HomeMy WebLinkAboutPermit Miscellaneous 2010-9-15
Structural Permit Application
DEPARTMENT USE ONLY
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Date: 1:7 0
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days 0
suspended for 180 days.
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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
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\Residential 0 Government 0 Commercial
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225 FIfth Street. Springfield. OR 97477. PH(541)726-3753. FAX(541)726,3689
ZIP C{i~77
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E-mail:
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 ORS 701.010,
Sign here:
'. CONTRAC:rOR,i~SIAl:.LA'n9N:'"-~,, .,
Business name: 72..-.
Address:
"1.'"-
City:
Phone:
E-mail:
CCB license no.:
Print name:
State:
Fax:
ZIP:
Signature:
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Name CCO License Number Phone Number
Electrical
Plumbing
Mechanical
.
Permit no.: 5iO .-JO L/
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(a) Job description: ('~- r :Ol".
Occupancy 'i2. S U
Construction type: (A io" lRc..mcJel
Square feet: ?-,(d)
Cost per square foot:
Other information:
Type of Heat: fA..dlef>~
Energy Path:
0 new [3'3.lteration 0 addition
(b) Foundation-only permit? 0 Yes 0 No
Total valuation: $ /lXJOO
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(a) Permit fee (use valuation table): $/3(j, g2
(b) Investigative fee (equal to [2a]): $
(c) Reinspection ($ per hour): $
(number of hours x fee per hour)
(d) Enter 12% surcharge (. 12 x [2a+2b+2c]): $
(e) Subtotal of fees above (2a tbrough 2d): $
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~~;1rJ~_~IteX~~~1~~~~~1\~,"5:~~!' i!J\:14\;~;if~~~:..t~\_~~i~~1~~G;~*t~1
(a) Plan review (65% x permit fee [2a]): $ ~'i9
(b) Fire and life safety (40% x permitfee [2a]): $
(c) Subtotal of fees above (3a and 3b): $
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(a) Seismic fee, 1% (01 x pemit fee [2a]): $
TOTAL fees and surcharges (2e+3c+4a): $
225 Fifth Street. Springfield, OR 97477tPH(541)726-J753t FAX(541)726-J689
DEPARTMENT USE ONLY
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Permit no.: S 1 0 - ]' 0
Dale:
()
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.
:'" '. '~.:IEOCALi:G0VERIiIMENT:~~f\ROvAlSi,:,'("',:i"tiji'i;i~
Zoning approval verified? 0 Yes 0 No
';:I,,:'~""-\,:'1:,..::CATEGOR:V:$OF, 'CONS'fRl1CTION1}:~;' .
O'Residenlial 0 Government 0 Commercial
f!:4:~~'fii,~toBj;jSI;rE~~INFORNiMloNl''AN[jA'lJ.O:CMloliI~~!~+ri;ri
Job site address: "(be. '''''' ~ S+.
City: $:~ J Slate: oP- ZIP: q7~77
Reference: 0 3. z to t{ ( Taxlot.: J t,( () 0
'DESCRIPTI0N.0F'WORK,.1ii'i",\,:i .::?;"?,. .':
# "'t.~ Wet..
Name:
PROPERTY. QWNER
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l V'<'- \
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).
Address:
City:
Phone:
E-mail:
CCB license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
ZIP:
BCD license no.:
440-2584-J (9108/COM)
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-' :.CosC,t,,:rotal.
;:N ~~~~r':o.f:i~fp~~i~~~~:.~~,f;'Y~_~; ..~')~~1~.:; R1Y' ,,:ea,', . ,.,cost .
Residential, per unit, service included:
1,000 sq. ft. or iess (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 iess (2) 1 $ 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 $
20] 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 2 $ 6.00 ${<6"'6
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 ~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 $
l~~~~~&~ff~M~tfj~t~:t~:~etIC'ANm~)js)~~,iF~~-~:,~;$f;fl~;'f;;f~}I;fJ~;M!:;~: ;~:'.1
(A) Enter subtotal of above fees $Ht
(Minimum Permit Fee $58.QO)
(B) Enter 12% surcharge (.12 x [AD $ iJ oi
(C) Technology Fee (5% of [AD $ ~7'>
TOTAL fees and surcharges (A through C): $ c/6~
Plumbing Permit Application
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. '.""DEPARTMENT USE ONL:V"s;,y<.
225 Fifth Street. Springfield, OR 97477 . PH(541)726.3753 . FAX(54I)726-3689
Date:
Pennit no.:
This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits
expire if work is not started within 180 days of issuance orifwork is suspended for 180 days.
';":i,'\;~T 'c;Il!OCALlGOVERN N1ENT:'APP R0V.G.IJ.'!lii't:;;??:;t'i!~:i,\1
Zoning approval verified? 0 Yes 0 No
Sanitation approval verified? 0 Yes 0 No
CATEC;ORY OF CONSTRUCTION .. '.
D Residential I D Government I D Commercial'
:,;,;";;';'JOS;:SfJiE " 'INFORMA.TION2i:ANp.,![0c:ATJON:;f1 f;l;,.;i:::,~
Job site address: ,2<J ob &vl\ tv I'I--<..-~
City: SI"'h..<) I State: I ZIP:
Reference: I Taxlo!.:
:~?:{: ,;::;i:}'~~"i':?, ',DESCRIp,'[10N'OE.::\lV.ORK;![i;:!$~:t:'i,:;jT:':;:"'f:!{
~~t C-'NV6~S:t' CJ__
" "', , . PROPER'TVtOWNER';"',?" ': 'i,,1 :;"4 )~~'~':~)%;~~W';:l:~;\
Name: (V'J't/lm,./ mt...<!:: Y
Address: /2Q c:; JIA (IVWt- ., ,
City: Q> l=-L 0 I State: I ZIP:
Phone: - - I Fax: - -
E-mail:
This installation is being made on residential or farm property
owned by me ar a member of my immediate family, and is
exempt from licensing requirements under OAR 9 I 8-695-0020.
Signature:
CONTRACTOR ,.INSTALLATION : ,::
"
Business name: tJ".J IV~.7t--
Address:
City: I State: I ZIP:
Phone: - - ' I Fax: - -
E-mail: ,
CCB license no.: I BCD license no.:
Plumbing license no.: ,
Print name:
Signature:
440-2500-J (II/08/COM)
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L::' ~\ ;';:",~'&;~i;iJ~I:2tti: /,~5~~l'}:~~?~~~fJ;~'
New residential
1 bathrooml] kitchen (includes: first
J 00 feet of water/sewer lines, hose
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms/! kitchen $374.00
J oathrooms/! kitchen $439.00
Each additional bathroom (over 3) $95.00
Each additional kitchen (over 1) $95.00
Residential fire sprinklers (includes plan review)
o to 2,000 square feet $58.00
2,001 to 3,600 square feet $116.00
'3,601 to 7,200 square feet $174.00
7,20l'square feet and greater $232.00
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and
water supply
Commercial, industrial, and dwellings other than one- or
two-family
Minimum fee
$238.00
~
$
$
$
$
$
$
$
$
$58.00
$
Each fixture
Miscellaneous fees
100' storm, sewer, water line
Each fix~ure, appurtenance, and piping
Storm water retention/detention facility
Irrigation systems
Piping or private storm drainage
svstems exceedin2: the first 100 feet
Specialty fixtures
Reinspection (no. ofhrs. x fee per hr.)
Special requested inspections (no. of
hrs. x fee per hr.)
Each additional inspection: (1)
'J
$58.00
$19.00
$
ijl'~u
gM:~~'f~~iigO~s'-rplp'ft:g~tr~~~f1~i~:~t~;i~'l;~~f~'j
$76.00 $
$19.00 $
$19.00 $
$19.00 $
$19.00 $
$19.00 $
$58.00 $
$58.00 $
$58.00 $
Mjnimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value. $
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ib~ti;~!m,'iil'4'lji~il\;'f~~p'~I!::'If,t:li['I!l:.ISE?"1:""l'i',:,."",~f'Fii:
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(8) Investigative fee (equal to [A])
(C) Enter 12% surcharge,C 12 x [MB])
(D) Technology Fee (5% of [A])
TOTAL fees and surcharges (A through D),
$0""
$
$ (g't"
$ z.. "u
$/o1"!.:!
..
SPR,I"NG.~,D
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" , ,OREGON
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00304
IVR Number: 811143855184
www.ci.springfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
11/02/2010
09/15/2010
Iss ued
11/02/2010
ISSUED:
APPLIED:
EXPIRES:
VALUE:
05/01/2011
$10,000,00
SITE ADDRESS: 1206 QUINAlT ST, Springfield, OR 97477-2621
ASSESOR'S PARCEL NO: 1703264116100
SCOPE: Garage Conversion
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Garage conversion to master bed/bath
Phone Number:
OWNER:
ADDRESS:
AllEN NATHAN D
1206 QUINAl T ST
SPRINGFIELD OR 97477
Contractor Type
General Contractor
Plumbing Contractor
Mechanical Contractor
Electrical Contractor
Contractor Name
OWNER
OWNER
OWN ER
OWN ER
CONTRACTOR INFORMATION ~
Lie Type
OWNER
:;
OWNER
OWNER
OWNER
BUilDING INFORMA TION ~
,.-'
#'Of~~r~~
Rt. I~ ~~Ii~ o~~ttueture:
~O\\Ct.: SW",,-\.. t.~\'~ \'t.RI<fYle\~tfeat:
1\-11S \'t.RW\\1 \.I~Dt.R 1\-1\ ~D()~W1t~~l'ype:
P--\.I1\-10\'-\1t. D O\'- IS P--\)J': Range Type:
C()W\W\t.~Ct. ~ \'t.\,-\()D. Hazmal:
p--~'/ \~() D~
# of Units:
o
Wall Heat
# 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: ,
Resi~ential Specialty Code Edition~:
Structural Spe'cialty Code Edition: \
Site Information
Engineered Fill:
Fill Volume:
Flood Hazard Area:
land Hazard Area:
Retaining Wall:
Soils Report Required:
Springfield Building Permit
11/2/2010 11:52:43AM
Lic No
0000000
0000000
0000000
0000000
Lic Exp
08'12'2025
08f12f2025
08/12/2025
08f12/2025
Phone
lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Occupancy Load:
o
,,'
2008 ' ~oU 10
la'/l le~UllesO(\ U\ili\~
, ~". megO(\, ",,,e ONg _ opl 101\\'1
1\'\'\'1::'1'1 I \U"aOO?\eu ~'se (\Jles ",\;; 95'2-00\-
10110'/1 t~;~Sce(\\eIO<6~~(OU9\'1 O~\'Ie luleS b~
.\ \il,ca,1 00\ -0 \ ?,eS 0 ,,\'Io(\e
,,0 1\1' 95'2- blal(\ CO . \\'Ie \ele--: \101'
in 0 'Iou ((\0.~ 0 \el \\,\o\e, '1'1" \,\o\\I,c0.
0090, \'Ie cen . I' U\I I, 44)
0.111(\9 \ \\'Ie 0(890 33'2-23 '
c pel 101 's \ _800-
nu((\ cen\el \
~
Page 1 of 4
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
CITY OF SPRINGFIELD'
Building I Residential Permit
PERMIT NO: 811-SPR2010-00304
IVR Number: 811143855184
Issued
11/02/2010
ISSUED:
APPLIED:
11/02/2010
09/15/2010
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield.or,us
EXPIRES:
VALUE:
05/01/2011
$10,000.00
SITE ADDRESS: 1206 QUINAL T ST, Springfield, OR 97477-2621
ASSESOR'S PARCEL NO: 1703264116100
PROJECT DESCRIPTION:
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
SCOPE: Garage Conversion
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
Garage conversion to master bed/bath
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:
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Descrietion
Springfield Building Permit
PUBLIC IMPROVEMENTS
~
Valuation Description
Tvoe of Construction
Unit Amount Unit Tvee
11/2/2010 11:52:43AM
Sidewalk Type:
Downspout/Drains:
~
Unit Cost
Value
Page 2 of4
5TH. G~.IE~~D..
~.h~ ..
~~
;c-: 'OREGON
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00304
IVR Number: 811143855184
www.ci.springfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
155 ued
pe rmitcenter@ci.springfield.or,us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
11/02/2010
09/15/2010
11/02/2010
EXPIRES:
VALUE:
05/01/2011
$10,000.00
SITE ADDRESS: 1206 QUINAlT ST, Sprin9field, OR 97477-2621
A5SESOR'S PARCEL NO: 1703264116100
SCOPE: Garage Conversion
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Garage conversion to master bed/bath
FEES PAID
1
DescriDtion
Structural Plan Review Fee Residential
SDC: Reimbursement Cost - Local Wastewater
sac: Total Sewer Administration Fee
SDC: Improvement Cost - Local Wastewater
Shower/Shower pan
Sink/basin/lavatory
Structural Building Permit Fee
Water closet
Branch circuits with service Of feeder each circuit
.~----
Balance of Minimum Plumbing Permit Fees
First Appliance Fee
Se!~ices 200 amps or less
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
Total Amount Paid
Amount Paid
$88.40
$645.92
$49.68
$347.68
$19.00
$19.00
$136.00
$19.00
$18.00
$1.00
$79.00
$81.00
$44.64
$18.60
$1,566.92
Date Pa id
09/15/2010
11/02/2010
11/02/2010
11/02/2010 '
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
11/02/2010
Receipt #
374311
374770
374770
374770
374770
374770
374770
374770
374770
374770
374770
374770
374770
374770
Plan Review
I.
Department
~pplication Acceptance
Result
Application Accepted
Received Due Date Completed
09/15/2010 09/15/2010 09/24/2010
Reviewer
David Bowlsby
Initial Review
09/24/2010 09/24/2010 09/24/2010
Approved
David Bowlsby
Public Works Review 09/30/2010 10/04/2010 10/04/2010
Comments: Application Received 10/1/2010.
Approved
Todd Singleton
Springfield Building Permit
11/2/2010 11:52:43AM
Page3of4
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00304
IVR Number: 811143855184
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenler@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Iss ued
11/02/2010
ISSUED:
APPLIED:
11/02/2010
09/15/2010
EXPIRES:
VALUE:
05/01/2011
$10,000.00
SITE ADDRESS: 1206 QUINALT ST, Springfield, OR 97477-2621
ASSESOR'S PARCEL NO: 1703264116100
SCOPE: Garage Conversion
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Garage conversion to master bed/bath
INSPECTIONS REQUIRED ~
Inspections
1220 Underlloorframing
1260 Framing
Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1410 Underfloor insulation
1420 Insulation Vapor Barrier
1430 Insulation Wall
Wall Insulation: Prior to cover.
1440 Insulation Ceiling
1540 Gypsum Board/Lath/Drywall
1999 Final Building
Ceiling Insulation:' Prior to cover.
Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum
board, interior and. exterior are in place, but prior to plastering.
Final Building: After all required inspections have been requested and approved and
the building is complete.
Rough Mechanical: Prior to Cover
Final Mechanical: 'When all mechanical work is complete.
Underfloor Plumbing: Prior to insulation or decking.
Rough Plumbing: ,Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
2300 Rough Mechanical
2999 Final Mechanical
3170 Underfloor Plumbing
3500 Rough Plumbing
3999 Final Plumbing
4225 Service or Feeder
4500 Rough Electrical
4999 Final Electrical
Rough Electric: Prior to Cover
. Final Electric: Wh~n all electrical work is complete.
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 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.
-----~~/
./
Owner or Contractor Signature
~
((_? - /0
Date
Springfield Building Permit
11/2/2010 11:52:43AM
Page 4 of 4
,
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law 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. (ORS 701.055 (4))
This statement is required for residential building. electrical, mechanical. and plumbing 'permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.01'0 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
-0 I own, reside in, or will reside in the completed structure and my general contractor is:
k
"
~
Name
CCB#
Expiration Date
D I will inform my general contractor that all: subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
~
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board, If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
No. ~l..", N\-('0
Print Name of Permit Applicant
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;::;' Signature of p~rmit Applicant , Date
1:' /5"'-1 cJ
Permit #: S 10 <30 (...1
Address: 120 G QcM \J........... \.r
Issued by: ~Date:
sff:L-~ 191L q'lLl'17
This Copy for Permit Offices
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00304
1206 QUINAL T ST
CITY OF SPRINGFIELD
225 Fifth St
Springfleld,OR 97477
541~726.3753
perrnitcenter@ci.sprlngfield.or.us
RECEIPT NO: 2010000726
RECORD NO: 8II-SPR20IO-00304
DATE: 11/02/2010
,Branch circuits with service or feeder each circuit
~~~ce of ~~,~imum Plumbin~ Permit Fees
~jrst~~p'~~,nce Fee
Services 200 amps J?r less
-State of Orego~ Surcharge (12% of aEplicable fees)
Technol09Y fee (5% of permit total)
,~>'~;: At ,'_ i$~c:,c;_6JJ:~j:..t.QOE-',--~::--:~MOJ.it:lJJiU:E~:
442-00000-448024 $645.92
719-00000-426604 $49.68
443-00000-448025 $347.68
224-00000-425603 $19.00
224-00000-425603 $19.00
224-00000-425602 $136.00
224-00000-425603 $19.00
---,-,--,,--
224-00000-426102 $18.00
_--'- ___~-00~00-4~5603 $1.00
._____~~4-00000-425604 $79.00
224-00000-426102 $81.00
821-00000-215004 $44.64
100-00000-425605 $18.60
TOTAL DUE: $1,478.52
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tQ.~_$j;}~!E.TIQN" 0.,:if5i::i' "~ :o-j "'~'1;:-"::~~z:.;,,~~',;- ~~",~)~ ~-<<S', '
sac: Reimbursement Cost ~ Local Wastewater
SDC: Total Sewer Administration Fee
SDC: Improvement Cost - Local Wastewater
Shower/Shower pan
Sink/basin/lavatory
Structural Building Permit Fee
Water closet
r- P.AYMENT_T-Y-PEi~~~I'AY6R,,_ _ Cj\~;HIER::CCARPENTER-";StOMMENTS-7--'
_." _ '~.,d..___,=.
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Check
843
ALLEN NATHAN D
$1,478.52
$1,478.52
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SF'R2010-00304
1206 QUINAL T ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726.3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2010000324 RECORD NO: ,811-SPR201O-00304 DATE: 09/15/2010
tQE.$C BIf"nQ~':" .;: ~X":",~;".2i". "".~:~ l~ .~;: ~;f:~ f~'~; ,~/ :;s}2~<::<i6.IJNJ~C:'ODE;': -;;:Y''':-:- "'re!:MPUNJ'OYE "
Structural Plan Review Fee Residential 224-00000-425602 $88.40
TOTAL DUE: $88.40
1:"PAYMENr;ftif'E._ : PA.Y6Rg'Si6!sH1~~.CC~RPEi{j-~.f0'J\'G."-1'i1r~'L~~;rs-'~~i"Y~-,,:,:,/: . : r..ANfPUNTf'AIO" . .~)J
Check
869
ALLEN NATHAN D
$88.40
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$88.40
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TRANSACTION RECEIPT
COM2009-00041
205 57TH ST
CITY OF SPRINGFIELD
225 Fifth St
Springfleld,OR 97477
541-726.3753
permitcenter@ci.springfield.or.~
RECEIPT NO: 2010000735
RECORD NO: COM2009-00041
DATE: 11/03/2010
H)ESCRIPTION\""*'i_;-~-~';~ -:.p: :."ir1, :i-_ii~~--;, -. :;--. - -;" ~!<~.0JjNtC~o.QE- -, .-;;E';~~M9UJ-IJ;[(t~_: -J
Inspections - Hourly Building 224-00000-425602 $58.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $6.96
Technology fee (5% of permit total) 100-00000-425605 $2.90
TOTAL DUE: $67.86
Le.AYMEt((-TYP.I:~-fl8X.QB1;CAS':nE,,:NMAcHADO:' . . 'C.0MIVIENJS,-S.:;/;-:i,=". . " PAM()lJN'(P~ID, .1
Check
1355
BENSON DEVELOPMENT
$67.86
$67.86