HomeMy WebLinkAboutPermit Building 2009-2-10
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
.541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6754 A ST
. ASSESSOR'S PARCEL NO.: 1702344106802
PROJECT DESCRIPTION: Garage
Owner:
Address:
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2009-00189
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 08/1012009
VALUE: $ 15,851.00
Springfield TYPE OF WORK: Garage
TYPE OF USE: New
Residential
MADDY WAYNE A & JANICE L
PO BOX 383
WALTERVILLE OR 97489-0383.
Contractor Type
General
Contractor
OWNER
# of Units:
Primary Occ~pancy Group: U
Secondary Occupancy Group:
Primary Construction Type VB
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
.~! I cNTfOf\l. ^
J~l'~e0N1iRACrORIINF.QRMATlON I
. L"~QI/Dn C ,.~u uy fh ' -~ y.ftJ to
,In OAR 9 enter. Th e Oleon/) I) , . "
0090 \,52-001-0010 oSe rUlJe1seJlse IilltjExplratton Date
. IOU ma through 0 ' Set forth
CAtlin.... ,. Y Obtt=lin ~_. AR OJ::""l ~_
nUII/~~I}l&fuNF(()RMlirr6~'ll rUle~by'-
., 11~llJl; ~.~Ih
l.ienteris 1 ~d 'I tility N;' ,iJ One
# of Stonef?:OO-332-2344) fIt/cation '
Height of Structure .
Type of Heat:
Water Type:
, Range Type:
Energy Path:
Sprinkled Building:
Phone
n/a
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
476
I DEVELOP~ENT INFORMATION'
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Overlay Dist:
Ncti1tE" # Street Trees Rqd:
"Paved Drive Rqd: Yes
THlH'rfRMIT SHAL108l<cIlIRINli''llIiE WORK 17.20
~~!~~~~~ ~ND~RTH'S PERMIT IS NOT
ANY'180/(D~l\WIW\i~m~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Sidewalk Type:
Downspouts/Drains:
I Valuation Descriotion I
$ Per Sq Ft '
or multiplier
Sqnare Footage
or Bid Amount
Value
Date Calcnlated
Paee I of 3
_.fi1,~,~~~~I!1!~
'11 ,.,'
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00I89
ISSUED: 02110/2009
APPLIED: 02/10/2009
EXPIRES: 08/10/2009
VALUE: $ 15,851.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Estimate
. Estimate
$1.00
15,851.00
$15,851.00
$15,851.00
02/10/2009
Total Valne of Project
I ' ';P,M< r1W
Fee Description Amonnt Paid Date Paid Receipt Nnmber
+ 12% State Surcharge $23.34 2/10/09 1200900000000000090
+ 5% Technology Fee $15.68 2/10/09 1200900000000000090
Building Permit $194.50 2/10/09 1200900000000000090
Fire SF Fee - Residential $23.80 2/10/09 1200900000000000090
Plan Review Minor - Planning $119.00 2/10/09 1200900000000000090
Plan Review Residential $126.43 2/10/09 1200900000000000090
SDC Sanitary/Storm Admin $11.13 '2/1 0/09 1200900000000000090
Storm Drainage Impervious Area $222.61 2/1 0/09 1200900000000000090
Total Amount Paid $736.49
I Plan Reviews I
Public Works Review 02/10/2009 02/01/2009 APP LKW Storm water to tie i":to existing
system
Planning Review 02/10/2009 02/10/2009 APP DDK
Strnctnral Review . 02/10/2009 02/10/2009 APP CJC As noted on plans
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. .
't~m,ir'p~. In~I'~i't~
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Framing Inspection: Prior to cover and after all rongh in inspections have been approved.
Final Bnilding: After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Perimeter Foundation Drains: After gravel and Iilter cloth is installed but prior to backfill.
Page 2 of 3'
Status
Issued
225 Fifth Street, Springfield, OR
54i-726-3753 phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00I89
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 08/10/2009
VALUE: $ 15,851.00
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 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 structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, tbat 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 constrnction. .
, VnZ-' 7'J1'h-lk
, ,;
Owner or ontractors Signature
Page 3 01'3
~ J~ /cJ. :l00 9
Date
Structural Permit Application
':!,j5EPARffiMEN'Thi1iSEt0NT!:i(~
\?tfi'1;>.~-"'-"'<;""l!'''':':kt}i;;;'".''~l!;lfll~l~~~~;&.'tiC:-j
- CO"" z..oo 7-00/6 '1
Penn it no.:
225 F;jlh Street. Springfield. OR 97477. PH(541)726-3753. FAX(54 1)726-3689
I Date: Z /10/0 7
This permit is issued under OAR 918-460-0030. Permits expire if ;"ork is not started within 180 days of fssnan~e or if. work is
suspended for 180 days.
1~~~{G:9E~,8.ij,ME:tlJf;71@B"[~~'C~~~
I ~is project has fin~11and-use approvaL I
SIgnature: Date:
'/ This project has DEQ approval. I
Signature: Date:
1 Zoning approval verified: 0 Yes, 0 No 1 I
I Property is within flood plain: 0 Yes 0 No I I,
1._~~l\T~:Q[fiQ~lG~(Ifij~illfilJ.~IrI<[ij~li:p~~1%~~1 I
~.~~~1~ttf~0~~i~i~bJ~~~i!~R_~~11
I Job site address: C '}S''/ A r STReel 1 I
I City: ,"I'/);t1J(FIEU I State: o/<: I ZIP: 9!)Y?,r 1 I
. . .1/ Energy Path:
II'~~~~:::~:;:":S',.,~.. ._~, '"~'-, .~~L~_;~:I~::" :~.~~r~12~f:,-:::,:~JI i (~F::datio~o:~~;~:it?
~ ..' ',;?""""f4#"ii 'F1ROF1ERlC'Ii.%OWNER".",1'1t-'li""",,,.-!'f"-'i!:>'!,'!'
=.'-~, . ,Sk,tY/',h" . -,., ..,"')l>"u....s._-'<-.._.h..,.~.."..,__,___,,:,:~~)"j,.,"'~N,~,J)i" '>,dill.n.6<.",.'.' -h""-"l I Total valuation:
1 Name: 'v.!;1 '//Je ..j- .TI9IJ m/ldrl y I
1 Address: ;:; "lS-l/ )(). Sfi2ee.., I
I City:.'?jlj);AlI.?,,;Lrl I State:o,f' 1 ZIP:'1I)Y?J I
1 PhoneS'!'! -?26- - '1 G2 y I Fax: 1
I E-mail: 1
This installation is being made on residential or farmproperty'owned.by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
1;.~~t{~~{R~b~~~~6N~~~{t4$":1*~il
~~~~,~~~"""-:~L'~._"'~______=~'_,~~__,--,- _"_.).t.~.-;ttlYf,,,];f:~)~~~v-
I Business name: L",,:;11.4I J IIWtJCt! 1
Address; / I
.1 City: I State: 1 ZIP: I
1 Phone: Fax: 1
I E-mail:
I CCB license no.;
I Print name;
I Signature:
1~~S:Q_i:lI\~:i:!~m['gf1F@.Blltil~pJ~Mg:f;i~BF,iit~iijj)B;B~
I Name CCB License Number Phone Number
I Electrical /'irS-() 8'6 5"11-(;5'3 -83.2.3
I Plumbing
I Mechanical
C'--I'1IUt!'E
I
I
I
I
I
I
I
I
I
_.....\1
/'S 6 ~ I
/VOlVo:..
Construction type: s71'ot:- I3vt-(r
Squarefeet: 7'9 {,
Cost per square fool:'%.13,30
Other information:
Type of Heat:
NJ:VL
o addition
DYes
ONo
I
1
I
1
I (e) Subtotal offee, above (2a through 2d): $ I
1!f3~~lfmr~~ilWft&~~~~~~!E@~~~~~,:1
.~_._......._.....,,_.._.~_.9~~~,"'~...lij......_iii!i;g~___.Jilj_
I (a) Plan review (65% x permit fee [2a]): $ I Z b l(l_
I (b) Fire and life safety (40% x permit fee [2a]): $
1 (c) Subtotal of fees above (3a and 3b): $
I (a) Permit fee (use valuation table):
1 (b) Investigative fee (equal to [2a]):
I (e) Reinspection ($ per hour):
(number of hours x fee per hour)
I (d) Enter 12';' surcharge (,12 x [2a+2b+2c]):
$
$
$
$
I (a) Seismic fee, 1 % (.01 x pennit fee [2a]): I $
TOTAL fees and surcharges (2e+ 3c+4a): 1 $
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F.I CHARGE I
I 624.00 I $0.357 I = I $222.61
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
,I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
I 0.00 I $0.357 I 50% I ~
ITEM I TOTAL-STORM DRAINAGE SDC ,.$222.61
2. SANITARY SEWER - CITY
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
L STORM DRAINAGE
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 0 I
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 I
COM2009-00189
Wa"!'e & Jane Maddv
6754 A Street
1702344106802
Single Family Residence
o BUILDING SIZE (SF:
COST PER DFU
$27.67
COST PER DFU
$21.04
3. TRANSPORTATION
ITEM 2 TOTAL- CITY SANITARY SEWER SDC
A. REIMBURSEMENT COST:
1 ADT TRIP RATE I x
I 9.57 I
I NUMBER OF UNITS I x I
I 0 I I
B. IMPROVEMENT COST:
I ADT TRJP RATE 1 x I NUMBER OF UNITS I x I
9.57 I I 0 1 1
ITEM3TOTAL-TRANSPORTATlONSDC = I
4 SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
[NUMBER OF FEU's 1 x
I 0 I
B. IMPROVEMENT COST:
INUMBER OF FEU's I
' I 0 ,
ICOST PER FEU
I $97.90
x
ICOST PER FEU
I $1,009.17
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM4TOTAL-MWMCSANITARYSEWERSDC ~ I
SUBTOTAL (ADD ITEMS 1.2,3, & 4) ~ ,
5. ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE I~
I $222.61 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
476
en
W
Cl
o
U
0::
W
f-
en
-
O.
~
LOT SIZE (SF):
10454
DISCOUNT
$0.00
$222.61
11070
$0.00
1091
$0.00
I
11092
I
~ ,
$0.00
COST PER TRIP
21.06
x INEW TRIP FACTORI
i 1.00 I
$0.00 1'1093
I
$0.00 1 1094
I
~_nl
$0.00 1 1054
I
COST PER TRIP
$92.89
$0.00
x, INEW TRIP FACTORI
I 1.00 1
=
= $0.00 1 JOSS
$0.00 I 1054
$0.00 11056
$0.00 I
$222.6 I I
I
CHARGE
$11.13
I 11.13 11079
..J $0.00 11078
TOTAL SDC CHARGES =, $233.74 1
.".---..
- -
Kaye Wilson
PREPARED BY -
2/] 0/2009
DATE
DRAINAGE FIXTURE UNIT (DFU) CALCULA TION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXl1JRE UNITS
(NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES
UNIT
FIXTURE TYPE NEW OLD EQUIVALENT
I BATHTUB 0 0 .3 =
DRINKING FOUNTAIN 0 0 1 =
I FLOOR DRAIN 0 0 3 =
1 INTERCEPTORS FOR GREASE 1 OIL 1 SOLIDS 1 ETC. 0 0 3 =
I INTERCEPTORS FOR SAND 1 AUTO WASH 1 ETC. 0 0 6 =
I LAUNDRY TUB 0 0 2 =
1 CLOTHESW ASHER 1 MOP SINK 0 0 3 =
ICLOTHESWASHER - 3 OR MORE (EA) 0' 0 6 =
IMOBILE HOME PARK TRAP (I.PER TRAILER) 0 0 12 =
IRECEPTOR FOR REFRIG 1 WATER STATION 1 ETC. 0 0 1 =
RECEPTOR FOR'COM. SINK 1 DISHWASHER 1 ETC. 0 0 3 =
SHOWER., SINGLE STALL 0 0 2 =
SHOWER., GANG (NUMBER OF HEADSl. 0 0 2 =
ISINK: COMMERCIAI.JRESIDENTIAL KITCHEN 0 0 3 =
I SINK: COMMERCIAL BAR 0 0 2 =
ISINK: WASHBASIN/DOUBLE LAVATORY 0 0 2 =
ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 0 0 1 =
IURINAL. STALL/WALL 0 0 5 =
ITOILET. PUBLIC INSTALLATION 0 0 6 =
ITOILET. PRIVATE INSTALLATION 0 0 3 =
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 =
TOTAL DRAINAGE FIXTURE UNITS
:EDU (Equivalent Dwelling Unit) is a discharge equivale:nt to a single family dwelling unit (20 DFlfs) set at 167 gallons per day
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
r--- YEAR
l ANNEXED
1 BEFORE 1979
I 1979
1 1980
1981
1982
1983
1984
198~
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
'::'[[::,L]!!,;':'"
;t:IL
;"i'(i.-";:,
": I , ~;o
~-".,. .
$3.67 L.
.$322".". .. ,:
'I. $2': ~~'~;.!;.i~:!~::~1
$2.2'('_ '~.
$1.80~
$1.59
'$1.4
$1.2
i,~$1.0~li~:\,i;i;,I'
$O.92',*"1~:!c!!!!'i :.,'
$0 72c:l::_ '
$0.48~- ,
$0.28" , ..
$00'9''"-''''''''1''',''
. .~t"~;;I:I;,.:~i;:
....,~""'~". I
$0.05_~-
I.
r
IS LAND ELGIBLE FOR ANNEXA nON CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE 1 1000 CREDIT RATE
$0.00 x $5.29
CREDIT FOR IMPROVEMENT (IF AnER ANNEXATION)
VALUE 1 1000 CREDIT RATE
$0.00 x $5.29
.,
TOTAL MWMC CREDIT
~ ,
=
1979
$0.00
$0.00
. 01
, .
I
I.
I
1
I
I
I
I
I
I
I.
I
1
1
I
I
~
2
-I
I
I
I
1
I
2
o
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
C0M2009-00 189
COM2009-00 189
COM2009-00 189
COM2009-00 189
COM2009-00 189
COM2009-00 189
COM2009-00 189
COM2009-00 189
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department,
1200900000000000090
Date: 02110/2009
Description '
Plan Review Residential
Plan Review Minor - Planning
Building Pennit
Stonn Drainage Impervious Area
SDC SanitarylStorm Admin
Fire SF Fee - Residential
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
WAYNE MADDY
Item Total:
L:heck Number Authorization
Received By Batch Number Number How Received
djb
06093c In Person
Payment Total:
Page I of I
2:07:25PM
. Amount Due
126.43
119.00
194,50
222.61
11.13
23.80
15.68
23.34
$736.49
Amount Paid
$736.49
$736.49
2/10/2009
Status
Issued
CITY OF ~J:"KINlJl< lELD
Building/Combination Permit
PERMIT NO: COM2009-00189
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 10/27/2009
VALUE: $ 15,851.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6754 A ST
ASSESSOR'S PARCEL NO,: 1702344106802
Springlield TYPE OF WORK: Garage
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Garage
Owner: MADDY WAYNE A & JANICE L
Address: PO BOX 383
W AL TERVILLE OR 97489-0383
Phone Number: 541-726-9624
t. CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Contractor
OWNER
LMi ELECTRIC LLC
License
Expiration Date' Phone
185086
01/09/2011
541,729,8727
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I BUILDING INFORMATION'
'Ore 011 law reqUire:> j U" t.o
ATTENTION# of S~o"ie" the Oregon Utility
iJlloW rules H~\gh't~f~t.<ncture are set forth
NotificatlOn.C~r'~e:,o,f:if~at':J9h OAR 952,001-
vaOAR 952 OW,,<!pni!!Mp.e>pies olthe rules by
0090, you rnJra~ ve TJ(i>i!.te: the telephone
calling the "'v, ~--.. 1,1l',Utility Notification
b r lor"ne."" ",a , )
nurn e ~ "~;'~L-l ij-,n'\., ,,"?2344., /
Certtllr.,.,.,. e ""'HOlOg, n a
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
476
1 DEVELOPMENT INFORMATION ,I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback: ,
Rearyard Setback:
Solar Setbacks:
5,00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Yes
17,20
Total:
Handicapped: .
Compact:
2
, 10,00
6,80
Street Improvements:
Storm Sewer Available:
Special Instruction:
, 1 PUBLIC IMPROVEMENTS I ' \"3e1 ^'<JO oca~ ^N~
. QOo ~~j~~O~
oetNtNdgl"t!'D ~1i\'tl0\-\1.(\\I
'cIOj 03\11 S\\-\~~tl(V{,l\~c'\: S\\-\1.
Adding 1.5 feet no increased SDC10\ll S\ 1I~'tl3e1 'tllel)(3 "rW\-\S t ';13\10"
)\'tlON\ 3\-\1. j\ :I '
Notes:
.-...~'
,~~
Paee I of 3
._~8;~1~,q.~~.'~b~>"'!I'!~!'~!'J.,~llt,
,
Status
Issued
225 Fifth Street, Springt1eld, OR
541,726,3753 Phone
541-726,3676 Fax
54].726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
+ 12% State Surcharge
+ 5% Technology Fcc
Fire SF Fee - Residential
Garage/Carport
Plan Review Minor. Planning
Plan Review Residential
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
+ ]2% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend CiJ'c Ea Add
Perm SeJ'v/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fcc
Storlll Sewer - ]st ]00'
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00189
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 10/27/2009
VALUE: $ 15,851.00
I Valuation Descriotion I
$ Per Sq Ft '
or multiplier
$1.00
Square Footage
or Bid Amount
]5,851.00
Value
Date Calculated
Total Value of Project
$]5,851.00
$]5,851.00
02/10/2009
,F~PJ P1WJ
Amount Paid
Receipt Number
Date Paid
$23,34
$]5,68
$23,80
$194,50
$]]9,00
$126.43
$] I.13
$222,61
$] 1.88
$4,95
$18,00
$81.00
$9,12
$3,80
$76,00
2/10/09
2/10/09
2/1 0/09
2/10/09
2/1 0/09
2/] 0/09
2/10/09
2/10/09
4/22/09
4/22/09
4/22/09
4/22/09
4/28/09
4/28/09
4/28/09
1200900000000000090
1200900000000000090
1200900000000000090
]200900000000000090
]200900000000000090
1200900000000000090
]200900000000000090
1200900000000000090
22009000000000004]3
22009000000000004]3
2200900000000000413
22009000000000004]3
2200900000000000447
2200900000000000447
2200900000000000447
Total Amount Paid $941.24
I Plan Reviews .1
Public Works Review 02/10/2009 02/01/2009 APP LKW Storm water to tie into existing
system
Plannin1! Review 02/10/2009 02/10/2009 APP DDK
Structural Review 02/10/2009 02/1 0/2009 APP CJC As noted on plans
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,
~lIirprllnl;'.nections I
Footing: After trenches are excavated,
Foundation: After forms are erected but prior to concrete placement.
, Paee 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issu'ed
PERMIT NO: COM2009-00189
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 10/27/2009
VALUE: $ 15,851.00
225 Fifth Street, Springfield, OR
541-726,3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Framing Inspection: Prior to cover and after all rough in inspections have been approved,
Final Building: After all required inspections have been requested and approved and the building is complete,
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
Perimeter Foundation Drains: After gravel and Iilter cloth is installed but prior to backlill,
Electric Service: Approval required prior to utility company energizing service,
Underground Electric: Prior to cover
By signature, I state aud 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 Springlield and the Laws of the State of Oregon pertaining to the workdescribed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project,
I further agree to ensure that all required inspections, are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the properly, and the approved set of plans will remain on the site at all
times during construction. .
Ua-/4L<' /Y!r;#
Owner or Contractors Signature
i/-2,f~o9
Date
J
Paee 3 013
225 Fifth, Street'
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009,OO 189
COM2009-00 189
COM2009-00 189
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Storm Sew,er . I st 100'
+ 5% Technology Fcc
+ 12% State Surcharge
Paid By
, WAYNE MADDY
City of Springfield Official Receipt
Development Services Department
Publie Works Department
2200900000000000447
Date: 04/28/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
09726c In Person
Payment Total:
Page 1 of 1
9:33:46AM
Amount Due
76,00
3,80':
9,12
$88,92
Amount Paid
$88,92 .
$88,92
4/28/2009