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Home My WebLink AboutPermit Septic Tank 2003-11-12 ... . ' . , . 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 '. 1. ,LOC.hTI~ ~F INSTAholfllJ; ION 1/./7 ~ ~5d' f../J 0 . . ' ' LEGAL DqpjS TIOND -L!J 0 3_,~ ,() f7 -:3 (J -, . A. JOB'DESCRIPT ON . · f;~ , ' \ ~"~Qu'~~yvu'- .:\ '.f~ :,\~ r~r.Y~\::f ){::;~1t)r. ia' I . Vii , .t 11 i ~vi'.~~\f P~rmlt"s. aloe\ no, ,n-l,tr:ansfe,r(abil.'e)'ahanexplve : lIf~.tf ... f;',t 1,\. ,)\,."",'''-- ""'#.1 .f:, (,. . i f "'ot:~' ~i S.' 'riO,l.:,S ~~r t,e~0~Yj. tb~in; ;;180Sday:sr of 'lssuaride" o'r"i!f'work is susp"ende-d~-for . . ". .-, . , \ _"'\1/ J!'r..; r I -' , ,,~ . -. . 180 dl' <~, '.; Ill"-' I " ..1, '-. .... 9~S. .J'; . .. " ,,' .: , ;".... ~'., "r')C\ fll\es ' , 1..,1.......'\ r_n,"',.-. i" l"_J \' " '\ ~" "'-'. .' .. ..~....-).V" . C'()C\' \ ' ' "!, y,.' , .. " , ~I<J\" 1',.< "<, (.!\t"<;""'('<1"'~91~':'none , 2. CO~80R ,dNS!~~:fg~:, ~~tJt:1icationB. \', ~.\,,-..':.\, .r."'1....\fJ'J"Il,yl.~ nl\~l1l "". \..1 ',< - ,".. ') Electrical~ po,r..tFflP~tP+',: n Q3!? 2:3,-;'," . . Addr~sr!'J. J-,C{J-jOY] ! CitY~IYIAf) -> PhoneJ1 ;'5-',;'151 Supervisor License NU,mber M ~ " _J .. ExpiJ;atiqn Date 10 -J - O-y Constr Contr. Number ,10 q K'lo lj Expiration Date 01- It.f,.. o-6( .. ; . .. .\....... S1J~ sur~ectridan o",n:rs Namef)'\i U-e.. K~t.'V u...J $ , . r1. f 5lA.c..Yi\~(JQV; II v Address'll1?> ~ep5-{" " Ci ty .j., I (:;. Phone OVNER INSTALLATION The installation is being made on property I o",n ",hich is not intended for sale, lease or rent. Owners Signa ture:. \ --------------------------------------- , .\ . . DATE: RECEIPT #: RECEIVED BY: , ELECTRICAL PERMIT APPLICATION City Job NumberLDn110rA 00'-/0 U 3. COMPLETE FEE SCHEDULE BELOY Ne'" Residential-Single or Multi-Family per d",elling Service Included: Items 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or ModularD",elling . Service or Feeder ~ ~, i'~ ~TC~:E:Temporary Services or Feeders I f'I~'1 i.JtRI'l-nst-aa..lataoJ:lIr:JEALt,e,:"atjpn or Relocation , "I 'III unt'.ll tM"'n 11- I H!: WORK I,Ul H(;R1Lf0bU~\h1rfsl;{'Jfllq,~~MIT IS NOT CUMMEN(2ffi GiihpCS AtEb\t~19gl\~r[p~O,R ANY 180 ~N~pa:R~D~o 600 amps Over 600 amps or 1000 volts Services or Feeders Installation, Alterations or Relocation: 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 D. Branch Circuits uni t. Cost $~O. $ 15.00, $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $ 40.00 $ 55.00 $ 80.00 see "B" Sum jO~ 3i above , ,. Ne"" Altetation or Extension Per Panel One Circu'i t EachAdditional .. Circui t or ",i th S,ervice or Feeder Permit E. Miscellaneous (Service/feeder -Each installation Pump or irrigation : Sign/Outline Lighting. Limited Energy/Res Limited Energy/Comm :, 5. SUBTOTAL OF ABOVE ~% State Surcharge I~Administrativ~Fee TOTAL . $ 35.00 $ 2.00 not included) $ $ $ $ 36.00 L!/i ,;;:l~1 40.00 40.00 20.00 . , CITY OF ~ .UNGFIELD, OREGON 225 FIFTH STREET,. SPRINGFIELD~OR 97417 . PH:(541)726-315J. ---FAX: (541)726-3689 ELEl,J,lUCALPERMrF 4PPElCATION Cityklb Number' CO tv\ ZOO3 .Ct) 40""2..- Date , -3 1.,ioCATION()F lNSTMi:A/iIDN':;; .., 3; ....17)~. C (le-~tl1Jz~ .'CoMPk~-FEE'~~jjiILE BELOW .- . ., ".. - . .... :,.',". LEGAL DESCRIPTION l103~~t4--01 ~OO , JOB,DESCRIPTION, A. 'N~~ lt~jdential";Singilor Midti~FamiJypcr dwelling unil ' .... ' ;..;..'. ..,).. '..... ..,. .: ".:~ " . . . Service Included , . 1000 sq. it, or less Each additional 500sq: ft: or portion thereof Each Manufact'd Home or Modular Dwelling'Service'or'. , FeedeJ- ' . / $t06.00 /0 V ~~~ VI t 4) 1-fffilJl1 U 2--- $ [9~00 Permits are non-transferable and expii:e iCworkis, . not started within 180 days of issuance. ot if wOrk is- . Suspended for 180 days. $50.00 Owners Signature: ~.,~: M.... ..:~~'f'" :::;:.::" ...:. .;.', .::'~1~':<''':::;::~.1:'.'' ';.:--:',=:',' "",,'::. '::':~i::",:': :::;,~,..' ..V::;.,.... ,':.JI'."" '.. .... "Y';'.. 2.:.~CO~9:r~!;!V,st~!If!~ml)'~ 'It. :, S~f~i~~~r~eedtrS::ln~~t~!~tiO~~,Altet~tiOlis,OE Relocation: '; , Electrical Contractor ~ I J ~ 200 Amps or less $ 63.00 ~ .0 ' (>o,c .' 201 Amps to 400 Amps $ 75.00 ~ <? S?V ~ ~ v 41 ~, :~~=:~^::. ;,<2,.>. ::~::: City -iu ~ ~,,Jl/ Phone 9-1i)'''' :?(5 c.f Over lOOO'AmpsNolts -AO 5-...& '" $375~OO o .:::..'5 ~ Reconnect Only ~,00 O~ _0- _ $)..... _ $ 50.00 ~~ ~"V ~ ~ 0'!6v ~0J 0 SunPf:1,ncnr License,Number. " /.1,~.s, . "-~A ~ ~ c. .~T~nipo' '~~n:'serVf~~~~~~~~'0~ ,^,o~:..p,~ ," .' ~-"":'),{~;"': Y""''''''' I::T ~ ....~~ '.(..'S'- ~''', ' , '''~ -J " ',l!t 0" ~'U- 0'( .',~ -':f}:' q;- , '. u'\;' ; ! () --I - 0 # ~<Z~ Installation, Alte~:m~8;-~~oJi~4&-':. , ~->(;' ~ C\.~ 0U) 0 ''^'o' ~o '~-;s-v _\ .J?" "~ ~v 200 AmPS'Of.tes~~0 "'.....os' oQ 0" ..:~ _().', $'50.00' -I ) q @..< ~~ s.y ~~.~. C) Ci ~ ~' ~v Constr: Contr. Number I ~ ,Q;> 201 Amp6td 4Q.a ~l~' 'S- ~O 'V III $ 69.00 ~Sj ~ ~. 401 ~~to~60.olAmCPs~q,; ~~~'':'or::>-' $100.00 Expiration Date 4)~......~ ,(,~ ~ V ~" . 0 ~0 (0~ ,,_ ~~ . ~v~- ~~ ~!:2$:i!<.'j@(~l~~?~~~'B"_~bove:;, _, . ",. SignatureOfS~~~~~q" D. ~~Branr.h;~mc~lts~ ~.<,,~ -'~' "'>'" , ':.,., ',;"",.,' ',0' - ~~~.~...~ ' ,,",' " "~0~,~J 'crr.~'~' '~<qj'~(J,ji"'!Ii! ',< '", ',: ' c". .".;:4,'; O ~~ ~" N AJ~ ~ti ~ .-"'. ~O.~. P P I J" 1/ ~ ' CQ-y<::S ew .te~ ~ ~~~x~ens~on er ane ..,L.~/,,- (; (". ,~~ ,One Circ'Uits::>Q) vii} ~0 ( $ 43.00 - ~ Each Additi1nal <;;itCuit or with Own= NCame JJY e / +~r;tf)f;9i ru.. n ~;:,Of:-:;::::'~'i""'" s~'~ > '. .,..., Address '7-!1?' 6t~ ( :.r ., . I .. - E. ',>~~!~~,(~j;~~;'i~.~~~~t ~~~~~) :-E~:f~Jn~~I~iI~9~': City 5 I' P - Ph:n~ kf '/ ~ ~ / Y () S -- PumjHlr-irrigation- $ 50.00, . , e.. i1 'f '? t1 Sign/Outline Lighting $ 50.00 OWNER INSThLATION Limited, EnergylResidentia1- $ 25.00 The installation is being made on.property 1 oWn-which-, , , . LimifedEnergyfCOmmereial- $ 45.00' is not intended for sale, lease OJ: renL Minimum Electric Peririit mspection Fee is $45.00 + Surcharges :. . :';~:.: :,':,:." :~~;:,~~j.::.,:~ : ;J~:"':".:; :,:;~.;:i::; :.'.{::~,<::!t~$~~: ., -'.'. . ..~~.:.:.... ."~ ': 4 ....SUB... 'TO',7:AFOFAB' 'O"!TE:~~.:<'~\,,: .'. 'c:."-,-, . , , n.LJ. , ,1'..0;"" ,c,,' ,e '.,' 'c," ~ ,:-'~~'~:r.;.~,..+" ~;~~~tV~\' .::.~' ;;~:':> .':~~;.;'!:";.,(~7::; r.:?::'~~..:';,:) : ~;::~~:~ :';;..'i:" :if:,:.. . ".,' ,.. .... Expiration Date 7% State Surcharge 10% Administrative Fee ~ ~ lX:) /(0. 0(5 ~ L\ ,40 -+ l Co B "- 4-e> Inspection Request: 726-3769 TOTAL C:OL.___..J "-~.. .''T'" ",_ .... _ ~9JiNGlJJlIfIL.D ~ . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00402 ISSUED: 11/12/2003 APPLIED: OS/23/2003 EXPIRES: 05/12/2004 VALUE: $ 139,461.00 " . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 723 Crest Lane ASSESSOR'S PARCEL NO.: 1703341407300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: SFR Owner: KOIVULA MICHAEL G Address: 743 CREST LN SPRINGFIELD OR 97477 Phone Number: 541-746-1805 I CONTRACTOR INFORMATION' Contractor Type General Electrical Mechanical Plumbing Contractor WATER BROTHERS CONSTRUCTION INC OWNER OWNER OWNER License 118345 Expiration Date 10/31/2004 Phone 541-345-5080 _0 ' <--:- I O~ .~""'l !..: ~<:)'(~UlLDING INFORMATION ~ .;S5 \,...0 ~ ll~" ~ . 0'0 ^' "..,":-- CS ~" ~ ~ ~y r;;: n: ~ ..c. ~ t\.. # of Stories: 2::> l>~ot.SlZe: ,,0 1>, ~"' ~- ~~ ""~ ~Q)J ,,,, ..., Primary Occupancy Group: 1\1.3 -~ ' ~-v Height of Structure 29;50 O~ Slt Mst~ocfri:, o~ ~~'~ ~. '?..... 0 ~~ ~ Secondary Occupancy Group: ~ ~<<; Type of Heat: Forced Air EI~ct,,0 ,~Sq'Ft,<)ha1.1:100T-: R.... '"" ",v ~''V "1\ ~ ~'O ~,'V Primary Construction Type l~ ~ S::) Water Type: .. ElecttJc 040;. ~q RtBaselIi"ent: " .~ ~ (jv ,'V: c:; .;: ~ -... ,u ,r. . Secondary Construction Type'N ~. ~ Range Type: (?}ElectrIc ,0 SQZilik,6atagei.Garport ~t\..~- O~~~~O~~~ # of Bedrooms: ~'^<Q- ~2 Energy Path: . ~Path]~ 'So f;t e.tti~r:' C;) ~'V ~ ^ ~. ,>-0 ~. C) Ci.~~, ,v ~ ..:;s- ~ ~'V. 0 'b-v ~0 ~" 'S- ~mper..viP-1is Surface Area: . <t. -~ '"\ ,,<<-- /'\~ A~ r_ _~ <:5 .....'li ~ ""~ (1,' ~~ q,,~~'" ~ ~ q,,'V' I DEVELOPMENT IN~QIDv.ii'l:.fONS'I~ 0"" ~0~,(0) 5<"&' SE'N!'V<dRlS~ # <::)~ ~ ~O"- qf !f:r ~~ CJ0 0.v-" REQUIRED PARKING ~~ ~ S) Cf .~ OJ ~ ,^0 ~ ,,'- Front yard Setbac~ &' ~ 21.00 Overlay Dist: ~,~ ~ -l,,0 ~~Jsi~e" Total: 2 Side 1 Setback: ~ ~ 6.00 # Street Trees Rq(l~ 0 ~Cy ~<:' ~ C~ 2 Handicapped: Side 2 Setback: ~ 23.00 Paved Drive Rqd: (;)':5 CJ'lj;> Y Compact: ~ es ~ 22.00 # of Buildings: 1,200 409 562 Rearyard Setback: Solar Setbacks: 48.00 0.00 % of Lot Coverage: ;, I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Partially Improved Yes Downspouts/Drains: Curb and Gutter As per Don Branch 10/15/02, no sidewalks, driveway approach to be build to city standards for future curbside sidewalks. Storm water to be pumped to Crest Street as per applicant. Sanitary to connect to 6-inch line off Level Lane. ' Sidewalk Type: Notes: Pal!e 1 of 5 , . . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00402 ISSUED: 11/12/2003 APPLIED: OS/23/2003 EXPIRES: 05/12/2004 VALUE: $ 139,461.00 " , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description , Description Tvpe of Construction $ Per Sq Ft Square Footage Value Date Calculated or multiplier or Bid Amount Dwelline:s V Wood Frame $74.60 1,200.00 $89,520.00 OS/23/2003 Dwelline:s V Wood Frame $74.60 562.00 $41,925.20 06/20/2003 Garae:e Garae:e $19.60 409.00 $8,016.40 OS/23/2003 Total Value of Project $139,461.60 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $362.60 5/23/03 1200200000000001309 -Mechanical Issuance Fee- $10.00 6/26/03 1200200000000001651 + 10% Administrative Fee $93.57 6/26/03 1200200000000001651 + 7% State Surcharge $65.50 6/26/03 1200200000000001651 1 Bath One & Two Family $145.00 6/26/03 1200200000000001651 Addressing Assignment $8.00 6/26/03 1200200000000001651 Annexed 1979 or Before $-158.67 6/26/03 1200200000000001651 Building Permit $695.65 6/26/03 1200200000000001651 Curbcut Permit $75.00 6/26/03 1200200000000001651 Dryer Vent $6.00 6/26/03 1200200000000001651 Exhaust Hoods $9.00 6/26/03 1200200000000001651 Furnace - up to 100,000 btu $12.00 6/26/03 1200200000000001651 Minimum/Adjustment Mechanical $12.00 6/26/03 1200200000000001651 Plan Review - Planning $59.00 6/26/03 1200200000000001651 " Plan Review Residential $89.57 6/26/03 1200200000000001651 Sanitary Sewer - Improvement $268.64 6/26/03 1200200000000001651 Sanitary Sewer - Reimbursement $353.44 6/26/03 1200200000000001651 SDC MWMC Administration $10.00 6/26/03 1200200000000001651 SDC MWMC Improvement $34.83 6/26/03 1200200000000001651 SDC MWMC Reimbursement $332.86 6/26/03 1200200000000001651 SDC Sanitary/Storm Admin $71.87 6/26/03 1200200000000001651 SDC Transpo Admin $47.91 6/26/03 1200200000000001651 SDC Transpo Improvement $709.81 6/26/03 1200200000000001651 SDC Transpo Reimbursement $160.87 6/26/03 1200200000000001651 Storm Drainage Impervious Area $683.85 6/26/03 1200200000000001651 Temp Power 200 amps or less $50.00 6/26/03 1200200000000001651 Vent Fan $6.00 6/26/03 1200200000000001651 Willamalane Single Family $1,000.00 6/26/03 1200200000000001651 Plan ReviewIResidential Hourly $90.00 9/30/03 1200200000000002234 Sanitary Sewer - Improvement $103.26 9/30/03 1200200000000002234 Sanitary Sewer - Reimbursement $135.84 9/30/03 1200200000000002234 SDC Sanitary/Storm Admin $11.96 9/30/03 1200200000000002234 + 10% Administrative Fee $11.50 10/6/03 2200200000000001622 + 7% State Surcharge $8.05 10/6/03 2200200000000001622 Pae:e 2 of 5 .. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Miscellaneous Plumbing Vent Fan + 10% Administrative Fee + 7% State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Total Amount Paid Initial Review Planninl!: Review Public Works Review Public Works Review . OS/27/2003 OS/27/2003 06/03/2003 06/13/2003 $109.00 $6.00 $14.40 $10.08 $106.00 $38.00 $5,858.39 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00402 ISSUED: 11/12/2003 APPLIED: OS/23/2003 EXPIRES: 05/12/2004 VALUE: $ 139,461.00 10/6/03 10/6/03 11/12/03 11/12/03 11/12/03 11/12/03 2200200000000001622 2200200000000001622 1200200000000002452 1200200000000002452 1200200000000002452 1200200000000002452 I Plan Reviews I OS/27/2003 06/04/2003 06/05/2003 06/13/2003 APP LLH APP AID Tree felling permit required if more than 5 trees (5"dbh) are removed because lots 6 and 7 of Emerald Heights are in common ownership. Contacted applicant 6/5/03, site plan does not show connection for sanitary and storm sewer. Spoke with Sue asked for re-submittal site plan with sanitary and storm sewer clearly marked on plans, also if either private line crossed another parcel a private easement is required prior to building permit approval or issuance. Applicant has been made aware of this and that their permit is on hold waiting for external information from them. As per Don Branch 10/15/02, no sidewalks, driveway approach to be build to city standards for future curbside sidewalks. Storm water to be pumped to Crest Street as per applicant. Sanitary to connect to 6-inch line off Level Lane. Applicant s~bmitted information regarding sewer connection from Level Lane. PW Engineering is waiting to hear from PW Maintenance regarding sewer line, expectation is for a call on 6/16/2003, PW review and fees have been completed, waiting for information from PW Maintenance. WE VRJ WI VRJ Pal!:e 3 of5 J . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2003-00402 ISSUED: 11/12/2003 APPLIED: OS/23/2003 EXPIRES: 05/12/2004 VALUE: $ 139,461.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 06/16/2003 06/16/2003 APP VRJ As per Don Branch 10/15/02, no sidewalks, driveway approach to be build to city standards for future curbside sidewalks. Storm water to be pumped to Crest Street as per applicant. Sanitary to connect to 6-inch line off Level Lane. Please coordinate with Keith Miyata, Sewel Supervisor, Public Works Maintenance, #726-3761, to have line TV'ed once exposed at the property line. Public Works Review 09/25/2003 09/25/2003 APP VRJ SDC's calCulated for bathroom added after first review. Revised Plan Review - Pu 06/10/2003 06/17/2003 APP VRJ Revised plot plan brought to office 6/6/2003. Received on 6/10/2003 because I was out of the office Revised Plans ReceivedIRo 06/17/2003 APP LLH Plot plan received as requested by Virginia J. Structural Review OS/27/2003 06/17/2003 APP RJB Structural Review 09/19/2003 09/29/2003 APP DLM Changing garage to one-car & adding additional bath and library in deleted garage area. 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. 1 Curbcut - Standard: After forms are erected but prior to placement of concrete. 2 Site Inspection: To be made after excavation but prior to setting forms. 3 Erosion/Grading Inspection: After all erosion measures are in place. 4 Vfer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 5 Footing: After trenches are excavated. 6 Foundation: After forms are erected but prior to concrete placement. 7 Post and Beam: Prior to floor insulation or decking. 8 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 9 Floor Insulation: Prior to decking. 10 Shear Wall Nailing: Before covering sheathing with finish materials. 11 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 12 Wall Insulation: Prior to cover. 13 Ceiling Insulation: Prior to cover. 14 Drywall: Prior to taping. 15 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 16 Final Building: After all required inspections have been requested and approved and the building is complete. 17 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Pae:e 4 of 5 . _.fiB9J~IaJ!I!BLD . . . CITY OF SPRINGFIELD . oJ Status Issued Building/Combination Permit PERMIT NO: COM2003-00402 ISSUED: 11/12/2003 APPLIED: OS/23/2003 EXPIRES: 05/12/2004 VALUE: $ 139,461.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 18 Underfloor Plumbing: Prior to insulation or decking. 19 Underfloor Drain: Prior to cover or placement of concrete. 20 Rough Plumbing: Prior to cover and including required testing. 21 Water Line: Prior to filling trench and including required testing. 22 Sanitary Sewer Line: Prior to filling trench and including required testing. 23 Storm Sewer Line: Prior to filling trench. 24 Final Plumbing: When all plumbing work is complete. 25 Rough Mechanical: Prior to Cover 26 Final Mechanical: When all mechanical work is complete. 27 Temporary Electric: Approval required prior to Utility Company energizing pole. 28 Ufor Electrical Ground: Install ground rod at footing and call for inspection in conjuction with footing and/or foundation inspection. 29 Rough Electric: Prior to Cover 30 Electric Service: Approval required prior to utility company energizing service. 31 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. IJ a,( MAAA'lA Owner or Contractors Signature fA ) .......... v/o_, ~ , {s Pae:e 5 of 5 225~Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00402 COM2003-00402 COM2003-00402 COM2003-00402 Payments: Type of Payment Check p .' Receipt #: 1200200000000002452 Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 7% State Surcharge + 10% Administrative Fee Check Number Batch Number Authorization Number Paid By DELL'S ELECTRIC Received By JMP 5094 . City of Springfield Official Receipt Development Services Department," Public Works Department Date: 11/12/2003 11:06:19AM . I Amount Paid Item Total: 106.00 38.00 10.08 14.40 $168.48 How Received In Person Payment Total: Amount Paid $168.48 $168.48 . .