HomeMy WebLinkAboutPermit Building 2010-4-7
PERMIT NO: COM2010-00290
ISSUED: 04/07/2010
o\l \0 APPLIED: 03/08/2010
. o,,s,\es ~ \l\,\,\'l&,XPIRES: 10/07/2010
0\\ \lJ.'4'l ~~ O\e<;joe sa\ \~~\;ALUE: $ 28,564.00
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SITE ADDRESS: 1284 HAMIL ~~O\\ce('\ ..()Q\O\~ ~~If\4\' F WORK: Bedroom
ASSESSOR'S PARCEL NO.: 170-<<~~OO\ O'O'I:Q.\\\ ~O\e" 'S\\'! ~O\S .
O~ ()I)~-'~' 0\\\1<' .~YPEOFUSE: Addition
PROJECT DESCRIPTION: Bedro~i~eC:eO'e~~
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EMMETT ANDREW E & JANE E.
1284 HAMILTON ST. ...,-,):.).:"
SPRINGFIELD OR 974.77.
Sta tus
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection'Line
Owner:
Address:
Contractor Type
General
Electrical
Mechanical
Contractor
OWNER
OWNER
OWNER
# of Units:
Primary Occupancy Group: R-3
Secondary Occupancy Gro~p:
Primary Construction Type VB
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
10.00
18.57
5.00
Street Improvements:
Storm Sewer Available:
Special Instruction:
';,!:,:,:..
CITY OF SPRINGFIELD
Building/Combination Permit
Residential
Phone Number:
541-505-1506
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I CONTRACTOR INFORMATION t....:.;
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. '.' _:!C.,.::.;>T'Ei~~'n~e~:IQf*piration Date
," ...... .... .. ,,,- 1\\t." Q~
.-;,:;Ii'.~': .~?\?>.t. ,. \'t \S~.
~~ ,\\\'0 ?~~~~ fQ?>.,.,~j;:"
\~~~N. .
CG~~'!'l\l'Th~'{,s~'C.~ .
fI-~ Height of Structure
Type of Heat: ..
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Phone
I
16.50
Electric
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occupant Load:
6,970
295
No
I DEVELOPMENT INFORMATION ~
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Total:
Handicapped:
Compact:
34.42
I PUBLIC.IMPRO,VEMENTS ~
.~.....' ~"~~.-'
Sidewalk Type:
Downspouts/Drains:
Storm water to connect t~; e~isting system
,. 'i',~ .,
Notes:
Page 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 Snrcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Building Permit
Fire SF Fee - Residential
Plan Review Major.. Planning
Plan Review Residential
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Total Amount Paid
Structural Review
Initial Review
Plannine: Review
Public Works Review
Structural Review
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00290
ISSUED: 04/07/2010
APPLIED: 03/08/2010
EXPIRES: 10/07/2010
VALUE: $ 28,564.00
I v aluati~n Description ~
$ Per Sq Ft
or multiplier
$96.83
Square Footage
or Bid Amount
295.00
Value
Date Calculated
Total Value of Project
$28,564.85
$28,564.85
03/0912010
~.
Amount Paid
Date Paid
Receipt Number
$88.40
$44.70
$29.18
$55.00
$6.00
$311.53
$14.78;l-,i.
$211.00 .,.,
$1I4.0L '..
$7.05:. '
$140.95
3/8/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
,
2201000000000000210
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
"..: '-..
. .: :~~; ;;~ ;;~. "",.
$1,022.68
I Plan Reviews ~
03/09/2010
03/09/2010 03/09/2010 APP LLH Adjusted value and plan review to
meet minimum default value of
$28,564.
03/09/2010 03/15/2010 APP DDK
03/15/2010 03/16/2010 APP LKW Storm water to connect to existing
system
03/2912010 03/29/2010 APP KLK
"
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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.
Pa2e 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00290
ISSUED: 04/07/2010
APPLIED: 03/08/2010
EXPIRES: 10/07/2010
VALUE: $ 28,564.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I Reauired InSDections ~
Ufer Electrical Gronnd: Install gronnd rod a!,footing and call for inspection in conjnnction with footing andlor
foundation inspection. "I~";,' ".. ".~
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Footing: After trenches are excavated. ',,"(./,..
;;:;,' ,. ,-.,
Foundation: After forms are erected hut prior to concrete placement.
Post and Beam: Prior to 11001' insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing ,,:ith finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling [nsulation: Prior to cover.
Roof SheathinglNailing: Before covering sheathing with Iinish material.
Bolts Installed in Concrete: To be done by a State Certilied Special [nspector. Provide inspection test reports to
City Building [nspector.
Hold Downs [nstalled: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complet.f-" '\<'
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By signature, [ state and agree, that I have carefully,~ex'amined 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, Bnilding 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.
JJw~
ad 2 ;<0/(')
Date '-1'
Owner or Contractors Signatnre
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Electrical Permit Application
225 Fifth Street+Springfield, OR 97477.PH(541)726~31S3. FAX(541)726-3689
.. . DEPARTMENT USE ONL. y.
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Permitno.:d!O - '10
Date:
This permit is issued under OAR 918-309-0000. Permits are nontra~sferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
'LOCAL: 'GOVERNMENT" AP.P.~OVALJc>:','i'i'
Zoning approval verified? 0 Yes 0 No
. " . .C;6;TEGORY\OI'.CON$TRUCTIOto,j'
o Residential 0 Government 0 Commercial
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Job site address: 1:2-0<-( /-f-1f:;M? L-7CJoV
City: 2; rFuo State: c>t:- ZIP:
Reference:
',:' ;_:";-N-':':::~'. ~,'
It-<-:r 2-
Name:
ZIP: '1'7'-('1
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
properly is not intended for sale, exchange, lease, or rent OAR
479.540(1) and ?9)i60(l).
Signature: ~
. CONTRACTOR INSTAllATION.
Business name: [JIV f1 a-
Address:
City:
Phone:
E-mail:
CCB license no.:
ZIP:
Fax:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
~
~~
~~
440-2584-J (9108/COM)
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'._, '. '.',d . .,,' _., Cost Total
N umber' ~f,inspectio'ris per. .it~m: (.) I ; " (Hy.
", 't, _'. :';" '-,-:: , : ." ,:' ,-:-_,.':.- :-,-... ,,-' ,,; ~i.- - '. ',~'."., ," '~ea.:' ~ost, .
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1.000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2) ( $ 55.00 $ S)'
Each additional branch circuit $ 6.00 $ 0
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alter~tion. <,)r extension (2)
Each additional inspection: (1) $58.00 $
~r~~~N;;im~~J~:~~~t~iJ!L~t~'Re~i1iC~NT&U'Sa:t~~4~t;;!\:j:;~(~~~f!:,;A~}~::~:'h?;;JP~: ,,:'-:
(A) Enter subtotal of above fees $ ~ (
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $
(C) Technology Fee (5% of [A]) $
TOTAL fees and surcharges (A through C): $
~( I
~~ctural Permit Application.
-
225 Fifth Street. Splingfield, OR 97477 tPH(54 1)726-3753 . FAX(541)726-3689
.
"'-:\
',D,EPARTMENTUSE6ri1~ Y "
COI41ZOtO -00 Z9u
Penn it no,:
Date: S - '8' -I 0
This permit is issued under OAR 918-460-0030, Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days,
~. _ _ _ ," .:" ,-''- " - :t'" '." ,'. . ,,',"""'''' ,~~.,~,,~- ';""-~:'f'; ~-., r"_"F""':'-""<__'T"'_':~,<~--:_"";;"~:::"'f:~
S,\""",,:,"'ii;' {j"II"OCAt:"<>.oYe:~!:lM,e:N1ji~pp~QVAl4t:~j)rlJ;;~\'!ill.!?ffi'~l
This project has final land-use approval.
Signature: Date:
This project has DEQ approval.,
Signature: Date:
Zoning approval verified: 0 Yes 0 No
Property is within flood plain: 0 Yes 0 No
~!~~~,[$:t~f~f~G'At:~,g,~~i.tiY~_~ifjlc~qN%f:Bu_C:rti9~ij~~~~ii~Li~Sifuf:~,ti
~Residential 0 Government 0 Commercial
~~,!i,':-~f:l~~h~rqQijyZs)~t_~l;"fNj%9i~MAIIQr{~);N~~~9!5A:fiQ:~1;~rit1t~~~~t~
; ,"-:';};~~:',~..~'~"',l'FEE~ scirEDuLEI3"':~ "~'.
>t)~y~~i~~iI.9bXfQ.;io;}Hii1i'n9:Q.:11:;Xt!L4~14~k~W;~qf~~~{i~~~~~Jlf7;,;iJJ{~L~;:'
(a) Job description:
Occupancy
L'3t7:,(LOCIAA
~J'
A-~1\1 it ~V
Construction type: V ~
Square feet:
Cost per square foot:
,Qther information:
Type of Heat: G--~ t-';
Energy Path:
o new 0 alteration .-EJaddition
(b) Foundation-only pennit? 0 Yes .-B-rro
E-mail: e.
This installation i~ being made on residential or farm property owned by
me or a member afmy immediate family, and is exempt from licensing
requirements under O?lOI.OlO.
Sign here: ~
'. CONIRAC'IORfr-j$l:AL:L,A,1]QN-..
Business name: CX,,;.I IV&..
Address:
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
(d) Enter 12% surcharge (,12 x [2a+2h+2c]):
(ej Subtotal of fees above (2a through 2d):
$
$
$
"
City:
Phone:
E-mail:
eeE license riD.:
Print name:
/'
....State:
/ Fax:
ZIP:
(a) Seismic fee, 1% (,01 x permit fee [2a]): $
TOTAL fees and surcharges (2e+3c+4a): $
Signature:
l,~l~~~~~~M{f?qfV~;jrSO~,-G0N.jjt<'~G:tP f{iJ N_~,bJ~~-'A]l9~~}1~&Tht~!ff&~?~;~rf:i'
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
\ct'
b
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Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www.ccb.state.or.us .
Permit #:
Cl-:)j/{) .- /0.2'1 CJ
! 2r'f j-fftM/ '-7&'</;r JPfi.p DA-- q'7~ 'J '1.
~ Date: t.j (7/10
. .
Address:
. Issued by:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not
licensed with the Construction Contractors Board to sign the following statement before a building
permit can be issued. This statement is required for residential building, electrical, mechanical and
. plumbing permits. Licensed architect and engineer applicants, exempt from licensing under
ORS 701.010(7), need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
cr2e 1.
~..2.
I own, reside in, or will r~side in the completed structure.
I understand that I must become licensed as a construction contractor if the structure is sold or
offered for sale before or on completion.
o 3A. My general contractor is
(Name)
(CCB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
OR
'<1!.- 3B. I will be my own general contractor.
If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. If! change my mind 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 building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to. Property Owners about Construction Responsibilities on the reverse side oftbis form.
.!)~U,. g__.# ~ 7; ;JC)/(j
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
. ,
Property_owner.doc 06-01-04
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Acting' a's'Y-oii'lr~Own General Contractor?
<; (.~':"', -\'.iN~b'RMI)."l'lb~ NOTICE TO PROPERTY OWNERS
ABQUT: CQN.5TRUCTION' RESPONSIBILITIES
"I" t1\ I......
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NOTE: This Information Notice.to Property Owners about Construction Responsibilities was developed by the
Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
- ..... '.+' .
If you are acting as your own contractor to construct a, new home or make a subsu,mtial improvement to an existing
structure, you can prevent'many problems 'by being aware of the following responsibilities and concerns.
Employer Responsibilities
You will, in most instances, be ruled to be an "employer" and the e<?ntractors you eontraet""ith will be "employees" if
you use contraetors not licensed with the Construction Contrac~o~s Board to do labor in constructing or to assist in the
construction or improvement of a resideniial structUre. As the employer, you must comply with the following:
~ \. . ~ " . . .
-, -....
. ~. .
Oregon's Withholding Tax Law: A's'~ employer, you must withhold income bxes from employee wages at the time
, employees are paid. You will be liable ,for the, tax payments even if you don't aetually withhold the tax from your
employees. For more information, call the Department of Revenue at 503'378-498g.. '. .
'. .' ' . ... . . ':){...
Unemployment Insurance Tax: As an empl9yer; you are reqiiired'.to pay a tax'for unemployment insurance purposes ';
on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488.
. '.,..' " !;' ',".-.. c ':...~, .
- . .':'....
The Oregon Business Identifieation Number (BIN) is a combined number for, bo)h ~~gon Withholding and
Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.doLstate.oLus/formspav.htmll for the
appropriate forms.
"
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law,
and must obw,in workers' compensation insurance for your employees. If you fail to obtain workers' eompensation
insurance, yoil eould be subject to pertalties and b'e liable for all claim costs if one of Y01ir employees is in:jured on the .
job. For more information, call the Workers' Compensation DiVis'ion at the Department of Consumer and Business
Services at 503-947-7815.
U.S. Internal Revenue Service: As an employer, you must withhold federal 'income tax from employees' waget.. ..
You will be liable for the ta.'!: payment even if you didn't actually withhold the tax. For a Federal EIN number, call the
IRS"at 1-800-829-4933 orvisi't.their web site atwww.irs.ljov.. ',;", .
I;' . '10. -.
Otber Res]!)ol!lsibiliti~s .2I1Uj[ Areas Qf iConcem~
Code Compliance: As the perrriit holder for this project, you are responsible for resolving any failure to meet code
requirements that may be brought toyour a,ttention :h:ough inspections.
Liability and Property Damage Iilsurallce:Contacl' your insurance agent to see 'if you have adequate insurance
coverage for accident~ and omissions such as falling tools, paint over spray, water damage from pipe ~unctures, fire or
work that l!ll!s~b\r~don,e~_ ":'.,,~" ' \_'- Cf '\.,-) ~,
\... \\J /. \ \ , ,,,. '~ . .._ _.' \ '-""., '. _ . "J'~"-' '. '
Time: Make sure you have sufficient time to supervise your employees.. .
Expertise: Make sure ~~u have the skilis' to act as your own 'generai'coritracto~; to coordinate the ~ork ofrough-in
and finish trades, and to notify huilding officials as the appropriate times so they can perform the required inspections.
If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO
Box 14140, Salem, OR 97309.5052.
Propcrty_owneLdoc 06-01.04
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.~~
C.f Springfield Official Receipt
DMlopment Services Department
Public Works Department
RECEIPT #: 2201000000000000210 Date: 03/08/2010 11 :48:25AM
Job/Journal Number Description Amount Due
COM20 1 0-00290 Plan Review Residential 88.40
Item Total: $88.40
I'ayments: Check Number Authorization
Type of Pltyment Paid By Received By Batch Number Number How Received Amount Paid
Check ANDREW EMMETT djb 1039 In Person $88.40
Payment Total: $88.40
. ..'
cKeceintl
Page 1 of 1
3/8/20 I 0
225 Fifth Street
Springfield, Oregon 97477
541;~726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000304
Date: 04/07/2010
9:59:44AM
Job/Journal Number
COM20 I 0-00290
COM2010-00290
COM20 I 0-00290
COM20 I 0-00290
COM20 I 0-00290
COM20) 0-00290
COM20 I 0-00290
COM20 I 0-00290
COM20 I 0-00290
COM20 I 0-00290
Payments:
Type of Payment
Check
cReceintl
Description
Plan Review Residential
Fire SF Fee - Residential
Plan Review Major - Planning
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Building Permit
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ANDREW EMMETT
Check Number
Received By Batch Number
"cjc ,",r';1," 1056
.",\~l
,~-.::ll( '."i:!, ".-
".'
-~j~td(- ::1
i.,f
Page I of I
Item Total:
Authorization
Number How Received
Amount Due
114.09
]4.78
211.00
140.95
7.05
311.53
55.00
6.00
44.70
29.18
$934.28
Amount Paid
]n Person
Payment Total:
$934.28
$934.28
4/7/20 I 0
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1284 HAMILTON ST
ASSESSOR'S PARCEL NO.: 1703342200223
PROJECT DESCRIPTION: Bedroom addition
Owner: EMMETT ANDREW E & JANE E
Address: 1284 HAMIL TON ST
SPRINGFIELD OR 97477
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00290
ISSUED: 04/07/2010
APPLIED: 03/08/2010
EXPIRES: 12/11/2010
VALUE: $ 28,564.00
Springfield TYPE OF WORK: Bedroom
,..".~ . _ h
TYPE OF USE: Addition
Residential
Phone Number: 541-505-1506
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
OWNER
OWNER
OWNER
OWNER
# of Units:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VB
BUILDING INFORMATION ,
# of Stories:
Height of Sirueture
fype of H~~t: .., .
"
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
License
Expiration Date Phone
I
16.50
Electric
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
6,970
295
No
I DEVELOPMENT INFORMATION I
o , uires you t.O
. . I PUBLIC IMPROVEMi~m:$'l~ ~dOP\;d by the osreir~ set torth
,~'. C r,I.<ih Those rule 2.()()1
Street Improvements: NotiJication e t,:oofii'lhr1llJ\lfI OAR 95 .
Storm Sewer Available: in OAR 952-00'~Ai<l. ,.,,,,,\as at the lule8 by
M90 '{ou mar""''"''I'01l1'SWtffil'\'l3lephOne
Special Instruction: Storm water to connect to existing sy'steM ca.liing the center. (~~t~tility NotlticatlOft
:IlOTlCE: . .' number 'O~:~~i~;~~00-332.2344).
Notes: 'HIS PERMIT SHALL EXPIRE IF THE Wo,RK . ,.,i' '~':,: Ce
UTHORIZED UNDER THIS PERMIT IS' NOT ".' 1
iJMMENCED OR IS ABANDONED FOR'
.IV 180 DAY PERIOD.
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
10.00
18.57
5.00
Overlay Dist: .
)j!re~;I-;:~;~ Rqd:
,;iR~,Eed, ~ij.r,e ~qd:
% of Lot Coverage:
Paee I of4
REQUIRED PARKING
.......Total:
Handicapped:
Compact:
34.42
.."..-,,-"
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
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Building Permit
Fire SF Fee - Residential
Plan Review Major - Planning
Plan Review Residential
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Fixture
Total Amount Paid
Structural Review
Initial Review
Plannintz Review
Public Works Review
Structural Review
03/09/2010 APP LLH Adjusted value and plan review to
{.iy~; :.' . ".~ to':
..-'" meet minimum default value of
, ~ f i.;;; t .1:j....,"," $28,564.
,.;-:~-I.~~'""':'; ~1'''(-
Il,:.~ ,-' "
" ~,.
03/15/2010 APP DDK
03/16/2010 APP LKW Storm water to connect to existing
system
03/29/2010 APP KLK
(lH" '.:;.~ .~L:? i'.~"
it Si :ti >,'; 'i
'~'i<:~!<~" . ~;-;;.. :.
:.,
"
I Val~ation De~cril1ti6n I
$ Per SqJ't
or multiplier
$96.83
Square Footage
.. or Bid Amount
295.00
Total Value of Project
~
Amount Paid
$88.40('-0<- ',\ T.,c;'
$44 70 ';-.:; ;,r - c::,:'
. I; .~~~.'.. , .
$29.18~..i*~, i:ilf;:q t
"I'~~" r ',;' ~.'
$55.00 ': ,
$6.00
$31 1.53
$14.78
$211.00
$114.09
$7.05
$140.95
$16.32' ,
$6.80 '
$79.00' .
$57;0(J'i[ '.
,
Date Paid
3/8/10
., 4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
4/7/10
,4/7/10
.4/7/10
i: '6/25/10
6/25/10
," -6/25/10
6/25/10
$1,181.80
I Plan Reviews ~
03/09/2010
03109/2010
03/09/2010
03/15/2010
03/29/2010
-1 f ;l
.,..::il:!'i!
,
Paee 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00290
ISSUED: 04/07/2010
APPLIED; 03/08/20] 0
EXPIRES: 12/11/2010
VALUE: $ 28,564.00
Value
Date Calculated
$28,564.85
$28,564.85
03/09/2010
Receipt Number
2201000000000000210
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
1201000000000000304
3201000000000000337
3201000000000000337
3201000000000000337
3201000000000000337
ii"'
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
',,,;;1'-."
1':\,;
CITY OF SPRINGFIELD
Building/Combination Permit
. PERMIT NO: COM2010-00290
ISSUED: 04/0712010
APPLIED: 03/08/2010
EXPIRES: 12/11/2010
VALUE: $ 28,564.00
, ...,;;
......,.>
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.
Ueouire<Unsnections I
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction withfooting andlor
foundation insp.ection.
Footing: After trenches are excavated.
__.J .:",
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor 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.
"r.,',. . '. '-',
. -'
...._.".~ '''''''~''' ".
Roof SheathinglNailing: Before covering sh~!'tliing wit,h finish material.
'.r"-'" , .
Bolts Installed in Concrete: To be done by a'State Certified Special Inspector. Provide inspection test reports to
City Building Inspector.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Final Plumbing: When all plumbing work is complete. .
Final Mechanical: When all mechanical\h)r~ is complet.!.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
" '.
.~,("._dJ.1; ,4 : itJli .
l,t~
Page 3 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'I' .
'."
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00290
ISSUED: 04/07/2010
APPLIED: 03/08/2010
EXPIRES: 12/11/2010
VALUE: $ 28,564.00
By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 structurewitbou\ 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 inspectioh,s:3re'req~ested at the proper time, that each address is readable from the
'-'""."..1 ,."
street, that the permit card is located at the front of!he property, and the approved set of plans will remain on the site at all
times during construction. """,
Xl ;r: .1
Owner or Contractors Signature
ri;....\\ _,..,oj.:,.:' j.
'::,.I-;;'i ::fl':':;jt 'I'i."
.;i';~~~ ~
:',..."
"/
~, ,',
'<.~.
;-';':y'
, '. '''"P~2e' 4 of4
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;""'.
"1<
L
Dp7
c2 5 ;;?O/(j
I
"
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000090000000337
Date: 06/25/2010
2:10:26PM
Job/Journal Number
COM20 1 0-00290
COM20 I 0-00290
COM20 I 0-00290
COM2010-00290
Payments:
Type of Payment
Check
cReceint 1
Description
1 st Appliance
Fixture
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ANDREW EMMETT
'M")., _,
Check Number
Received By Batch Number
NJM 7218
. '. ~,
,,-'..'
,1)11(,': r'l"il,f'n"
\.\t~hU 1)\",
',. j'
".:-"'"f"" ""-1'"
.;;1,. !
d,.
,nf~~)J ';i..f!l-:)til,\ .1;,
....:;"'.
'". "t;:.':
"',,,^,
,
. '
, . Pcage 1 of 1 '"
Item Totat:
Authorization
Number How Received
Amount Due
79.00
57.00
16,32
6:80
$159.12
Amount Paid
In Person
Payment Total:
$159.12
$159.12
6/25/20 I 0