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Home My WebLink AboutPermit 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 I I ~--I'" '"' , I .,0' I ,,~ ~t- 'J'c?-f4/..?T~/..-v/~':>&I!ril!. J' Ie \l- 'L,f'-- FI"fPA 71iP1V'fT'I II ~ ~-\ fir, ~ ~ ' I .I iT" pCU/ rC~.?-MTJf;l-?: .J.tJ!t~if ~"J , _l._ " ~ l';~\~'f\~ 'i' j.l. \\ ~ ~WJ $ -I:- XEf7.<<1:.#5'<:.T 1fEPt<''?P;pf1 4;r.~ ~ / (:i"~J2~ 11~~~~{ ;;;Y.57b4! Q ___________ ' ~~_~_ ;0~~): u--/rYTU~T ' ,10'-o'f .-.~... ~. iiif ): "#..{'1'PE 5et.C-P'TEP.' hLl d ,~, ~ ~ ~" /> ~ , ~# 0 .If.\~~j '9 01 ~\" ~V\ ('l"'"" '~\70~1- L\ \7~ 4;~- '~c_ K 5,P/fWCFlEcP K~~ L~ R(f~ACu<~J 0. ~D ~ r CNlWALKU * 5('"5-75/<< 5rcc:;; CyrJ'/7#6 T1:;*:~ 10-,0 # ./'": A SLl~ED ELEVATION L/~' 1'. 4.35' .I Z2:>-' ~..p.?/aJ>/;5,9J-U1t. J/ c' - "" 97'-0" l j?;J7'1/W7ltu;J~ ",,",,", ~ -, /:i/~f~ ;36 ,:#~J( 71FCRM PFMJ_ fZ I c. ~ ) C{ I]~ 7 t ----- ?'f3~ .,(1t be W!I4 l,)JiD ';~~'~l~~:-'~.~-:~':'i1,,~tions ~Sll~.i:;,"J""., ;f"_'OC~CIl ,.eiOf' ,,,to.. """.~ b , il>""Ul\'letO \1lfo *' Eq?tt'..f{ j7jjp"l!~f,(FtJ..{/ , /IiI. fllEv?Ci/ %'77G'fl? ,u<<:>T !Pc Lf'f/Cl. l?/TIf ~,*j! e77f&{ '11_/' .4'f,f36?ri #?r. SEW AGE DISPOSAL PLA1",AP~" "-0 " -Zz pcr:nlt /; ....=.--,---- n'TP g-/;;,-'l5 ~ ~y-- c:;:z,.(-6 ~4'Af/o -_ EI~V.tRoN'f:'1ENTAL HEALTH SERVICES 125 fOA3TSTI-l AVENUE E7lli~NE. OR 97401 : ~ r- C / T!..!!zr:: ~Cl11 i/v!3 ' ,/,. AS~ICll Q,[~rJl i 14J5' '----- -0" ,'" tll /( , ' / :"20' /?J-()2 ~Ob-'1/-'1 ASSU!.lEDELE\lATlCI 435' c, ( ~ ~-..,~~ ,,' , , I , '10' I ,L s" I '1c .41'4-I#NI# /tf? ;>,67$'kll"Q ! . C ,0'_ ,Krw:?/-i FIfpf?5?fT'I Ilk.- 'r\ fJ\ ' 'I ,1- I r;- ~;;<-</ rl9~..</M1lC-?: J-*P~l"fN . \~."" ~ u~\;(JJ!i*" ' ,J J>l.' .. L_ I y) L~~1f~ 'T/ ',' ." ~tl;;Y/'-;.rI!~ / .j-- XEIJ..-kJ.=AFv?T; /fCN.?P"",p'F: 'U(\V' ~ (~~i~;:mfi~~,'~' ~ 7)1/7b4/ G ~ no" ~;.;, .,.~ H'// mU~r " ' ,OO'-O'{ ',' ~M~ ~~:~ ~~;~m ,~ "q4'fPR' 5etC--.b"TEP.' ~J! 0 ,,~;:;2~:~ :%;~ ~V_i!' 0 m//o//o//., ~ ~ k.\f~,1 ~ ,,01 * ~~:; 0 ' ": ~;~~\. I 11 5r/1j;?/C REU7 W'c;.~ \'f ' "\ ;1l @i ~ ",Ii '~~lIc}/ {II U'tl,t'vt1 ~ ~ j(,f) v!1' V t (;/ ((//fA ~D '* 5/'775/,:'.,/ 5rcC'?': c;.rr5f7#" T-1"~, "'------- 1 ",-Ir. v '" w#.~_" . ~~"/j? ASUt.lEDEILVATION . L/"/'''''"f./ ',t 435' 22.5-' ~vt?F/cz;.P(;St9.u1t. J'" --=' 97'-0" LPIJJ'11Iffi:f77o:JL-------- ^'"::~ ~- /?):n-f~ ;36 'f#~J( lrFcRM PI=I71J_ ;) -I cJ ) ({ f) I f\ U\. st ?f3~ <" ,,_, '1O'tbe ~ ~~;;~;~~,-,~~o"~:i,:~:',~~~"'~Gr """ed<""C;I">., ".~~ iIlcOU1\'\etO \1d * Ef't/-f{ J7!JTJ'7!/YI-f71t?..{/ , .jIL 1l1E~1I j7-P J7!?fl? ,vt'f.("T !3c Lf'//EL t-Vt17f E..{c;f. e17fF{, i-/- j ,r #-I36?rl 4-,t." SE\V AGe D1SPOSAL PLAi"l APP.RQVftD P=';l' :J/f/2)'::Zt D^,TE f, -J;, - r: _cr/' -. ;J'i ~/..L -:-p/AV. Cl"MRQMt1ENTAL HEALTH- SERVIC~ 125 EAST Bn~ AVENUE E~NE, OR 97401 %,-C/Tt 4zO JrClT1 t/~!3 , "'~o' A$I;JIC91>l.E?;:i~ I 1436' "'-_..--.-C. ~--~--~- ,1- tIV I( / ::::.20 /o-()2 -Ob-7'/~'1 ZWMEDElEIIAT1(l ------ J 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~