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Home My WebLink AboutPermit Building 2008-8-6 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01043 ISSUED 08/06/2008 APPLIED: 07/1 1/2008 EXPIRES 02/06/2009 VALUE' $ 145,99600 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 2155 YOLANDA AVE ASSESSOR'S PARCEL NO 1703244302400 Sprmgfield TYPE OF WORK Smgle FamIly Residence TYPE OF VSE AddItIon ResidentIal PROJECT DESCRIPTION ResIdentIal AddItIon - Bed, Bath, Dmmg Owner SWEENEY PHILIP M & EMILY S Address 2155 YOLANDA AVE SPRINGFIELD OR 97477 Phone Nnmber 541-285-3879 I CONTRACTOR INFORMA TION , Contractor Type Gene. al Electncal Mechamcal Plumbmg Contractor OWNER OWNER OWNER ROBINSON PLVMBlNG INC License ExpIratIOn Date Phone 107124 07;1312009 541-345-6909 BUILDING INFORMATION I # of VOltS 1 # of Stones 1 Lot SIze Pnmary Occupancy Group R3 HeIght of Structure 1400 Sq Ft 1 st Floor 1,286 Secondary Occupancy Group Type of Heat Sq Ft 2nd Floor Pnmary ConstructIOn Type VB Water Type Sq Ft Basement Secondary ConstructIOn Type Range Type Sq Ft Garage/Carport 162 # of Bedrooms 3 Energy Path Path 1 Sq Ft Other Sprmkled Bmldmg No Occupant Load I DEVELOPMENT INFORMATION' Front yard Setback S.de 1 Setback SIde 2 Setback Rearyard Setback Solar Setbacks 1800 10 00 2500 2800 000 Overlay Dlst # Street Trees Rqd Paved Dnve Rqd % of Lot Coverage V rban Fnnge REQUIRED PARKING Total Hand.capped Compact I PUBLIC IMPROVEMENTS' Street Improvements Storm Sewer AvaIlable Special InstructIOn Storm water to curb, tie mto eXlstmg system S.dewalk Type DownspoutslDrams Notes Paee 1 of4 Status Issued 225 FIfth Street, Spnngtield, OR 541-726-3753 Phone 541-726-3676 FdX 541-726-3769 Inspection Lme DescrIotIon Tvue of Construct IOU A C - Reslden Dwelhngs Gara2c AC - Resldent..l V Wood Frame Gar.Ule Fee Description Plan RevIew ResIdential -Mech Iss 2+ Apphdnces- + 10% Admlmstratlve Fee + 12% State Surcharge + 5% Technology Fee BUlldmg PermIt Dryer Vent Exhaust Hoods FIre SF Fee - Resldentldl Fixture Furnace - up to 100,000 btu Mlmmum/AdJustment Mechamcal Plan RevIew Mmor - Planmng SDC Samtary/Storm Admm Storm DralOage ImpervIOus Area Vent Fdn Totdl Amount PaId CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO, COM2008-01043 ISSUED: 08/06/2008 APPLIED 07/1112008 EXPIRES, 02/06/2009 VALUE' $ 145,996,00 I ValuatIOn DescrmtlOn I $ Per Sq Ft or multlpher $500 $10500 $28 00 Square Footage or BId Amount 1,286 00 1,28600 16200 Value Date Calculated Total Value of ProJect $6,430 00 $135,03000 $4,536 00 $145,99600 07/11/2008 07/11/2008 07;17/2008 Ff>f>.,~ Amount PaId ReceIpt Number Date PaId $502 58 $40 00 $10129 $112 86 $52 98 $787 52 $700 $1000 $72 40 $96 00 $1400 $1900 $11900 $25 83 $51657 $700 7/11 ;08 8/6;08 8/6/08 8/6/08 8/6/08 8/6/08 8/6/08 8;6/08 8/6/08 8;6/08 8;6/08 8/6/08 8;6/08 8;6/08 8;6/08 8;6/08 1200800000000000766 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 1200800000000000847 $2,484 03 I Plan RevIews I Imtlal RevIew 07;15/2008 07/15/2008 APP NJM Pubhc Works Review 07/15/2008 07/21/2008 APP LKW Storm water to curb, tiC mto eXlstmg system Structural RevIew 07 i15;2008 07/29;2008 APP CJC Planmng RevIew 07/15/2008 08/04/2008 APP TAJ Keep constructIOn outSide of VISIOn clearance tnangle Page 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-01043 ISSUED, 08/06/2008 APPLIED, 07/11/2008 EXPIRES' 02/0612009 VALUE: $ 145,996,00 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Line To Request an mspectIon call the 24 hour recording at 726-3769, All mspectlOns requested before 7'00 a m Will be made the same workmg day, mspectIons requested after 7 00 a,m, wIll be made the followmg work day, UpnJllrPrlJn~'?~fhl\~ SIte InspectIOn To be made alter excavatIOn bnt prIor to setting forms EroslOn/Gradmg InspectIOn Prior to ground disturbance dod after erOSIOn measures are IUstalled Ufer ElectrIcal Ground Install ground rod at footing and call lor inspectIOn In couJunctlOn WIth looting and/or foundatIOn mspectlon Footing After trenches are excavated FounddtJOD After forms are erected but pnor to concrete placement Post dnd Beam PrIor to 1I00r msuldtlon or decking Floor InsulatIOn PrIor to decking Shear Wall NdllIng Before coverIng sheatlllng WIth fimsh materIals Frammg InspectIOn PrIor to cover and after all rough m mspectlons have been approved Wall IllsuldtlOn PrIor to cover CeIling InsulatIOn PrIor to cover Final BUIlding After all reqUIred mspectlOns have beell requested and approved and the buIlding IS complete Underlloor Plumbing PrIor to insulation or decking Rough Plumbing PrIor to cover and mcludlng reqUIred testmg Shower Pan Prior to covenng and mcludlllg reqUired testmg Water Line PrIor to fillIug trench dnd including reqUIred testing Line to Septic T dnk PrIor to fillIng trench and reqUIred testing Storm Sewer Line PrIor to fillIng trench Fmal Plumbing When all plnmblng work IS complete Undertloor Mechamcal Prior to msuldtlOn 01 deckmg and mcludmg reqUIred testmg Rough Mechamcal PrIor to Cover Fmal Mechamcal When all mechamcal work IS complete Rough ElectrIC PrIor to Cover ElectrIC Serv.ce Approval. eqUlred prIor to utilIty compdny ellerglZmg servIce Final ElectrIC When all electrIcal work IS complete Paee 3 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO, COM2008-01043 ISSUED 08/0612008 APPLIED, 07/1112008 EXPIRES: 02/06/2009 VALUE: $ 145,99600 225 F,lth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspecllOn Lme By slgnatnre, 1 slate and agree, Ihal 1 have carefully exammed Ihe compleled apphcatlOn and do hereby cerhfy Ihal dll mformatlOn hereon IS Irue and correcl, dnd I furlher certify that any and all work performed shall he done 10 accordance wIth Ihe Ordmances 01 the CIty of Sprmgfield and Ihe Laws of Ihe Slale of Oregon pertammg 10 Ihe work descnhed herem, and thdt NO OCCUPANCY will be made of any slruclure wIthout permIssIOn of Ihe CommuDlty ServIces DIVISIOn, Bulldmg Safety 1 further cerhfy thaI only contractors and employees who are 10 comphance wllh ORS 701 005 wIll be used on Ihls project 1 further agree to ensure that all reqUIred mspectlOns are requested al the proper hme, that each address IS readable Irom the street, thdt Ihe permIt card IS located dt the Ironl of Ihe property, and the approved set of plans WIll remam on Ihe SIte at all hmetloS~ ~ 8/~Jo8 Owner or Contrdclors Slgnalure ( Dale P d2e 4 of 4 DIRECT RUNOFF TO CITY STORM SYSTCM I IMPERVIOUS S r x I COST PER S F CHARGE I I 144800 I $0357 I I $51657 RUNorr ROU I ED TO DRYWELL DESIGNED AND CONSTRUCl ED TO CI I Y S I ANDARDS I IMPERVIOUS sri x I COST PER S F I x I DISCOUNT RATE I I I 000 I $0357 I I 50% ~ I ITEM 1 TOTAL - STORM DRAINAGE SDC $51657 A REIMBURSEMENT COST I NUMBER OF DFU's I x I 0 B IMPROVEMENTcosr I NUMBER OF DFU's I x COST PER DFU o I $2104 ITEM 2 TOTAL - CITY SANITARY SEWER SDC JOURNAL OR JOB NUMBER NAME OR COMPANY LOCATION TAX LOT NUMBER DEVELOPMENT TYPE NEW DWELLING UNITS 1 STORM DRAINAGC 2 SANITARY ~LWER - r:ITY 3 TRAN"'OR I A1ION CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET -; ,. COM2008-01043 PhtlhtJ Sweeney 2155 Yolanda 1703244302400 Smgle Farmly ReSIdence o BUILDING SIZC (SF LOT SIZE (SF) 9583 r/) ~ ~ o u p: ~ r/) t3 ~ 1286 DISCOUNT $000 $51657 1070 COST PER DFU $27 67 $000 1091 $000 1092 = , $000 A REIMBURSEMENT COST I ADT TRIP RATe I x I NUMBER OF UNITS I x I COST PCR 1 RIP x INEW TRIP I ACfORI 957 I I 0 I 2106 , 100 I $000 , 1093 B IMPROVbMENl COST I I ADT TRIP RA I E I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 957 I 0 I $92 89 I 100 I $000 I 1094 ITEM 3 TOTAL - TRANSPORT A nON SDC ~, $000 I 4 SANITARY SEWER - MWMC l A REIMBURSEMENT COST INUMBER OF rEU's I x ICOST PER FEU I 0 $97 90 = $000 I 1054 B IMPROVEMENT COST I INUMBER OF FEU's I x ICOST PCR FEU I 0 I i $1,00917 = $000 1055 MWMC CREDIT IF APPLlCABLC (SEE REVERSE) $000 1054 MWMC ADMINISTRATIVE FEE $000 I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ , $000 j SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ , $51657 I 5 ADMINIS rRA lIVE FEE I I SUBTOTAL x I ADM FEE RATE I~ CHARGE I $51657 I 5% I $25 83 TOTAL SANIrARY ADMINISTRATION FEE 2583 11079 IO r AL I RANSPORT A TION ADMINISTRATION FEE $000 ' 1078 Kaye WIlson 712112008 TOTAL SDC CHARGES $542 40 PREPARED BY DATE "'_.~ - DRAINAGE FIXTURE UNIT (DFU) CALCU~ATI<?N TAHLE I NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT = DRAINAGE fo1XTURE UNITS (NOTE FOR REMODELS CALCULATE ONt. Y THE NET ADDITIONAL FJXTIJRES) NO OF FIXTURES DRAINAGE II UNIT FIXTURE FIXTURE TYPE NEW OLD EQUlV ALENT UNlTS J I BATHTUB 0 0 3 ~ 0 ',' I DRINKING FOUNTAIN 0 0 1 ~ 0 I FLOOR DRAIN 0 0 3 ~ 0 I IN rERCEP I ORS lOR GREASE / OIL / ~Ol IDS / LTC 0 0 3 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 ~ 0 I LAUNDRY TUB 0 0 2 ~ 0 I CLOTHESW ASHCR / MOP SINK 0 0 3 ~ 0 I CLOTHCSW^~HER - 3 OR MORE reA) 0 0 6 ~ 0 I MOIllIX HOMb PARK TRAP(I PLR I RAILeR) 0 0 12 ~ 0 I IRECEPTOR FOR RErRlG / WATCR STATION / HC 0 0 1 ~ 0 I IRECEPTOR FOR COM SINK / DISHWASHER / ETC 0 0 3 ~ 0 _SHOWER, SINGLE STALL 0 0 2 ~ 0 I .SHOWER, GANG (1'IUMBER OF HEADS) 0 0 2 ~ 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 ~ 0 I ISINK COMMERCIAL BAR 0 0 2 ~ 0 I I,INK WASH BASINIDOUBLE LAVATORY 0 0 2 0 I ISINK SINGLE LA V ATORYIRESIDENTIAL BAR 0 0 1 ~ 0 I WRlNAL, STALL/WALL 0 0 5 ~ 0 I TOILCT, PUBLIC INSTALLATION 0 0 6 ~ 0 I I IOILel, PRIVATC INS lALLATION 0 0 3 0 MISCCLLANbOUS DFU TYPE NUMBER OF CDU'S 20 ~ 0 TOTAL DRAINAGE FIXTURE UNITS 0 .EDU (EqUIvalent Dwelling Umt) IS a discharge eqUIvalent to a smgle family dwelling umt (20.DI<U ~~at 167 .l!:allo~ per ~y -- MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE YEAR ANNLXED BLFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 ]991 ]992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOOl ASSESSED VALUE I - $529 $529 $519 $512 $498 $4 80 $463 $440 $407 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $028 $009 $005 1 I I I IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 ror No) IS IMPROVI:MENT ELGIBLE I OR ANNEX CREDIT? (Cnter I for Yes, 2 lor No) BASE YEAR 2 2 1979 CREDIT FOR LAND (If APPLICABLE) VALUE/1000 CREDIT RATE $000 x $529 ~ , $000 CREDIT FOR IMPROVEMEN I (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $000 x $529 o TOTAL MWMC CREDIT ~ $000 . 8/8/2008 7 II 24AM CIty of Sprmgfield Development Services Department Pnblic Works Department TransactIOn Log For Date: 08/06/2008 L Receipt No: 1200800000000000847 ~I LIRe Items JobfJournal Num~ Tran Cod npfil.l'rlu1iJlp Revenue Account No Amount Paid COM2008-0] 043 9] I] Fife SF Fee - ResidentIal 100-00000-424005 $72 40 COM2008-0 I 043 1231 Plan Review Mmor - Planmng 100-00000-425002 $1l9 00 COM2008-01043 1002 BUlldmg Permit 224-00000-425602 $787 52 COM2008-01043 1006 Furnace - up to 100,000 btu 224-00000-425604 $1400 COM2008-0 I 043 1006 Exhaust Hoods 224-00000-425604 $1000 COM2008-01043 1006 Dryer Vent 224-00000-425604 $700 COM2008-01043 1005 Fixture 224-00000-425603 $96 00 COM2008-01043 1087 ~Mech Iss 2+ Appl1ances- 224-00000-425604 $40 00 COM2008-01043 1006 Vent Fan 224-00000-425604 $700 COM2008-01043 1006 Mmlmurnl Adjustment Mechanical 224-00000-425604 $1900 COM2008-01043 1190 SDC SanltaryfStorm Admm 719-00000-426604 $25 83 COM2008-01043 2099 + 5% Technology Fee ] 00-00000-425605 $52 98 COM2008-01043 1099 + 12% State Surcharge 821-00000-215004 $11286 COM2008-01043 1098 + 10% AdmlmstratIve Fee 224-00000-426605 $10129 COM2008-01043 1178 Storm Dramage ImpervIOUs Area 440-00000-448028 $51657 Lme Item Total $1,981.45 Page 5 of 15 , cTmnsactlOnLog cpt Status Iss u ed 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 54]-726-3769 Inspection Line S]TE ADDRESS: 2155 YOLANDA AVE ASSESSOR'S PARCEL NO.: 1703244302400 t;p.... }Jrv-,:;P ~, r~<,( ]V CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01043 ISSUED: 08/06/2008 APPLIED: 07/1112008 EXPIRES: 04/09/2009 VALUE: $ 145,996.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Residen.tial Addition - Bed, Bath, Dining Phone N umher: 541-285-3879 o.wner: SWEENEY PHILIP M & EM]L Y S Address: 2]55 YOLANDA AVE SPRINGFIELD OR 97477 Contractor Type General Eleclrical Mechanical Plumhing I CO~TRACTOR INFO~~ATION I License Expiration Date Phone Contractor OWNER OWNER OWNER ROBINSON PLUMBING INC #of Units:' Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side I Sethack: 'Side 2 Selhack: Rearyard Selhack: Solar Sethacks: 18.00 10:00 25.00 28.00 0.00 107124 07/13/2009 541-345-6909 BUILDING INFOR~A TlON I R3 # of Stories: Height of Structure Type of Heat: . Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq FI Garage/Carpo~t Sq Ft Other: Occupant Load: 162 1 14.00 9,583 1,286 VB 3 Path 1 No I DEVELOPMENT INFORMATION I . " ' ATTENTION' REQUIRED PARKING f 1/ . Oreqon law req' "'0 Overlay Dist: . 0 .~W rU[l'Jr,l@.J!cF~ing'Oy th 0 lfotaWOU to # Street Trees ~~ifleation Cent;'. ~Those e1 H~O'di~JW4d: Paved Drive R Jb~ AR 952-001-001 0 throu~~ E~c.~f?~aHflrth % of Lot Covel~, ~," You may obtain eODies Of~' ";02-001- a" Ing the center (N '. . I ,e.ruJes by number In, tho ,.,_~ _ _ ole,the lel.~phonA 1 PUBLIC ]MPROVEMENTsynter is 1-80-6:332~~3~'~!Il1cat'on Sidewalk Type: MOT'''!:. Street Improvellients: Storm sei,~!g~~fJ~J,T SHALL EXPIRE IF THE WORK Special ]nslrJtlldn:'ZED U~fiR wirtl& f08IiIW,1titsi'lleJ'fXisting system COMMENCED OR IS ABANDONED FOR Notes: ANY 180 DAY PERIOD. DownspoutsfDrains: Paee I of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: (:OM2008-01043 ISSUED: 08/06/2008 APPLIED: 07/11/2008 EXPIRES: 04/09/2009 VALUE: $ 145,996.00 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line I V aluation Descrirtio~ , A.C. - Residen Dwellings Garage AC - Residential V'Wood Frame Garage $ Per Sq Ft or multiplier $5.00 $105.00 $28.00 Square Footage or Bid Amount 1,286.00 1,286.00 162.00 Value Date Calculated Description Tvoe of Construction . Total Value of Project $6,430.00 $135,030.00 $4,536.00 $145,996.00 07/] 1/2008 07/1112008 07/17/2008 , fpP.5.. EiWU Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $502.58 7/11/08 1200800000000000766 -Mech Iss 2+ Appliances- $40.00 8/6/08 1200800000000000847 + 10% Administrative Fee $101.29 8/6/08 1200800000000000847 + 12% State Surcharge $112.86 8/6/08 1200800000000000847 + 5% Technology Fee $52.98 8/6/08 1200800000000000847 Building Permit $787.52 8/6/08 1200800000000000847 Dryer Vent $7.00 8/6/08 1200800000000000847 Exhaust Hoods $]0.00 8/6/08 1200800000000000847 Fire SF Fee - Residential $72.40 8/6/08 1200800000000000847 Fixtu're $96.00 8/6/08 1200800000000000847 Furnace - up to 100,000 btu $]4.00 8/6/08 ]200800000000000847 Minimum/Adjustment Mechanical $19.00 8/6/08 ]200800000000000847 Plan Review Minor - Planning $119.00 8/6/08 1200800000000000847 SDC Sanitary/Storm Admin $25.83 8/6/08 1200800000000000847 Storm Drainage Impervious Area $5]6.57 8/6/08 ]200800000000000847 Vent Fan $7.00 8/6/08 1200800000000000847 + 100/0 Administrative Fee $7.30 ]0/9/08 3200800000000000697 + 12% State Surcharge $8.76 10/9/08 3200800000000000697 + 5% Technology Fee $3.65 10/9/08 3200800000000000697 Perm Serv/Fdr 200 amps or less $73.00 10/9/08 3200800000000000697 Total Amount Paid $2,576.74 Public Works Review I Plan. Reviews I 07/15/2008 07/15/2008 APP NJM 07/15/2008 07/21/2008 APP LKW Storm water to curb, tie into existing system 07/15/2008 07/29/2008 APP CJC 07/] 5/2008 08/04/2008 APP TAJ Keep construction outside of vision clearance triangle. Page 20f 4 ]nitial Review Structural Review Planning Review CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2008-01043 ISSUED: 08/06/2008 APPLIED: 07/11/2008 EXPIRES: 04/09/2009 VALUE: $ 145,996.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54]-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 . i a.m. will be made the same working day, inspections requested' after 7:00 a.m. will be made the following work day. i Rponirprl rn~,nections I Site Inspection: To be made a'fter excavation but prior to setting folms. , Erosion/Grading Inspection: Prior to,ground disturbance and after~erosion measures are installed. , Ufer Electrical Ground: Install ground rod at footing and call for inspectionin conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. foundation: After forms are erected but prior to concrete placeme~t. I Post and Beam: Prior to 11001' insulation or decking. Floor Insulation: Prior to decking. Sbear Wall Nailing: Before covering sheathing with finish materials. . , Framing ]nspection: Prior to cover and after all rough in inspectio~s have been approved. Wall Insulation: Prior to cover. Ceiling ]nsulation: Prior to cover. Final Building: After all required inspections have. been reqnested and approved and the building is complete. Underl100r Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Water Lin'e: Prior to filling" trench and including required testing. Line to Septic Tank: Prior to filling trench and required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. I I. Rough Mechanical: Prior to Cover 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. Electric Service: Approval required prior to utility company energizing s,ervice. Pa2e 3 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54]-726-3676 Fax 54]-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-0I043 ISSUED: 08/06/2008 APPLIED: 07/11/2008 EXPIRES: 04/09/2009 VALUE: $ 145,996.00 By signature, 1 state and agree, that 1 have carefully examined.the completed application and do hereby certify that all information hereon is true and correct, and 1 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. ] further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. ] further agree to ensure that all reqnired 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 Signatnre Paee 4 of 4 Date . , 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 I 043 COM2008-0 I 043 COM2008-0 I 043 COM2008-0 I 043 Payments: Type of Payment Cred itCard cRcceintl RECEIPT #: Description PermServ/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By EMILY SWEENEY City of Springfield Official Receipt Development Services Department Public Works Department 3200800000000000697 Date: 10/09/2008 Item Total: Check Number Authorization Received By Batch Number Number How Received NJM 040170 ]n Person Payment Total: \ Page I of I 1O:11:45AM Amount Due 73.00 3.65 8.76 7.30 $92.71 Amount Paid $92,71 $92.71 10/9/2008 ZON L6.V INITlA.LS N }'II DATE lO/(/1-o( SOURCE f'/\;)?S CY7..J 10 I q I ()~ \ . " '~. 225 FIFrH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ~.UJD () - (0 \ 0 C-f3 Date !!~--~"''''''-.--~''--. '...---.'''.........--.'!ilr:il'!- ..;:;'_-:.ii_.""!Ylll ' 1. o/,C06ltT-IONI'DPlINSTdHiJNitfIIION:f:fi5fiij'- ""' .' , , '1ii:\''"'_*~'''<;'''''''wxKzi0,rj"J''''''V''''''t" ,_ '''''''"'.~ '_iN'" ", . och , . _ 3. l/;~o.Mi?i!E'FE1EEE1S€.HEiifi1BEEOml!!lr-!~d!!ljllL",' ~_'~""""""""""'",i""""''''Wffl'Ml'&='1i!ft'1'~~00'=_'1Ml~~,;.qi0'~,,~*~~tlff!J'~~ '2ISC; IJola.r1r.1CL(~lrl n'f- W/LtT7 LEGAL DESCRIPTION: I--ZD3':::<'402 OU-IOU JOB,DESCRlPTION: ",: '-'&j>*%lf20l'?'S.Q.'.fl@r1!12'ii.,i1iffiTH'1'iillR~~m:.1).,-~.,,:,,,~"fT0l~'!t%fj~~.m.i~~.,:0~'10.~7.~~.'. -;'"'-:' , A. !llSel\(-Restd~ntlBl'''dSI~)!t'lfM_I!!t~JI1!.!!I!!Y~PJ...rsi.!tl;\:~Ilmgt'''~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof ' Each Manufact'd Home or Modular Dwe]ling Service or Feeder ' $]21.00 t?gJr:at+" 1 J--!PLtnCoJ c..nvirp J $ 22.00 Permits are non,transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $57.00 !iii0\"++8'lf'0'11Uiq%'I%'h'i*""""\t"'",~W$'C!2%E0]5hij0&Wli&'""'''N4""'~~"'\Kijd;%!I [€ONFR1i€toR1INSr;;fEHArt6Nio'im1{"" 2. . ,2.3.JG1l!M1t@MllllJlMi);;wl1nl1~..i,"'"W;;n'mU4:>"''f~.~''~'hini40dt;;;1i01_,;iffi1f~"i0-'\%i0;&ti'!:~ B. '13- o-v ./ 200 Amps or less 20] A1!1ps to 400,Amps 40] Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only Electrica] Contractor $ 73.00 $ 86.00 $]43.00 $186.00 $426.00 $ 57.00 Ad~ / City c. Installation, Alteration or ,Relocation 200 Amps or less 20] Amps to 400 Amps . 40] Amps to 600 Amps Expiration Date ' / CODStr2Co tr. Number '-Expir tion Date / -"Signature of Supervising Electrician ~ ~ . $ 57.00 $ 79.00 $]]4.00 Over 600 Amps or 1000 Volts see "B" above. D. "- New Alteration or Extension Per Panel , One Circuit Each Additional Circuit or with Semce or Feeder:'Permit $ 50.00 $ 5.00 Owners Name -:n~1i p lEwU Ii {C:;o..xzenP..(j Address 1.Iffi U/)Io.ndo... Ji..Vu 'oJ E. City _9j)V~ri Pump or iITigation $ 57.00 Sign/Outline LigJIting $ 57.00 Limited Energy/Residential $ 29.00 Limited Energy/Conimercial $ 52.00 Minimnm Electric Permit Inspection Fee is $52.00 + Surcharges /3.0'> :s ."'5 R"'.7S 7.:50 q.) -71 Phone 0-!1-Z9,t;- ::W,'lq' OWNER INSTALLATION The installation is being made on property] own which is not intended for sale, lease or rent. 4. OW"?';~"1~I''''''O 12% State Surch~ge ] 0% Administrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL :Shared Drive(T:)JBuilding FormslElectricalPermit Applicalion 7-QS.doc e. . . . . . . " " . ..... Constru~tionContractors Board 700Summer St ~ Suite 300 . PO Box 14140 . Salem OR 97309-5052 . Phon.e:' 503-378-4621 Weh Address: www;cch.state.or.us Pennit #:C _ '8'"." 0 \ l') Lf~ " . Addr~ss: t) J S~ (Ao!.eP ~ ~']ss~~nv1 (J Date/O 0'iJOY . / U !/'. . Statement:lriformation Notice' to Property Owners . ,.... '-. , '.. - About Construction Respqnsibilities ....1 ',':, . Note: Oregon Law, :ORS 701.055 (4) requir~s residential conftruction permit applicants who are not licensed with the Construction ,Contractors Board to sign the foll()wing statement before a building permit can be issued. This statement is reqiiiredfor residential-building, electrical, mechanical and . plumbing p'ermits. Licensed arcizite~t an({engineer applicants, 'exempt from licensing under ORS 701,010(7), need not su.bm,if this ~tatement. This statement wifl be filed with the permit. , ' Fil~i~ the appropnate blanks andinitiaiboxes 1. and 2, and. either bol,' 3A: odfl: rn ;.1. 0 2. . I own, res.ide in, or will reside in the completed structure. ,i " . . . I understand that-lmustbecomelicensed as a construction contractorlffue structure is sold or . offered.fors~le befoie or on completion. " . ,~ o 3A. My general contractor is ';', . ,', (Name) (CCB #) . , ' If! hiresubcontnictors, I will hire only'subcontractors licensed with the Construction Contractors . Board. If I change my mind' and hire a generalcontrac~or, I ~ill contract with a contractor who is 'licensed with the CCBand will immediately notify the office issuing 'this building permit of the 'name of the yontractor. . "1-' I hereby certify that the above information is correct ani! tliat I have read and do understand the Information . Notice to, Property Owners about Construction Respo,!sibilities on the reverse side oftbis form. C~kUJ A'11ll0HM11.' IO/q/o/O' (S~ature ofpermiyapplicant)" ,.:' I (bate) }. (White COPY~o.~ssl!ing agency PfJ~mitjile, plnk,copy to appl{S(Jnt.) Property_owner.doc 06001-04 " ~ ," . .