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Home My WebLink AboutPermit Building 2006-9-13 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01068 ISSUED: 09/13/2006 APPLIED: 08/1712006 EXPIRES: 03/13/2007 VALUE: $ 372,932,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2148 Lomond Ave ASSESSOR'S PARCEL NO.: 1703251203500 Springfield TYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single Family Residence TYPEOFUSE';" q~'e~::;S YC1_~ to Residential " .' ,~ '". -,,~ ' \iiity , '~_ . . ,-' _ I :_ _ ...... ~~ 'J I I v, !" . ...'.-.. . '-.....,- r-:. r"L 1':>3 2r8 S'3'~ ~'orth ~... '. ~ : ..J -i; . ~ .......1. I I 1.J' .~ I ,.... _ _' _ ~. _...... "..... "" Owner: Address: ALAN & GAIL REYNOLDS 231 E 34TH AVE EUGENE OR 97405 (","_... ',J.- p'll(r. t't:' \' '- \11 vvr_ vv , :-- '~ , - Co': ~.' I" ~p,i(one'~iul}1btjr::s ~~ 1-484-1264 C~,-_:. ........L..l r.l~-!.\./ CJ~~....ln CC;':IC~ Ul 1- I~. '-' (': '. ,+' e to1op"one cc.t~i!:~; 'l:~12 C8:-~'~8r. ,\JL8. ~ll ..c.l~, II . _. ._I_.~>, .;~. ~h '" nr:"nnn Utility NO'~lflcatlon ,,~... ,,- - r~ -+M ;co 1-800-332-2344). I CONTRACTOR INFORMATION-, . Contractor Type Architect General Contractor ARBOR SOUTH ARCHITECTURE OWNER License Expiration Date Phone 344-3332 BUILDING INFORMATION I 4 # of Stories: 2 Height of Structure 25.50 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Electric Energy Path: Path 1 Sprinkled Building;. nfa Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 2,612 456 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VN 700 376 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 14.00 5.00 12.00 10.00 33.00 . ",1 r", ,"", ,1', ~'LL L.f\t tilL Ir I i'lL \/lfUf1I\ I DEVELOPMENT IN,F,O,RMA-J:JPNi\IJE:R nitS PERivilT I~ i\lor 'r, V' .'V1E' In(:r r.R IS A B^IIDOI\JFREO P-l{IRED PARKING c 01 II t\L''-U U i.... \. 1\ _ rUd Overlay Dist;\:\i\' .; 0 'l:J'rl;J~iPf~~9~e Total: 2 # Street Trees Rqd: 3 Handicapped: Paved Qrive Rqd: Yes Compact: % of Lot Coverage: 35.20 I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Fullv Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: Storm Drainage to curb & gutter.Sanitary Must be hooked up & drainfield from adjoining property abandoned per Lane County Sanitarian's rules & regulations. PW must be provided a "Sanitation Authorization Notice" form from the Lane County Sanitarian! Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction A.C. - Residen DwelIin2s Gara2e AC - Residential V Wood Frame Gara2e Fee Description Plan Review Residential ~Mechanical Issuance Fee~ + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 3 Baths One & Two Family Addressing Assignment Appliance Vent Boiler/Comp Up To 100,000 btu Building Permit Curbcut - Additional Driveway DI-yer Vent Exhaust Hoods Fire SF Fee - Residential Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 PW Disc - 2nd Permit Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Storm Sewer Each Addtll00' Temp Power 200 amps or less UGB Plan Rev Mj/Min - Planning Vent Fan Willamalane Single Family I Valuation Description I $ Per Sq Ft or multiplier $4.00 $99.00 $26.00 Square Footage or Bid Amount 3,444.00 3,444.00 700.00 Total Value of Project ~ Amount Paid $944.39 $10.00 $216.21 $97.75 $156.39 $306.00 $31.00 $6.00 $24.00 $1,452.90 $80.00 $6.00 $9.00 $207.20 $24.00 $15.00 $4.00 $-30.00 $1,147.85 $1,509.54 $10.00 $1,923.04 $183.22 $284.85 $136.95 $1,672.64 $379.16 $80.00 $1,610.46 $28.00 $50.00 $268.00 $30.00 $1,000.00 Date Paid 8/15/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 9/13/06 Pa2e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01068 ISSUED: 09/1312006 APPLIED: 08/1712006 EXPIRES: 03/1312007 VALUE: $ 372,932.00 Value Date Calculated $13,776.00 $340,956.00 $18,200.00 $372,932.00 08/21/2006 08/21/2006 08/21/2006 Receipt Number 2200600000000001147 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 1200600000000001409 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-0l068 ISSUED: 09/1312006 APPLIED: 08/17/2006 EXPIRES: 03/13/2007 VALUE: $ 372,932.00 Status Issued 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 54] -726-3676 Fax 54]-726-3769 Inspection Line Total Amount Paid $13,873.55 Plan Reviews I Initial Review Plannine Review 08/17/2006 08/21/2006 08/21/2006 08/25/2006 APP APP LLH TAJ Public Works Review 08/21/2006 08/24/2006 APP JLP Structural Review 08/21/2006 08/25/2006 APP DLM Annexation application submitted 9/1/06. Per City Council direction on 8/21/06, no occupancy may occur until the Boundary Commission approves the annexation. 3 Street trees are required: 1 to be located on the cul-de-sac part of Lomand and the other 2 on the through street part. Storm Drainage to curb & gutter.Sanitary Must be hooked up & drain field from adjoining property abandoned per Lane County Sanitarian's rules & regulations. PW must be provided a "Sanitation Authorization Notice" form from the Lane County Sanitarian! Prior to Final Occupancy. Roxie @ the HBA has been notified by telephone of the sanitation requirements.JLP See documents for plan review comments To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. [..Reouired.Jnsnections 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 floor insulation or decking. Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Paee 3 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01068 ISSUED: 09/13/2006 APPLIED: 08/17/2006 EXPIRES: 03/13/2007 VALUE: $ 372,932.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. 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. 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. Shower Pan. Prior to covering 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. U ndertloor 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. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Overwidth: After forms are erected but prior to placement of concrete. 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 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 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 tim:'dUdngco 2~-4~ Owner or Contractors signa~ '/ ?~/3~b ( Date Page 4 of 4 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 #: C&? - 01 00 r Address: ~ \ q g' L;'G'~ ~ 'I ~ Issued by, ~ ' Ma.0htl ~ '" Date, q - I ~ - oeo Statement: Information Notice to Property Owners About Construction Responsibilities. Note: Oregon Law, ORS 701.055 (4) requires residential construction permit applicants who are 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 ORS701.010(7), need not submit this st~tem.ent. This statem..entwill be filed with the permit. " , , . Fill in the appropriate blanks and initial boxes 1 and 2; and eith~r box 3A or 3B:' .' ,RIO 1. D 2. I own, reside in, or will reside iIi 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. D 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 JQ:",' J8. I will be, my own. general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction ContraCt.ors Board. If I 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 issui~g this. building permit of the name of the contractor. . I hereby certify thatthe above information is correct and that I have read andJJounder:stand th~Informati~n . Notice top;ropertyOwners about Con'structionResponsibilitiesonthe re~erseside oCthisJorm. ~~/~~~. f7-13~X , (Sign~tur~permit ap~t) . . ,(Date)(....... , (W!zite copy to issuing agency permit file, pink copy to applic~nt.) , PropertLowner.doc 06-01-04 " Acting as ~ o'ur Own 'G'eneral Contractor? INFORMATION NOTICE TO PROPERTY OWNE.RS ' ABOUT COf\lSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction Responsibi7ttfes 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 s~bstantial ifupfovement to an existing structure, you can prevent many problems by being aware of the following responsibilities and c()ncems. Employer Responsibilities You win, in most instances, be ruled to be an "employer" and the contractors you, contract with will be '''employees''if you use. contractors not licensed with the Construction Contractor~ Board to dq labor in constructing or to assist in the construction or improvement of a residential structure. As tbee~ployer, you must comply witb the following: . . - ~ Oregon's Withbolding Tax Law: As an employer, you'must withhold income taxes from employee wages at'the time employees are paid. You will be liable for the tax p.ayments even if you don't actually withhold the tax fron: your employees. For more information, call the DeprirtmenfofRevenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes . on the wages of all employees. For more information, caB the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, can 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the appWpf;ate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' CompensatIon Law, and must obtain w,orkers' compensation insurance for your employees. ,If you fail to obtain workers' compensation insurance, you could'be subject to penalties and be liable for all claim costs if one of your employees is' injUred on the job. For more information, can the Workers' Compensation Division 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' wages'. ' You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at .1-800-829-4933 or visit their web site at www.irs.l!ov. Ot.her R~sponsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving' any faih.rreto meet code requirements that may be brought to your attention through inspections. , . . Liability and Property Damage Insurance: Contact your insurance agent to "see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. . Expertise: Make sure you have the skills to aetas your own general eon1ta'ctor: to coordinate the work o{rough-in and finish trades, and to notify building 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. .:. '\. . PropertLowner.doc 06-01-04 ~..... '\ -~ CITY OF :SI \r{INGFIELD SYSTEMS DEVELOPMEN<I"'WORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. - x I COST PER S.F. CHARGE I 4798.50 I $0.336 I. = I $1,610.46 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. ) x I COST PER S.F. I x I DISCOUNT RATE 1 I I 0.00 I $0.336 I I 50% I = , ITEM 1 TOTAL - STORM DRAINAGE SDC I $1,610.46 I COM2006-0 1068 Alan & Gail Reynolds I Home Builders Association "Reynolds House Project" 2148 Lomond Ave 1703251203500 SINGLE FAMILY RESIDENCE 2 BUILDING SIZE (SF: 3670 LOT SIZE (SF): 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's I x 58 I' B. IMPROVEMENT COST: NUMBER OF DFU's I x 58' I COST PER DFU $26.03 $19.79 ITEM 2 TOTAL - CITY SANITARY SEWER"SDC =, $2,657.39 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE' x NUMBER OF UNITS x ~57 2 COST PER TRIP $19.81 B. IMPROVEMENT COST: I ADT TRIP RATE x NUMBER OF UNITS x ,COST PER TRIP I 9.57 2 $87.39 ITEM 3 TOTAL - TRANSPORT A nON SDC , =, $2,051.80 4. SANITARY SEWER - MWMC A." REIMBURSEMENT COST: INUMBER OF FEU's' x I 2 COST PER FEU $91.61 B.'IMPROVEMENT COST: INUMBER OF FEU's x I 2 ICOST PER FEU I $961.52 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2, 3, & 4) = " 5: ADMINISTRATIVE FEE; SUBTOTAL x I ADM. FEE RATE $8,435.91 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: $2,116.26 $8,435.91 CHARGE $421.80 Jeff Prociw 8/24/2006 DISCOUNT $0.00 x I NEW TRIP FACTOR I 1.00 , x INEWTRIPFACTOR , 1.00 I PREPARED BY DATE TOTAL SDC CHARGES 10524 $1,610.46 $1;509.54 $1,147.85 $379.16 $1,672.64 = , $183.22 = $1,923.04 $0.00 $10.00 284.85 $136.95 $8,857.71 r:/) ~ Q o U ~ ~ t-< r:/) >-< o ~ 1070 1091 1092 1093 " 1094 1054 1055 ' 1054 1056 1079 i 1078 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 1 0 3 = 3 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 1 0 3 3 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 I LAUNDRY TUB 1 0 2 = 2 ICLOTHESWASHER / MOP SINK 2 0 3 = 6 I CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 2 0 3 = 6 ;! ISHOWER, SINGLE STALL 4 0 2 = 8 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 2 0 3 = 6 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V ATORYIRESIDENTIAL BAR 9 0 1 = 9 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 5 0 3 = 15 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 58 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFD's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4;63 $4AO $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $OA8 $0.28 $0.09 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5.29 = , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $5.29 o TOTAL MWMC CREDIT = $0.00 Date ZON . L:t>L INITIALS t..I fY'\ DATE Ol-f~.....oCp SOURCE~~#'~ q-13- z.~ ~~" " ~.', l~ . .. { ~', /~ l!~: Ji. :-;," , .t~.'t~Ji)~_.fX~,p.,,~R~S>~,: .",. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (\ 1.0 ;. \Dlog ~. . . - - ~ 1. LA\~~OF\n~ON:[ LEGiL~D~~F5{0- n.~rooo JO~~NVlJd( ~~ P"mll< ... non-I"n,'",b'. and .xpl'. " ~ I, not started within 180 days ofissuance or if work is Suspended for 180 days. 2. Elec City / Phone ~ / // Supervisor License Expiration Date Own=Name\_~\~1\ 4- 6na. ~~ Address ~\ ~ ~ *h Ave Q E. City ~,4 Phone A:~. \rJJot OWNER INST~LLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. A. 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 $106.00 $ 19.00 $50.00 B. :"" (::f~',:i(2S YOL! to 200 Amps 6rless . .C.' '"" ~$-63~09L';'ili+" ,. . - . ~ . .... - ~'I , '. . - .J 201 Amps to 400 Amps_' ..:r. 'I ;1:J:::2 ri '~j?P:.oQ8;';nr;h 401 Amp~to 600 AmpL.:; <. :::. C' ~'.:C:L 'ii, C.$.1J~.gQ2-nn1_ 601 AmprtoiOOOAmps.~' c~;i'.i,'J CO;Ji3S 0$1163.0013S bv Over 1000 AfuPSNol'fs:l Cf;;T;8r. (:'.!Ole: ti18$3l7:5iO:Oone . Reconnect~:hi.1y~':-;' fer tha Oreran Utililv $J2.Q:.PQaiinn 1 is 1- C. ." ." '.', I' i ['PIKE IF THE WORK Installation, N~~]a;ti!!i1\ orl Rel~~a.t!~_n.l\ PER M \ T \ S~ \,f hI \ 200 Amps or l~sl HORIZtO U\\J[)E:ti l\H,I?, $ 50.00 Fn~ j.UJ 201 Amps t040m.Q\rnws:\jl~tO OR I~ }-\o!-\II~I$(J~~&6) ". ,- 40 I Amps to ~QIQ '.{\mr-s ;y'.'.' (H'd U L1. $100.00 Over 600 or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 M:.nimum Electric Permit Inspection Fee !S $45.00 + surC~halr :W 8% State Surcharge f"\'" I 0% Administrative Fee ~ 5% Technology Fee ~~ ~\~ TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 8-06.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-0 I 068 COM2006-0 I 068 COM2006-0] 068 COM2006-0] 068 COM2006-0]068 COM2006-0] 068 COM2006-0 I 068 COM2006-0 1 068 CO M2006-0 I 068 COM2006-0 I 068 COM2006-0]068 COM2006-0] 068 COM2006-0] 068 COM2006-0]068 COM2006-0 I 068 CO M2006-0 I 068 COM2006-0 I 068 COM2006-0] 068 COM2006-0] 068 COM2006-0] 068 COM2006-0 1 068 COM2006-0 I 068 COM2006-0 I 068 COM2006-0] 068 COM2006-0] 068 CO M2006-0] 068 COM2006-0 1 068 CO M2006-0 I 068 CO M2006-0 I 068 COM2006-01068 COM2006-01068 COM2006-01068 COM2006-0 1 068 Payments: Type of Payment Check Check cReceiot I RECEIPT #: 1200600000000001409 Description Addressing Assignment Willamalane Single Family Temp Power 200 amps or less Fire SF Fee - Residential Building Permit 3 Baths One & Two Family Storm Sewer Each Addtl ] 00' Furnace - up to 100,000 btu Boiler/Comp Up To 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Sidewalk Permit Curbcut - Additional Driveway PW Disc - 2nd Permit Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin UGB Plan Rev Mj/Min - Planning Received By Check Number Batch Number Paid By ALAN D. REYNOLDS ALAN D. REYNOLDS nJill nJill Page] of2 417988 ]885 r . of Springfield Official Receipt ... _t'elopment Services Department Public Works Department Date: 09/13/2006 Item Total: Authorization Number How Received In Person In Person Payment Total: 11 :44:48AM Amount Due 31.00 ] ,000.00 50.00 207.20 1,452.90 306.00 28.00 24.00 24.00 30.00 6.00 9.00 6.00 4.00 ]5.00 ]0.00 97.75 ]56.39 216.21 80.00 80.00 (30.00) ],6]0.46 ],509.54 1,]47.85 379.16 1,672.64 ] 83.22 1,923.04 10.00 284.85 136.95 268.00 $12,929.16 Amount Paid $12,900.00 $29.16 $12,929.16 9/1 3/2006