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Home My WebLink AboutPermit Building 2009-3-23 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00354 ISSUED: 03/23/2009 APPLIED: 03/17/2009 EXPIRES: 09/23/2009 VALUE: $ 30,779.52 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6849 MAIN ST ASSESSOR'S PARCEL NO.: 1702344400601 Springfield TYPE OF WORK: Garage TYPE OF USE: Residential PROJECT DESCRIPTION: Garage O\,"'ner: Address: JERRY LIVINGSTON 302 72ND PL SPRINGFIELD OR 97478 Phone Number: 541-521-2067 I CONTRACTOR INFORMATION I Contractor Type General Contractor OWNER License Expiration Date Phone BUILDING INFOR~A nON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Coustrnction Type: # of Bedrooms: U # of Stories: Height of Structnre Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq FtBasement: , Sq Ft Garage/Carport Sq Ft Other: Occnpant Load: 816 VB n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 7.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of lot Coverage: Yes 17.20 Total: Handicapped: Compact: 2 17.00 0.00 Street Improvements: Storm Sewer Available: Speciallnstrnction: I PUBLIC IMPROVEMENlT:S'INTION' OregonlaWtlreqoUrlel~~~U\lilty . I dop'ed by .1e ~ tOIlOW ru eSs.da Ik' T .> rules are set forth f. t I ewa ,ype" 001 Notl lea 101' vv'H-" hOAR 952- - . R 95- ~n1_nn1 0 throu.9 , In OA 'DownsllOntslDrams:of the rLffio,st~rm Sewer 0090.. You may Oi.l1al[IN~~~\he telephone calling the cen~r. (on Utility Notification number tor the r1e8900_332-2344). Center IS - Yes Notes: SfJl<2~~~~NOFF TO EXISTING T.UIC' nrnn"I'T" .....1... i'UTH -....,,'. U'''''LL CN'flit I: i1;;: 'NJnro. i:Om/lORIZED UNDER THIS PEF!n,Vahlatiotl Description I J \ ENGED OR IS ABANDONfn r: ' D.' . .\NY J8Tn n,w,HfD1r:1f" t' $"P'eP~q Ft Square Footage escllptlOn ype 0 ,-,ons FIIC IOn I . I' B'd A or mu tip lef or I mount Valne Date Calcnlated Page I of3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00354 ISSUED: 03/23/2009 APPLIED: 03/17/2009 EXPIRES: 09/2312009 VALUE: $ 30,779.52 225 Fifth Street, Springfield, OR 541-726,3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Garage/Misc U VB Utility $37.72 816.00 $30,779.52 $30,779.52 03/20/2009 Total Valne of Project ~PPlii'.~ Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee Fire SF Fee - Residential Garage/Carport Plan Review Minor - Planning Plan Review Residential Sanitary Sewer - 1st 100 Feet SDC Sanitary/Storm Admin Storm Drainage Impervious Area Amount Paid Date Paid Receipt Number $120.09 $48:26 $26.06 $40.80 $326.17 $119.00 $126.43 $76.00 $21.83 $436.66 3/17/09 3123109 3123/09 3123/09 3123/09 3/23/09 3/23/09 3123/09 3/23/09 3123/09 2200900000000000271 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 2200900000000000287 Total Amonnt Paid $1.341.30 Strnctnral Review 03/1912009 PhlO Reviews I REC Plnmbing permit to npgrade sanitary sc..\'er line that will be under the new,garage slab Planninf! Review Pnblic Works Review 03/18/2009 03/18/2009 03/1812009 03/18/2009 APP DON DDK BJG Structural Review 03118/2009 03/2012009 APP CJC As noted on plans and in revieew letter To Request an inspection caIl 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. ~Pf'tion~l Ufer Electrical Gronnd: Install gronnd rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After f'o'rms arc crecte.d but prior to concrete placement. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Bnilding: After allreqnired inspections have been reqnested and approved and the bnilding is complete. Page 2 of 3 _GP,;AI"'Ql'1I/it1o..9~ , ., !; Statns Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00354 ISSUED: 03/2312009 APPLIED: 03/1712009 EXPIRES: 09/23/2009 VALUE: $ 30,779.52 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Sanitary Sewer Line: Prior to filling trench and inclnding reqnired testing. Slab: To be made"fter"1I inslab bnilding service equipment, condnit piping and other eqnipment items are in place bnt prior to concrete. Underslab Plumbing: Prior to tilling the trench and inclnding required testing. By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is trne "nd 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 strnctnre withont permission of theCommnnity Services Division, Building Safety. I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project. I fnrther agree to ensnre that all reqnired 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 property, and the approved set of plans will remain on the site at "II times during construction. V--y-?~~'L 3/23/2-00/ Owner OJ' Contractors Signature Date Pa2e 3 of 3 I CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2009-00354 I NAME OR COMPANY: LIVINGSTON LOCATION: 6849 MAIN ST. I TAX LOT NUMBER: 170234440060 I I DEVELOPMENT TYPE: Sin~1e Family Residence I NEW DWELLING UNITS 0 BUILDING SIZE (SF: 1224 LOT SIZE (SF): LSTORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS SF x I COST PER S.F. CHARGE I 1224.00 I, $0.357 I = I $436,66 RUNOFF ROUTED TO DRYWELL 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 I $0.357 I I 50% I ~ ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARV SEWER - CITV $436.66 A. REIMBURSEMENT COST: r NUMBER OF DFU's I x I . 0 I B, IMPROVEMENT COST: . I NUMBER OF DFU's I x I 0 I COST PER DFU $27,67 COST PER DFU $21.04 ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~ I $0.00 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x 1 9.57 I B. IMPROVEMENT COST: 1 ADT TRIP RATE I I 9.57 I I NUMBER OF UNITS I x I I 0 I 1 COST PER TRIP 21.06 1 NUMBER OF UNITS I x I I 0 I I ,= , COST PER TRIP $92.89 $0.00 x ITEM 3 TOTAL- TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x o I 1 COST PER FEU I $97.90 B. IMPROVEMENT COST: INUMBER OF FEU's 1 x I 0 I ICOST I'ER FEU $1,009.17 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL- MWMC SANITARY SEWER SDC ~, SO.OO SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I S436.66 5 ADMINISTRATIVE FEE: I SUBTOTAL x I ADM, FEE RATE I~ I I S436.66 i 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: CHARGE $21.83 DISCOUNT $0.00 , . I I I ~ I I III x INEW TRIP FACTORI I 1.00 I I :1 II , x INEW TRIP FACTORI I 1.00 ! 11720 $436.66 .SO.OO ~ , SO.OO [/) 1Il Q o U '~ -I ~ ~ 1070 ' 11091 11092 I 11093 I, 11094 I ~ I 'I I SO.OO SO.OO = SO.OO = SO.OO SO.OO SO.OO 1 11054 l 11055 .1 1054 1056 21.83 1079 SO.OO J 1078 = I $458.49 I' I --.- Ben Gibson 3/18/2009 PREPARED BY DATE TOTAL SDC CHARGES DRAINAGEFlXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS [BATHTUB 0 0 3 = 0' IDRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 !LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER / MOP SINK 0 0 3 = 0 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER STATION / ETe. 0 O. 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETe. 0 0 3 = 0 SHOWER. SINGLE STALL 0 0 2 = 0 I SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 ISINK: COMMERCiAL/RESIDENTIAL KITCHEN 0 0 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0 I URINAL. STALL / WALL .0 0 5 = 0 ITOILET, PUBLIC INSTALLATION. 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 OFlfs) set at 167 ~allons per day .....iI MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE CREDIT RATEI$I,OOO l ASSESSED VALUE . $5,?.~' $5.2~;~ ..~ t ,$5,;,1~~,f~i!i:;;Jii':',t'irj~rf,~ '~$5:'12~"1:., ;'!JW~;:~ YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 "$4.9if $1,59c $1.45". . , $.L.?c!:ff;t;wii.u. ~f ~~ $-1;-;b~1!:~;Ii::::li::':"i:,~ I. $O:92~-;' ":-":i '$0,72 . ",:g~~::.i :~:~i. $0,09.~ $0 ,.05 ~= IS LAND ELGlBLE FOR ANNEXA nON CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5.29 ~ , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $5.29 ~ , o JI".; ,h TOTAL MWMC.CREDlT $0.00 = ~'l~DERAR.:;r,MEN:nrUS. E. T0NT.~ir/.~1 ~~':"~~""'-"'~'''';:''''''='';'.'')>Zil'1'lfm;d'5-~"'!j~~: COWl ZOO, - Permit no,: 0 0 '3S<.{ '. . . . I Date: "3/17/0 I This permit is issned n!,der OAR 918-460-0030. Permits expire if work is not started within 180 days of issuaice or if workis suspended for 180 days. Structural Permit Application - 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 1~"I!gg~!tQ~NM1&'I'~PJ:l!f~p;.~~:i1 I ~is pr~ject has finall~d-use ap~roval. I Signature:. Date: '1' This project has DEQ approval. I Signature: Date: I Zoning approval verified: DYes D No I I Property is within flood plain: DYes D No I ' -.,!lli~"~a',t.;l!EG0R'i;fwQF1"C0NSffiRUBT,i0N~,1~.l'Pi'~1i!(f~~;:j;i:i =~~_~."'-"~_""j~"~,,,,Jt'i'~,_,,,_,~,~,"'~,I"......_,,,"~~;r",dk."j<I.~,,~~"_ I i~t~alr,~jE.Go~~m=~~,:._,.,kC?~~.:;,~~:"":,,,I' _="'i"!'1!@!;lit;l>.IJ1E]lm!i~J~M~m!!+lNlt~Nl>J;t[H1l,c:.~]!QNk~)?t'.!jfi' I I Job site address: 68'19 UIh'rJ srt2-td . . I I City: 5i/tZ;;oJ G. H El..-D I State: 0/2.- I ZIP: '1'7Y 181 I Subdivision: . J Lot no.: I I Reference: 1702. J44 L(I Taxlot: . 0060 ( ~ 1;,~~'",~~)1fu'\!&tu-""'~--","""'~~0",,,,,,=",,,~?&~,;o'~'f'~re~~;:I.V',;,'-"'-:::"~:~ 1I111)'l!'<l;~oii','iii~e~'i1c'l!.";!I'4l!!?B.QRI';8E!li(-&:.@,Wt(I';E!',i:c.1K~~ii.jiii;,<'.':f;;;:':;:) I Name:vEeM J,L-(V tNGsro;J i .l)o.J,..J,'l c, .ecYcEl I Address: c3D2. 72;JD t /.A-C.k" I I City: S/JtZ; tJG. Ft El--b I State: olZ I ZIP: 9'/V 18 I I Phone: 5'f/_ 6Z/_ 2"-1;, -; - I Fax:,J4- I I E-mail: V~t...i I.Jt,)(; "-;;J Y /Hfoo, <..Z>N I This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing reqUiremeVndey~~' L-{\ Sign here: '0 NOnj\lL cJ(, Ir~~~ti[[RAGFfiEi Jlti,~~~W'~Ii'.1QN_-: I Business name: ..v~ OW Nt:"1L I Address: I City: I Phone: I E-mail: I CCB license no.: I State: Fax: I ZIP: Print name: Signature: 1~~,{J~:t(r~rn~T;Q.Ell!ll.f&BM~]i0!'l~~JI:('~1 I Name l CCB License Number I Phone Number I I Electrical I I I Plumbing I I I Mechanical SPAI~G.~ELD " )i~- '.-.,+"!-'13: ~. I I I I I I I I I I I Total valuation: I $ / )'OOp 1:!i:lltii:IdTi'{gif';~'S~!f"'''X~li1~~'.~)\;[ :.i::ij:;If!!Wl1!4i:-~~!I~I{~!'1 _ . .' ,,_ __."_._~.'_ ...".".~..".~",_,,~~r:t.t";\h'" P"'''' , ,'_en_' ~., ~.."<__..._,}~~~~'\",!",,,!l,_.,".nh~, I (a) Permit fee (use valuation table): $ I I (b) Investigative fee (equal to [ZaJ\ $ I I (c) Reinspection ($ pcr hour): I (number of hours x fee per hour) $ I (d) Enter 12% surcharge (. IZ x [2a+Zb+Zc]): $ I I (e) Subtotal of fees above (2a through 2d): '. $ I Ill\flrTit.u~j~fui;T'''''.l,,",~\'iilt'':!'lfi)''~~jSji*-~i!j;_-"1'!'>~ ! 1!l,-~.IL_,......"._."",_._~__!*',Uli,JjJ;?~"'1iiRlli~'h.~_ ., I (a) Plan review (65% x permitfee [Za]): $ I tt-O I (b) Fire and life safety (40% x permit fee [Zaj): $ I l,(c) Subtotal of fees above (3a and 3b): $ I ~~>~~~M~]~~lX~n~:<<~[f~~~l@:~t!~~.~R~;";~",:;-..~t~J,~i?';1t;,tit~_~~1 (a)Seismicfee,l%(.Olxpermitf~e'[2a]): $ I I LA.. vi] Construction type: Square feet: Cost per square foot Other information: Type of Heat: KA- Energy Path: 1J.pew D alteration I (b) Foundation-only permit? D addition DYes J\;rNo TOTAL fees and surcharges (2e+3c+4a): $ Plumbing Permit Application rrzllJDER:klllRmMEN~wsEf0N~it~ 4>>."i/"0;fJfi!"":~>;4~>"^""_"";€"'C0__".",..""",,,.W=;h~~~. '7!:;;Wi;m_'L"",~~_~'$""".""""""~~",,,,,~~,,,,~__~___1'I:'~ I4VDcD 10 AJ9' ?r-U I Permit no.; U -.::;>..:> 7 I Date:,S//'1/"'/ I / I 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 This permit is issned nnder OAR 918-780-0060. Permits are issned only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is snspended for 180 days. 1~~1r0Q~I!f(r0.~E~NMENrr'M~R0v.~l"j,m~"a'1~~~:\\!:;jl I Zoning approval verified? D Yes D No I I Sanitation approval verified? DYes D No . I lI~iIli0:J.\.'liEG:QRlfi.rQFJ!.0:0N$m.RI!J,Q}rJQN"~1k,1!l'~1 I J8l Residential I D Government. I D Commercial I 1~~i!JQBlslm.E~INFi.ORI\irMIQN!lJ.\.NQ,Il!0.CJ.\.T:I.c)N~~~1 I Job site address: h8'!'! NIr7;J $f I I City: 8M,)6, n EZ-J) I State: 012... I ZIP: 17tz78 I I Subdivision: I Lot no,: I 1'::i""'"if~"""'~~""4;;ogD'ES'CRln"'IO'N".0""W"0RK.~w-1""~~":"~-'m'l ~1r'~~it~'f.#'~i!l'__:. ;. r:::ft';.'.._ _~' .~!h_ ~'_._._'f.:$~~~i~~~~H~'t4~ 1-k=PU+-e.l? l:)<rSTI,...)6; $e;v.JE:Y2- L(,.JE I I StulD".) W/Trt' 5C.H ,+0 Ms Of'- PUC!.. I I I I zlP1'7<f78'" I I I I Name:d~ LI cJIAJr;S'(7).-J I Address:- 302. 72.r'p p~ I city:<;:;fl2-l,.JC,f-/c-W I State: ~ I Phone: 5't( -;;2/- 'Lei. 7 I Fax: I E-mail:~ U U I~ b:.0 V A-1f-oo. C-lJ r-1 This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt frO~Sing re~en~18-695-0020, SIgnature: . -,.:;- y. I~mlll. 0NiIi~C;tQRl1INSmAl:1l!'A;m0N~~-'ll!:~~~! I Business name: I I Address: I I City: I State: I ZIP: I I Phone: I Fax: I I E-mail: I I CCB license no.: I BCD license no,: I I Plumbing license no, : I I Print name: I I Signature: I 440-2500-) (11I08/COM) ~C"i''''};'1'*'''''''\''.t~Ii:E:E:""S08EDl:JI1E~~~;'fi;1 ~~lD~'~'~;~=t-~_~"~' - -. < -~, 'if~~1~!I. .~'~!iI;"'Q'~:tj~il'-I'~~ii5i!i\lt~~1-I~yt~ia;.;~":1 ~;-,~-~c;;,nHJ~[L..c' -~ - --~J':iHr~' ':~ ,,' "Y/,' ~ea."_ ,~Vcost ~_,itl't;"#"',;,,'il'l:d,,,_,,, _ ,,",,46in ,t!'.Il!ir',f;;? "" ,!\t, ::l!ilh:':SY - .WL '''_, ,,?, _ W'1W__~__ - ~ I New residential 1 bathroomll kitchen (includes: first 100 feet of water/sewer lines, hose bibs, ice maker, under floor low-point drains and rain~drain packages) I 2 bathroomsll kitchen $374.00 1 3 bathrooms/I kitchen $439.00 1 Each additional bathroom (over 3) I $95.00 I Each additional kitchen (over I) $95.00 I Residential fire sprinklers (includes plan review) 1.0 to 2,000 square feet I I $58.00 I 2,001 to 3,600 square feet $116.00 1 3,601 to 7,200 square feet .' I I $174.00 I 7.201 squarefeet and greater 1 I $232.00 Manufactured dwellin~ Dr pre-fab (circle one) . Connections to building sewer-and I I $5800 I $ water supply . I Commercial, industrial, and dwellings other than one- or two-family I, Minimum fee I I $58.00 I $ I Each fixture 1 $19.00 $ I Miscellaneous fees I 100' stonn, sewer, water line . I I Each fixture, appurtenance, and piping I Storm water retention/detention facility I I Irrigation systems I Piping or private stonn drainage systems exceedinl! the first 100 feet I Specialty fixtures I Reinspection (no. orhrs. x fee per hr.) I Special requested inspections (no. of hr5. x fee per hI.) Each additional inspection: (I) $238.00 $76.00 $19.00 $19.00 $19.00 $19.00 $19.00 I $58.00 1 $58.00 I $58.00 $ $ ~"""'.'^"h"_"""'~_"llll~''''''~''\1'''11~'1 i.>M&dJc"J;g1!!itpjpX~g~~c~~%~ Minimum fee I Enter value of installation and equipment $ _" I Enter fee based on installation and equipment value. I (A) Enter subtotal of above fees (Minimnm Permit Fee $58.00) I (B) Investigative fee (equal to [AD 1 (C) Enter 12% surcharge (,12 x [A+BJ) I (D) Technology Fee (5% of[AD I TOTAL fees and snrcharges (A through D): $ 1 I 1 1 I I 1 I I 1 I I I 1 1 $ '7 {. 1 $ I $ 1 $ I $ I $ I $ 1 $ I I 1 1 $ $ $ $ $ $ $ $ $ $ $ $ $ $ I I I 1 . 225 FIFTH STREET SPRINGFIELD, OR 97477 PHONE (541)726-3753 FAX (541)726-3689 www.ci.springfie/d.or.us MOISTURE-CONTENT ACKNOWLEDGEMENT FORM I, J~ 0. LIV'; ~6:STV~ builder at the following address: <.302 7z.JD PcA-e.E Street Address . am the general' contractor or the owner- .sp t4;,.)6: Pt 8-1:> . City ~C\ _ .~tA . Pernit # If applicable: \ f}Cfl~ L\4-- 001cO l Subdivision/Lot' Map and Tax Lot To conform with the 2008 Oregon Residential Specialty Code (ORSe), Section R318.2,I am notifying the building official that I am aware ofthe moisture content requirement of ORSC Section R318.2 and have'taken steps to meet this code requirement: [Section R318.2 is provided for reference.] Section R318.2 Moisture content.. Prior to issu;mce ofthe insulation/vapor barrier approval required byR109.1.5.2 of this code: (A) AU moisture-sensitive wood framing members used.in construction shaU have a moisture content of not more than 19 percent of the weight of dry wood J[aming members. (B) The general contractor or the owner who was issued the structural permit shaU notify the building official on a division approved form that the contractor or the owner . who was issued the structural permit is aware of and has taken steps to ]TIeetthe requirement in paragraph (A). 9oyd~L Signature Date I:\Moisture Content Atknow Form;doc, , 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 COM2009-00354 Payments: Type of Payment Check cReceintl RECEIPT #: iiF~. City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000287 Date: 03/23/2009 Description Storm Drainage Impervious Area SDC Sanitary/SlOnn Admin Plan Review Minor" Planning Sanitary Sewer - 1st 10'0 Feet Plan Review Residential 'Garage/Carport Fire SF Fee - Residential + 5% Technology Fee + 12% State Surcharge Paid By JERRY LIVINGSTON Item Total: Check Number Authorization Received By Batch .Number Number How Received njm 5695 In Person Payment Total: Page I of I 8:05:24AM Amount Due 436,66 21.83 119,00 76,00 )26.43 326,17 40,80 26,06 48.26 $1,221.21 Amount Paid $1,221.21 $1,221.2] 3/23/2009