HomeMy WebLinkAboutPermit Building 2008-9-2
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3936 R1CHLAND ST
ASSESSOR'S PARCEL NO,: 1802064106600
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: 09/0212008
APPLIED: 08/0612008
EXPIRES: 03/0212009
'VALUE: $ q5,000.00
SPRlNGF1ETYPE OF WORK: Single Family Resideoce
PROJECT DESCRIPTION: Family and dining room additioo
Owoer: MCCALLUM DUSTIN N & C L
Address: 3936 RICH LAND ST
SPRINGFIELD OR 97478
TYPE OF USE: Addition
Residential
I CONTRACTOR INFORMATION I
Contractor Type
Applicaot
Architect
General
Mechaoical
Plnmbing
Contractor
KURT ALBROCHT, KURT
CHUCK BAILEY AlA
ROGER WIND HElM
OWNER
OWNER
License
Expiration Date Phone
485-3315
541-485-3315
541-953-1110
BUI~~ING INFORMATION I
# of Uoits:
Primary Occnpaocy Gronp:
Secoodary Occnp,aocy Group:
Primary Coostructioo Type
Secondary Coostructioo Type:
# of Bedrooms:
# of Stories:
Height of Structnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Spriokled Building:
1
R3
VB
2
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 20d Floor: ,.....J
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupaot Load:
11,195
781
Heat Pump
Electric
Electric
No
I, DEVELOPMENT I~FORMA TlON I
, Urbao Fringe Total:
,Handicaf!,ped: ,',
"""',' 'E' 1'-'-''''''''''' ,"'r<>WH'\' Il'C"',"""-(1nJ ,es you to
'AT'I '<","_1'., . ~,"- om!!...c Tt
itO;[C\'N'1;;'1?!i adopted by the,uregon Uti I y
INdi!l\~,!tio",8p.nter" :nlOse ,rules are s"et_tort~
,,' e>,," ",,').(',f11'-il' 11l' thrOl.,qh OAR 902001
I PUBLIC 1MPROVEMENTS;i190': You may,obtalnlCOples 01 \lie IUI"~ uy
.0: 'iir -, the center. (Note: the telephone
'l' :~irlewalk-T""e:'on Utility Notificationl
TjUITIl)t:r .v' <' W ~ )'
, .. - r' 1-800-332:2344:.
Dowm!>1Ju'fslDrams: Curb and Gutte,r
Frootyard Setback:
Side 1 Sctback:
Side 2 Setback:
Rearyard Setback:
Sola.' Setbacks:
20,00
26,00
29.00
,,,>,36,00
, -10,00
Overlay Dist:
# Street Trees Rqd::
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction: NOT~Gthole to curb E IF THE WORK
THIS PERMIT ~~~~~ ;X~~ PERMIT IS NOT
AUTHORIZED OR IS ABANDONED FOR
COMMENCED
ANY 180 DAY PERIOD.
Notes:
Paee 1 of 4
REQUIRED PARKING
_'~'N~P'I~~'
ij
, '
Status
Issued
CITY OFSPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: ' 09/02/2008
APPLIED: 08/0612008
EXPIRES: 03/02/2009
VALUE: ' $ 115,000.00
225 Fifth Street, Sprioglield, OR
541-726-3753 Phooe
541-726-3676 Fax
541-726-3769 I ospection. Lioe
I Valuation Descriotion ,
Bid Amouot
Dwellioes
Tvpe of Constructioo
Use Bid Amoont
V Wood Frame
$ Per Sq Ft
or multiplier
$1.00
$105.00
Square Footage
or Bid Amount
32,995.00
781.00
Value
Date Calculated
Descrintion
Total Value of Project
$32,995.00
$82,005.00
$115,00Q,OO
08/06/2008
08/06/2008
U~P' P'lilU
Fee Description Amount Paid Date Paid Receipt Number
, Plan Review Residential $439.75 8/6/08 1200800000000000849
-Mech 1ss 2+ Appliances- $40.00 9/2/08 1200800000000000927
+ 10% Administrative Fee $119,66 9/2/08 1200800000000000927
+ 12% State Surcharge $134.22 9/2/08 1200800000000000927
+ 5% Technology Fee $61.88 9/2108 1200800000000000927
Building Permit ' $676.54 9/2/08 1200800000000000927
Dryer Veot $7.00 9/2/08 1200800000000000927
Exhaust Hoods $10.00 9/2/08 1200800000000000927
Fire SF Fee - Residential $39.05 9/2/08 1200800000000000927
Fire SF Fee - Residential $39.05 9/2/08 1200800000000000927
Fixture $240.00 9/2/08 ' 1200800000000000927 '
Heat Pnmp $14.00 9/2/08 1200800000000000927
Plao Review Minor. Plaoniog $119.00 9/2/08 1200800000000000927
Sanitary Sewer - 1st 50 Feet $50,00 9/2/08, 1200800000000000927
SDC Saoitary/Storm Admio $9.31 9/2/08 1200800000000000927
Storm Drainage ImperVious Area $186.22 9/2/08 1200800000000000927
Storm Sewer - 1st 50 Feet $50.00 9/2/08 1200800000000000927
Vent Fao $21.00 9/2/08 1200800000000000927
Water Lioe - Isl50 Feet $50,00 912/08 1200800000000000927
Total Amouot Paid $2,306.68
I Plan Reviews I
Initial Review 08/07/2008 08/0712008 APP .NJM
Public Works Review 08/07/2008 08/1112008 APP LKW weep hole to curb
Structural Review 08/0712008 08/14/2008 APP CJC
Plan nine Review 08/07/2008 ' 08120/2008 APP TAJ
Paee 2 of 4
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: 09/02/2008
APPLIED: 08/06/2008
EXPIRES: 03/02/2009
VALUE: $ 115,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phooe
541-726-3676 Fax'
541-726-3769 Inspection Line
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.
Rpnllin~11"snections I
Footiog: After treoches are excavated.
Foundatioo: After forms are erected but prior to coocrete placemeot.
Post and Beam: Prior to floor insulatioo or decking.
Floor losulation: Prior to deckiog,
Shear Wall Nailiog: Before covering sheathiog with fioish materials.
Framiog Inspection: Prior to cover and after all roogh io inspectioos have been approved.
Wall Insulation: Prior to cover,
Ceiling Insulation: Prior to cover.
Orywall: Prior to taping.
Hold Oowos Installed: Special Inspection performed prior to placement of concrete, Provide report to City
Building Inspector.
Final Building: After all required iospections have beeo requested aod approved aod the boilding is complete,
Perimeter Foundatioo Oraios: After gravel and filter cloth is iostalled but prior to backfill.
Underlloor Plumbiog: Prior to insolation'or deckiog,
Underfloor Drain: Prior to cover or placement of.concrete.
Rough Plumbing: Pr~or to cover and including required, testing..
Water Line: Prior to filliog treoch and including required testiog.
Sanitary Sewer Line: Prior to tilling treoch and includiog required testin~.
Line to Septic Tank: Prior to ,filling treoch aod required testiog.
Storm Sewer Line: Prior to filliog treoch.
Fioal Plumbiog: Wheo all plombing work is complete.
Underlloor Mechaoical. Prior to iosulation or deckiog and iocludiog required testiog,
Rough Mechanical: Prior to Cover
Fioal Mechanical: When all mechanical work is complete,
Paee 3 of 4
Status
ISsued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO:, COM2008-01169
ISSUED: 09/02/2008
APPLIED: 08/06/2008
EXPIRES: 03/02/2009
VALUE: '$ 115,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Iospectioo Line
By signature, I state and agree, that 1 have carefully examioed the completed applicatioo aod do hereby certify that all
informatioo hereon is true aod correct, and I further certify that any aod all work performed shall be done in accordaoce with
the Ordinances of the City of Spriogfield and the Laws of the State of Oregon pertaining to the work described herein, aod
that NO OCCUPANCY will be made of aoy strocture withoot permission of the Commuoity Services Division, Building Safety.
I further certify that ooly contractors and employees who are in compliaoce with ORS 701.005 will be 'used on this project.
I further agree to eosure that all required inspectioos 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 00 the site at all
timesd~~;o:tJk '1- 2- - 03
I 1/'
Owner or Contrattors Signature
Date
Pa2e 4 of 4
225 Fifth 8.treet
Spriiigfi~ld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008'-01169
COM2008-0 I 169
COM2008-0 1169
COM2008-01169
COM2008-01169
COM2008-0 1169
COM2008-0 1169
COM2008-01169
COM2008-01169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169 '
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
Payments:
Type of Payment
Check
cRcceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000000927 '
Date: 09/0212008
~escription
Fire SF Fee - Residential
Storm Drainage Impervious Area
SDC Sanitary/Stonn Admin
Building Pennit
Fixture
Sanitary Sewer - 1st 50 Feet
Water Line - 1st 50 Feet
Stonn Sewer - 1st 50 Feet
'Vent Fan
Exhaust Hoods
Dryer Vent
Hcat Pump
-Mech Iss 2+ Appliances-
Fire SF Fee - Residential
Plan Review Minor - Planning
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
CHRYSTI MCCALLUM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
LLH
7045
7045 In Person
Paymeot Total:
j
Page I of I
2:00:43PM
Amount Due
39,05
186.22
9.31
676.54
240,00
50,00
50,00
50,00
21.00
10,00
7,00
14,00
40,00
39,05
119,00
61.88
134.22
119,66
$1,866,93
Amount Paid
$1,866,93
$1,866;93
912/2008
"
APPLICANT'S COpy
SEPTIC INST ALLA TION PERMIT
SP087265
Parcels 18-02-06-41-06600 Site: S 42ND/W'JASPER RD/S 39THIE RICHLAND ST
3936 RICHLAND ST SPR
Applicant:
MCCALLUM DUSTIN N
Owner:
, MCCALLUM DUSTIN N & C L
3936 RICHLAND ST
SPRINGFIELD OR
97478
3936 RICHLAND ST
SPRINGFIELD OR
97478
Site Inspection Number:
Work Description: MAJOR SEPTIC ALTERATION
System Type: ALT_MJR , STD
Issued Date: 08/13/2008
'Expiration Date: 08/13/2009
INST ALLA TION REOUlREMENTS:
Projected Daily Flow: 450 gallons
Drainfield Size: 225 feet
Special Conditions: Stake out check required prior to
construction if homeowner install.
See sight plan notes,
Call 682-3751 for inspection or
questions,
ALL DEQ SETBACKS AND RULES APPLY,
Septic Tank Size: 1000 gallons
Trench D~pth: 18-36 in,
OTHER REOUlREMENTS:
1. Installation of an effluent pump requires and Electrical Permit.
2. Install disposal trenches on contour. The trench bottom shall be level within a tolerance of plus or minus one (I)
inch over the,entire trench length,
3. Minimum of eight (8) inch fall from top of septic tank outlet to top of first header pipe leaving D-box,
4. New systems m~st 7t setback requirements in Table L
~p~-- - 08/13/2008
J~;hison, Environmental Health Specialist Date
LANE COUNTY ON-S1TE-SEW AGE OFFICE
125 E 8TH Avenue, Eugene OR 97401. PH: (541) 682-3754, Fax: (541) 682.3947
TO:
SEWAGE DISPOSAL SYSTEMS PERMIT APPLICANTS
FROM:
LANE COUNTY ON-SITE SEW AGE SECTION
You are required by law (OAR 340-71-160) to be in possession of a permit authorizing installation of a
sewage disposal system before construction of your septic system can begin, In addition, the law
specifies that all work on said system must be performed by a person licensed with the State of '
Oregon Department of Environmental Quality (DEQ), The work can also be completed by the owner,
contract purchaser or their regular employees,' Before starting any digging, carefully read all the
specifications on the installation permit, plot plan & plans, If you have any questions regarding
installation procedures or specifications of the approved area, call your sanitarian at (541) 682-3754
& they will be glad to assist you,
If you intend to hire someone to do the work for you, you should make sure that the person is,licensed,
with the DEQ to perform 'such work. This protects you as the consumer, as each licensed installer has
to post a bond & is liable for the work performed, To check the licensing of an individual, you can call
the Lane County On-Site Sewage Section at (541) 682-3754 & we will check for you to see if the
individual or contractor you have chosen is licensed, ORS 454,705(3) requires that every licensed
installer must provide to e,ach permittee (owner) a written notice of the name & address of the
bonding agent & of the permittee's rights, This must be provided before the work is completed, We
urqe you to request this from the installer or contractor you have chosen prior to hiring them,
When the construction of your. septic system is complete & before you backfill, it is necessary to have
the system inspected, To obtain an inspection, make a drawing of the system as installed on the
detailed system plot plan (As-Built) form provided, Submit the completed As-Built & Materials List
forms to this office & the inspection will be scheduled, Final insoection for sewaae systems con'
not be reauested bv teleohone.
Do not hesitate to contad Lane County On-Site Sewage Section if you have any' questions.. ,
Lone County Land Management Division
On-Site Sewage Program
125 East 8th Avenue
Eugene OR 97401
H:\LMD\SANIT A TION\FORMS\Permit Cover letter,do
MATERIALS LIST
(Required) OAR 340-71 170(3)(b)
LANE COUNTY ON-SITE SEWAGE DISPOSAL PROGRAM
Office: (541) 682-3754 Fax: (541)682-3947
SP# Off-1ZJ5
T /8
R 02.
S tJt
Y<S ~ / TL jjg;z
Owner
Installer
A PRE-COVER INSPECTION WILL NOTBE SCHEDULED UNTIL THIS MATERIALS LIST & AS-BUILT
DRAWING ARE SUBMITTED TO THE LANE COUNTY ON-SITE SEW AGE DISPOSAL PROGRAM
SEPTIC TANK
Mfg,
TypelMaterial
Gallons
o Water tightness tcsted after placement. Results w/in allowed limits (Required)
o Riser (water tight) inches to ground surface (Required)
o Effluent filter - Mfg,
o Anti-buoyancy provided as per mfg, specs,
DISPOSAL SYSTEM {D Std./Saprolite 0 Cap fill' 0 Pressurized Dist' 0' Sand Filter' 0 Other
* Alternative systems require additional information/inspections
o Curtin Drain - Depth of trench
o Effl uent sewer pipe - Length
o Distribution material - Perforated pipe Dia,
o Drop/Distribution box installed - Mk
o Disposal Trench - Total Length
o Drain media - Total depth
Depth of gravel/media
Diameter
ASTM
Outlet location
ASTM
Infiltrator/EeeZzz drain/other
Material
Depth
Depth below pipe
Supplier
PUMP lNST ALLA TION RECORD (IF APPLICABLE)
Mfg, & Model
HP
Pump Installer
o Pump & float switches installed - Gallons/dose
o Audible-visual alarm installed & tested - Location
o Pressure pipe - Diameter ASTM
o Hydrosplitter Mfg./Supplier
PSI
Comments
I understand that 1 am responsible for the satisfactory completion of all required testiog, corrections & final cover of the system within
30 days of completion. I certify that construction described above complies with the requirements of Oregon Administrative Rules
Chapler 340 & the permit issued by the LANE COUNTY ON-SITE SEW AGE DISPOSAL PROGRAM,
INSTALLER'S SIGNATURE
DATE
ATTACH TO AS-BUILT
1:\Forms\Matcrials List.doc
Installer
(Title as shown on DEQ license)
Telephone
License #
Banding Campany_
(Signature of Licensee)
If Installed by Owner-:-
- - --'-.'--"--'-".- --'."--'"..'-"-
(Signature of Owner)
(Dat~)
(Date)
Name & Address of person(s) to receive form:
VICINITY MAP
MUST BE IN INK
Permit # 5"e76Jb5 Twnshp / "t Range 02. Section ct. 'I. / Tax Lot "-k~O
Standard System Alternative System Type?_
Site Location (Street Address) ,J'lYh I?JclllA&P 5'T 5,P~.
DETAIL SYSTEM SITE PLAN (AS-BUILT*)
Scalp =
N
.. ATTACH MATERIALS UST
N
FOR OFFICE USE ONLY Approved
COMMENTS AdZl# 4/T
S?f2!? 1/~i3 07/ V/T.F~.
Not Approved - ,
Needs Corrected
System Capacity ~
System Corrected Date
Date
gal/day Signature
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION when signed by the County's Environmental Health Specialist
This certificate is evidence as per ORS 454.665 of satisfactory completion of Q subsurface sewage disposal system at the above location.
To request inspection, return this form and the Materials List to: Lane County' Land Management Division, located in the. basement of the Public
Service Building, 125 East 8th Avenue; Eugene OR 97401
I\FORMS\As Built Form.com
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125 fOA3TSTI-l AVENUE
E7lli~NE. OR 97401
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Cl"MRQMt1ENTAL HEALTH- SERVIC~
125 EAST Bn~ AVENUE
E~NE, OR 97401
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DEPARTMENT OF ENVIRONMENTAL QUALITY
MINIMUM SEPARATION DISTANCES
Items Requiring Setback
From Subsurface
,
Absorption Area
Including Replacement
Area
*IQo ft
From Septic Tank &
Other Treatment Units,
Effluent Sewer &
Distribution Units
Groundwater Supplies & Wells
Springs
.Upgradient
. Downgradient
**Surface Public Woters
. Year round
. Seasonal
Intermittent Streams
. Piped (watertight not less, than 25'
from any part of the on-site system)
. Unpiped
Groundwater interceptors
. On a slope of 3'>'0 or less
. On a slope greater than 3'ro
. Upgradient
. Downgradient
Irrigation Canals
. Lined (watertight canal)
. Unlined
. Upgradient
. Downgradient
Cuts Manmade in Excess of 30" (top
of downsl~pe cut)
-Which intersect layers that limit
effective soil depth wlin 48" of surface
. Which don't intersect layers that limit
effective soil depth
Escarpments
. Which intersect layers that limit
effective soil depth
. Which don't intersect layers that limit
effective soil depth
Properties Lines
Water Lines
Foundation, Lines of any Bldg or Structure,
including Garages & Out Bldgs 10ft
I Underground Utilities Hi ft
*50-foot setback for wells constructed w/special standards granted by WRD
**This doesn't prevent stream crossing of pressure effluent sewers '
50 ft
I
5q' ft
100 ft
50 ft
50 ft
10C) ft
50' ft
50 ft
50 ft
20 ft
50 ft
20 ft
50 ft
20 ft
10 ft
,
10 ft
50 ft
5 ft
10 ft
25 ft
25 ft
25 ft
50 ft
25 ft
50 ft
5q ft
25 ft
25 ft
10 ft
50 ft
10 ft
25 ft
lei ft
10 ft
10 ft
5 ft
10 ft
5 ft
N/A
.. ';'
You have recently applied for a permit or you just came to our office to get some information. You can help us
achieve high customer service standards by taking a few minutes to compl~te this questionnaire. Your feedback will
help us improve our operations and improve service. '.
,
Once you have completed this questionnaire, just fold it, and tape it closed, It is already postage paid, so you can
simply drop it in the mail to us, Thank you!
fold here
Row would you describe the assistance you receive~i?
Please, give us an overall grade:
o Excellent [][] Very Good @]Avefage [Q] Below A v~rage rn Unacceptable
Please, give us a grade CA, B, C, D, Of F) for each category below:
Knowledgeable Frieodly Timely Service
"
Reception Desk 0 ':D D
Planning 0 iD D
1 '
Building 0 D 0
Surveying 0 D D
Sanitation D D D
Other: D D D
fold here
What type of application was submitted?
(such as special use perrnit, varianCe, bUilding perrnit,etc)
Was the application approved or denied?
Permit Nmriber: '9RJ 8' -l.)..loS
D Approved
D Denied
Staff member serving you (ifknown):
Over please
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726~3769 Inspection Line
CITY VI' ~rKll~\.Jl'lELD
Building/Combination Permit,
PERMIT NO: COM2008-0] ]69
ISSUED: 09/02/2008
APPLIED: 08/06/2008
EXPIRES: 04/30/2009
VALUE: $ 115,000.00
SITE ADDRESS: 3936 RICHLAND ST
ASSESSOR'S PARCEL NO.: 1802064106600
SPRINGFIETYPE'OF WORK: Single Family Residence'
PROJECT DESCRIPTION: Family and dining room addition
Owner: MCCALLUM DUSTIN N & C L
Address: 3936 RICH LAND ST
SPRINGFIELD OR 97478
TYPE:'OF USE: Additiou
Residential
Phone Nnmber: 541-741-2358
I CONTRACTOR INFORMATION'
Contractor Type
Applicant
Architect
General
Electrical
Mechanical
Plumbing
Contractor \
KURT ALBROCHT, KURT
CHUCK BAILEY AlA
ROGER WINDHEIM
BEAR MOUNTAIN.ELECTRIC LLC
OWNER
OWNER
License
Expiration Date
Phone
485-3315
541-485-3315
541-953-1110
541-741-8844
,>
136298
08/0612009
BUILDING INFORMA nON I
# of Units:
Primary Occnpancy Gronp:
Sec9ndary Occnpancy Group:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
# of Stories:
Height of Strnctnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
R3
VB
2
Lot'Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
1l,195
781
Heat Pump
Electric
Electric
'No
I DEVELOPMENT INFORMATION,'
Front yard Setback:
Side 1 Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
. Paved Drive Rqd:
% of Lot Coverage:
20.00
26.00
29.00
36.00
10.00
UrbanFringe
REQUIRED PARKING
Total:
Handicapped:
Compact:
NOTICE- I PUBLIC IMPROVEMENTS I ATTENTION: Oregon law requires you to
. ' follow rules adopted by the Oregon Utility
Street Impr"Tffi5'JS1!RMIT SHAlL EXPIRE IF THE WORK Notili~'Clil\\'4t. Those rules are set forth
Storm SewerAtHiHMllED UNDER THIS PERMIT IS NOT In O~.gg,.l1flRllttl;1rough ~Q9.1fter
Special Ins~rOOMMENCEf)',\)R ~S1'A19AHOONED FOR 0090. You,mayobtaln coPi.es ofilii iiiies by
, ANY 180 DAY PERIOD calling the _center. (Note. the telephone
Notes: ' . number for the Oregon Utility Notification
Center 18 10800-332-2344).
Page >] of 4
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
Description
Bid Amount
DwelJincs
Tvpe of Construction
Use Bid Amonnt
V Wood Frame
Fee Description
Plan Review Residential
-Mech Iss 2+ Appliances-
+ ]0% Administrative Fee
+ 12% State Snrcharge
+ 5% Technology Fee
Building Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fire SF Fee - Residential
Fixture
Heat Pump
Plan Review Minor - Planning
Sanitary Sewer - ]st 50 Feet
SDC Sanitary/Storm Admin
Storm Drainage Impc<vious Area
Storm Sewer - ]st 50 Feet
Vent Fan
Water Line - 1st 50 Feet
+ 100/0 Administrative Fee
+ ]2% State Snrcharge
+ 5% Technology Fee
Service Reconnect
+ 100/0 Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea. Add
Perm Serv/Fdr 200 amps or less
Total Amonnt Paid
Initial Review
08/07/2008
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: 09/0212008
APPLIED: 08/0612008
EXPIRES: 04/30/2009
VALUE: $ 115,000.00
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$1.00
$]05.00
Square Footage
or Bid Amount
32,995.00
781.00
Valne
Date Calculated
Total Value of Project
$32,995.00
$82,005.00
$] ]5,000.00
08/06/2008
08/06/2008
Fees Paid I
Amount Paid
Date Paid
Receipt Nnmber
$439.75
$40.00 .
$119.66
$134.22
$61.88
$676.54
$7.00
$]0.00
$39.05
$39.05
$240.00
$]4.00
$119.00
$50.00
$9.3]
$]86.22
$50.00
$21.00
$50.00
$5.70
$6.84
$2.85
$57.00
$]7.30
$20.76
$8.65
$ I 00.00
$73.00
8/6/08
9/2/08
, 9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/2/08
9/15/08
9/15/08
9/]5/08
9/] 5/08
] 0/31/08
] 0/31/08
] 0/31/08
10/31/08
] 0/31108
1200800000000000849'
1200800000000000927
]200800000000000927
1200800000000000927
]200800000000000927
]200800000000000927
]200800000000000927
1200800000000000927
]200800000000000927
]200800000000000927
]200800000000000927
]200800000000000927
]200800000000000927
1200800000000000927 .
]200800000000000927
1200800000000000927
]200800000000000927
]200~00000000000927
]200800000000000927
]200800000000000968
1200800000000000968
]200800000000000968
1200800000000000968
220080000000000]588
2200800000000001588
2200800000000001588
2200800000000001588
2200800000000001588
$2,598.78
I Plan Reviews ~
08/07/2008
APP NJM
Pace 2 of 4
Status
Issued.
CITY OF ~rt<INGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: 09/02/2008
APPLIED: 08/06/2008
EXPIRES: 04/30/2009
VALUE: $ 115,000.00
.
225 Fifth Street,-Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Public Works Review
08/07/2008
08/11/2008
APP LKW
weep hole to cnrb
Structural Review
08/07/2008 '
08/14/2008
APP CJC
Planning Review
08/0712008
08/2012008
APP TAJ
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.
Relluired Insn~ctio,n~ I
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insnlation: 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 Inspectiou performed prior to placement of concrete. Provide report to Cily
I Building luspector.
,
Final Building: After all required inspections have beeu reqnested and approved and the building is complete.
Perimeter Fonndation Drains: After gravel and filter cloth is installed but prior to backfill.
Undertloor Plumbing: Prior to insulation or decking.
Undernoor Drain: Prior to cover or placement of concrete.
Rough Plnmbing: Prior to cover and including required testing.
Wiler Line: Prior to filling trench and including reqnired testing.
Sanitary Sewer Line: Prior to tilling 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.
Undertloor Mechanical. Prior to insnlation or decking and including reqnired testing.
Rough Mechanical: Prior to Cover
Final Mechanical: When all, mechanical work is complete.
Electric Service: Approval required Jlrior to ntilily company energizing service.
Page 3 of 4
Status
Issued'
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Final Electric: When all electrical work is complete.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01169
ISSUED: 09/02/2008
APPLIED: 08/06/2008
EXPIRES: 04/30/2009
VALliE: $ 115,000.00
By signature, I state and agree, that I have carefully examined the completed application and do he~eby certify that all .
information hereon is trne and correct, and "fnrther 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 structnre without permission of the Community Services Division, Bnilding Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensnre that all required inspections are reqnested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the properly, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Page 4 of4
Date
City of Springfield Official Receipt
Development Services Department
. Public Works Department
225 Fifth Street
Springficid, Oregon 97477
541-726'-3759 Phone
Job/Journal Number
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
COM2008-0 1169
Payments:
Type of Payment
ONLINE CHGS
cRcccintl.
RECEIPT #:
2200800000000001588
1:30:16PM
Date: 10/31/2008
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Amount Due
73.00
100.00
8.65
20.76
17,30
$219.71
Paid By
ONLINE PERMIT CHGS
Item" Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
ONLINE BEAR Online
MOUNTAI
N
$219.71
KR
Payment Total:
$219.71
Page I of I
10/3 1/2008
City of Springfield
Electrical Authorization To Begin Work
E-mailedTo:jackie@bearmountainelectric.com
Receipt # EC541053
10/31/200812:17:21 PM
Check on status of permit
By Phone: (541)726-3753 or [mail: permitcenter@ci.springfield.or.us
, D New construction
lliJ Addition/alteration/replacement
Qty,
Ea.
.1
Total I
IJKJ I or 2 family dwelling
DMulti-family
o Commercial./ Industrial
I ] ,000 sq. ft, or 'less
I Ea. addl 500 sq. ft, or porti'on'
IJob no.: IJob address: 3936 RICH LAND ST
!City/StateJZIP: SPRINGFIELD, OR 97478-8518
I Suitc!bldg./apt.no.: ;
I Project name:
Cross street/directions tojob site: Main 51 to 32nd tolasper to 39th to Richland
I Subdi~'ision:
I Tax map/parcel no.: ]802064]06600
1 Lot no.:
I - Limited energy, residential
(with above Sq. ft)
I-Limited energy, multifamily
residentiaJ'(with above Sq, ft,)
I .- Limited energy, coinmerci,i]
(with above Sq, fn
I - Stand-alone limited energy,
residential
I - Stand-alone limited energy,
multi-familv
I - Stand-alone limited energy,
commercia]
II $73001 $73.001
1
I I I
"t.
Service Change
I 200 amps or less
I 20] amps "to 400 amps
1401 amps to 599.amps
IN:lmc: Rory
I Phone:
!Email:
IFul:
I 200 amps or less
I 201 amps to 400 amps
I 140] amps to 599 amps
1
1
$100.001
I
I ,,,h addl AT.IENJ10N: or'tQon law reqUIreS fOIl to I
I,MOS"Il,.IIQJIQW r:t!!eSAaQgR~eq;flYfill)l!."V.!I:!9\.!lM!,illl)' "
~,,~ jn =; ::'~'7~;;:I~~":%TI~:;Q:~,.~~-Q~;'wv ~r1OfttF
Servlce'~ -. ~
Each m o.
dw,lllnOQ9,()., MGI4_<IIllIW,O~ lain CO~llS of the
I P,mp 0' 1.-cIllilliflg,the centl ,r. (Note the tele hone
I SIgn 0' ..Iilu.m~~lor me l regon U'IIIty' NOIll callan
I Signal. circuit(s) or li\iftW.ter lS. o.()UU~ ct=23zi.....J.
energy panel, alteration, or
extension.
I A. Fee for branch circuit~ with _ I
servIce or feeder fee, each .
branch circuit. .
I B, Fee for branch circuits I
without service or feeder fee,
first bmnch circuit
201
I
$5.001
I EI. lie. no.: 20-448C I CCB Iic. no.: \36298
I Business Name: BEAR MOUNTA]N ELECTRIC LLC
I Contact: Chad Perkins
IAddm" 85388 Dl~~t~~S RD
ICily/Slate/ZIP: EU~AAIT s,,~ - .HE WORK
I Phone: (541 )741884~UTH{)ru;!E:l Ur~{)Itf.:7~{f:lfifsJfs
II Eman: Jaekie@b'Ul~~~~:~a OR to IlitS PER~~~~ NOT
Me'm he, no,: \N\l +8&- . _ ~
ISupe",;,iog ele"deh" s~lc,"o.: Q^~sf:E, ,Ite:". ......
I SupcrvisingeJedrician's name: CHAD IRVIN PERKfNS
Upon review and approval by your local jurisdiction, your
permit will be a-mailed or faxed within one business day,
with instructions on how to schedule your inspection.
NOTE: This Authorization To Begin Work expires within 180
days if a permit is not obtained.
I Subtotal I $173.00 I
I State Surcharge (12% of permit fee) I $20.76 I
I' City Of Springfield fees" I $25.95 I
1 TOTAL PERMIT FEE 1 $219.711
.. City Of Springfield fees: IO%Administration Fec; 5% Technology Fee
The local buil~ing department may determine that an
Authorization To Begin Work is null and void if it dOe\!)"./ rxnDQ DI ( I ,n
meet applicable land use laws and local ordlnanees.l~q;- COM' (JJ ~ - UL-'1
. . \ Vb'\) :1,.. RCPT#:~- \~
. \\-. ~ .. DATE PROCESSED:~ i 02>
This Authorization To Begin Work must be posted at the jab,. ;ite until replaced bY,a permiQ.
. .' PROCESSED BY: I I II. ./
. t<-,I~