HomeMy WebLinkAboutPermit Building 2009-6-25
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CITy OF SPRINGFIELD!
BUi~g/Combi?ation P~rmit
PERMIT NO: cOM2009-00904
ISSUED: 06/25/2009
APPLIED: 06/23/2009'
EXPIRES: 12/25/2009
VALUE: $ 205,000.00
Issued
225 Fifth Street, Springfield, OR
'/ 541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 1865 S 58TH ST
ASSESSOR'S PARCEL NO.: 1802033305200
. , TYPE OF USE: New
'Rnrn" ""CR''',"N, ^'W "NGO, F A"UN nWe"'NG_ ''''F. """nw, Cm '"
SAME AS 5770 MINERAL ,
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,SPRINGFIETYPE OF WORK: Single Family Residence
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Owner:
Address:
Residential
Contractor Type
General
Electrical
Mechanical
,Plumbing
Contractor
OWNER
TOP NOTCH ELECTRIC INC. " 172366
PACIFIC AIR COMFORT INC "39237
STUTZMANSERVICESINC 1\ 31747
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[BUILDING INFORMATION,
I NOT/CEil of Stories: I Lot Size:
R-3 THIS PEAAelghlloP$.tnLC't'n1icRE IF THEIWIORK Sq Ft 1st Floor:
U AUTI-IOR1!~eel9'l-!:!t~tTH'srfom!!lIfJ~~M)T Sq Ft 2nd Floor:
VB COMMENn'~ty'ljfrI'S:ABANDON'En F@s Sq Ft Basement:
" ANY 180 RangpType:p , , l:lectnc Sq Ft Garage/Carport
3 E~'thllpW~.. 1 Sq Ft Other:
Sprinkled Building; No Occupant Load:
in OAR 952-001-00-JQ through'OAR 952-001_
,,~+. -"v~ "'~J ',:":_:.;. ~-,,,:_,~ < ::;~~ '~:-~-a:";
va ':C0NTRAC.T0R'INF,ORMA1JON:' ,
nurl -. -- .-. -- ~ . 10
Center is 1-BGO-332-2:;'4i11.
LICense
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Expiration Date
Phone
09/29/2010
03/25/2010
05112/2010
541-317-1998
541-672-9510
541-928-8942
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
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6,425
. 1,579
,I
400
'rontyard Setback:
ide I Setback:
ide 2 Setback:
earyard Setback:
liar Setbacks:
[DEVELOPMENT INFORMATION i
18.00
15.00
5.00
31.53
3.75
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
2
Yl'S
30.60
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
reet Improvements:
Jrm Sewer Available:
ecial Instruction:
FullV Improved
Yes
Storm water to weep hole in curb
L PUBLIC IMPROVEMEN1t1
Sidewalk Type:
Downspouts/Drains:,
Curbside 7'
Curb and Gutter
4
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Paee I of 4 .
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Status ,,;r,(Jii~~d ' .
225 FifiifSireet, Springfield, OR
, .
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
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. Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Building Permit
Credit - Trans Improv SDC
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
, Fireplace (Listed)
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
PW Disc - 2nd Permit
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500 .,
Sanitary Sewer - Improvement..~
Sanitary Sewer - Reimburseme,!!
SDC MWMC Administration
SDC MWMC Improvement ,.,,'
SDC MWMC Reimbursemeot
SDC Sanitary/Storm Admin ./'
SDC Tr'm Reimburs-Residential
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SDC Trans Improvement-Resident!
SDC Transportation Admin I'
Sidewalk Permit !{
Storm Drainage Impervious Area,
t(.'
Temp Power 200 amps or less'"
Vent Fan
Willamalane Single Family
, ,
,
Total Amount Paid
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l.r4aluation D~scriotion ,
~}er Sq Ft Square Footage
of,inultiplier or Bid Amonnt
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jfj:, Total Value of Project
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Amo! t Paid
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, ;,/3.09
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, 10.81
I,
;~7. 9.00
! q37.00
~..fJ8.00
~FI$9.00
~ i{ 36.10
'-*1388.98
~88.00
: $9.00
$ 13.00
, $98.95
'$20.00
$7.00
$211.00
$250.00
$'30.00
$134.00
$25.00
$546.95
$719.29
$10.00
$1,009.17
$97.90
$160.27
$201.54
$888.98
'$14.80
$88.00
$916.48
$63.00
$27.00
$2,858.00
$9;471.35
Paee 2 of4
Date Paid
6/25/09
6/25/09
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6/25/09
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6/25/09
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6/25/09
6/25/09
6/25109
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6/25109
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6/25/09
CITY OF ~rrtlJ"t.l'lJ!,LD '
Building/Combination Permit
PERMIT NO: cOM2009-00904
ISSUED: 06125/2009
APPLIED: 06/23/2009
EXPIRES: ]2/2512009
V ALllE: $ 205,000.00
Value
Date Calculated
Receipt Number
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
2200900000000000717
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CITY OF SPRING., U,LU
Building/Combination Permit
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Status . ,,J~Sl!~I;t' '",
~."'~"i'~"~.'4'-': .'~
225 Fifth Street, Springfield, OR
,
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: cOM2009-00904
ISSUED: 06125/2009
APPLIED: 0612312009
EXPIRES:. ]2/2512009'
VALUE: $205,000.00
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. I ..' Plan ,~eviews ~:
Plan nine Review Q~/23/200~ 06/23/2009 APP T AJ
Public Works Review Q~/23/200\ 06/23/2009 APP LKW Storm water to weep hole in curb
Structural Review ~t23/2001 06/23/2009 APP CJC AS NOTED ON PLANS
To Request an inspection ~~!I the t hour recording at 726-3769. All inspections requested before 7:00 .
a.m. will be made the sarhe~orkit I day, inspections requested after 7:00 a.m. will be made the following
work day. ' "
~rpti In~nections _
'''...;
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Erosion/Grading Inspeclip,n: prl to ground disturbance and after erosion measures are installed.
Ufer Electrical Ground: "-",stall pund rod at footing and call for, inspection in conjnnction with footing and/or
'foundation inspection. \.,,~ I
Footing: After trenches ~r~ excr'ed.
Foundation: After forms Qre e~ed but prior to concrete placement.
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Post and Beam: Prior to;!1oor ~Iation or decking. .
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Floor Insulation: Prior to'decJg.
/"1 , " ,
Shear Wall Nailing: Bei:or'e C<fing sheathing with finish materials. '
Framing Inspection: P:'~~; toler and after all rough in inspecti~ns have been approved.
Wall Insulation: priort~~rf
Ceiling Insulation: Prio] t~ ~r.
Drywall: Prior to tapin~;:,
Fioal Building: After alj r~",d j'nspections have been requested,'and approved and the building is complete.
Perimeter Foundation Qr~;/After gravel and filter cloth is installed but prior to backfill.
~~, . .
Underfloor"Plumbing:' 'el,:ic:insl,Jlation or decking.
.f>j.
Undertloor Drain: Prio'r t<fer or placement of concrete.
Rough Plumbing: priotJ.!er and including required testing.
Water Line: Prior to ,hliiJnch and including required testing., '
Sanitary Sewer Line: ;~~~{'lilling trench and including requir~d testing.
Storm Sewer Line: Priorlling trench. '..
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Final Plumbing: Wh~n. a m?ing work is complete.
~'. . . ,
Underfloor Mechanical, . to InsulatIOn or decking and including required testing.
Underfloor Gas: Aftlr"lfinstalled and required testing and capped if not attached to an appliance.
Rough Gas: After'lin~, i~lIed and required testing and capped if not attached to an appliance.
".' J, Paee 3 of 4
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Status
Issued
CITy OF SPRINGFIELD
BUilding/Combination Permit
PERMIT NO: cOM2009-00904
mSVED: " 06/25/2009
APPLIED: 06/23/2009
EXPIRES: 12/25/2009
VALUE: $ 205,000.00
.,'-
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Ga~ Service: After line is installed and line has been Connected to a minimum of one ,. . J d" .
testlOg. Presure test done at this p(jinl. app lance IOc u 109 required
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is Complete.
Final Mecllanical: When all mecllanical work is cori!plete.
Rough Electric: Prior to COver i
Electric Service: Approval required prior to utility cJ.npany energizing service.
Temporary Electric: Approval required prior to Utili~ Company energizing pole.
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Final Electric: When al,l electrical work is ~omplete. \
Erosion/Grading Inspection: Prior to ground disturbanie and after erosion measures are installed.
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Sidewalk - Curbside: After fo~ms a;'~ erected but prior t~ placement of concrete.
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Cnrbcut - Standard: After forms are erected but prior to:placemerit of concrete.
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By signature, I state and agree, that I have carefully examined the,completed application and do hereby certity 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 Statt, of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure,without peniiission of the Community Services'Division, Building Safety.
I fnrthercertify that only contractors and employees who are in C01pliance with ORS 701.005 will be used on this project.
I fnrther agree to ensure thatall required iils'rections are requestedi.t the proper time, that each address is readable from the
street, that the permit card is located at the f,\ont of the property, aDd the approved set of plans will remain on the site at all
times during construction. '\ , . \
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Owner or Contractors Signatnre V: I
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Date
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Structural Permit Application
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225 Fifth Street. Sp,ingfield, OR 97477. PH(541)726-3753. FAX(541)726,3689
Pennit no.:{;'Cj- Cj oc;
I Date: &/7 ~/07
This permit is issned nnder OAR 918-460-0030. Permits expire if work is not started within 180 days ofissnance or if work is
suspended for ISO days.
"
:PR,INGFIELD ~, . '!
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1~~~l[~Q~~~lG:g;ygBgrm;~~RRQY:.r~~~Jllt.1!WtWll
This pwject has final land-use appwvaL 1 1*'" "''''~'''':' '*"gg' .,'-w'<..,,,."',.,,.,,,......, "'m' ,"",,,,,,,,,--w',,,,,.,,,
, Date. )".jg~; .':" ' ',~"', Ii:EE"'SGI'IEDl!JIOoE~"" ,~. .~",>"i"'i\"1!o-'1h'~
Signature: . .;;:u.,"",",~ ,~. '-' ,-". i\iziL..,,~~,::$;-''-'~''''''~'-''''~''-<<'~''__'r,....... -. '''.,. .. _K'"j!,It\i.iiI:.F'if~i,~1ii~".t
~;;~;:ct hasDEQ appwvaL Date. 11~~~~~~~!~:~~6n~I~~~::~~~~
I Zoning appwval verified. !lQ Yes D No r I :Occupancy te 1'-'1 '
1~~=;;:'~s":~,~00:!.:::lJ:..~7::~W_~.~~.._"'..",..'ffi.'T":.'~ I . Construction type II 13
.1t.~!:is1!ll~'JiijQ~1li:;.,GC2R.Y,;,.,<,':lE""c;9!'!~IlBI,I,c;.ml!'?N;fu\t.~~~ijjM;:,rif{/ I Square feet. /,79;e / tf cJo t1
l~;~~~:..".,~~,'I!'LD"~~,~;':'':'.:~~~,~.L9.:~,~_rr;,~~:::,I,,~!,~11 .Cost per square foot.
p,;,iitL..~~GJ1.il~11lE,....[!;!!TQBI'!l~'Jj)QN~,t;lQJ.J!Qg~][!'>.!;!ll4:iilflli;W~,i I Other information: I
I Job site address: 18''-5' S S6J~ I I I
I I ,] :Type nfHeat: G.....- Fourr...",A A:'
City. _~.,.."..c.-..,J. State: oR. I ZIP.'r'!tnV I Energyrath::JA I
I SubdivisIon. ~ ~r- fvI-d"""c I Lot no,. ~ 1"1 I I ~ new D alteration D addition I
l_i}~~~I~Ei@i:gi~~~h~~~~ft~;~ej;:;g;[~~i I ~~t:~~:~::i~:~~nlY permit? DYes D No I $oloS.Q- I
I Name: ~n ~#4 1 li~i:~if;t~1;ij)~!~rg[t~~j~~~fl~~~jlM%~u:,n:Bt:TS;'[(f:@~:;:,R~~~fJii~~i~~{
I Address: ~'I&c{ ~w M.l"~' fl I \
(a)'Permit fee (use valuation table): $
I City: l...",.........l State. ~ I ZIP. 'i'n'n. \
I I I (b) Investigative fee (equal to [2a]). $
rhone.,",1 -,In. - Yt'if'" Fax. I
I (c),Reinspection ($ per hom).
\ E-mail: ,(number of ~ours x fee per hour) $
This installation is being made on residential or farm property owned by I (d)'Enter 12% surcharge (.12 x (2a+2b+2c]): $ I
me or a member of my immediate family, and is exempt from licensing
,equi,ements under ORS 701010. ,'. I~~~;;;;;;;~;,~ ~2;;;~:;~~:i~~~il~.$, '.:~ . ,,}~~l
Sign here: li~.^~::c~~''';1i.,'~..''"'''''''^_''''^',,_,_~Jl?!tN:t_.,_~.-.,_~,,_')~!<.rt__""",~""~l
I""', <<, !!\\""..ftjl-'~w~. ' ,-r''',-~,..1lI~S-'.'''''.'''11r-0'..N'''iCfS<''''''''~. ;'",""".,,,.;"....""1 I (a) rlan review (65% x permit fee'[2a]):SA-Me-AS $.2'50 ~
j -" .. c,;,,w-,,,,C0NiIiR;6;CT0R IN,t;6;I1I!ATI' ,j"!Jij'.::?',,\,,~'i!"'ll':"'!,
",.;, ,.[M.m...."',,,""~'i'i,__~~~.."_."'~l-"_'- _~'"_,,_,,""_~.,,'__"-,_.__","1!'_,__ .R>'i:!T'J!,. (d],;i/,,"""'=,ol I (b) Fire and life safety (40%x permit fee [2a]): $
I Business name: o...,~~r I (e) Subtotal of fees above (3a-and 3b): $
I Address:
r City. I State' I ZIr.
I (aY Seismic fee, 1% (.01 x permit fee [2a]). $
Phone: Fax:
1 E-mail: TOTAL fees and surcharges (2e+3c+4a): $
1 CCB license no.:
I Print name:
I Signature:
~'!"",..""'IISl!JBl~f0IiiiliRA0f,0RfINF.ORMA'fION""jC><qjltllO;';;';;~(i:i1
I~Jtaifw&'~.,~_,__=~,~_~,J,~,_~_,~..=~,_~.-'___.\..'._~""_N_.'~-',~...._,_m1:kr-i.i..:ti;:-[~'''d&''''~iJ:,
I Name CCB License Number I Phone Number 1.
I Electdcal /').;1"3'" 5<11- ""'..;10")") 1
I rlnmbing 1-Q'l2 .lNt ~ 'Ii"I- 7e.So I
I Mechanical I 3"f.;l~1 ,..." - 'j'Q. -.53"" I
ZON \~
IN1TIALS LA< ,
, DATE .lJ:.1"'W~
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 SOURCE ~
ELECTRICAL PERMIT APPLICATION ,--" V,T
City Job Number . ()o;~ 7CY-! I, Date' G/J-:s,/o '7
r';;~~'P.<:\rriE~~;::~~\%',1Ul~"i>>;t~~~:~4.f}']i;"~11ffi~;j~~;~1tr.'i~\~. ~1JmR~!~~Y~Ij:~1~r\B~~~Il.~~~~~~~';:I,'~j,;1i1tJ;'9'\i111fJ~~>'?.rrp;'!\:~/t'~i"~'P:'"~'
1. r}~~~~~~,~~~\~~m~~~ili:;~t~!;;~~~~~~~;t1~1~~:~tf~~~~~~ 3. ,,,~~lrffiE1!JtLWi,-.rlX1L;D0Rl(JtLl{ymE,,:B:cJ.d))llMi\l~\"""'I).,_..,.t,, "-~i!l"~~ ..j)~ . ",
"~'~"~i',"~:i::fd:,~,,;:t":,,?~:;k,~~v'~;';i;~'~~:';~::-'I''!':";i~:,,!:,~;~~~~;yii;;:;~~;C:;f~~;r~iS
A '~"'1:.~"ijNj'i\~i'l'f~a':~ ,,!l)\1li!\l1I'!\:WS"~'il"g,,1m)~jijj;~i'l'I:'",~;~,'i:\(:~'!"j}!'~!l!1Jr~'iW;"\ji!"''1\'.I~..i''''))''~I\l\lj
. '1~,~~,,,;:,,~e~l "e\Na,r~ 111 c'>un\mU,'"'"",l, .jl'iemuwclling''lIDlhN'"''
. 'h"li~1'\J:l,::7~~;I,)~"';.!1;~...";1!~fil,.w:nz.":i:;,i\ikl.\<H~i~:l&..&:l~ :LL\f:t'~1l.'i;i!.m~...!~!Ail~,m,~lia,;oh>:J!';j~"~';M'.'!J'.:li!'.1:i.:;:i~",'l
ServiCC'Inclnded ! nL( 1'3,(-
1000 Sqj ft or less' J, $H'r.oO !Jllf
Ea.ch ad~itional 500 sq, ft, or .-,' .' 1-'5" S'O -
;1/&tN JiNt" F'l1f'1. VI-1JLfv~ portion ihereof / ~ $.J.Hl'O 1U
Permits are non-transferable and expire if work is Ea.cb Manufact'd Home or
" not started within 180 days of issnancc or ifworli is Modulaf Dwelling Service or
_______ __ _Snspended.Jol'.180_days___.___.__ __u_ __'__________Ee,eder-+-,- ._ $55.0~
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. .'~lri'e.t!Mmes QrtP',t,)~ee.t..s~'i:!U'Dsaa IOn,{mtenamOlls~or~Rcloc'lltJon.\JT>':Ii1-
" kll~"t~1!f~...~~~.. "'~~~.W)w:~ti:l~~~~!J.~l1l~~1.1$.\!t.l:t1)ll~~~~~:l~.l'G~~Q~ffl1'i
'Notlfl(:atlon Center. 1 hoselrules are set torth
200 ~ps,or;less1-001 0 throqgh OAR 952-'$070.00
26\)i\?np~'10' 400YA'ili'pSlin copilJS ot the rUleS '8i.00
401 C){ill\\,{'t6r606~j{s (Not~:th~ ;:~;:!~~'.u1$'i3800
numoer lOr me uregon qtillt; . .~....~_tIUII
60 I Amps l.9d.Q,Q.Q <\;mp~OO-332-2344). $180,00
'11
Over roOa-AIDpslVohs $4'13-0v
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Reconnect Only $ 55.00
. I:
C ~'~ml"';'e;"~m'il.ll"[~~!ii1 W?l:;reJ,fili1~,", '~t;'N;i'l!i~.I~!:~lli1l~,~!I&1r~d~~~."S}~, .~,"~ltl~I:~~lr,'\Jlj~~!\i!yjV!~~.""i~r~,.:~p~1;)~'},j'1"tf~r,t~,:f'ri,rrJ
. - !' ~.,; tl'_o'b. 1\ :{), 'r' , 9,e"..'l 'O!iltlb::e 17 :~'I\";roit ", - 'J!~:~' .,~hti:~I\l;hi:(!'Ii:i,~'~'.:.I;' J'"I~').rl'd';l~j
~'W ~~.;, ~,<ru:..! '~:I~;"~'.!ll1.1~:"I:-W~\Il'OOfWf~";, '~llii :r~~~::i.Ili(i!1_~t:2t.1l'ifrf.l.,;;j~!fi'tfurj]i~
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Installation, Alteration or Relocation tJ5 ~:J-
200 An1p~ or less I ,$~ ~
201 Arrips to 400 Amps $ 76,00
401 ~P'st0600Amps I ( , $t10,00
OV 6QO Amps or 1000 Volts see "B" above,
I
~h) S. srM.
LEGAL DESCRIPTION:
/,fil2 o33~ tf5;J-d()
JOB DESCRIPTION:
.- .- '~__o)i~,.r., ~lm,i1imlij,~f~il~.J.~!il''r~~A :;ji~'~-I~I:W~~K~~,,~~:m:1~J~,.. :~~~,' ,'Ii~lifi'"
1"1,'i!)(1R(j),. " lfl,fa:!Fif}i,,(j)RllI'1!/srl1 .'Mi'm'@l'ivh,,"'1'I:1~,
2. Wi~~~".;,~Wr:d~i>'l!I~~j~~W'.1: 'r1~~~.lgl,W~~1;5.~Sh~:~m~
Electrical Contractor -r;"j?)J~lcjl i:"/ec
Address
;;2.081'1
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PEone 5'7/--:Jn7''hjj
Expiration Date
LfoYlf 5
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J7 2- ~~c,
~kf/7
Supervisor License Number
Constr, Contr. Number
Expiration Date
Si,~al '~e of s~pervjsing~!';~,Ci, , II' ~,
C0~~~.dR~S2~~~-
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Owners Name r"._,.,.. _h,~ ,',
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Address ?'-f:{f;.Lj St-:J~o/U?C./c.~,4L,
, '. V _ _
City 12t7~M"'rv/) cJRhone Co... 4.22-Ft::'13~,
O~R'lNSTALLkTION
'-The installation is being made onpropertY Town:wblcb-
is not intended for sale, lease or rent.
Owners Signature: ~ \~.-
~'~i.\Q
~ C\.'lJ_
Inspection Request: 726-3769
D.
1 vi All CXR'Rf:./C T.
New/1\,Ite"at','onoofjExtffis,ion Per-Y~ncIHE WORK
rlV I nUrjlLt IVOER THIS '
One,G:i:!cuit '._ PERMIT 'S$\~8J)0
. V~II',rlll!I1-I\Jr:l-n ()R lQ I\DI'INO""
Each Atlilitional'Circuit-orwitl:i v/vEO FOR
S""\lY I kiF' n ^dV <:<rn..,O ' $ 400
ervl?e ~r' ee erryetIiiit: , .
E '~l~~f.~~~~.j;irilll'~'1l~~w~mf~m~~giJltij~'~~~W.'~f@!~ilWlJli~1\a~"f;!ii:l~~~$iE~~~~J11[~~Il~l~~~
. ", 'I~~e ~ ~vno, e" ce'l eev n,n1:>tlmc II e ,."; 'acij"J):<ta alJ"ll'
'ut.:.tt1;r'~1 1 ~~\i!d1Zi~~1! 91il:i!r.ill '!I "'::li,;]; ~'tih~'1ii!!'.li~" ~,ill.ItJi :i~~~.t.1,jt.'lillj;tf.r~trJJ~.~~n~
_ . ' 1
Pinnp or irrigation : $ 55.00
Si,gnIoy\line Lighting $ 55,00 '
Limited EnergyiResidential-' .- "'$'28:00
, I
uu,unuCl1ll1te~ Energy/co=erclarr------- ~ :,U,UU
MiDim~m El,e~tric Permit Inspectipn Fee is $50.00 + Surcharges
1:~;r;i~~~"I;l~~~~~ffi:1l~'i1iI.;.~"i . rm~l~~~~?~, i~I;0!l~ .,;\t,~: ~n11",'lm,i",:I;:~1l"1~@',',~I' 1fPJ1 ~ ~
4 ",' UPlil1'1i(6l, , .., (j) , ~IDME'~,""'!!lII!l, 'k~I<I"!'"~(\lli'I"*i"'''1 ,?U 7
. '.I'~~~~ ., 'if'''' r~.illlilJ~~~~t ,:1 ~Rl:W~1j~~~lli~tl~~~li~~~ .?- -,
,.
- 12% State Surcharge 1- '1 ~
10% Administrative Fee
., I
5% Technology Fee
I .
TOTAL . ;2fl;.' '7"1
. -\ Shared Drive(T:)/Building Forrhs/Electrical Permit Application I~O&.doc
, , ' I
~ 1;)...)<)
,.r" .
/
'''. .
.f'1 ~ Willamalane
. . t Park & Recreation District .
Job. No.
C7- 10Y
. SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
NAME: //J1Yt1J.L--r PHONE: :;2"'2.1 G):' J5-
p -
ADDRESS:2<j'~Y 4~~ /2D/V',t/O'STATE:o-~IP: C;1?~t:
/ . ' .
LOCATION OFPROPOSED BUILDING SITE:
. Street Address: /K?5 ;;; 5"'3 I t...
Plat Name: /~ 2-'6'557 TadotNumber: 52c9.U
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the
back.) , '
A. Sinole-Familv Detached
NO. OF UNITS.. /.
, $. .-.,~ r, 51
X $2;858 per unit = ..L-C>
. B. Sinole-Familv Attached
NO. OF UNITS
X $3,100 per unit =
$
C. Multi-Familv Aoartment
NO.OF UNITS
X $2,641 per unit =
$,
D. Sino Ie Room Occuoancv
. .NO. OF UNITS
X $1.,321 per unit = ' '$
E. Accessorv Dwellina Unit
NO. OF UNITS
X $1,550 per unit =
'$
$~c:D
J!f".
$
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer mustfumish proof of
'Willamalane Credit approval.)
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credii)
~
Development Serviges Department
City of Springfield
$ ;2J sF
U!5
C;; I ~rcJ 1
,~
Date
5
.,'"
225 Fifth Street
Sprillgfield, Oregon 97477
54]:126-3759 Phone
-"!'<,..""-
Job/JournaL~urnber
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904 '
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904
COM2009-00904 '
Payments:
Type of rayment
CreditCard
cReceintl
:/-
RECEIPT #:
2200900000000000717,
Description
Plan Review Same As !
Building Pennit I
Addressing Assignment
Wi llama lane Single Fa4ily ,
,
2 Baths One or Two Fainilyl
1st Appliance '/"
Vent Fan
I "
Appliance Vent ""
Exhaust Hoods I
Dryer Vent
Gas Outlets 1-4 '
'I
Fireplace (Listed) i!
Residence Wiring I OOOSq Ft
Reside~ce Wiring Efl Addtl ?OO
Temp Power 200 amps or less
.... ~ t."
Fire SF Fee - Residential
Plan ie~;~w Major.: Plan~ilig
-."- , -
Sidewalk Pennit '
.--. .-",
Curbcut Permit
PW Disc -' ~~d Pemlit
Stonn Drainage Impervious Area
Sanitary S~~9r - RlJiin:b~rsement
Sanitary Seii:~r - I~'provement
SDC Tran Relmbufs:flesidential
SDC Trans i';I1Provement,Residem
SDC MWMGRei1~ursement
,.., "
SDC MWMGJmpro/o'ement
SDC MWfI1;9Ad1l1illistration
SDC Sanitary/StcrflJ,Admin
SDC TransR9'rtatioDi Admin
Credit - TriO's In::piQv,;SDC
,h, -'. '." ,
+ 5% Techl1glogy; 1i'~,
+ 12% Stat~_:~ur.:tha:rge
~,1
',;;" ;....[1'1
~1.1..,
Check Number
Batch Number
raid By
TIM DREILING
';;-{
'U -
Received By
CJC
rri.
tJl ',I
"';',~.i:
,
~,
, ,
(r '
,'lIj1-r..1
J ,.-,-~..
:.lu:, .
j1',
..-',
,-
,.- ".7'-
Page I of I
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 06/25/2009
Item Total:
Authorization
Number How Received
060534 In Person
Payment Total: '
2:I6:0IPM
Amaunt Due
250,00
1.136,10
38,00
2,858,00
337,00
79,00
27.00
9,00
13,00
9.00
7,00
20,00
134,00
25,00
63.00
98,95
211.00
88.00
88,00
(30,00)
916.48
719.29
546,95
201.54
888.98
97,90
1,009, ]7
10,00
160.27
14,80
(888,98)
110.81
223,09
$9,471.35
Amount Paid
$9,471.35
$9,471.35
6/25/2009