HomeMy WebLinkAboutPermit Building 2009-7-23
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CITY OJ:< ~rKmuJ:<lI!.LD
Building/Combination Permit
~i .
Status
Issued
PERMIT NO: COM2009-01065
ISSUED: 07/2312009
APPLIED: 07/23/2009
EXPIRES: 0'112312010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa.
541-726-3769 Inspection Line
SITE ADDRESS: 926 MCKENZIE CREST DR
ASSESSOR'S PARCEL NO.: 1703234406300
Springtield TYPE OF WORK: Batliroom
TYPE OF USE: Alteration
Residential
PROJECT ~ESCRIPTION: Bathroom remodel
Owner:
Address:
STUMP JAROLD G & DONNA J
926 MCKENZIE CREST DR
SPRINGFIELD OR 97477 f~;;::'~~!.f?N; Orei;lOn I~,,, _.
l\Jotifin~tir.:;" '-\uufJred bv thc>. ;!.~"n:;~ yoU to
ifl ((WN:J;RACT0R INRORMATIONf,Utility ,
. .. Oli"u, You~' _0 ,t] tnrOu'gh OAR- ~ctforth
Contractor' calling the ~y,obtam COPie,Licens~'i2-0CKxpiration Date
OWNER nUmber for th~n~r, (Note; th~'t~;: r~'es by
EASTSIDE ELECTRIC INGnter is ;~fo~~ UtiliIWm~197ca~~e 10/04/2009
OWNER 332-2344), on
BILL BAILEY PLUMBING INC 84110
Phone
Contractor Type
General
Electrical
Mechanical
Plumhing
541-915-9828
06/24/201 ]
541-998-1141
BUILDING INFORMA nON I '
VB
# of Stories: Lot Siz~:
Height of Structure Sq Ft 1st Floor:
NOTlC::xpe, of Heat: Sq Ft 2nd Floor:
THI Water Type: Sq Ft B.asement:
A ,5 PER'&,ii[e 1!'~!!Il: L Sq Ft Garage/Carport
" IJ, HOFEi'@tgVn~lei:1 ~XPIRE IF THE W Sq Ft Other:
'oOMME/SprinkleirBuild;\!iJS PERM/"rll/.a ORK Occupant Load:
L1MV <~." qJ UK /,<:; 60,,,_. I I" ^'rJT '
I DEVEioPMENTU1~FciR.MATioNil:J
# of Units:
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
" REQUIRED PARKING
"
i Total:
Handicapped:
Compact:
I PU~L1C IMPROV~MENTS I
Street Improvements:
Storm Sewer Available:
Special Instr~ction:
Sidewalk Type:
Downspouts/Drai,ns:
Ii
Notes:
c
Pal!e I of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa.
541-726-3769 Inspection Line
i y ~II\Jation Desc~!,ot.i~~ ,
Description
TVDe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
F""o P~I',j n
,I{ /",,'W
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
]st Appliance
Add, Alter, Extend Circ
Add, Alter, If.tend Circ Ea Add
Fixture
Minimum/Adjustment Plumbing
Miscellaneous Mechanical ,
Amount Paid
Date Paid
$27.48
$11.45
$79,00
$55.00
$18.00
$38,00
$20,00
$19.00
7/23/09
7/23/09
7123/09
7/23/09
7/23/09
7123/09
7/23/09
7/23/09
Total Amount Paid
$267.93
Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01065
ISSUED: 07/23/2009
APPLIED:' 07/23/2009
EXPIRES: 01/23/2010
VALUE:
Valuej:
Date Calcul,ated
Receipt Number
2200900000000000836
2200900000000000836
2200900000000000836
2200900000000000836
2200~00000000000836
2200900000000000836
2200900000000000836
2200900000000000836 '
To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested 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.'
, R~(lllirp:rl 'nsnections_
Shower Pan. Prior to covering and including required testing.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbiug: When all plumbing work is complete.
Rough Mechanical: Prior to Cov~r
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Page 2 of 3
Status
Issued
"
225 Fifth Street, Springfield, OR
541-726-3753 Phone
'541-726-3676 Fa.
541-726-3769 Inspection Line
CITY ,OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01065 .
ISSUED: 07/23/2009
APPLIED: 07/23/2009
EXPIRES: Oi/2312010
VALUE:
By signature, 1 state and agree, that 1 have carefully e.amined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify that any and all work performed shal(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 or'any structure without permission of the Community Services Division. Building Safety.
1 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 wiil remain on the site at all
n I,
times during construction.'
, l' 'I
(" -.
~ I, ;b1) /c~~-7n/'I--f::l,+t1
1 I; u' -- , -
owner\.:Jontractors Signature
Paee 3 of 3
, i/;!?/{JC"
Date
ZON LD P-
INITIALS ( A-\
DATE '\.. '2..A-0'\
SOURCE M.Srt2-
3.
~ . ". ~ - . ~ ", .;. . ~ ' ___ . _00<:1': ~:,
,;~'.~.~~;gl,,!:Y: Q~};:~~Q~,IPL)?, OREH,~NJ~ ' "
225 FIFIll STREET. SPRINGFIELD, OR 97477 . PH:(541)72"'3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Ninnber f!. <1 .. /0/" \ Date
1. 1~@TIO'N{(!)E0iNS1f.AJ:Tr:4ffON~~~:lI'll
,-". 't\lM&i7,"":7".'4W"r.'Jll"-nWj'"biJ9'\%.""';NjW':m'Wb~'"M"';;'i1f'%"'"""""'",,~1iI
CJJ-c,' /P1~f:t-YZlc- 'GeEJ.-r
LEGAL DESCRIPTION:
\~ (}lJ)~
JOB DESCRIPTION:
;3A:T li~ ~ ~'MO l::tL:- L{ LI fU-
Permits are non"transferable and expire if work is
not started within 180 days of issuance or if work is ,
Suspended for 180 days.
A.flil~:$Jf#';iBrtii~Sirg.'}r=Mijlfi~Flifi~y' '.I!-if~tm~lliirgrer:rilf!1~~~
0'. "..."'.....>,... "" -,". ",. ""'Y.d.;"_,,"'"""~~~~_"""~' .~_'"- ",,,",""""_,',. ",,,,..,,.--_A~.Ii~'4
Service Included
1000 sq. ft. or less
Each additional 500 sq, ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$121.00
$ 22.00
$57.00
, ,
'. lit*~~er@RJiNsm~~HlRfJNl@mi.,f]"\
2. ~R"~iW:F'$i/i:::r4\;1iliM:"Ii)1l~i'W;ll1f'$JiL"~~;~+~0I@mt1;>\880"'i'tfl:iVf;~5#,ff~_: - 1'i - . B.
ElectricalContractor fASTS JD( fUCrl\/C.
Address 3~).r-.s 'BOSCM0 Uv,
City spr;;w Phone 7Y /~/V79
Expiration Date
LJ7 ). 7 s
)(J~!- /CY
1/7770
ID"Y-09
Supervisor:License Number
Constr. Contr. Number
Expiration Date
f'
Signature of Supervising Electrician
~&q)1 ~
"
Owners NaJne Do tV W/if 4 .5J::.,1<-(l.-,-/ Sh........,o
Address <A '2-U M<.-lL..",-,..... Z,,:- ~s'r
City
~(> FW)
Phone
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
.. I:
$ 73.00
$ 86.00
$143.00
$186,00
$426.00
$ 57.00
c.
Installatiun, Alteration or Relocation
, ,
200 Amps or less
201 Amps to 400 Amps
401 Ampsto 600 Amps
$ 57.00
$ 79.00
$114.00
Over 600 Amps or 1000 Volts see"B" above.
D.
"
New Alteration or Extension Per ~anel
One Circuit :! I
Each Additional Circuit or with
Service or Feeder Permit
0:;"-
: 'n.M 55"<90
$>~vO
'$fio / r
'"
I;:;>
54 I 321 'F ( 2-Pump orinigation
Sign/Outline LigJ.ting
Limited EnergyIResidential
Limited Energy/Commercial.
, ,
Minimum EleCtric Permit Inspection Fee is $52.00 + Surcharges
OWNER INSTALLATION
The installation is being made on property I own which
, is not intended for sale, lease or rent.
~ ;}~~ .
(2), Q'
Inspection,Request: 726-3769
Owners Signature:
$ 57.00
$ 57.00
$ 29,00
$ 52.00
.Ii'.
12% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
- Shared Drive(L)/Building FornisrElectrical Permit Application 7-08.doc
';
Mechanical Permit Application
I~""...""'.""""-~.,. <"-.' ",~<.",~."=",,. ....~"-",.._",.......""""~'-"~ "'~~"""<'I
.[.'~,' '\.~..""~.,'.,"'-"""'.l""=,''''"-. -'. _,.f_.,'=,','" "''':''=->'<~',''' ." .,." ,.,"""".""'-""."""",.v....n..';,.... ~'i..:
!~~H~f;ffi;~]~~JI~~~L~~~~~
IPe~itnb,a'1':' lOCo) I
IDate:'}/23JO/ I
225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689
"
I
This permit is issued under OAR 918-440-0050. Permits e.pire jfwotk is not started within 180 days of issuance or if work is
. . . t .
suspended for 180 days. ' .' ,.
. . ~
1f!i,fu~il't"'{Gl\mEGl)RYK0~"0-0Nsii!RUGmi0W'i"'~~ys:ei!t~.
iiil....'llll"ji!~!!'L,,~,,~,__. _~~~~~~..~....~~~,,__,R_&;I.J'!iill!1
J:! Residential I 0 Government .I 0 Commercial ,
~W~!ili~Jj[~[Q~M8:TJ.WI\j~~pj[@g~illi~Eillt~~~
I Job site address: (;/1b MliiLt'/'?i'I'jlf1l<;"/ /)V
I City: ~YiI1h'y(ti I State: '(rR._ I ZIPC/1.411
I Subdivis;on:\')Ofu-o"" I Lotn~ _
1'~$~it'~~DEseRI~ij[0N!ll0~"W0RK..'~""~J"""~'It--;l
~~'l'Eii!l!;l{'\"JL_..__~"""~...",...!il!L_,......,1ik~_Th1il0.
I - I
I
I
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I
I
I
I Name:Ui1VlIL t-hd 'Te VYl1' StvUl1(f'
I Address: qZftJ rv/c,t!Ulvi'f. J (W,'\+ Dy.
I City: stvlV\A\' I J I State: 'CIL I ZIP: q7477
I Phone: - - ~ I Fax:
I E-mail:
This installation is being made on property owned by me or a
member of my immediate family, and is exempt from licensing
requirements under ORS 701.0 I 0: '
Signature:
!o,~'t""j!~G-0NmR.1\c;if0R~hNSmAiII!Affii0N.~'l1l!.,./\'~4,\
~~>....~,_,'i..j.._A.~.._:"t_""'~_.h,_.'"_._"'__:,...._~"_.c__M,*.,_.Mtt~.JGf*"tm"l~J!l~~.l.,<
Business name: N ei I 1(; IlI/J (0,
I Address::)ifJ /1 OC1. t. Sf",
I City: /J!{ );;;Lw..... I State: 'OIL
I Phone: e::4-1 - 3'2/-Q B/ z.1 Fax:
I E-mail:
I CCB license no,:
I Print name:
I Signature:
I zIP(;1'1Ijt!:,
I'
I
440-2545-J (11/08/COM)
'.'?.'."""''!!I''''''''''','.~.''''''F',~.. ~tJ<'j, -,.'.' ""!lo,,","+!o"'~."..'llf".""IIl"~O".st. -II' TO-lil"I"Y'j
~~ResichHltial~.l~Rt ;2~~1.h":c;,Tt'~;:41., ';Qffl{ . -~-_~..:' _-. '\
~",t_~'V;'''''''''_YMJOiV!i;t~IS:: _ J'~,.'i"~1;:ft\t~0~._~;;,~!i.;!,\~,('~[. ~ ea:'lt~". cost~:
I First Appliance ," ($79,00 I $ rT1 I
jFurnace/burner including ducts and vents
I Up to lOOk BTU/hr. 'I I
lOver lOOk BTU/hr. '
I Heaters/stoves/vents
I Unit heater
Wood/pellet/gas stove/flue "
Repair/alter/add to heating appliance/
refrigeration unit or cooling system! ~i
absorption system I:
I Evaporated cooler Ii
I Vent fan with one duct/appliance vent
I Hood with exhaust and duct
I Floor furnace including vent
I Gas piping
lOne to four outlets
I Additional outlets (each)
I Air-handling units, including ducts
I Up to \0.000 CFM 1, I $11.00 I
lOver 10,000 CFM I I $20.00
I Compressor/absorption svstem/heat pump
I Up to 3 hpll OOk BTU $17,00
I Up to 15 hp/500k BTU $29.00
I Up to 30 hpll,OOO BTU $43.00
I Up to 50 hpll, 750 BTU $57,00
lOver 50 hpll,750 BTU $95.00 I
I Incinerators
I Domestic incinerator
$17,00 1
$20.00
$17.00
$38.00
$58.00
I
I
I
I
$13.00
$9,00
$13,00
$58,00
I I
$7,00 I
$4.00
$20,00
I
$ I
$ I
I
$ I
$ I
$ 1
$ I
$ I
$ I
$ I
I
$ I
$ I
I
$ I
$ I
I
$ I
$ I
$ I
$ I
$ I
I
I
I Enter fee based on valuation of medianical system, etc. I $ I
1~'M<'''~.''."=I'I~~''lrf"'',,l)1l;m1IS;~~1''~;'!'I]''t'';;;.:!;I~CO~1~'!fjTotiili!lliI'
:Ji;,,)!~'i~~"'~JJ!g~.:~~~~~~?rtv~?W~:~ ,,~J _ea'. ~cost~
I Reinspection I' $58.00 I $ I
I Specially requested inspections (per hr.) I I $58,00 $' I
I Regulated equipment (un classed) II I $13.00 I $ I
~ch additional inspection: (I) I .1 $58,00 J $ I
_'i"""""i~!l!l!l~"mli!"'.""'''n. "'.iiilii"A".',N"Tl~i."r"S"E'.~-';'!li1it'~"".!!l-," a'i'1
~::t'fi1\!~~'3'Ji\"iF'l'-'2~~~r;::~fi;J.:: "":; ,JI~l.U., .. &"f<J~f$.m;m1~wff.{~Jtm
. (A) Enter subtotal of above fees (or e'l1ter set I'
minimum fee of $ 79.0Ql ': $
'I (B) Investigative fee (equal to fA]) ; $ I
I (C) Enter 12% surcharge (12 x [A+B]) $ I
I (D) Seismic fee, 1% (01 x [A]) $ I
I (E) Technology Fee (5% of [A]) $ I
I TOTAL fees and surcharges (A through E): $ I
I Enter total valuation of mechanical SY." stem
and installation costs $ _ ~~
Plumbing Permit Application
,
"
1.I:DER:6;BTM'!~sElON~.Yi,.,i "I
!;:;q1iifljE:;Fi:'rm'~'~'ft!:0i'illi~_~~~~l~i~
I Permit rio.: e q - 100) I
I Date: :, 7lx5/0 ') I
/
225'Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726'3689
i;
This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contrac,tqr doing the work, Permits
e.pire if work is not started within 180 days of issuance or if work is suspended for 180 days,
1~1!0~~l!iGOS~ERNMENJzl~I'lB~0':'/A..tr~~~~~jSj~'1W~1
'I Zoning approval verified? 0 Yes 0 No
, I Sanitation approval verified? 0 Yes 0 No
, 1i.~l~~AmEG.0BJ~O~.G:ON$j'ijRl!tCIJjI!:>:N~~'"
I 0 Residential I 0 Government 'I 0 Commercial .
If1l!?,mJ,0B.1iSillrE!lHN'iQBM~mION.1i~NPjjI!OC~jtll:ONlti'll!~1"!,j
I Job site addr~ss: [.lU' t'IL '~(1111 eLV.19-1:>v, I
I City: ~~8"M. I State: 0f2. I ZIP: e'iJ1]L
I Subdivision\ID~''1~A'~, I L~
1~.[jE~tQRIR~10.N[0~WOBlSiffiJ~~'I~~~1
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11~~"'~'J!!lm.~"']p.R0F!ERm1t:4YoWNERi$~]]t"'''iiJ:~"",<::3f,",i!J''~''!''1
~~;;g~Hlj'~lllL~L , . 'P. _,; s"ft, _. 0' ,_,_,~'1?ZI~.w.rud:~2..~,;m;t:~~Ri
I Name Thl1Vltt a.W:i.1i'WJ!j ~.\11P I
I Address: {;1~1P IVtUUitlZi"t Lrv@1 Dv
I City: (,Qv\ 1'\11\(:; P Id I State: Dc I ZIP: 0]'74Tl
I Phone: ~ ,-' .J I Fax: I
I E.mail: 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 requirements under OAR 918-695-0020,
Signature:
1!I\~0lII<::ONmR)l:CiIloR!ifIN$yP.:J'il!'AiliION~111~~1~lj'i!i!f!,~'4;,.;m1
I Business name: ,~~~ \7111 &, i ~tJ1 I
I Address: J I
I City: I State: I ZIP: I
I Phone54-1- t/12-- CJ1-20 1 Fax: 1
I.E-mail: I
I CCB license no,: I BCD license no,: ' I
Plumbing license no,: I
Print name:
I Signature:
440-2500-) (ll/08/COM)
1~,~;~}&II'''Yy,,~'ii'''~~~l;.EE\\1SCRE[)I!JI!E'''''~:f~'''>!;;;;illI'-=~~{~1
m.'~'"m(~"~1Jj,;r;,,l>41J:L'~_m__'::""'_ .__, _ .j __ _ _ ~rn!!+Y!'~$:lA.~~j~~8:1
l~g~i~~~tTh"hlf~~:"''', ,..~jIQ'ij~I''''~~~lIli1ilJ%i~I~1
~"~?.~,,,-:J0~~~~~'tm___:Wt .:1'~J:'" Ii~_.._~,,~ ~._.._B
I New residential I
1 bathroom/l kitchen (includes: first
100 feet of water/sewer lines, hose :l
bibs, ice maker, under floor low-point
drains and rain-drain packages) 1:
I 2 hathroomslI kitchen $374,00 $
I 3 bathroomslI kitchen $439,00 I $
I Each additional bathroom (over 3) :l $95,00 $
I Each additional kitchen (over I)!I $95,00 I $
I Residential fire sprinklers (includes plan review)
1,0 to 2,000 square feet I $58,00
I 2,001 to 3,600 square feet $115.00
I 3,601 to 7,200 square feet $174,00
I 7,201 squarefeet and greater I. $232,00
. Manufactured dwelline; or pre-fab;,{circ1e one)
Connections to building sewer arid j! I 1 $58.00 I, $
water supply ,11
1 Commercial, industrial, and dwellings other than one- or
two-family '.
I Minimum fee I / I $58.00 I $
I Each fixture ~ $19,00 $
I Miscellaneous fees
I 100' storm, gewer, water line I
1 Each fixture, appurtenance, and pipi~g
I Storm water retention/detention facility I
Irrigation systems If
. Piping or private storm drainage
svstems exceeding the first 100 feet
I Specialty fixtures
Rei~spection (no. ofhrs. x fee per hf)
Special requested inspections (no. of
hrs. x fee per hr), '
Each additional inspection: (I)
$238,00
$
$
$
$
$
$76,00 $
$19,00 $
$19.00 $
$19,00 $
$19,00 $
$19.00 $
$58.00 I $
$58,00 $
$58,00 $
$
'jWC"..,,-.""=_.""'"....~"' .. ~ ~~.""='I I
'M' ~'d','''l~.c. '.""..""-,,.. '. =', "",,' "'" M.' fi
." "_~. M~~~Uga~p-lpln.g." .;""', ~ .. r.:~ !Olmum ee
Enter vaiue of installation and equipf!tcnt $ _'
Enter fee based on installation and equipment value,
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
I (B) Investigative fee (equal to [A])
I (C) Enter 12% surcharge (,12 x [A+B])
1 (D) Technology Pee (5% of [A])
I TOTAL fees and surcharges (A through D):
I
I'
Ii'
$~I
I
I
I
I
$
$
$
$ c,') ~y
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
7r~";.," :
~,.
~'-""
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Num~er
COM2009-0 I 065
COM2009-0 I 065
COM2009-0 I 065
COM2009-0 I 065
COM2009-0 I 065
COM2009-0 I 065
COM2009-01065
COM2009-01065
Payments:
Type of Payment
Check
cRecciot I
RECEIPT #:
2200900000000000836
Dale: 07/f3/2009
Description
Fixture
Minimum/Adjustment Plumbing
1 st Appliance
Miscellaneous Mechanical
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
NIEL KELLY CO,
Item Total:
Check Number Authorization
Received By Batch Number Number How.Received
4035
In Person
PaymJnt Total:
cJc
"
\
Page I of I
II :39:07 AM
Amount Due
38,00
20,00
.79,00
19,00
55,00
18,00
\\.45
27.48
$267.93
Amount Paid
$267,93
$267.93
7123/2009