HomeMy WebLinkAboutPermit Building 2009-8-28
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2009-01264
ISSUED: 08/28/2009
APPLIED: 08/27/2009
EXPIRES: 02/28/2010
VALUE: $ 164,000.00
SPRINGFIETYPE OF WORK: Single Family Residence.
SITE ADDRESS: 5764 MICA ST
ASSESSOR'S PARCEL NO.: 1802033303100
Residential
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence - SAME AS COM2009-00534
Owner: HAYDEN HOMES LLC
Address: 2464 SW GLACIER PL STE IIO
REDMOND OR 97756
Contractor Type
Contractor
# of Units: 1
Primary Occupancy Gronp: R-3
Secondary Occupancy Group: U
Primary Construction Type VB
Secondary Construction Type:
# of Bedrooms: 3
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements;
Storm SewerAvailable:
Special Instr"ction:
18.00
7.00
12.00
24.00
8.75.
Notes: Stormwater to curb and gutter.
Description
Tvpe of Construction
_ .rn\..\\O
.. l'p:QD\\V-in \)\\\W1
I CONTRACTOR INR0RMAUON'I, set 101\~.
... ":ilui.. "'\8.... ~, ' "'1\.1\"" -,; 95?--00
:\1\0" "'c\o~ I\\O~e. ~nl>-" . p~ il'/ .
p.. 'J'Ilulesce(\\61. \\\klc~nse \\\e lExPlfation Date
lalla. i\o(\ _00~0 leS 0' le?\\O'~
,_hhCa _'"' l\\\'\ . _~'" co? ~,^D \e .. _",hO(\
I BiiiLIjiNG:fNFORMATioN~"\III\'i NI,~\:"
. \jV~~. \\1" - 01""-' "'3'(.:23
. . rO\\\(\<;) , \\\e '000'" .
# ofStoriesSlx ( IS ~. 1
~\\1\\V- ,Rc>(\\e
Height of :>tructure 15.50
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path: .
Sprinkled Building:
Phone
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
4,950
1,031
400
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
2
Total:
Handicapped:
Compact:
~IJ"'f..
~f'_ \\ ,\\~ ,e. ~()\
. I ~UBLlC IMP~OVEME~;rS I ~\\\.\. 't-'i-~~S?'t-,,~~ t()~
..\n \ 'v - ,"\\ '21 . ,co.., .,nIJ'I'l
,..v ?'t-"\" ~J,IJ!lwalk~~'"
. ,\\\'21 \1f\l Q \'21 p;
. '!J,\\IJ'{. c,'t-g>'Ownsru"~tS/Drains:
. rx ~~'t-~ f\C\ ?'t-"
c,IJ "\'6(J\)r
\\~'{ .
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
2
Yes
28.90
I Valuation D~scription I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
, Pae:e 1 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fpp<. P.~irl J
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01264
ISSUED: 08/28/2009
APPLIED: 08/27/2009
EXPIRES: 02/28/2010
VALUE: $ 164,000.00
Fee Description. Amount Paid Date Paid Receipt Number
+ 12% State Surcharge $200.67 8/28/09 1200900000000001004
+ 5% Technology Fee $101.46 8/28/09 1200900000000001004
1st Appliance $79.00 8/28/09 1200900000000001004
2 Baths One or Two Family $337.00 8/28/09 1200900000000001004
Addressing Assigoment $38.00 8/28/09 1200900000000001004
Appliance Vent $9.00 8/28/09 1200900000000001004
Buildiog Permit $969.23 8/28/09 1200900000000001004
Curbcut Permit $88.00 8/28/09 1200900000000001004
Dryer Vent $9.00 8/28/09 1200900000000001004
Exhaust Hoods $13.00 8/28/09 1200900000000001004
Fire SF Fee - Residential $71.55 8/28/09 1200900000000001004
Gas Outlets 1-4 $7.00 8/28/09 t200900000000001004
Plan Review Major - Planning $2 t 1.00 8/28/09 1200900000000001004
Plan Review Same As $250.00 8/28/09 1200900000000001004
PW Disc - 2nd Permit . $-30.00 8/28/09 1200900000000001004
Residence Wiring 1000 Sq Ft $134.00 8/28/09 1200900000000001004
Residence Wiring Ea Addtl 500 $25.00 8/28/09 120090000000000t004
Sanitary Sewer - Improvement $507.07 8/28/09 1200900000000001004
Sanitary Sewer - Reimbursement $666.84 8/28/09 1200900000000001004
SDC MWMC Administration $10.00 8/28/09 1200900000000001004
SDC MWMC Improvement $1,044.54 ' 8/28/09 1200900000000001004
SDC MWMC Reimbursement $101.97 8/28/09 1200900000000001004
SDC Sanitary/Storm Admin $133.04 8/28/09 t200900000000001004
SDC Transpo Reimbursement $211.21 8/28/09 1200900000000001004
SDC Transportation Admin $78.62 8/28/09 1200900000000001004
Sidewalk Permit $88.00 8/28/09 1200900000000001004
Storm Drainage Impervious Area $759.99 8/28/09 1200900000000001004
Temp Power 200 amps or less $63.00 8/28/09 1200900000000001004
Vent Fan $27.00 8/28/09 1200900000000001004
Willamalane Single Family $2,858.00 8/28/09 1200900000000001004
Total Amount Paid $9,062.19
I Plan Reviews ,
08/27/2009 08/27/2009 APP DDK Access restricted to 1 driveway/tot.
Follow street tree plan.
08/27/2009 08/27/2009 APP TSS Stormwater to curb and gutter.
08/27/2009 08/28/2009 APP CJC As noted on plans
Planninl! Review
Public Works Review
Structural Review
Paee 2 of 4
CITY OF SPRIN\.r1' u,LD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-0I264
ISSUED: 08/28/2009
APPLIED: 08/27/2009
EXPIRES: 02/2812010
VALUE: $ 164,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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.
Rpnnirpri Ir~nprtion~ I
Ufer Electrical Ground: Install ground rod at footing and call for 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 tloor 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.
Walllnsulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Undertloor Plumbing: Prior to insulation or decking.
Undertloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Paee 3 of 4
_G.ell~~$\'!J!~r
~ Ht .'" . ~>;
=J.- i.,
CITY OF SPRlNGJflELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01264
ISSUED: 08/28/2009
APPLIED: 08/27/2009
EXPIRES: 02/28/2010
VALUE: $ 164,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
By signature, I state and agree, tbat 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 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.
~fl~~
g-~.r- a'7
Own;r or Contractors Signature 0
Date
Paee 4.of 4
Job. No. t!9-/2t?/
NAME: HN-I DEN .1-!-OM.E:5 , PHONE: ?-".Lo O<jjS"' '-
ADDRESS:J....,"~ SW &L.I":t:.I/:;~ ,l.pJViJJT> STATE~IP: q "}l..{')'i
. LOCATION OF PROPOSED BUILDING SITE:.
Street Address: . 7'7 U t.f #1.1 CI1-
SY~TEM DEVELOPMENT CHARGE WORKSHEET I:'QR 2009_ ..
. , ,
. Plat Name:
Tax Lot Number: ~2- a'?JJ3 47/4i)
. .
1. DEVELOPMENT TYPE (Check appropriate dwelling(s): Dwelling type definitions are on the
back.) .. . .
A Sinale"Familv Detached
NO. OF UNITS .
( _X $2,858 perunit =
$, :L'i'T"d
B. Sinale~Familit Attached
NO. OF UNITS
~,~ ..
X $3,100 per unit =
$
C. Multi-Familv Aoartmelit
NO. OF UNITS
X $2,641 per unit =
$
D. Sinale Room Occuoancv
NO. OF UNITS
.. .
_X $1,321 per unit =
$
E. ActessorvDwellina Uni\
NO_ OF UNITS
X $1,550perLJnit =
.$
WILLAMALANE SDC $
. 2. SDC CREDIT (If.applicable) SDC payer must fumish proof of .
Willamalane Credit approvaL) $.
.",0".
3.. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit) $ 2.3 S (J
~ Y/ .77/ a)
Development Services Department Date
. City of Springfield
5
5AVVlr.:' AS
. Structural Permit ApplicatioIl
.
:57&tt (Vl(nec',j
C 'f- 53 l(
225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 t FAX(541)726-3689
SPRlNCOFIEl--D i',,":::;,",,~.:;
1)~~i~:.;;;~~l
I' DEPARTMENT-USE ONLY I
Coh1 ZOO '1 - 0 ( 2cl,'{
PenTIlt no.: .
I Date 9;- 2-7-0 "1
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of is sua nee or if work is
suspended for t 80 days.
. .,/, ;>L0CA~G'9YESNMg"lT-i.t(B~R0y,@i;;n;'}'i;,; ,,;,'1
I i~~~~;eect has final land-use approvaL Date I r . ..' . . ,,;.. .JEE 'scHEDULE'
I ;~~~~;eect has DEQ approvaL Date J i'~~)~:2~::~~~;,:~Or~~~~;g ~.~:..
1 Zoning approval verified: DYes D No j I Occupancy .r2...?/ CA '
I Property is within fiood plain:. DYes D No I I . I If ,?
- COIl~truction 'type: ~
. 11~~1lt:~;,:&i;i;;:.f#i));;Air~GQRYliQEtM8QN~ltRVGml(:JNJJ.;;);;<";';( I Square feet IO:S I + '-(00
IIXI R,esidential I 0 Government I 0 Commercial I
Cost per square foot:
1;,)i>i?;.f.;~9.~;sl!fE;rN#[)SMAfiQHii;)i;NR'i.~QPMI'QN;;;i::;~,/,g'.1 Other information.
I Job site address: t:;7(;,C( VZ1,C4 s'f: J I
. Type ~f Heat: b-.._'5
1 City: <"",.';";(I_lr,( .1 State: oR I ZIP't7'{7r I I Jlr. .
I ."1':' . .1 Energy Path: .;l
SubdIvISIon: , ".~P<>f'. Ml'..dJ,IIJ" Lot no.: ';:1"7)(. I I _ .
1 . ) 1 ~ l?i-or . DSl new D alteration ' D addition.
i~;';~"~~:~~~;~:i,~2 ap~ 41 i ;";:::::::':::"'"""''' 0 '""M'. .
I I (a) Permit fee (use-valuation table): I $
City:RftlYVjo~J . Statu:)((. ZIP:177.fC, I
--.- .-U. I (b) Investigative fee (equal to [2a]):
Phone: -~,- &1~S-. I Fax:- )'fl- .2S7;; . I
,. (c) Reinspection ($ per hOllr):
I E-mail: _ _ j (number of hours x fee per hour)
This installation is being made on residential or farm property owned by I
(d) E. nter 12% surcharge (. 12 x [2a+2b+2c]):
me or a member afmy immediate family, and is exempt from licensing _
requirements under ORS 701010. (e) Subtotal of fees above-(2a thr:ough 2d):
I Sign here:,.~~{tl~::=, ..1 .1 (a) Plan review (65% x permit fee [2a])
I 'v J I (b) Fire and life safety (40% x permit fee [2a]):
Business name.: J-Io.~d.~.'" I~wv(.
I I (c) Subtot,1 of fees above (3a and 3b):
Address: <t>.V'I. - . I
City: '.State: I ZIP: , .,
1 J (a) Seismic fee, ]% (.01 x permit fee [2aJ):
Phone: Fax:
I E.mail: j 'I TOTAL fees and surchar.ges (2e+3c+4a): $
I CCB license no.: I
I Print name; ~ j
Signature; ~ I
I
'j
j
I
j
j
I
I
j
j
$ lG'i. ~o'"
$
J
j
$
$
$
$
!
I
'1
J
J
I:
l;if{:t,,:.'},!: J::i';$V!B'C.f'JN)riR~'qtf(jR ..~,.!
I Name I CCB License N'U;;;ber I
I ElcctrkaI n :2.) CA;' ...
I Plumb;ng 13l f'-n
I Mechanical 3'1;}i> '7
Phone Number
:<n - Flwi
'1)~- kq '-{?-
c/'/}.- '1~'O,
,J
225 Fifth Street. Springfield, OR 97477HH(541)726-3753+FAX(541)726-3689
I~F:~/6EPARTM'gt:JT:~U$E't5'Nib~~1t:~1
..f""'_-f:J"":"_;-'-~-',;,;'i';i"_;:zo..~-;:(>,2~2E:~~:U-F,~~)f~:1
I PermSRo~e.oo 1- 01 Z 6}(.
I Date: 'i -27 -0 '} I
Electrical Permit Application
II
This permit is issued under OAR 918-3Q9-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
l;iiii,jj!'i~I!EfG;"'U!"'G0~ERNMENliil~A'e'?'R""'i!A'i"""'''''''''''}''1f,~,'';
~~, _"_"k"~_;.m__"..' _L,_1_.",~__._,,-,-_"_~'L,._lt:!idLYJ';'J:\~'ilS~~...,~.q!41
r:~5~~~;~~~~;::~~iR~~t~0~i~~:~':t111 Residential, per unit, service included: I
~4~i3I$lmf~lNIi:0.gMW\1~I\f~lI_Nw~~!,:[()'P,i;llI9Nl!lj~t~~;1 1,000 sq. ft. or less (4) I $134.00 $) 3111
I.. - . .. I Each additional 500 sq. ft. or portion I
Job sIte address: "'l/w't /rt1rc.c, thereof. I $ 25.00 $ Z:>
I City: fY"'~('.'''' io! I State: 0\,Z I ZIP: '17'-f715' I Limited energy (2) $ 32.00 $ I
I SubdiVision.) ~Cl<;[)?( IfV\c1:>Iav-J,) I Lot no.: 2~ I I Each manufactured home or modular $ 63.00 $ I
ml~~~r!1l, ~S'!37'Rr~!~~Di0~\~~~~!~~_~:.~~1 I dwelling service or feeder (2) I.
r/Dv~ vY ~<:- ,,~, ~uL.U)"":) ll~ I Services or feeders: installation, alteration, relocation
I I . . 200 amps or less(2) $ 81.00 $ I
~~~~~~e8'QR.E]Rilt(~t'iWNER~~~~lr~Ji:~fJ;{,i,'t4)U ,'201 to 400 amps (2) $ 95,00 $ I
Name: l-L.jJ(V\ KCVY'l'<;'_n, :-,,<,.(~\a~:,~.~h;~g~nl~~~,q!\t0600ampS(2). $158,00 $ I
Address: ;}i(C C-( S<-v hI", i N:c,.,c:),3~,~~~e (\J\e~ ~~ d"'~ .~91.to 1,000 amps (2) $205.00 $ I
I City: Q."o/ ""CO"" vi \ I State::o,Q ."'~~I\iIP:lr'7?~Q. \\\EI I\J :~~~~ 1 ,000 amps or volts (2) $469.00 $ I
I \,\\1, I ." ").- IIJ \ ""- ~ ',n GU\-"'- - te\1 :~\, Recopnect only (2) $ 6300 $ I
Phone: 5'11-228- G'1~5. '.~. .c, ,Fax:2:y/,;;:?'/f-'?;;>$:'?2\l:.\\le "c ,ill :'....u. .
I E-mail:' '0' (",:)0, ,'(UU ,.' cef\\6\', '" f\ \Jt\\\\)'\~ i). Temporary services or feeders: installation, alteration, relocation -)
U "'_~ ,\,"\e t"'\rp.CO _.....f"l ,9'34 I
This installation is being made Sll'Pe'siiientiai'b'flal\ftlpP6pertY 200 amps or less (2) /I $ 63.00 I $ /"'J I
owned by me or a member ofniy:iilliTIedjate\faniily. This I 201 to 400 amps (2) I $ 87.00 I $ I
property is not intended for sale, exchange, lease, or rent. OAR I I I
479.540(1) and 479.560(1). 401 to 600 amps (2) I $126.00 $
Signa~e:' lOver 600 amps or 1,000 volts, see services or feeders section above I
1~~~J~jJ9jfL~~!1L~;B.llJi.,'SmJXUiW~]1Q:~'~f?i~~tim4;1 I Branch circuits:' new, alteration, extension per panel 1
I Business name: J;;'p \\l>trh F I pC I I a. Fee for branch circuitswith purchase ofa service or feeder fee: I
I Address: .-JO~ A (ovt?"I C -\- I I Each branchcircui!. I $ 6.00 I $ I
\ City: &. 1'"\0\ I S~ate: 6R.. I ZIP- I b. Fee for branch ~tcuits without purchase of a service or feeder fee: I
I Phone:SZIi-311-i'1q€ I Fax: - - I F~S~'I"hJ1lQ~it(2) I I $ 55.00 I $ I
IE-mail: _"....t:.....~?\....rE.lI.c)1.:~~qil;on\i\branch circUIt $ 6.00 $ I
I ~)? I "Ul\\V- "1"~,",r-""- L1ly\..... t:n~ I
CCB license no.: ) ~ -..J0C. BCD licen~e p'q!;J,~j,\~i;i(.)"I'? \" ,'M~sp,~U~i/l'uus fees: servIce or feeder not Included
Signing supervisor's license no.: 40 YS~U~llt:.\)_0~~ IS ~'i'I \E\Mii' pump or irrigation circle (2) $ 63.00 $ I
Print name of signing supervisor: \J -<..r l~u(\''t'{v/fr.~t{:.~k ~ru.1 Each sign.or outline lighting (2) $ 63.00 $ I
I Signature of signing supervisor: l f) A. v ~ a" \J 11'0 ~ Signal. circuit 'or a limited-energy pan,l. $ 63.00 $ I
. - ..h~ ~ ~ ~ ;16 ~(.. alteration;. or extenSIOn (2)
~ I (C) Technology Fee (5% of[AD
I TOTAL fees and surcharges (A through C):
"
$ z,:z.:Z-
$ 'lbb.(
$ 1/ IVI
$ H-c;17j
'VJ'
440-2584-) (9108ICOM)
,
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009~0 t 264
COM2009-0 1264
COM2009-0 1264
COM2009-0 t 264
COM2009-0 t 264
COM2009-0t264
COM2009-0 1264
C0M2009-0 t 264
COM2009-0 1264
COM2009-01264
COM2009-0 1264
COM2009-0t264
COM2009-0 1264
C0M2009-01264
COM2009-0 1264
COM2009-01264
COM2009-01264
COM2009-0t264
COM2009-0 1264
COM2009-0 1264
COM2009-0 t 264
COM2009-0 t 264
COM2009-0 1264
COM2009-0 1264
COM2009-0 1264
COM2009-0 1264
COM2009-0 t 264
COM2009-0 t 264
COM2009-0 t 264
COM2009-0 t 264
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Date: 08/28/2009
1200900000000001004
Description
Plan Review Same As
Plan Review Major.- Planning
Building Penn it
Addressing Assignment
Willamalane Singte Family
2 Baths One or Two Family
I st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets t-4
Temp Power 200 amps or less
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddU 500
Fire SF Fee - Residential
Sidewalk Pennit
Curbcut Pennit
PW Disc - 2nd Pennit
Stonn Drainage Impervious Area
Sanitary Sewer - Reimburse~ent
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Stonn Admin
SDC Transportation Admin
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
HAYDEN ENT
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
DJ B 063609 In Person
Payment Total:
Page I of 1
11 :36:37 AM
Amount Due
250.00
211.00
969.23
38.00
2,858.00
337.00
79.00
27.00
9.00
13.00
9.00
7.00
63.00
134.00
25.00
71.55
88.00
88.00
(30.00)
759.99
666.84
507.07
211.21
101.97
1,04454
10.00
133.04
78.62
101.46
200.67
$9,062.19
Amount Paid
$9,062.19
$9,062,19
8/28/2009