HomeMy WebLinkAboutPermit Building 2010-10-27
225 Fifth Street. Springfield, OR 97477+ PH(541)726-375JtFAX(541)726-3689
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DE~ARTMENT USE ONLY
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Date: /0 ~ Z 7 - / 0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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Zoning approval verified? ~Yes 0 No
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Name:
Address:
City: '7
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
~
ZIP: '1 2Lf-Cj
E-mail:
CCB license no.: 1'):38'1 \ BCD license no.~- 2QQC
Signing supervisor's license no.: 3C;GC- 5
Print na)11e of signing supervisor:G- (",,-..I f4.. pt;
Signature of signing supervisor: a ,
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440-2584-) (9/08/COM)
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. c. _ . _' . ',,- ';"... I,'''' ,- ':~'~-','. '~r ." ""~" 'cosn. Total.
.Number or inspections peritem{). ,;. Qty. ...;-';~a.~> cost
".' '~",;.~, ._....~.-..:: '-:":,:,~:',,"'i" ,-it,.,' <'-~i"".' ~b~"',; '..-,.'" ,.
Residential, per unit, service inc~uded:
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: instaflation, alteration, relocation
200 amps or less (2) A $ 81.00 $ <('I
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 of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder l!ot 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 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
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(A) Enter subtotal of above fees 'ii)
(Minimum Permit Fee $58.00) $
(B) Enter 12% surcharge (.12 x [AD $ 'Tn
(C) Technology Fee (5% of [AD $ 4 0)
TOTAL rees and surcharges (A through C): $ 91./77
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CITY OF SPRINGFIELD
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.X1illl4Q::);.:>O R EGON
Building I Residential Permit
PERMIT NO: 811-SPR2010-00598
IVR Number: 811177676285
www.ci.springfield.or.us
225 Fifth Sf
Springfield,OR g7477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@cl.springfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
10/27/2010
10/27/2010
Issued
10/27/2010
EXPIRES:
VALUE:
04/25/2011
$1,000,00
SITE ADDRESS: 4854 ELDERBERRY LOOP, Springfield, OR 97478-6796
ASSESOR'S PARCEL NO: 1802051100101
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Duplex
Alteration
Residential
PROJECT DESCRIPTION:
Panel Change
Phone Number:
OWNER:
ADDRESS:
SMITH SCOTT ALLEN
728 POND LN
EUGENE OR 97401
Contractor Type
Contractor Name
CONTRACTOR INFORMATION ~
Lie Type
Lic No
Lic Exp
Phone
# of Units:
r BUILDING INFORMATION" .
NOTlCL I
2 THIS PERM1~SSl'liJ!.H EXPIRE IF THE WORK
AUTHORIt'Eill~M?~'Nc\'M'S PERMIT IS NOT
Type VB
R-3 COMMEN\IX,~'OIt~'1}:ABANDONED FOR
One side of DYP'I,Ei~1 180 ~j\~e'FTI!PI'OD,
Range Type:
Hazmat:
Construction Type
Occupancy Type
Occupancy
Comments
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal I Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
I Site Information
ATTENTlm.' ^ ,
-~_.. ....... ''-'\-I'''IIG;:J yLlu lO
foHow rules adopted by the Oregon Utility
Notification Center, Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090" You may obtain copies of the rules by
calling the center, (Note: the teiephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Reql!ired:
Springfield Building Permit
10/27/201 3:17:18PM
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other: 0
Occupancy Load:
2008
I
Page 1 of 3
.
www.ci.sprlngfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00598
IVR Number: 811177676285
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenler@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
155 ued
10/27/2010
ISSUED:
APPLIED:
10/27/2010
10/27/2010
EXPIRES:
VALUE:
04/25/2011
$1,000.00
SITE ADDRESS: 4854 ELDERBERRY LOOP, Springfield, OR 97478-6796
ASSESOR'S PARCEL NO: 1802051100101
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Duplex
Alteration
Residential
PROJECT DESCRIPTION:
Panel Change
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Description
Tvpe of Construction
Unit Amount Unit Tvee
Unit Cost
Value
DescriDtion
Services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Total Amount Paid
FEES PAID
Amount Paid
$81.00
$4.05
$9.72
$94.77
~
Date Paid
10/27/2010
. 10/27/2010
10/27/2010
ReceiDt #
374724
374724
374724
Springfield Building Permit
101271201 3:17:18PM
Page 2 of 3
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SP~IN. G.. FIE.L~
.
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:-;;;;;;. OREGON
www.ci.springfield.or.u$
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00598
IVR Number: 811177676285
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
10/27/2010
ISSUED:
APPLIED:
10/27/2010
10/27/2010
EXPIRES:
VALUE:
04/25/2011
$1,000.00
SITE ADDRESS: 4854 ELDERBERRY LOOP, Springfield, OR 97478-6796
ASSESOR'S PARCEL NO: 1802051100101
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Duplex
Alteration
Residential
PROJECT DESCRIPTION:
Panel Change
Plan Review
I
Denartment
. Permit Issuance
Received
10/27/2010
Due Date Comoleted
10/27/2010 10/27/2010
Result
Issued
Reviewer
Kip Kaufman
Initial'Review
10/27/2010
10/27/2010 10/27/2010
Over the Counter
Kip Kaufman
Comments: Over the counter permit
lAPPlica~iOrt:fr,c<:ep~a:~.ce?:~/tt0 " 1 0/27 /2_9JQyt:~!Q~~?/29.~~9!??':1 O/Z71fOj Q,"~~;-.~q:yer,the:CC?ynt;!~,<;
l,r~;4hst ':'{ ~ ,~'^: ': :' ::;~;~.~>.~>~ 'i>~~ffihi-~:o~'>,;A;,~f- -;>i':.;~~:tlI"2':;{, :a.;;;":':;;~~,':' .~"". .i\ ~";,~ii~/
,~~,1r~lp"Kaufmari
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INSPECTIONS REQUIRED ~
Inspections
4220 Electrical - Service
By signature, I state and agree, that 1 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 or 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 times during
construction.
ALa, ~.frti(
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Date
Owner or Contractor Signature
Springfield Building Permit
10/27/201 3:17:18PM
Page 3 of 3
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00598
4854 ELDERBERRY LOOP
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
541-726-3753
permilcenter@ci,springfield.or.us
RECEIPT NO: 2010000684
RECORD NO: 81 ] -SPR20 1 0-00598
DATE: 10/27/2010
"l>~"';;"?' ~1ti;";~i:"l<1+c4Yr>;l~GCQU.r{(CQi:tE z,1'-'; -:i ~MQU!':IJ.::R.QE .i:i';1.i~i...:J
224-00000-426102 $81.00
100-00000-425605 $4.05
821-00000-215004 $9.72
TOTAL DUE: $94.77
~ P~YMEN;TTY.R~-i;j"'eA Y6R~~; CASHIERii<<UEMAN~;;C:()MMEf.liJ-S'l'.:r",,:,. .. .. k>;z";::::.. >i:AIVI.9J.tNT-I'Alb~'; ;'0.,t'.':J
[bESCRIf'tION.;;:r-T~ii$j . .V'
Services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Check
4572
Campbell Electric
$94.77
$94.77