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Home My WebLink AboutPermit Building 2009-4-14 _~.~._"'.IN. .<i...p"li!-!'.l.......iIi...... .. ....... -. .. I :Lj~ rmr . '! .-:~. . "!.i.Vfi' : , u..", .... ". __.,_", '- .,.,.....:.> ~ . . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00484 ISSUED: 04/14/2009 APPLIED: 04/13/2009 EXPIRES: 10/14/2009 VALUE: $ 176,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1995 S 57TH ST ASSESSOR'S PARCEL NO.: 1802033301100 Spr,ingfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single Family Dwelling Jasper Meadows lot 251 SAME AS 2010 S 57th Residential Owner: Address: HA YDEN HOMES LLC 2464 SW GLACIER PL STE 110 REDMOND OR 97756 Ar;j::r-.!:lr'\~I' nrp.r:nn I~HU rp.nllirf!s VQU to fnll""J ."I,,~ "riooled bv the Ore~on Utility , CONfI'RAGTOR,INFORMAffiION. Ire set forth In UAH ",0:<-UIJ1-UU1 U mrougn uAR 952-001- Contractor 0090. You may obtain cbiCensethe r!Dxplr.iltion Date HAYDEN ENTERPRISEsalling the center. (N9izoil1e telephonE07I29/2009 TOP NOTCH ELECTRI~IN,€3r for the Orego1j7236ii' Notificatio09/29/2010 PACIFIC AIR COMFORT INC Center is 1-80C3-9'23'12344). 03/25/2010 PLUMBING PLUS INC 90482 05/10/2009 BUILDING INFORMATION;! Phone 541-228-1081 541-317-1998 541-672-9510 541-926-3190 Contractor Type General Electrical Mechanical Plumbing 3 # of Stories: Lot Size: Height of Structure 16.00 Sq Ft 1st Floor: Type of Heat: Forced Air Gas Sq Ft 2nd Floor: N OTI\Yi(er Type: Gas Sq Ft Basement: THIS :R~p,~,~IT~I'fALL EXPIRE ~llW,I~CWOFlW Ft Garage/Carport AUTH,~l\~IW~I~(l'i[;j THIS PERMIT IS N~ Ft Other: COMrvT~r-Je~IOdcP~II;,'l\!j3ANDONErf'j:OR . ccupant Load: A.... ,-- ~."~-""""'r I DE'VEIlOPME!Nl'-INFeRMA TION I 1,152 # of Units: Primary Occopancy Group: Secondary Occopancy Groop: Primary Construction Type Secondary Cunstruction Type: # of Bedrooms: I R-3 U VB 400 REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setbllck: Rearyard Setback: Solar Setbacks: 18.00 12.00 8.00 22.78 0.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverllge: 2 Yes 29.40 Total: Handicapped: Compact: 2 I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Storm water to curb via weephole Sidewalk Type: Downspouts/Drains: Setb,lck 7' Curb and Gutter Notes: PlIge I of 4 Status Issued 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line r Description Tvne of Construction Bid Amonnt Gara2e/Misc SF/Duolex Use Bid Amount U VB Utilitv R-3 VB 1&2 Familv Fee Descriotion + 12% State Surcharge + 5% Technology Fee 1st Appliance 2 Baths One or Two Family Addressing Assignment Appliance Vent Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Gas Outlets 1-4 Plan Review Major - Planning Plan Review Residential . Refund CY - Trans Reimbnrse SDC Residen~e Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC.MWMC Reimbursement SDC Sanitary/Storm Admin SDC Tran Reimburs-Residential SDC Transpo Reimbursement SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00484 ISSUED: 04/14/2009 APPLIED: 04/1312009 EXPIRES:' 10/14/2009 VALUE: $ 176,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 $37.72 $96.83 Square Footage or Bid Amonnt 176,000.00 400.00 1,152.00 Value Date Calculated $176,000.00 $15,088.00 $111,548.16 $302,636.16 04/13/2009 0411312009 04113/2009 Total VallIe of Project Fpp,. pqiril Amount Paid $209.53 $106.65 $79.00 $337.00 $38.00 $9.00 $1,018.07 $88.00 $9.00 $ 13.00 $77.60 $7.00 $211.00 $661.75 $-888.98 $134.00 $50.00 $483.84 $636.30 $10.00 $1,009.17 $97.90 $143.15 $201.54 $888.98 $15.55 $88.00 $735.26 $63.00 $27.00 $2,858.00 $9,417.31 Date Paid Receipt Number 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 2200900000000000384 4/14/09 4/14/09 4/14109 4/14/09 '4/14/09 4114109 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14109 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14109 4/14/09 4/14/09 4/14/09 4/14/09 .4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 4/14/09 Pa2e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status .Issued PERMIT NO: COM2009-00484 ISSUED: 04/14/2009 APPLIED: 04/1312009 EXPIRES: 10/14/2009 VALUE: $ 176,000.00 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726"3769 Inspection Line Planninl! Review Public Works Review 04113/2009 04113/2009 I Plan Reviews I 04/1312009 APP 04/13/2009 APP TAJ LKW Storm water drains to weep hole in cnrb As noted on plans and in rev ie,,' letter. Structural Review 04/13/2009 04/1312009 APP CJC 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. I, Rpf'"irpfl Insoections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install gronnd rod at footing and callfor inspection in conjunction with footing and/or foundation inspection. 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 Insul:ltion: Prior to decking. Shear Wall Nailing: Before covering sheathing witb 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. Drywall: Prior to taping. Final Building: After all required inspections have been requested aud approved and the building is complete. Perimeter Foundation Drains: After gravel and IiIter cloth is installed but prior to backlill. Undertloor Plumbing: Prior to insulation or decking. Undertloor Drain: Prior to cover or placement of concrete. Ruugh Plumbing: Prior to cover and including required testing. Water Line: Prior to tilling trench and including required testing. Sanitary Sewer Line: Prior to tilling trench and including required testing. Pa~e 3 of 4 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2009-00484 ISSUED: 04/14/2009 APPLIED: 04/13/2009 EXPIRES: 10/14/2009 VALUE: $ 176,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Storm Sewer Line: Prior to filling trench. Final Plnmbing: When all plnmbing work is complete. Undertloor Mechanical. Prior to insulation or decking and inclnding required testing. Undertloor Cas: After line is installed and reqnired testing and capped if not attached to an appliance. Rongh Cas: After line is installed and required testing and capped if not attached to an appliance. Cas Service: After line is installed and line has been connected to a minimum of one appliance inclnding reqnired testing. Presnre test done at this point. . Rongh.Mechanical: Prior to Cover Final Cas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. By signatnre, I state and agree, that I have earefnlly examined the completed application and do hereby certify that all information hereon is trne 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 tbis 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. ~ -~~Cc/____ Owner or Contractors Signature y~' /~~c:;r~ Date Pa2e 4 of 4 Willa'malane Park & Recreation District , Job. No. fJ-r-f(?tf NAME:. ~t>tP-J t;:7vr . ADDRESS,2Yt." ~eJ!- lltt.bTY ~')Pl1/f> SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009 PHONE:;2.:2.E fl!r- STATE~IP: 71 ~ LOCATION OF PROPOSED BUILDING SITE: Street Address: M.5. ~.cr'J~ {'f. Plat Name: 1f1"~2 0'7" Tax Lot Number: tJllJV . .1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) . A. Sinole-Familv Detached NO. OF UNITS . ( X $2,858 per unit = $ ;Jig B. Sinale-Familv Attached NO. OF UNITS X $3,100 per unit = $ . C. Multi-Familv Aoartment NO. OF UNITS X $2,641 per unit = $ D. Sinale Room Occuoancv NO. OF UNITS X $1,321 per unit = $ E. Accessorv Dwellina Unit NO. OF UNITS X $1,550 per unit = '$ $ . WILLAMALANE SDC 2. 'SDC CREDIT (Ifapplicable) SDC payer must furnish proof of Willamalane Credit approval.) .- , $' , 3. TOTAL: WILLAMALANE NET SDC ASSESSED . !Jl1F" Development Services Department city of.Springfie~d $~J l( I / ~I tJ' Date 5 .';"'\. .. II .., ..' CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOIl NUMIlER: Com2009-00484 NAME OR COMPANY: Havden Homes LOCATION: 1995 S. 57th Street TAX LOT NUMBER: 1802033301\00 DEVELOPMENT TYPE:SinRle Familv Residence NEW DWELLING UNITS I BUILDING SIZE (SF: 1673 LOT SIZE (SF): 1. STORM ORA IN AGE DIRECT RUNOFF TO CITY STORM SYSTEM liMPER VIOUS S.F. x I COST PER S.F. CHARGE I I 2061.00 I $0.357 I = I $735.26 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 II $0.357 I I 50% ~ I DISCOUNT $0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC 7. SANITARY SEWER - CITY A REIMBURSEMENT COST: I NUMBER OF DFU's I x I 23 I $735.26 COST PER DFU $27.67 B.IMPROVEMENTCOST: I NUMBER OF DFU's I x I 23 I COST PER DFU $21.04 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = I $1,120.14 3.:rRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIP RATE i x I 9.57 I B.IMPROVEMENTCOST: I ADT TRIP RATE I I 9.57 I I NUMBER OF UNITS I x I I I I I COST PER TRIP 21.06 x INEWTRIP FACTORI I 1.00 I I NUMBER OF UNITS I x I I I I I = , COST PER TRIP $92.89 $201.54 x INEW TRIP FACTORI I 1.00 I x ITEM 3 TOTAL - TRANSPORT A nON SDC 4 SANITARY SEWER - MWMr. A. REIMBuRSEMENT COST: INUMBER OF FEU's I x . I I I ICOST PER FEU $97.90 B. IMPROVEMENT COST: INUMBER OF FEU's I x I I , ICOST PER FEU $1,009.17 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC 5227 $735.26 $636.30 $483.84 $201.54 $0.00 = $97.90 'If I~ IW i--o CJ) (3 ~ I 11070 1091 I 11092 I II I 1093 1094 ]054 SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. AOMINISTRATIVE FER: !SUBTOTAL x I ADM. FEE RATE I $3,174.01 I 5% TOTAL SANITARY ADMINlSTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Kaye Wilson PREPARED BY 4113/2009 DATE .J, -. DRAINAGE FIXTURE UNIT (DFU) CALCULA nON TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALbVf = DRAlNAGE FlXlURE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADOmONAL ilIX11)RES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EI)UIV ALENT UNITS [BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE lOlL 1 SOLIDS I ETe. 0 0 3 = 0 INTERCEPTORS FOR SAND 1 AUTO WASH I ETe. 0 0 6 = 0 [LAUNDRY TUB 0 0 2 = 0 ICLOllIESWASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBlLE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 [RECEPTOR FOR REFRlG 1 WATER STATION I ETe. 0 o. 1 = 0 fRECEPTOR FOR COM. SINK I DISHWASHER 1 ETe. 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 .3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V A TORY IRESlDENTIAL BAR 2 0 1 = 2 IURlNAL, STALL I WALL 0 0 5 = 0 fTOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRlVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS , . 23 *EDU (Equivalent Dwellin,g Unit) is a discharge equivalent to a single f~~ly d~lIing unit~~._Q.~s) ~t at 16~ gallons per day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE I ~ I I [ [ [ I [ [ [ YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RA TE/$I :oool] ASSESSED VALUE I ~!,![i'il'~' ':__~'~~':T~~_;~; _:,~~~'-','~ ~;;;::';_~::::,~~~~~~"~._~'!:r:;~TI1:'~~ ~ill:!I~~~L__'~$4.98\!'::: ,iJb;~::"i E2:;:"~~~":i~I~$4:~O~~:-:;;~T jf~, ::,~~',,,,,i~, ,,_~:E;3~",~~~H!-:~ ^ -'$440' , 1:-'~ :~~t~~'~""~:f '^~' "$3.22-~' ,-, '$2.73t " $2.25',," ,$1.80 f IS LAND ELGlBLE FOR ANNEX.\TION CREDIT? (Enter I for Yes, 2 for No) . IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 2 2005 CREDIT FOR LAND (IF APPLlCA BLE) VALUE 11000 CREDIT RATE $0.00 x $O.O~ ~ , $0.00 CREDIT FOR IMPROVEMENT (IF AI~rER ANNEXATION) VALUE 11000 CREDIT RATE $0.00 x $0.00 o TOTAL MWMC CREDIT . $0.00 = c~ . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2009-00484 NAME OR COMPANY: Havden Homes LOCATION: 1995 S. 57th Street TAX LOT NUMBER: 1802033301\00 DEVELOPMENT TYPE: Single Familv Residence NEW DWELLING UNITS I BUILDfNG SIZE (SF" 1673 LOT SIZE (SF): 5227 ~ I~ u I~ ~ f/) 6 ~ I STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. ,I COST PER S.F. CHARGE I 206100 i $0.357 I = I $735.26 RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I , I COST PER S.F. I, I DISCOUNT RATE I I 0.00 1 $0.357 i I 50% I ITEM 1 TOTAL - STORM DRAINAGE SDC '$735.26 I DISCOUNT $0.00 I $735.26 1070 2 SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I , I 23 1 B. IMPROVEMENT COST: I NUMBER OF DFU's I , I 23 I COST PER DFU $27.67 $636.30 11091 1 I $483.84 1092 = , $1,120.14 COST PER DFU $21.04 ITEM 2 TOTAL - CITY SANITARY SEWER SDC 1 TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRlP RATE I , I NUMBER OF UNITS I , I COST PER TRJP , INEWTRIPFACTORI 1 9.57 1 1 I 1 I 21.06 I 1.00 $201.54 11093 B. IMPROVEMENT COST: I ADT TRJP RATE I , I NUMBER OF UNITS I , I COST PER TRJP , INEWTRIPFACTORI I 9.57 I I I I I $92.89 1 1.00 I $888.98 1094 ITEM 3 TOTAL-TRANSPORTATION SDC = I $1,090.52 II 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x 1 COST PER FEU I I I .1 I $97.90 1 = $97.90 1054 B. IMPROVEMENT COST: I 1 NUMBER OF FEU's I x ICOST PER FEU I I I I $1,009.17 = $1,009.17 11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 11054 MWMC ADMINISTRATIVE FEE $10.00 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,117.07 I SUBTOTAL (ADD ITEMS 1,2,3;& 4) = I $4,062.99 -:i 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE 1= CHARGE I $4.062.99 1 5% I $203.15 TOTAL SANITARY ADMfNlSTRATION FEE: 127.95 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $75.20 . 11078 Kaye Wilson 4/13/2009 TOTAL SDC CHARGES =l $4,266.14 PREPARED BY DATE .- .- I .. . ~ -EDU (Equivalent Dwelling Unit) is a dischar~e eQuiva]~o a sinJ!;le ~ilv dwellin'i unit (20 DFU's) set at 167 gallons per da~ MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 , 1982 1983 1984 1985 ]986 ]987 1988 1989 1990 1991 1992 1993 1994 199Y 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO III ASSESSED v AlOE ~ r~"~ ,:}~~:' ,,,1:.,' 0:,~, E:~:~t. 'f'S~~~~ ,;~~$4_:.o7,'~~;;--i"i[~ilil-~1 -~ $3:67-~ - - .. "",," $3.22"~ $2J3 C ~- -- $2.25~ _ _ $1;8(f!~,'>;""~':' IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enler 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 11000 CREDIT ~A TE $0.00 x $0.00 ~ , CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE I 1000 CREDIT RATE $0.00 x $0.01l .~ I TOTAL MWMC CREDIT 2005. $0.00 $0.00 I ]1 I I I I I J 2 2 o , 225 FIFTII STREET. SPRINGFIELD, OR 97477 . PU,(541)726-3753 . FAX, (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number L!. '1 -'117" , I F. . ......,.. '""~.. .~,.;~ ,>>-"w,,~\;;;~t'i:f-~IfTh-~~-m~"'g'i~;~t'i;;'l Ft\WJ.i~f!.'G:...~t'8:!~w:rr.rp.,)~~:.:..\.~.11:r~fI~~\.1.'J';:.~i~~';;l;~~~~~."". ., f'l,lr.rgw..>;z.''!f!i!lI'''I':I''.~_ "??'","".,~ 1 "E'i1l'@Ih:,:t@Mi1i'.'diNSfIij.~rtItI@1f.t:;\'..';~~Wiiii 3. ti':tR01Vm.&;rrJ3;1ffili:'S(f;R1lE:f)&iIlli'iB1i:1tiD,lj,{:~"j;;;;i,~,,,,'i,j;',?,'\\i*,';l!f* i 91'5""'"~."?~';:""'7f;:""""")'~"\".,",~il\\l:\),'j\',j, 1/",""'i''''*''r~'''''''ii'''t'''i''''''''''"';'''"'I'"m'','''''''',",,,""';'i1\''i"",1(,t~.idMl1.i;':;!!Gt~iD2.1tl1 A ~~~f~V~I~-\,,~,'",,:~g~~m:~rFt ~'f;tS\l\g~.l1~~J"JJ.I~'t'~!l'f,i>\t..:)Tj.;'{(O'."tm~:~\'~",':.:rj.,"%:~,rrn., .}l?,l!'(,T~.,".,<.r;.'.',l.t{rii"~;~';\I,,,,'mrr~.';.:::il '"'~e ' "Sluenn~"!'c' 109 .e'o'M. nlti'., Ii . rY" "'d'''W'.'''- ..'.....,',~,.. LEGAL DESCRIPTION: . nti~rJiij t' ::'i\eoiW~j;i:~~~j;~~um.:..~~.r.'L~~~~~?1~"j~~m~~]'~I~.2~ \ \~Q2()~ ()\ \CD Service:Included . B DES'CRIPT~O- : - ' \~ 1000 sq! ft_ or less - t. - \).. _\ :OM f)Each ad?itional500 sq. ft. or ^ 0 ) W \LQ.D '\ \ \A '''1" portlOn thereof ermits ar on-transferable an~pire if work is Each Mhnufact'd Home or I. not started within 180 days of issuance or if work is Modular Dwelling Service or _____ __ _Suspended-for..l80,da.ys_ _ __ ____.. ___ _ __ ...fe.eder I I , -n' !!im~~1;S.'E~~::i~.~~Vl'~0.~i~i~~il:i~~i~1~~~i~~.;:,!'\l'it~;,!;~f:j'11'1q,:)'f!ti:'~t~1iU.~':'~l~llt\~;i~~:ti?J::!l;;m~l~i;}.BtC!I:~'i'il'I11~{}f.;f.ii"~1'1~~~r\\'~\,:;;: . '. en;\'llC'esiwr...~:ee e.tt'\p.!;,:mnsl3 a. O'J1,\lj\: eraHous"on;RclocallOn""{;t" W:-:";'I'ilJi",~l\:~~It~'~~~Yl;,'I,l~:'ii;'l.r:t\....r.;,tnl'lili'f.~~al:r;:'D1~if:1c'l>:O;;:"W''x,;~r';r~";:<'~ll",,"';i:4l.'i&F I 200 Amps or less $ 70.00 . . 1 20] Amps to 400 Amps $ 83.00 1 40] Amps to 600 Amps $138.00 . i 60] Amps to 1000 Amps $180.00 roone 5'o/t--:5n79'Jg~Over rqO()AfijpsNoltS- . '-$~T3:0v Reconnect Only $ 55 00 I '. C 1fII, ,",.,I,J]iif",""~",W~,W"""'''~'''''ll'1'. "'f""-d1''''''i'"~'I''''i.'ll;~i~.:. '" 1"i'!-lllij.,. 'W;~'i!/f,.l . ,,\ emnor,a I', )1' Cr.VilC~~I'O "Jree ersi.iil'I!!l:''f:"f:-",i:i!(~-W.t.tl~r0. .1". )~:;r, -'I" ;"'~ '_Ii" ;~ ; ,I .. . -~2'!:I.'i~~tw~,~~.:I~21!rliJ'~~~~..'.il'1',,~uOl)'t:ilfi::\Ub!l.~:!IJ:{ ~..:i;i.r;llt~Jf::l~:i~kl:J~'~ ~ojj!j1: I .::.:21/J;~~ IDstauJtion, Alteration or Relocation cO . I . l-d 200 ADjps or less \ $~O \LQ. 201 Amps to 400 Amps $ 76.00 I 40] Amps to 600 Amps $] 10.00 I Over 600 Amps or ] 000 Volts see "B" above. D. ~fl~~Wl13~fif~11,"1~~~W~~~I~"iii\~~~'f~r4R~''1f1)'' '\~;~~ll tY.wli2.iiiil.i.~'ll~,.....~)f~ ~,,\:>;;l~&"~a;:tJ'.; -i.~~W~~.,,,~~~~ ,- {~r ,'" e~, I ' New Alteration or Extension Per Panel . I . One Circuit , Eacb A'dditional Circuit or witb Servicd or Feeder Permit I " . E. ~~~~~~~i."I'f:ti'~~~~lt~,g~i'~~f8~a4"~~~~~Wll.!:~a~~rgRm!~~.i3:li~~~ ~- .~, ,c"'~21i"~~~,;..'b~\il,~_}-2f.:al n. _ ..~' _ ,[~ '!!-;(: I .. . Pump or lfTlgallon SignlO~tline Lighting i Limi ted EnergylResidential' 1 -The installation is being made onpropert)i rOWD~;;;Iiich---" ..... - . LimIte? Energy/Co=ercJaI --...-----$ 5U.UU IS not intended for sale, lease or rent. ~ Minimum E~ectric Permit Inspection Fee is $50.00 + Surchnrges ~ ~I"._~~'-""'''''''II' \~J!"'.'~'~c;\\i'",,"'ll"~' """~!I';'.';'~~ ~Js..U ......"') 4 'sr;FRrli'@,~l.i~jt([} iW')@'!Y.!lSti\i ~~I)I'I;. ~~~~~"~:':l~i~&~"It~lt l,A./ . ;~14"~~'h,~.~!iijJ'l'l:t"'l'nlll'!li1 1\ il~ilif1JtHS.j"., ,~ !I:!~~~~i , ,.. "t -12% state Surcharge I jA.( ..J'l \:j.J -.J..ClOI.. o.l.4'Il; , L t' I! Fee r'l, (\ l(,f() 5% Tethnology Fee ~z. .'Of> Inspection Request: 726-37);.y TOTJL ~ C\G\ ,I I Sh.red Drive(T:)/Buildi3g FOmlslElectric31 Pennit Applic'lion I-08.doc . .- .~?~~~. '<" 1:1~~":':'ti:'K<ili~~I~~i]'" ~r'>'~'I~':iJ""N~I~M~~.:\Ii\~fi~m~I"~1_*1\i)';l;A~ili\~1'i: ",(j)Nfli!RM'iIi!ff;(I1~N' S' ~~W~~ ,I 2 l;.....~c_.;,..~.....,.."','~,,,S1Ifr\;...,,~.,' "",- ..-,-....., . .,. ,.", . '~'" ,'.' . ,;\:u . , . f:l!~.r.",.I,.-,...",,,,,,,,~,.,~,,,,,,,", ,,' ".....c" '. . ..' Electrical Contractor -r;f)J~Ic.i-, r:-/ec Address ;;2087'1 Cve(' (.{ City , () I ,r) tm...?r Supervisor License Number . Lf oY '15 an"? J7;2. ::,~~ ~'1 Expiration Date Constr.. Contr. Number Expiration Date . Sigm;yre of Sgper.;jsingplectrician Czi~\"'-- . o ~ Address :;ltrJ7 C; n City 13~ ~ )4~2bn OWNER'INST:J.;ATION' . It 1.!6~ ~ Owners Signature: Date '1/1-;/g 7 I ~ lS4CP S:fJ $~O $,XOO $55.00 $ 48.00 $ 4.00 $ 55.00 $ 55.00 $ 28:00 225 Fifth Strcct Sprin'gf1cld, Oregon 97477 541-726-3759 Phonc ~.rj:Q~~ ~.'"' '.. -.:.. .-: . . 6!.:. . - ~. -'-' .. .'-, ',-,.. ...' ~..," City of Springfield Official Reccipt Dcvclopmcnt Serviccs Dcpartment Public Works Department Job/Journal Number COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 COM2009-00484 Payments: Type of Payment CreditCard cRt'ceintl RECEIPT #: 2200900000000000384 Date: 04/14/2009 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement Refund CY - Trans Reimburse SDC SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC SanitarylStorm Admin SDC Transportation Admin SDC Tran Reimburs-Residential Sidewaik Permit Curbcut Permit Plan Review Rcsidentiai Building Permit Addressing Assignment Willamalane Singie Famiiy 2 Baths One or Two Family I st Appliance Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets i-4 Temp Power 200 amps or less Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Fire SF Fee - Residential Plan Review Major - Planning + 5% Technology Fee + 12% State Surcharge Item Total: Paid By TIM DREILING Check Number Authorization Received By Batch Number Number I-low Received cjc 090245 In Person Payment Total: Page I of J 2:54: 12PM Amount Due 735.26 636.30 483.84 888.98 (888.98) 97.90 i,009.17 iO.OO 143.15 i 5.55 201.54 88.00 88.00 661.75 1,018.07 38.00 2,858.00 337.00 79.00 27.00 9.00 ] 3.00 9.00 7.00 63.00 134.00 50.00 77.60 2]1.00 106.65 209.53 $9,417.31 Amount Paid $9,417.31 $9,417.31 4114/2009