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Home My WebLink AboutPermit Building 2009-6-26 _ ~~~;~Q'~JiiA.;:Qii'^~ii!.j'il.,l~ll:,,~i' tl; # Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00874 ISSUED: 06/26/2009 APPLIED: 06/16/2009 EXPIRES: 12/26/2009 VALUE: $ 123,942.40 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3990 DOUGLAS DR ASSESSOR'S PARCEL NO.: 1802061108300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition PROJECT DESCRIPTION: Bedroom and Bath Addition on main \loor, second story Bonus Room Residential Owner: BELL TRAVIS & KAMMERA Address: 3990 DOUGLAS DR SPRINGFIELD OR 97478 Phone Number: 541-954-1150 \ I <':ONTRACTOR INFORMATION. Contractor Type General Electrical Mechanical Plumbing Contractor OWNER JEM ELECTRIC INC OWNER OWNER License Expiration Date Phone 161235 09/07/2010 541-729-1074 . BUILDING INFORMATION 1 VB # of Stories: 2 Height of Structure 25.00 Type of Heat: orced Air Electric Water Type: Range Type: Energy Path: Sprinkled Building: 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: 6,534 640 640 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 I DEVELOPMENT INFORMATION 1 REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 19.00 10.50 6.00 22.00 22.00. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: 31.20 I PUBLIC IMPROVEMENTS 1 ' J-\ I I ..:NTION: Oregon law reqUires you to Street Improvements: F I I d f II rul SidewalJ{oT~pe:the Oregon Utility ul v mprove OIOW e;;:t UUv!-'........ .) . . N 'f' \. "nnto, Th~qR 'ules are SRt forth Storm Sewer Available: Yes otllca IOIDownspoutslDrains:OAR gcGurh-and Gutter S . II . NOTlO"" .... . . '. r. ^ r.1 ,,~~ M11.rI111" tmougrl J"--VV' '. pecla nstructlOn: Storm water to lIe mlo eXlstmg storm dramland'p'peil'lilto weep hole. f th rules by THIS PERMITS HALL EXPiRE IF THE WORK OOg~iinYO~h~~~~t~":'(~~~~ih~ tel:phOne Notes: AUTHORIZED UNDER THIS PERMIT is NOT nCumb~r for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180 DAY PERiOD. Paee I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726.3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction SF/Duplex R.3 VB 1&2 Familv Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee I st Appliance Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fire SF Fee - Residen'tial Fixture Miscellaneous Mechanical Plan Review Minor - Planning, Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Total Amo-unt Paid CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2009-00874 ISSUED: 06/26/2009 APPLIED: 06/16/2009 EXPIRES: 12/26/2009 VALUE: $ 123,942.40 I Valuation Descri"tion I $ Per Sq Ft or multiplier $96.83 Square Footage or Bid Amount 1,280.00 $123,942.40 $123,942.40 06/16/2009 Value Date Calculated Total Valu~ of Project J;'ep~ p~ Amount Paid Date Paid Receipt Number $524.18 $124.25 $57,72 $79.00 $55.00 $6.00 $806.43 $74.00 $76.00 $ 13.00 $119.00 $105.18 $ 138.33 $26.53 $287.18 6/16/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 6/26/09 3200900000000000463 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 $2,491.80 I Plan Reviews, Initial Review 06/17/2009 06/18/2009 APP LLH Public Works Review 06/18/2009 06/22/2009 APP LKW Storm water to tie into existing storm drain and piped into weep hole Structural Review 06/18/2009 06/22/2009 APP CJC As noted on plans Planninl! Review 06/18/2009 06/24/2009 APP DDK Approved as shown 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. . Pal!e 2 of 3 _~I'l!~~FvI!'i!!,~, . '",' ~), .F CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2009-00874' ISSUED: 06/26/2009 APPLIED: 06/16/2009 EXPIRES: 12/2612009 VALUE: $ 123,942.40 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Reollired Insnect,ions I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to Iloor 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: Prior to cover. Underlloor Plumbing: Prior to insulation or decking. Underlloor Drain: Prior to cover or placement of concre~e. Rough Plumhing: Prior to cover and including required testing. Rough 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. Final Building: After all required inspections have been requested and approved and the building is complete. 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 he 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 property, and the approved set of plans will remain on the site at all times during construction. /~~ 0/z to/~ q Owner or Contractors Signature Date Page 3 of 3 Electrical Permit Application k~ 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 1~\lf3'O~~'W~Jl~~7NJfli!~0N~~~$1 l'>~-'o-",f;-"'-';-"'''-'-''''~-';';,','~'':~'''_t!;;71i?:V~~;:';'''::>t,::",*,~l Permit no.: Cc(l> J 7y I .1 Date: 0/:J(?/()Cj I This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 1~~I!O:G'~IE[GQV;t;RNMEtlIjfJf~I::J~OF~..0\l~L!!l~~1 t;{S:<PIi!t;[)l!Jlt~ I Zoning approval verified? 0 Yes 0 No I. >~~!ir,jrQ~I.9~~It' 5::~J:i~:~l;a:i : ~:::';':,:;;~~ ","" ;"'~::,-~,::' ," : I Job site address: :fRO Vou-1Io:.\ 0 r I I ~~~~:fditi.onaI500 sq ft. or portion $ 25.00 $ I I City: (~()J?'" . I State: 'or I ZIP: Cf7t/7ol I Limited energy (2) $ 32.00 $ I rll~~~~~ !~~:~~~r=~s::~"~,",~":.: ! ,~~"=11R~~#~~~,~~t I ~~: :::~~:::~~~ :1:::::: I I Addres,;G 19 u . cfs)lJvdaSr- D?.--J I 601 to 1,000 amps (2) $205.00 $ I I Ci~ --<JJI jl Lf.----' 1 s~rCY..-' I ZIP: q '77"'7i1' Over I ,000 amps or volts (2) $469.00 $ I I PhoneJ fJ. I Fax: I I Reconnect only (2) $ 63.00 $ I I E-mail: I I Temporary services or feeders: installation, alteration, relocation .1 This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ I owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ I property is not intended for sale, exchange, lease, or rent. OAR I I 479.540(1) and 479.560(1). 401 to 600 amps (2) I $126.00 $ Signature: lOver 600 amps or 1 ;000 volts, see services or feeders section above I 1~~~~Nf1fsI~lfJii::'(;i~~~~kwi I :r;::~o:i:::~~ :::~~:t:~~::r::::~~na~:~::e~r feeder fee I I Address: 3J<; SY ..JO- "> y~ ~A I Each branch circuit I I $ 6.00 I $ I I City: (~i?.l I State: Or I ZIP: Q7'-17'1: I b,Feeforbranchcircuitswithoutpurchaseofaserviceorfeederfee: I I Phone: - - 7'J:1-I07c.f I Fax: - 7t./t, 07 a ~ I First branch circuit (2) / $ 55.00 $ I I E-mail: I I Each additional branch circuit I $ 6.00 $ I I CCB license no.: i/"IJ.3fJ - I BCD Jicense no.:,[t) <0"'a7C I I Miscellaneous fees: service or feeder not included I I Signing supervisor's license no.: 'f70c-:' S I ' I Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signing supervisor: If I I Each sign or outline lighting (2) $ 63.00 $ I .1 Signature of signing su,pervisor: (}.-.~~._) fr. I I I Signal circuit or a limited-energy panel, I $ 63.00 $ I ... _ alteration, or extension (2) Each additional inspection: (I) I . $58.00 I $ tK ~1I>>~lJ!II'.B-'!""ifl7,i,.:.""l<i:i5"'-E~-.j;i!:!i~2_ ~~~[;~att~:.r:5~L:.S'~I~ll~_"!._,__:,i'~;-,~~,,;~$j,,.~ ~.J (~) Enter subtotal of above fees /'/ 50 , ti\ (Minimum Permit Fee $58.00) $ <4? . ~"'~' . .' ,(/ fJ/ I (B) Enter 12% surcharge (.12x [A]) $ I ~ D ~~ I (C) Technology Fee (5% of [A]) $ I , \\,~ ~ I TOTAL fees and surcharges (A through C): $=t7. f:" 7 C\., 440-2584-J (9/08/COM) .':0 o of , . Structural Permit Application. l.bEP;6;RTMENT USE ONLY .._,.._....-'~.'-;t'r.--l'...'."..".'''~..., " .. . " . -.,..... , , . .' . ., ,- '.' . 225 Fifth Street. Springfield. C?R 97477. PH(541)726-37'S3. FAX(S41)726-3689 Permi,t ~?C9 -:'i?r , . . .' I Date t /1 ~ /0 7' . This permit is issued under OAR 918-460-0030. Permits expire if work is not st~rted within 180 days ofis;uarfce or if work is suspended for)80 days. _INOfl"_l.O .;<";:';':'~';,,: l~;~~(;~i,,,,,,:~ l'to.cA(;,;'G-6\/ERNMENf)A~PROVAL~~';'" ,:,:' .'/:'1 I ~~~:r~;e~ct has fi~alland-us~ approval. Date; I .If&~~~:;~}~0\~NtH~,i~~.~L~-~~_E_~~'_S,9HEb~J._E. I I ::'~;eect has DEQ approvaL Date: '1 :i'i:~~:~U;::;O:~:i::ti'rm~~o::/~::rf\o:^ I I Zoning approval verified: 0 Yes D No I I Occupancy I I Property is within flood plain: DYes 0 No . .. I I Construction type: I 1':::::;":-~"~:':!:C:ATEG6R;({O,,;C6NSTRUpffqN~,;l{Wfl':~}}~:;.:;t.1:1 I Square feet: I :L)rD I i;!~ ~~i~:~t~~\,SitE:J~~6~M~~~6~~'~ND~J6~~;16~~_:i.~;:",i I. ~~::;:f::a:~::ot .. 1 I Job site address: "<C( ']" ()0I1t./"-' '~K I 1 I -1",01: ___ Type of Heat: I City:.",fl. .': ^~ t; p u . State: 01 I ZIP: ') )<.f)fi I I I I - I I Energy Path: II ~~;:::nl;~.:~}~.,",:.,.:_.-.:....\....\". IT.axlol ~N''-\''.;.''''';.''...'.' .~.,II : (~;::datio~o~~~;;:t? [g ~d~~;n D N6 I .t,.'~.. ,. ... ,'.~ "'.; it-,,'h':,,'.~SPROPER:r:v""OWNER';"''k-.,:~,' ,,;...)/$;:r~~,.,.t.,-;.'L.~'1::\\I'i! I ".'l_h~h."t",\",,,.,, L. .;r' . . ",;"","'''",,",,'''' "...;<" I Totalvaluatioll\ /)''3'1't2.l,t01$ I : ::r:ss: I{~~~~~ (t~<'/~ ( [)r'Z- I "2~lBuildiIig:fees""" I I . . r' {I ; I" 7 I I (a) Perrnlt fee (use valuatIOn table): I 1$ I City: VI,,,,..., e. . State: ()J I ZlP:'1~7 I I I r;,." - ' (b) Investigative fee (equal to [2a]): Phone'i, t -~""- II ':> 0 Fax: - I . , I I (c) RelfispectlOn ($ I per hour): I E-mail: T R,.l! f<) .R-s 0 , N ~ . t- (number of hours x fee per hour) $ I This installation is bein~ made, on resi~ential.o~ farm property ~wne~ by I (d) 'Enter 12% surcharge (.12 x [2a+2b+2c]): $ I me or a member of my Immediate family, and IS exempt from Iicensmg. . . requirements under ORS 701.010. I (e) Subtotal of fees above (2a through 2d): $ I Sign bere: ~ ~ W3~p,[aDmiewrees, .. , I I "". '.",- ,-""...~ ..' ........"" "."''','' ."""'<""1 I (a).Plan review (65% x p. errnit fee [2']): I $ 5:2'1!L. I - 'i:"i'. ,;.c:, ,':~CONT"ACTOR"IINSTAI.:L:1ITION~,,::(',,~t"'~","i::,',ijL:'~' 1$ I I'BUSln';;sn~;;-~'~ . .... '''"'"'>.'~'"''.''''~' ~.ll': (b) Fire and life safety (40% x perrnit fee [2a]): S I I Address:" I I.r~~~.,,,~.,,.~.~.~,~o.'~.',~c.,~.~/.,e.;~~..~.,~,.~_::.~2.,~._~,~..~.~.3..~?: O' " I II City: I State: I ZIP: ,. II I':~;~:~s:::-::,o;:~;e;t:~p:::t ;e:[~a])'.'" . .J $ I Phone: Fax: I . I I E-mail; I . . TOTAL fees andsurchnrgeS'(2e+3c:t4~}; - S":,,, '/ . r.',. , ces license no.: I I Print name; I I Signature: 'I I ~;f~i?!9~?J~;1:j~tJ,SU.I3,~C'PNTBA'qIO~'~I,NFf,9~MATIQN.~'{fJ1}t;~~1:'?df~WJI I Name CCB License Number . Phone Number I I Electrical I I~-q I 1 Mechanical _I 1 I Construction Contractors Board, Permit#: C.:; - j' rj' '. 700 Summer St NE S.uite300. Address: --S~i'O WV6i~ POBox 14140 . . E, ' Salem OR 97309-5052 I~SU~~. ,'/!)'-AJ Date: 6/;;::i//01. Phone: 503-378-4621 . / J . (~ 7 '- ~eb'Address: www.cch.state.or:us /. J Statem~nt: Information Noti:e to~r~~rty Owners , About Construction Responsibilities Note,' ,Oregon Law, ORs70 1,055(4 j requires ~esidential constructioll permit applicants who are not licensed with tJie Construction Contractors Board to sign the following statement before a b~ilding. permit can be 'issued. This,stat~ment is required for residential building, electrical, mechanical and :' 'plumbing permits. Licensed architect a'nd engineer applicants, exempt from licensing under ' . '. ORS 701.010(7), need, not sub/rlit this statemen't. This statement will ~e jiledwith the permit. . . "... . , , . . Fill inthe.appropriate blanks and'initial boxes I and 2, and either box 3Aor.3B: .' , '" ~L' I own, reside ~,-or:.vin.residein the completed structure, " o 2.. I understand thaII must become licensed as a construction contractor if the structure is sold or . r offered for sale'before or on' completion. " . . . ~ " .' . ~. o 3A. My general co~tractor is .".+', (Nmr.e) (cCB #) . . I will instruct my general contractor that all subcontractors who work on ~e S1f!1cture,must be li~ensed with the Construction Contractors Board. OR [SF 3B. I will be my own general contractor. . '-". ~ 'IfT,hire subcontractors, I will hire only subcontractors licensed 'with the Construction Contractors Board. If! change my fuind and hire a general contractor; I will'contract with a contractor who is' licensed with the. CcB and will immediately notify, the :Office issuing this buil4ing peJ7Ilit of the nameofthe contractor: ' ,~ '. ',I'" , ' . I hereby certify that the aboye iIiformation is correct and that I have read and do understand the Information' . Notice to Property, Owners about C;:onstruction Responsibilities onthe reversesideofthis form. . ,. i/' 8 /. /r ~A~J> ~'.<'>0 tP/Z/~~q (Signature of permit applicant) i (Date) (White c,opy to issuing agency permit jii'e, pinlf copy to applicant;) <' Property _ owner. doc 06-0 I ~04 \ ~. ... . .,.--.' "', ~cti~g a~~~~.l!,l:r9wn'Gen.etaltC~ntractor?.... .',......'1'\..-'\."\'.:, ,: _ -,;,.:...' ......,..... . INFORMATION NOTICE TO!PROPERTY'OWNERS " - - ,0 - . ~ -ABOUT CONSTRUCTION1RESPONSIBILlTIES: \:, '. . '.}-t....r.... I'..'....:. . ; ,- ~.P:-.~.-\.\'..\ " .... ~t. '. .,. ..... " , ., ~. -. -',\. , . ~. -.; ';,' -', '~ , . J"i'" NOTE: This /nforfJIation Notice to Property Owners about Construction Responslbiiities was developed b:v the. Construction Gontractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. ~. 'L- >>'. . :': . ,( ~:.:. J J .;....., ,,~~ ~'i'-~ .' ,: ,r":,.: .'".!, ,~<;:~.~....:. t,"- ~,_' _ _: "'. . -~!('"- , ... . . . If you are actmg as your own contractor to cohstruct a new home or make a substantIal Improvement to an eXlstmg structure, you can prevent~ani probi~ms'.by being a~~rd;flh;'; f611owing:t'esponsibilities ai1(fconcerns. Employer Responsibilities ".). t...., '.'- .: .", . \'''. ..', .,' . : -: ,'" ~~ -~ ~.::- "-....'l' .""lIt,.: '.. _....~.'l. Y ou-.will;, itpnosUnst;mces, pe,ru)edw,]?e l\n ':.t)mp!9y~r," and tht)9.ontr,actq~syouco?~af.t .~ith willbt;.,"t;mployt;es" if you. use contractors. not licensed with the Construction Contractors Board to-do labor in' constructing or to assist in the ""." '. .........' -1.., :. .,j,..,;, "~.' . .'.-'_ J.' . ..," ...: 1......: _..~'.. ..' ,.\....~.. .,' .,."" '_..'~ construction OJ; ilT!prq,veWimt ofi:re~id.eJltial strvcturt), A.st~e< ~~p!oy'eI:,.Yo~ 'must cl;linply' ~jth. the' follim:il!g: . " - "t,,'" 'l~ .... "1...., ,~ i. ", -', ,.." ';_;1).:.:: ;...-'....1.~\_ .~ H"~ _...-"....~ . ..I.U.... t . .-.....,r . . ,,~r . '\""'~ ,";'~\'-.1",; \i-'.~" ~~j,.~' .. "i!,.':I"" , ..~.;. \. ...... ';,,, "'_'~.. " ~. " ~.".. '~._, ,'.;.. " ,". . Oregon's Withholding Tax UIW: fu ari,employei';you mu'st witl\hold'iricot'ile taxes ITom .empJoyee Wages' at the time employees are paid. . You 'will be,ljable Jo.r the tax payinents even if you ~on 't ac~l1y withhold the tax from your employees. For more informatiort,'ca:li.:the DepilrtITl'ehf'of Re~eiiue at 503;-3''784988.:'.'; '.,.'.';,; . ,';' l~ .';, .."; -:, Unemployment Insurance Tax: As ~. employet',iyotiare;reqlJirCd to.pay~~ 't:iX'for,unemploYmeritirtsurance PwPose;.J on the wages of all employees. For more information, call the Oregon Employment Department at' 503-947-1488. ,~'-f..~). ',of:: ,'.<- ~"'_ ~.\J'"' ~'''!'''~'ll:,'':l-';::..l ":1,;' j,...... .... ;, 1.',.J, :.,).f~" :'f..;;fJ"~'f'"K;,' ',;1 ~.J~ '. :'. The Oregon Business Identification Number (BIN) is a com!?we.d..njNItbe.r, fqr~,Qoth)Qrs:gol} Wi!h.1Jp1ding and' Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.uslfiirmsnav.htmlI for the appropriate fornis. . [' __ _,_, ,___ ~ ,': !-~~-::.. .-:rl'J". ~';a. ',.!....,. :' ,-:. ; ':': ,i::'.!.~70 C:. . .~', .'- . Workers' Compensation Insurance: As an employer, you arc subject to the Oregon Workers' Compensation Law, and mu~t .o!?tain )'Vork,ers' compensation insurance for your employees.. If you fail to obtain workers' compensation insurance: yb~~~ould be 'subj~'ci to 'pe'i1~1lies 'and be'iiabl~ fik:.all' chiiIh~cosis if 9n~ o{yoiir 'efn~i1jyees is injured on the . job. For more iilformation, cali the Workers' Compen'slhlon Division: at the DepartIDent of Consumer and Business Services at 503-947-7815. . V,S. Internal Revenue Service: As an employer, you'~ust';"it4h\l](j:federa] iilcbme:taii'from emplbyees'.:waget' You will be liable for the tax payment even if you didn't actua'lly withhold the tax. For a Federal EIN number, call the IRSat.l-800c829-'4933 or.visittheirwebsiteatwww.ii.s.f!ov::-;.......I./.}-.~..fl;--i ''C. "'.. ., ..1 ')1' .~ ~"~.,..;. (,; ,'f'..J- ,''["d,,'--' . .cr:;f\..::~.:"l.'J~'~,,] n I:.~;., 1.+:... 1 . '. I: -:.........:-.~.... ."~.. . . '~'; :::,,,,other: RespOIlsibilit~es:,~IlI<lAre~~ 'OfCQD,Cer)1.s>, .:. :,' :. Code Compliance: As the p~rinit holder for this pioject, you arc responsible fortesb10hg'Kny'failure.i;;;ineet code . requirements that may be brought t() your attention through inspections. "t... ....1 i. ';"01('-' ""t~'.'.' 't,;...:~<;"" ~~,'j~''',}.t1::~')<'!.''''~...... ~.~"'::: ".~~..I..:':.,.r:;~;~.'..:....:!...~,,~. ...~.~~.~ Liability and Property Danlllge'insurance: COhtact yoh; ihsunlnce'agell't 'to see' Thounl"ie' adequate '1nsUraJ1ce'" coverage for accidents and omissions such as railing tools, paint over spray, water damage from pipe punctures, fire or work that' must be redone. ~,. - - - - \. ~ ., , '. .\ . , ":". .-- '.- t. . , ~ Time: Make sure you have sufficient-time to supervise your employees".. "\.';' '.. ':". ..' .'/ . . Expertise: Make sure y~'u' ha~€'the" skiil;:to ~c;,.;s ;our~Wh geil~~'il'c6ntiacto(t~ g;orlIliia~e the work of niugh-in and finish trades, and to notify:building officials as the appr?priate times so they can perform the required insp.:ctions. If you have additional questions call the Construction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. c:. _." .? ~ : i .' 'I:." . 't",'. Property_owner.doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone a.{RI~QFI.~...'" '. ..: ~,~a.~ .. . --= . . . .......... "'- ". "-... . City of Springficld Official Receipt Devclopment Scrvices Departmcnt Public Works Department . Job/Journal Number COM2009-00874 COM2009-00874 COM2009-00874 COM2009-00874 COM2009-00874 COM2009-00874 COM2009-00874 . COM2009-00874 COM2009-00874 COM2009-00874 COM2009-00874' COM2009-00874 COM2009-00874 COM2009-00874 Payments: Type of Payment Check 'cRccciotl RECEIPT #: 1200900000000000747 Date: 06/26/2009 Description Storm Drainage Impervious Area Sanitary Sewer- Reimbursement Sanitary Sew~r - Improvement SDC Sanitary/Storm Admin Building Permit Fixture 1st Appliance Miscellaneous Mechanical' Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Fire SF Fee - Residential Plan Review Minor - Planning + 5% Technology Fee + 12% State Surcharge Paid By OREG COMM CREDIT UNlON/KAMMERA BELL Item Total: Check Number Authorization Received By Blitch Number Number How Received njm 124012 In Person Payment Total: Page I of I I :44:07PM Amount Due 287.18 138.33 105,18 26,53 806.43 76,00 79,00 13,00 55.00 6.00 74.00 119.00 57.72 124,25 $1,967.62 Amount Paid $1,967,62 $1,967.62 6/26/2009 'Status .... IS~'ried:~';'::!" 225 Fifth Street, Springfield, OR, 541-726-3753 Phone' 541-726-3676 Fax 541-726-3769 Inspection Line. . r":. .r;.:~~t.. ':'" CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00874 . ISSUED: 06/2612009 APPLIED: 06/16/2009 EXPIRES: 03/18/2010 VALUE: $ 123,942.00 " SITE ADDRESS,:.... ~. 3990 DOUGLAS DR .- ASSESSOR'S PARC;ELNO.: . 1802061108300 . '..'0"" ': ...\...... .... .'",~. TYPE OF USE'. Add,'t,'on . ..'~, ).\ .~:;., ;', " PROJECT DESCRIPTION:, Bedroom an.d Bath Addition on main floor, second story Bonus Room Owner: Address: :; BELL TRAVIS & KAMMERA 3990. DOUGLAS DR;.t.... . ;"" -. ';,." " -.-.:- . SPRlNGFIELD"OR'97478 ,. '~-" . li~. :r '.1 :- . '!. Contractor Type General Electrical Mechanical Plumbing Springfield TYPE OF WORK: Single Family Residence Residential .f. . ~_ _.......... ___ ' UO!lBO!I!lON 71!~in- L;058;0'841' JotJ8qlPhone Number: 541.954-1150 8U04d8181 841 :810N) 'J8jU80 841 BU!lIB:J Aq s81nJ 84110 S8!do:J up:nqo IiBw no" '0600 _I (',,"L""'r." 1"'..... "R........."......, "" . ".... .......,...... ,,.. .,. InJnllnc.-nm~C\InIC\N"III~ .'....11'.....:- UO!lB:J!J!lON I ~ON,TRACT:OR-INE~RMA:nONI3InJ MOIIOI 01 noli s8J!nb8J MBI UOB8JO :NOI1~I'JIJ If License Expiration Date Phone Contractor OWNER JEM ELECTRlGINC OWNER. - ~, :;",;, OWNER': ..t ., , . ~ lL (' ii ~,{; # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type . Secondary Construction Type: # of Bedrooms: I.". '" i:. c. ",,1~. .. 'fR-3 VB .' I~ ~. " ., -.0' \, ',:1 .. " . J':~l.; f.,d \ " Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks:':; .~, .il' . F ~ 19;00 10.50 6.00 22.00 ,; 22.00 f,:' ~I \ \ . Street Improvements: ' '. . "l:, .::. 161235 09/071201.0 541-729-1074 BUILDING INFORMA nON I NOTlf..fr:Stories: 2 Lot Size: THIS iHeij{Ifn{St~t'cluFe<PIRE IF 2s!OdlVOF'Sq Ft 1st Floor: AUTHityp;;RilHWlii:ERorce:djAiEEI<\cfr\c') NC&'q Ft 2nd Floor: ,'-COR~I'vW~!!!.:'!'Ye~; IS ABANDONED FOR Sq Ft Basement: . ANY 1~t1Pg~'fY:P,"i110D. Sq Ft Garage/Carport , Energy Path: Sq Ft Otber: Sprinkled Building: . n/a Occupant Load: 6,534 640 640 I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Sfreet Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 31.20 I ~UBLlC IMPROVEMENTS I Sidewalk Type: Storm Sewer Available: Special Instruction: ,Fullv Improved Yes Downspouts/Drains: Storm water to tie into existing storm drain aud piped into weep hole , Curb and Gutter Notes: . ,. , .;~ , . .t~,:~ ..\~.: l~r..~ . r " i' ,f ,".' ,. .J. ';~ :.~. > ,\~." .ft l"~ '1/1 ~ii! ,.. ,1,0. Paee 1 of3 . \ - Status .. ISsui:ia~~r-~'-:--ry- ,,'~" 225 Fifth Street;'Sp~;'gfield; OR .: 541-726-3753 Phone: -,' '.! 541-726-3676 F~'i~:ii"j;; ". 541-726-3769 In:spectioo'Line, ,. .... ..:>. _ .1. ." /..:,;;~-.<:;;&:;';-" ~f :{~ ~:':~;j;p~~' . '.:'.:~ "\., Description ' .,~: _ Type of Construction ""'. . SF/Duple.~ i:;ipj'ii~f..~:;V~~ttir~milV. ~ , l' Fee DescriPtiont ;: ';!f..ri~~:'-. Plan Review Residential , ,t 12% Stale Sii,fcharge" ~:+ 5%1 Technology.F~e"~~L. ~'~"..".. .~', ,.. 1st Appliance Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fire SF Fee - Residential .;. .'i. F" :;j"'i\"' ll,; .. ..'." lxture ". . i;, ~';'. , I, Miscellaneous Me~lianical Plan Review Minor :- PI~nnii1g "' . Sanitary Sewer.c Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area + 12% State Surcharge .1, + 50/0 Technology Fee .: ,;;, Air Handling l{~!tV~.~~ 10,000 .:\ ReatPump' i 'Ii " ~':~t. .; TotaI-Amount Paid . CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2009-00874 ISSUED: 06/26/2009 APPLIED: 06/16/2009 . EXPIRES: 03/18/2010 VALUE: $ 123,942.00 '.) .' "1 Valuation D~~criDtion , $ Per Sq Ft or multiplier $96.83 Square Footage or Bid Amount 1,280.00 Value Date Calculated Total Value of Project $123,942.40 $123,942.40 06/16/2009 ,) l.Fpl;< J:'.,id I Amount Paid Date Paid Receipt Number ; $524.18 $124.25 $57.72 $79.00 $55.00 $6.00 $806.43 $74.00 $76.00 $13.00 $119.00 $105.18 $138.33 $26.53 $287.18 , $3.36 $1.40 $11.00 .$17.00 6/16109 6/26/09 6/26/09 6/26/09 6/26/09 . 6/26/09 6/26109 6/26/09 6/26/09, 6/26/09 6/26/09 6/26/09 6126109 6/26/09 6/26/09 10/6/09 10/6/09 10/6/09 1016/09 3200900000000000463 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 1200900000000000747 2200900000000001142 2200900000000001142 2200900000000001142 2200900000000001142 $2,524.56 I Plan Reviews I Initial Review 06/17/2009 06/1812009 APP. LLR , 'J Public Works Revie~j. 06/18/2009 0612212009 APP LKW . ;;.: .,f .~ I: i' . t '1 I ." . ,. Structural Review I: .1: 06/18/2009 0612212009 APP CJC t' . Plannine Review. 06/1812009 06/24/2009 APP DDK . ;~~ .,!; .ji :~~,f: ,', ." ':' i I.,' f!'.: i. - ":r',, Jlt " ~ ' Storm water to tie into existing storm drain ~nd piped into weep hole As noted on plans Approved as sbown on plans. Paee 20f3 " !. .'? ., , U 1 l' OF SrKlJ-..GFIELD -------- _.- . Building/Combination Permit PERMIT NO: COM2009-00874 ISSU ED :06/26/2009 APPLIED: 06/16/2009 EXPIRES: 03/18/2010 VALUE: $ 123,942.00 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"~:~;!;1if,;, r~ ,<.;,~.: ;":" '~;"', . Footing:}'Aftertrenches are excavated. , ...;. . ::'. " ~';' . -- ;". . Foundation: After forms are erected but prior to concrete placement. .:; ,,: ~i RefJuirerllnsnections I Post and Beam: Prior to floor insulation or decking. ., ., . Floor Insulation: Jrior to decking. ~: . ~~.. ....y' ... .t Shear Wall'Nailing: Before covering sheathing with finish materials. ":'::1 '. . Framing'~?s~ection: Prior to cover and after 'all rough in inspections have been approved. WaIlInsiilati~n: }'Prior to cover. Ceiling Insulation: Prior to cover. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior t~ .~.~ver or placement of concrete. .," 'L. Rough Plumbing:' Prior to'coverand including required testing. t; ;' .!' .. . . ~. Rough Mechanical: Prior to Cover f,~ ~ ; . Final Me~hanical: When all mechanical work is complete. - , Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Final Building: After all req~ired inspections have been requested and approved and the building is complete. it;. . ";-, i'r'~\' '.-.j' ~ By signatnre, I ~tate'an'd 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 ,~~ th:~ 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 CommuDity 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 property, and the approved set of plans will remain on the site at all times during con:t~:,:n. ~l '- ~;.~~ (O~{f;~O't V ,- Owner or Contractors !';ignature. Date .'~ '. ,. .pq ~'~". ~t'l '':' , : ~ ,.~ \. . Paee 3 of 3 .', i 1f ,;,' 225 Fifth 'Street Spri;;lgfield, Oregon 97477 . 541-72603759 Phone-------- ',~' ': :1(1:-:: '{)x:"rt,:"::" :...._~:"c'.-;~ ,:;;<; . ',.. ;:,.,,, '..' RECEIPT.#: '.;' .~, "- .: City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000001142 Date: 10/06/2009 Job/Journal Number,';'~..:." Description , COW009-00874 ~':~Vi..,;lAifHail(llingUnit Up to 10,000 ",' ,,,_,,,,''-,'' ""':'-''';'1, COM2009-00874 .. 'He.at PUnip';"...;c. COM2009.00874 . + 5% Technology Fee C0M2009.00874 -I; 12% State Surcharge .' _ .{ '.," 'i Payments: :i~;:::~:":~;~'<:i~;~.7 Type of Payment ... ';P.id".By,-- '. Check '::~.~~n' ;" ,'y..' '-' i-TRA VIS BELL '::t\;:~!'T~.:1~i:;. -... ..J :1;" '\ ~l ".Ji:. . ~ . '~.,: ~r -f ';1:':' ',. ~. t~L.,; ...;, ~; J j; , {-: ~l f ::' ll:'~! .1Q' 11.' .j, ~! ~ h fl' 1;. ~~~ , , ~; ~'. ,I.. j: {I .. Ii :\ ,. I , ,. '. 1 H ; I' .' ;, {! ,. . t " . , ~I '\ , ~,;!~ .' cReceintl '-:.~\! ,I ,'f; , .' . r, , : ,.!', I';:' " .. ,::t:t l. :; ~~; '. it ~ ,':. ,.1:;1 Item Total: Check Number Authorization Received By Batch Number Number How Received cjc In PersoD Payment Total: 1243 :', " .,l Page I of I 2:26:28PM Amount Due 11.00 17.00 1.40 3.36 $32.76 Amount Pa!d $32.76 $32.76 10/6/2009