 Review 07/02/2008 07/02/2008 APP TAJ PublIc Works RevIew 07/02/2008 07/0212008 APP LKW Storm water to weep hole In curb To Request an mspectJon call the 24 hour recordmg at 726-3769. All mspectJons requested before 7:00 a.m. will be made the same working day, inspectIOns requested after 7'00 a m wIll be made the followmg work day I R~'V"r~r11n<.npPt~ EroslOn/Gradmg InspectIOn Prior to ground disturbance and after erosIOn measures 31 e mstalled Sidewalk - CurbsIde After forms are erected bnt prior to placement of concrete Curbcut - Standard After forms are erected but prior to placement ot concrete Ufer Electrical Ground Install ground rod at footIng and call for InspectIOn In conjunctIOn wIth footIng and/or founddtlOD mspectlOD FootIng After trenches are excavated FoundatIOn After forms are erected but prior to concrete placement Post and Beam Prior to floor InsnlatlOn or deckIng Floor InsulalIon Prior to deckIng Shear Wall NadIng Before coverIng sheathIng WIth fimsh materials FramIng InspectIOn Prior to cover and after all rongh 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 BuddIng Inspector FInal BUIldIng Alter all reqUIred InspectIOns have been requested and approved and the bUIldIng IS complete. Underfloor PlnmbIng Prior to InsulatIOn or deckIng Underfloor DraIn Prior to cover or placement of concrete Rough PlumbIng Prior to cover and IncludIng reqUIred testIng Water LIne Prior to fillIng trench and IncludIng required testIng Samtary Sewer LIne PrIOr to fillIng trench and IncludIng reqUIred testIng Storm Sewer LIne Prior to fillIng trench Pal!e 3 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-00970 ISSUED: 07/07/2008 APPLIED: 07/02/2008 EXPIRES- 01/07/2009 VALUE: $ 180,83000 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlOn Lme Fmal Plnmbmg When all plumbmg work IS complete Undertloor Mechamcal PrIor to msulatlOn or deckmg and mclndmg reqUIred testmg U ndertloor Gas After Ime IS mstalled and reqUIred testmg and capped If not attached to an apphance Rough Gas Alter hne IS mstalled and reqUIred testmg and capped If not attached to an apphance Gas Service After Ime IS mstalled and hne has been connected to a mlmmnm of one apphance mcludmg reqUIred testmg Presure test done at thiS pomt Rough Mechamcal PrIor to Cover Fmal Gas When all gas work IS complete Fmdl Mechamcal When all mechamcal work IS complete. Rough ElectrIC PrIor to Cover ElectrIC Service Approval reqUIred prIor to ulIhty company energIZIng serv,ce Fmal ElectrIC When all electrIcal work IS complete By s'gnatnre, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby cerlIfy that all mformatlOn hereon IS true dnd correct, and I further cerlIfy that any and all work performed shall be done 10 accordance With the Ordmances of the City of SprIngfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY will be made of any structnre Without permissIOn of the Commumty Services DIVISiOn, BUlldmg Safety. I further certIfy that only contractors and employees who are m comphance With ORS 701 005 will be used on thiS project I further agree to ensure that all reqUIred mspectlOns are requested at the proper lIme, that each address IS readable from the street, that the perm.t card IS located at the front of the property, and the approved set of plans will remam on the site at all tImp7)=struclIon ~ /_ 7- () e '---"'" Owner or Contractors Signature Date Page 4 of4 ~:~ Willamalane t~ Park & Recreation Dlstnct Job No.~2cJ7J~-t'"JtJ '7 7t: SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME D...l,f /N//CSWa.fi:r PHONE 5'/7-~)ro ADDRESS~.{J/HM.J1)//fJ.{C CITY Eu,&.r;,Ji! STATE~ZIP 974t7~ LOCATION OF PROPOSED BUILDING SITE Street Address g4.o "5, '3/ if ~/., Plat Name 1J1riMtLy JjJ~!J Tax Lot Number /~L/:Jc,21 ~~JbC1O 1 DEVELOPMENT TYPE (Check appropnate dwelling(s) Dwelling type definitions are on the back) A Smale-Famllv Detached NO OF UNITS J B Slnale-Famllv Attached NO OF UNITS C MullI-Famllv Aoartment NO OF UNITS D Smale Room Occuoancv NO OF UNITS E Accessorv Dwelhna Unit NO OF UNITS WILLAMALANE SDC X $2,513 per Unit = $ 2S- /~ X $2,726 per Unit = $ X $2,323 per Unit = $ X $1,162 per Unit = $ X $1,257 per Unit = $ $ 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (If SDC reduced for Credit) $ 2~ / ,":5 J:::;:y "S. 7 I 7 I C:--!' Development Services Department City of Spnngfield Date 5 RECEIPT #. 2200800000000001032 Date. 07/07/2008 23218PM Job/Journal Number DeScriptIOn Amount Due COM2008-00970 Plan RevIew Major - Plannmg 21 100 COM2008-00970 S,dewalk Pel1mt 8800 COM2008-00970 Curbcut PermIt 8800 COM2008-00970 Storm Dramage ImpervIOus Area 1,03500 COM2008-00970 Sanitary Sewer - Improvement 483 84 COM2008-00970 SDC Transpo ReImbursement 20154 COM2008-00970 SDC Transpo Improvement 888 94 COM2008-00970 SDC MWMC ReImbursement 9790 COM2008-00970 SDC MWMC Improvement 1,009 17 COM2008-00970 SDC MWMC AdmmlstratlOn JO 00 COM2008-00970 SDC Samtary/Storm Admm 14485 COM2008-00970 SDC TransportatIOn Admm 7329 COM2008-00970 SDC MWMC ReImbursement 63630 COM2008-00970 Plan Rev,ew ReSldenlIal 593 33 COM2008-00970 BUlldmg Perm,t 91282 COM2008-00970 Addressmg AssIgnment 3500 COM2008-00970 Willamalane Smgle FamIly 2,51300 COM2008-00970 2 Baths One or Two FamIly 28000 COM2008-00970 Water Lme - Each Addtl 100' 1600 COM2008-00970 Furnace - up to 100,000 btu 1400 COM2008-00970 BOIler/Comp Up To 100,000 btu 1400 COM2008-00970 Vent Fan 2100 COM2008-00970 Apphance Vent 700 COM2008-00970 Exhaust Hoods 1000 COM2008-00970 Dryer Vent 700 COM2008-00970 Gas Outlets 1-4 500 COM2008-00970 -Mech Iss 2+ Apphances- 4000 COM2008-00970 Fife SF Fee - ResIdentIal 9990 COM2008-00970 + 5% Technology Fee 8369 COM2008-00970 + 12% State Surcharge 15442 COM2008-00970 + 10% Admm1stratlve Fec 13867 Item Total $9,912 66 Payments Check Number AuthOrIzatIOn Type of Payment PaId By Received By Batch Number Number How Received Amount Paid Cred,tCard DALE KAST dJb 09264C In Person $9,50000 Check DJS INVESTMENTS LLC dJb 5883 In Person $41266 Payment Total $9,912 66 c cRecelOtl Page 2 of2 7/7/2008 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO:.COM2008-00970 ISSUED: 07/07/2008 I. APPLIED: 07/02/2008 EXPIRES: 02/22/2009 . VALUE: $ 180,830.00 Status Issiled 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54t-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 840 S 31ST PL ASSESSOR'S PARCEL NO.: 1802062109800 Springfield TYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single family residence TYPE OF USE: New Residential' Owner: KAST CONSTRUCTION tNC Address: 2860 MARTINIQUE AVE EUGENE OR 97408 I CONTRACTOR INFORMATION. Contractor Type General Electrical Mechanical Plumbing Contractor DJS INVESTMENTS LLC BOB FISHER ELECTRIC INC MARS HALLS INC JAM MAL INC License 13t714 96275 25790 '158262 I, BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: 1 Height of Structure 22.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Energy Path: Sprinkled Building: No 1 R-3 U VB 3 I DEVELOPMENT INFORMATION I Expiration Date 10/09/2008 01/2512010 12123/2009 01/1212010 Phone 541-485-2655 541_689-7973 541-747-7445 . 54t-484-7440 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: 5,073 1,523 475 ~.. '.~. . REQUIRED PARKING Front yard Setback: 13.00 Overlay Dist: Total: 2 Side 1 Setback: 5.60 # Street Trees Rqd: 2 Handicapped: Side 2 Setback: 5.60 Paved Drive Rqd: TION' Oreq'::es It'.'!! r"q C:iimp,tc'r: ',Q Rearyard Setback: 19.40 % of Lot CoveraiiFEN \ ,,'a' do 39.70;)y It,,: Of~L1Di \ U~"\Y\h Solar Set~atl'nCE' 1.88 tollow ru e~ '~'-T'hQoe lI:irilS ~:" B"I rQI II 1. . n"'-'- EH:-!r..( ~r TUC \~/nR\( ~~\~f~~Ja\I~:_~~~t~~" ~ ~c ._, ':" nAi~ [Jt'i~-OOh TAHUITtiHl-'OtRKI;~I~ ~NOER THIS PER~iIlahf(!'uMPROVEl\}EN;rs,j)u may o. btain Cl)I"?;' ~,ittl\e r,i-lg~~\lY DQNrO "UK .... \h ,,-~1,>" (~!(lW, ,.hw tl io)!, I . Street Imp,rp;v,~mentS'EO OR IS ABFl\~\11 Ie, d callmg lIeSiltewalk:Typ,e::\lt1J N"g!j\j~\i()n C b'd 5' uulvll\IlL.l'lU r- U y mprove mber 10r tl18 UJeV...... ;:'I:~ I! 14'. ur 51 e S S ',"A' "I'br.l, 'Y PtRIOD Y nu D . ,n'-"ID' '. );.\~). C torm e~~rll.';'"v.a! 'a e:.,. es Cer.__ownspouts . rams: urb'and Gutter Special Instruction: Notes: Stormwater to weep hole in curb. Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54t-726-3769 Inspection Line Descriotion Tvpe of Construction AC - Residential V Wood Frame Garaee A.C. - Residen Dwellines Garaee Fee Descriotion -Mech Iss 2+ Appliances- + 10% Administrative Fee + 12% State Snrcharge + 5% Technology Fee 2 Baths One or Two Family Addressing Assignment Appliance Vent Boiler/Comp Up To 100,000 btn Bnilding Permit ' Cnrbcnt Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fnrnace - np to 100,000 btn Gas Ontlets t-4 Plan Review Major - Planning Plan Review Residential Sanitary Sewer - Improvef!lent SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Improvement SDC Transpo Reimbursement SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area Vent Fan Water Line - Each AddtlIOO' Willamalane Single Family + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee I V aluation nesc~intion ~ $ Per Sq F:t or mnltiplier $5.00 $105.00 $28.00 Sqnare Footage or Bid Amount 1,523.00 1,523.00 475.00 Total Valne of Project Fpp~ PiWU Amount Paid $40.00 $138.67 , $t54.42 $83.69 $280.00 $35.00 c $7.00 $t4.00 $912.82 $88.00 $7.00 $10.00 $99.90 $14.00 $5.00 $211.00 $593.33 $483.84 $10.00 $],009.17 $97.90 $636.30 . $144.85 $888.94 $201.54 $73.29 $88.00 $1,035.00 $21.00 $16.00 $2,513.00 $5.20 $6.24 $2.60 Date Paid 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 717108 7i7/08' 717108 717108 717108 717108 717108 717108 717108 717108 8/26/08 8/26/08 8126/08 Paee 2 of4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00970 ISSUED: 07/07/2008 . APPLIED: 07/02/2008 EXPIRES: 02/22/2009 VALUE: $ 180,830.()0 Value' Date Calculated $7,615.00 $159,915.00 $13,300.00 $180,830.00 0710712008 07102/2008 07/02/2008 Receipt Number 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032. 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 -2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 2200800000000001032 3200800000000000605 3200800000000000605 3200800000000000605 _Sf!RlNGf:I~~, . I: 1: Status Issued CITY OF SPRINtJt'l~LD' Building/Combination Permit PERMIT NO: COM2008-00970 ISSUED: 07/07/2008 APPLIED: 07/02/2008 EXPIRES: 02/22/2009 VALUE: $ 180,830.00 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Low Voltage - Residential Minimum/Adjustment Electrical $29.00 $23.00 8126/08 8/26108 3200800000000000605 3200800000000000605 Total A"mount Paid $9,978.70 I Plan Reviews I Plan nine Review 07/0212008 0710212008 APP TAJ Public Works Review 07/0212008 0710212008 APP LKW Stormwater to weep hole in curb. 'Structural Review ' 07/07/2008 07/0712008 . APP DLM See documents for phm review comments To Request an inspection call the 24 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. I Rpr."ljrPI,~ In.r~tions I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floo~ Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. 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 Iuspection 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. UnderOo"r Plumbing: Prior to insulation or decking. Undertloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to' cover and inclnding required testing. Paee 3 of 4 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2008-00970 ISSUED: 07/07/2008 APPLIED: 07/02/2008 EXPIRES: 02/22/2009 VALUE: $ 180,830.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54t-726-3676 Fax 541-726-3769 Inspection Line Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Priodo tilling trench and iucluding required testing. Storm Sewer Liue: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Gas: After line is installed and-required testing a~d capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Low Voltage: Prior to cover. 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 reqnired inspections are reqnested at the proper time, that each address is readable from the street, that the permit card is locatcd 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 Page 4 of 4 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 Payments: Type of Payment Check Check Change Job/Journal Number COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 Payments: Type of Payment Check Check Change Job/Journal Number COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 COM2008-00970 Payments: Type of Payment Check Check Change cReceintl RECEIPT #: Description Minimum/Adjustment Electrical Low Voltage - Residential + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By SECURETECH SECURETECH SECURETECH Description Minimum/Adjustment Electrical Low Voltage - Residential + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid'By SECURETECH SECURETECH SECURETECH Description Minimum/Adjustment Electrical Low Voltage - Residential . + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By SECURETECH SECURETECH SECURETECH City of Springfield Official Receipt Development Services Department Public. Works Department 3200800000000000605 Date: 08/26/2008 Item Total: t:heck NUl!lber Authorization Received By Batch Number Number How Received. njm njm njm 7551 7595 In Person In Person In Person Payment Total: Item Total: Check Number Authorization Received By Batch Number Number How Received njm njm nJm 7551 7595 In Person In Person In Person Payment Total: Item Total: Check Number Authorization Received By Batch Number Number How Received njm njm njm 7551 7595 In Person In Person In Person Payment Total: Page I of I 1:41:36PM Amount Due 23.00 29.00 .2.60 6.24 5.20 $66.04 Amount Paid $36.83 $29.29 ($0.08) $66.04 Amount Due 23.00 '29.00 2.60 6.24 5.20 $66.04 Amount Paid $36.83 $29.29 ($0.08) $66.04 Amount Due 23.00. 29.00 2.60 6.24 5.20 $66.04 Amount Paid $36.83 $29.29 ($0.08) .$66.04 8/26/2008 ZON U V INITIALS _1 DATE SOURCE ' - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726~3689 ELECTRIC# !'ERMJ1'AP!:PCATION City Job NumbeWm ~!\7) X {In CJi 0 :j0:::'?':~f;;;"'';'##4:W'''IfS*!<=+i<::1'.1f;;j;;gj/''''kj~~dt:~~'"'1SS0-;PJii!f!f'%ZR';ru 1. "TLDeA.''F. cr. ONjOEc1NS1.:,rnIfA1'IDNn'.~.G'.,.-.,.Jffi~, 3, 840P~~3'~*"Q~~JJ~- LEGAL DESCRIPTION I-Ot (.Q 0DI\~ ,lS\:. qlYl\? JOBbESCRIPT~ ~~~ OM.-wW.,&uO~- T\l,~. Permits arc non-transferable and llpire if work 'is not started \vithin 180 days of issuance or if\,",ork is Suspended for 180 days. ' ~1/ 'I~\ \ i~~~ 8J~/o'1 Ii I ~:&~;: Electrician o\VnersNamt~:")( CcnSr- Addres~ Z aaO t'YV1N1lJhlrylJvL-.- City ~_ rJ ) r\U Phone'). Pump or irrigation $ 57.00 ()lLj025' Sign/Outline Lighting $ 57.00 OWNER IN TALLATl6N Limited Energy/Residential I S 29.00 dCj'.OC> The 1l1staIlation istJJil~!f~~,o~-vr,Q~~LL 'ID/.'?rlW:'IF THE ~d Energy/Commercial 2.00 IS Ilotmtended forlS~HSI~a.JOor'1,clnP THIS PER~N!l'ItlGli.lectricp~e,~~~~}t, Ins~ection Fee ~, :-2,0 + '.!rcharges . , . ',AUTHORIZED UNDER r:Orn...4Wj'''''~'~W'~~,ifLf''''""'''''t:ffiW0Bf'i&' ~J:J ,'n o\vner~Sif,'11~tureCnM~JfENCED OR IS' ABANDONED'fO ~~Mr!k,~~;;!:~"L\i!~~~f~~G~~:<Pl1!'0"Ij':,~1 .... "u '. ' ";) DAY PERIO\) ~Io St';;;'Surcl13fg~ - '" -~ ' <-J ~ I\I~ r ,,() , , 10% Administrative,Pee ..;:) , 90 5% Tcchnology Pee \ . <-i S IGomT~~~1ifiNs?jiA1111iTi(JNitJNI{f!l 2. ffiii';:70(?fAf1'ii0'F1t2t''"'''-':'''ipdj0iq!fuj=""",,~,,-,,,+,c;''~;~ssiillllli:2::r;~1;;F"n;AF"~ ElcctricaIC~:tr:';:S;,0'~f b~ Address (O~(o (',-.Q[~~~, "- Citf~~lh~~ Phonc C\~?lD9/iD Supervisor License Number ~O -Ii leoe' ,l.~ c. . "\"n,,: 1'1" Expiration Dat~ Canstr. COlJtr. Number Expiration Date Inspection Request: 726-3769 Date ()~ A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $ 121.00 $ 22.00 Each Manufact'd Home or Modular Dwelling Service or Feeder 557.00 B. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 73.00 $ 86.00 $143.00 $186.00 5426.00 .,57.00 Installation, Alteration or Relo~atioll- 2~mff~~r.>()regon law iequiresYOU!.~7.00. , f8i!cf:jl1l1!li\9s4i1.QJepips:j by the Oregon ut~Ity;.OO t#l!i1fuJ1/iAJto t'i001i.\J1ip;Jhose rules are 5_81 f\lr\l4oo ;l1J~rl9fr-~~1-0/)'),Q \5Jrough ,'Y~n ""z-crOl- 009:.0 Ot";:";Yc~. u:;;I.<ly;rQI?'1#1!:h~~8~~~~:~\~~!~!~5~,~,~'i'.Af"i'i!.iI\l*.'!.>.;'!:!::'7'"" D. 'l!cnarlall" '1(~trCllll"'~r~~:g:'~ote1ilhejtel"pfj()(1e~,1li~>,j"0!,llc2jj'~1 lfn,' w nt:ht.;~ n'O.~\"___,_;,~~=,,,!M;"_<<iMW_.~"~"'- l'i1OOltItlfrmrotN!: ~{~.lhg~ VjjJ~~~o~ficallon One CircJrlenler IS 1-800 3~: 2 'lI) $ 50.00 Each Additional-Circuit or with Service or feeder Permit ,5.00 E. 5'L,~ (Q.z.~ 5~ t .ldJ .~.~.~ Shared Drive(f:)/Building FotTI1S/Electrical Pemlit Application 7~08.d~ TOTAL (Qlo .01