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Home My WebLink AboutPermit Building 2008-11-18 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01607 ISSUED: 11/18/2008 APPLIED: 10/31/2008 EXPIRES: 05/18/2009 VALUE: $ 72,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1122 CUSTOM WAY ASSESSOR'S PARCEL NO.: 1703263408200 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition PROJECT DESCRIPTION: Addtion to residence (Recreation Rm. & Bath) Residential Owner: MAZET TYM ANN Address: PO BOX 2391 EUGENE OR 97402 Phone Number: 541-736-3891 I CONTRACTOR INFORMATION 1 Contractor Type General Designer Electrical Plumbing Contractor License OWNER BILL CONANT BURRELL BROS ENTERPRISES INC 136446 EUGENE EXCA V A TION & PLUMBING INC 138003 BUILDING INFORMATION i. Expiration Date Phone 08/20/2009 04/27/2009 9545746 541-747-2724 541-988-0868 ......-. # of Stories: Height of Structure , Type of Heat: Water Type: Range Type: Energy Path: SprinkledBuilding: I 13.00 Wall Heat Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft.Garage/Carport Sq Ft Other: Occupant Load: 10,890 360 # ofUuits: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB Secondary Construction Type: # of Bedrooms: No I DEVELOPMENT INFORMATION' REQUIRED PARKING F~ontyard Setback: " ,~, requires yo:~rlay Dist: NOTICE: 'Total:. 2 SIde I Setba'trTENTIO, N: Oregon 1'0.808 Oregon L#;Stl-eet Trees Rqd:THIS PERMIT ~ALL EXP~~'WORK Side 2 Setbaf6)iow rules adopted b~ ~) ules are selPav\li\ Drive Rqd: AU '~QlJlP,lll; . Rearyard S~&~f,~;;\iOn Center. Th3tqp hOAR 952';I;1\!fLot Coverage: THORIZEDI. O'ER THI t-'tlilVI T IS NOT Solar setbadg()~R 852.-001-0010 tno.OO~s 0\ the lules bY COMMENCED OR IS ABANDONED FOR , \n ' .' . ~",..,,\f nhtatn CU~1 . J.-1"'....nnnA .llMV 1 Qn nAV DCDIf'ln UU~~\\i~9-the centoer. g\~~'Uii\ii\7llp.U.B&re'lmPROVEMENTS I 111101 thp Ie <," , anl1 er '-' 00 "'32-:::'''''t'''tJ' Street Improwme S:center is 1-8 F~fIy Improved ,Sidewalk Type: Storm Sewer Available: Yes Downspouts/Drains: Curb and Gutter Special Instruction: Notes: Storm water to curb via ~eep hole .,- ~..., Paee I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriotion Tv De of Construction Estimate Estimate Fee Description Plan Review Residential + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Building Permit Fire SF Fee - Residential Fixtu re MinimumlAdjustment Mechanical Plan Review Minor - Planning Plan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Vent Fan Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01607 ISSUED: 11/1812008 APPLIED: 10/31/2008 EXPIRES: 05/18/2009 VALUE: $ 72,000.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 72,000.00 Value . Date Calculated Total Value of Project $72,000.00 $72,000.00 11/03/2008 F"", P~irl I Amount Paid Date Paid Receipt Number. $222.45 $70.95 $82.98 $40.52 $519.49 $18.00 $68.00 $44.00 $119.00 $115.22 $189.33 $248.99 $30.39 $169.45 $52.00 $8.00 10/31/08 11/18/08 11/18/08 11/18/08 11/18/08 11/18/08 I III 8/08 11/18/08 11/18108 11/18/08 11/18/08 11/18/08 11118108 11/18108 11118/08 11118/08 2200800000000001589 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750, 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 $1,998.77 Plan Reviews I Initial Review 1110312008 I II0312008 APP LLH Public Works Review I II03/2008 11/04/2008 APP LKW Planning Review 1 II03/2008 1110512008 APP DDK Structural Review 11/0312008 11/14/2008 APP DLM Storm water to curb via weep hole See documents for Plan review comments. To Request an inspection call the,24 hour recording at 726-3769. All inspections requestep 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. . Paee 2 01'3 CITY OF SPRINGFIELD. Building/Combination Permit Status Iss u ed PERMIT NO: COM2008-01607 ISSUED: 11/18/2008 APPLIED: 10/31/2008 EXPIRES: 05/18/2009 VALUE: $ 72,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541' 726-3676 Fax 541-726-3769 Inspection Line I Reouirecl Insoections . ,111.111111 II", 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 Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with tinish 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Underlloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required'testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rongh Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Erosion/Grading Inspection: Prior to .ground disturbance and after erosion measures are installed. Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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 withont permission of the Community Services Division, Bnilding 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. ~1IAhaJ- lI~!<6-ci Owner or co~tt ors Signature (j Date , Paee 3 of 3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS 1 STORM DRAINAGE DIRECT RUNOFF TO CITY' STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S,F. CHARGE 475,00 I $0.357 [ = I $169.45 I RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x COST PER S.F. I x I DISCOUNT RATE I I I 0,00 I $0.357 I 50% I ~ I ITEM I TOTAL - STORM DRAINAGE SDC '$169.45 I C0M2008-01607 TVIIl Mazet 1122 Custom Wav 1703263408200 Single Family Residence o BUILDING SIZE (SF: 360 LOT SIZE (SF): DISCOUNT $0,00 10890 $169.45 1-' I(/) C-L1 10 18 I~ 1C-L1 t- (/) t3 gJ 11070 2, SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x i 9 I B. IMPROVEMENT COST: I NUMBER90FDFU'S: COST PER DFU $27.67 COST PER DFU $21.04 x ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~ I $438.32 ;3, TRANSPORTATION A. REIMBURSEMENT COST: I ,ADTTRIPRATE I x I 9.57 I I NUMBER OF UNITS I x I I 0 I I COST PER TRIP 2106 x INEWTRIP FACTORI I 1.00 I B. IMPROVEMENT COST: I ADT TRJP RATE I x I NUMBER OF UNITS I 1 9.57 I 0 I . ITEM 3 TOTAL- TRANSPORTATION SDC x I. I ~ I COST PER-TRJP $92.89 $0.00 x [NEW TRIP FACTORI I 1.00 = $0,00 1055 $0.00 1054 $0,00 11056 I I 4, SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x I 0 I ICOST PER FEU I $97.90 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I' I 0 I $1.009.17 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SUC ~ , " . SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I 5 ADMINISTRATIVR FEE: I SUBTOTAL x I ADM. FEE RATE 1= I $607,77 I 5% I TOTAL SANITARY ADMJNlSTRATlON FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 . $607.77 $248.99 $189.33 ~ $0.00 ' $0.00 = $0.00 CHARGE $30.39 Kaye Wilson PREPARED BY 11/4/2008 TOTAL SDC CHARGES DATE 30.39 $0.00 = I $638.16 il1091 I I 1092 1093 1094 1054 11079 11078 MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE r- YEAR -rcREDIT RATFJ$I,OOO I ANNEXED I ASSESSED VALUE BEFORE 1979 1979 1980 .1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 ]993 1994 1995 1996 1997 1998. 1999 2000 2001 , $4.40 c .~ $2.73 $2.25 $1 $1.59 $1.45 - ;i" ,$1.25 _/ , ,I""",,, $1 09d,' I' "_ ~!~,~~';r d" $0.48 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for 1'0) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000' CREDIT RATE SO.OO x S5,29 ~I CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE I 1000 CREDIT RATE $0.00 x $5.29 = , TOTAL MWMC CREDIT = 2 2 1979 SO.OO o $0.00" 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journ'al Number COM2008-01607 COM2008-01607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008-0 1607 COM2008~0]607 COM2008-01607 COM2008-0 1607 COM2008-0 1607 Payments: Type of Payment CreditCard cReceinll RECEIPT #: 3200800000000000750 , . Date: 11/18/2008 Description Plan Review Residential Fire SF Fee - Residential Stann Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Stoml Admin Plan Review Minor - Planning Building Pennit Fixture Vent Fan Minimum/Adjustment Mechanical Storm Sewer - 1st 50 Feet + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By TYM ANN MAZET Item Total: Check Number Authorization . Received By Batch Number Number How Received KR 03536A In Person Payment Total: Page] of] II :35:23AM Amount Due 115.22 18.00 169.45 248.99 189.33 30.39 . 119.00 519.49 68.00 8.00 44.00 52,00 40.52 82.98 70.95 $1,776.32 Amount Paid $1,776,32 $1,776.32 11/18/2008 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: Jl22 CUSTOM WAY ASSESSOR'S PARCEL NO.: 1703263408200 CITY OF SPKll'ItJl'IELD Building/,Combination Permit PERMIT NO: COM2008-01607 ISSUED: 11/18/2008 APPLIED: 10/31/2008 EXPIRES: 06/16/2009 VALUE: $ 72,000.00 Springtield TYPE OF WORK: Single Family Rcsidence TYPE OF USE: Addition PROJECT DESCRIPTION: Addtion to residence (Recreation Rm. & Bath) Owner: MAZET TYM ANN Address: PO BOX 2391 EUGENE OR 974112 Residential Phone Nnmber: 541-736-3891 I CONTRACTOR INFORMATION I . Contractor Type Contractor License Expiration Date Phone General OWNER Designer BILL CONANT 9545746 Electrical BURRELL BROS ENTERPRISES INC 136446 08/20/2009 541-747-2724 Plnmbing JAM MAL INC t58262 0I/12/20tO 54 I -484- 7 440 . I BUILDING INFORMA TIO~ I # of Units: Primary Occnpancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of BedroOl1's: R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VB I 13.00 Wall Heat Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 10,890 360 No I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: ' Solar Setbacks: 10.80 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 36.00 0.00 . I PUBLIC IMPROVEMENTS I Street Ilroll~ts:. I Storm Slt<lffi !'ffiMI~:SHALL EXpm"E Y{lffi~~R~ Special ~lf~{ll'lfi1EO UNDER THIS PERMIT IS'NOT CgMMENCED OR IS ABANDON~[) F9R . Notes: A~l.?riM''tll\Vj!lEm'lJD~ weep hole ~ \~M ':S-~~ . Page I of 4 -'Of:,' REQUIRED PARKING Yes 13.80 Total: Handicapped: Compact: 2 ATTI:f\ml'\t"I. t"\"~g~_ ......, rrqYfrsg yey 1: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In ~.4R'9!llNlO'flOO10through OAR 952-001- OO~(>..Y.<w,_;1jP.llli9:copies gt,IWuI8S/Ir1er calliiiij"the center. (Note: the telephone . number for the Oregon Utility Notification . . Center is 1-800-332-2344). ',.,' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54t-726-3676 Fax 541-726-3769 Inspection Line Description. Estimate Tvpe of Construction Estimate Fee Description Plan Review Residential + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Building Permit Fire SF Fee - Residential Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning . Plan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Vent Fan -Mechanical Issuance Fee- + t2% State Snrcharge + 5% Technology Fee . Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid CITY OF SrKu~GFIELD Building/Combination Permit PERMIT NO: COM2008-01607 ISSUED: 11118/2008 . APPLIED: 10/31/2008 EXPIRES: 06/16/2009 VALUE: $ 72,000.00 I Valuatilin Description I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 72,000.00 Value Date Calculated Total Value of Project $72,000.00 $72,000.00 11/03/2008 Fees 'p~id I Amount Paid Date Paid Receipt Numher $222.45 $70.95 $82.98 $40.52 $519.49 $18.00 $68.00 $44,00 $119.00 $115.22 $189.33 $248.99 $30.39 $169.45 $52.00 $8.00 $21.00 $13.32 $5,55 $30.00 $81.00 10/31/08 11/18/08 11/18/08 11/18/08 11/18/08 ll/18/O8 . ll/18/08 t 1/t8/08 ll/18/08 ll/18/08 ll/18/08 ll/18/08 ll/ 18/08 ll/18/08 ll/18/08 11/18/08 ll/26/08 1/2/09 1/2/09 1/2/09 1/2/09 2200800000000001589 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 3200800000000000750 t200800000000001180 2200900000000000004 2200900000000000004 2200900000000000004 2200900000000000004 $2,149,64 I Plan Reviews I Initial Review 11/03/2008 11/03/2008 APP LLH Public Works Review ' 11/03/2008 11/04/2008 APP LKW Plannin2 Review 11/03/2008 11/05/2008 APP DDK Structural Review ll/03/2008 11/14/2008 APP DLM Storm water to curb via weep hole See documents for Plan review comments. Paee 2 of 4 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2008-01607 ISSUED: 11/18/2008 APPLIED: 10/3112008 EXPIRES: 06/16/2009 VALUE: $ 72,000.00 225 Fifth Street, Springtiel~, OR 541-726-3753 Phone 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. ' Reollirecl Insnections I Footing: After trenches are excavated. Fonndation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: ,Before covering sheathing with finish materials, Framing Inspection: Prior to cover'and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: ~rior to cover. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. :' Final Bnilding: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or;: placement of concrete. Rough Plumbing: Prior to cover and'including required testing. Storm Sewer Line: Prior to IiIling t~ench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: , Prior to Cover' Final Mechanical: When all mechariical work is complete. Rough Electric: Prior to Cover Final Electric: Whe~ all electrical work is complete. Erosion/Gra~ing InSpection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Page 3 of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line CITY OF ~l"K1NGFIELD . Building/Combina~ion Permit PERMIT NO: COM2008-0I607 ISSUED: 11/18/2008 APPLIED: 10/3112008 EXPIRES: 06/16/2009 VALUE: $ 72,000.00 By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify tbat 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 a~d 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. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 furtber 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. Owner or Contractors Signature Paee 4 of4 Date Electrical Authorization To Begin Work E-mailedTo:burrellbros@integraonline.com Receipt # EC544428 1/2/20092:50:16 PM City of Springfield ~heck on status of permit By Phone: (541)726-3753 or Em.ii: permitcenter@ci.springfield.or,us [i] I or 2 family dwelling D Multi-family o Commercial J Industrial 500 sq. n. or portion I D New construction [X] Addition/alteration/replacement Job no,: IJob address: 1 in CUSTOM WAY I City/Slate/ZIP: SPRINGFIELD; OR 97477-3023 ISujtclhldg.lapt.~o.: J. I Project name: Cross street/directions to job site: I Subdivision: Tax map/parcel no.: 1703263408200 ILot no.: ~ Limited energy, residential (with above SQ. [1.) ~ Limited energy, multifamily residential (with above sq. tU I-Limited energy, commercia-I not ol1ercd online at this jurisdiction (wilhabove SQ. f1.) - Stand-alone limited energy, residential - Stand-alone limited energy, multi-family I - Stand-alone limited energy, commercial . square foot addition and a panel change 1200 amps or less [2] 120] amps to 400 amps [2] 401 amps to 599 amps l2] $81.00 $81.001 I 1200 amps or less [2] 1201 amps to 400 amps [2] 1401 amps to 599 amps [2] I Name: Tymann Mazet Iphooo: (541)736~3S91 I Email: I.'a" Upon review and approval by your local jurisdiction, your permit will bee-mailed or faxed within one business day, with instructions on how to schedule your inspection. I A. Fee for branch circuits with service or feeder fee, each branch circuit B. Fee for branch circuits I w;thoAl"T'eN1Ft~ @rege n law re ulres YOII to lirst r r" ') no 11"i1iht I '''",I" ,. ra~6~ct'!''lt.ef hI> ~ are set forth I I;IVif'~'~MJgs~",;Tn';\ .7"" ". h'''' 'H,c:jjga;"52roo~~1'1 ,..!'/ifI,v,'!'J!l,Q!i2-001,0010,t roug , . ,.",>" ..,"'~,~. I I Ser'fRtl!ll11l9nf\lsltrlTluM obtai ~ copies )\ tne ru~s y Each ~l'1 't!re'~Atar. (Note: tr e te.lepn n" I I dWell;n'bi'h'BiWi"t/i'WOre ~on Utilit I Notific lion I I 121 .' l-fOO-S32-':644) I I Pump or ;rdgat;o"'!l~~'" . ,.. I I I Sign or outline lighting [2] I I I Signal circuit(s) or h.mited- I lllteratlOn, or 51 $6001 $30.00 I lEI. lie. no.: 20-442C ICCB lie. no.: ]36446 1 Business Name: BURRELL BROS ENTERPR]SES lNt /Contllct: Joshua Burrell IAddress: PO B.}}$'~"".. I CitY/StRtelZIPL~~f.LE OR 97489-0697 I Phone: (541)74~ftt'i1 t'tKIVIII liHALL ~P.I!Ui:li4TcWE WORK lEma;!, burreUt.\l,l@;\;\!,!I:IJ,(itRU,JJ,NUI:H lHIS l'ERMIT IS NOT IM"ro lie. oo.,vUlVIIVII:NlitU UH IS ~HRtNDImED FOR I Supmi,in, "lilllliaHIIJ.I.\AY 4h'JlRIOD. I Supervising electrician's name: JOSHUA J BURRELL NOTE: This Authorization To Begin Work expires within 180 days if a permitis not obtained. . I I I I TOTAL PERMIT FEE * City OfSpringfie]d fees: 5% Technology Fee [Defal/lf number o(insoectiunsallowedl COM" rmO'K - 01 (vi)'l RCPU' ?J?DoC/ - Lj DATE PROCESSED: II ?J rR This Authorization To Begin Work must be posted at the job site until rePlacedObY a I?ermit. . . PROCESSED BY'!) ~ 0 O! Subtotal State Surcharge (12% of permit fee) CilY Of Springfield fees + $111.00 I $13.32 I $5.55 I $129.87 I The local building department may determine that an Authorization To Begin Work is null and void if it does riot meet applicable land use laws and local ordinances. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM200S-01607 COM200S-01607 COM200S'01607 COM200S-0 1607 Payments: Type of Payment RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department .2200900000000000004 Date: 01/02/2009 3:09:47PM Item Total: <"':heck Number Authorization Received By Batch Number Number How Received Amount Due S1.00 30.00 5.55 t3.32 $129,87 Description Pe:", Serv/Fdr 200 amps or less Add, Alter, Extend Cire Ea Add + 5% Technology Fee + 12% State Surcharge ONLINE CHGS .ONLlNE PERMIT CHGS Paid By cReceintl Amount Paid kr ONLINE burrell bros Online Payment Total: $129,S7 $129.87 Page I of I 1/2/2009