HomeMy WebLinkAboutPermit Building 2002-3-19
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Job# 02-00187-01
Page 1 of 2
TRANS#:Ol-0008341
DA iE : I1Af;: 19 2002
AMT RECD~2 $ 176.56
CHANGE:
CASHIER:QOl
225 Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00187-01
Office: 726-3759
Inspection Line: -726-3769
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Location Of Proposed Site: 5077 Forsythia Dr Spr
Assessors Map#: 18020422
Lot: Block: Addition:
Owner:
Address:
Tax Lot #: 02000
Subdivision:
Robert Slaymaker
5077 Forsythia Drive
Phone Number: 541-726-5470
City/State/Zip: Springfield, OR 97478
Alteration Value: $5,000
Scope Of Work: Garage Conversion
Contractor Type
General Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Contractor
Robert Slaymaker
5077 Forsythia Drive, Springfield, OR E.\NO~"
97478 .. C' ... O\t\€. \r~ \c. NO\
"-\ 0 \ \ C ..:: eW'-\..\.. \.-1.. c ?€.~\\j'\\
i - \C;p~<<w.~ ~O€.? \ \-\~... ON€.U rO~
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Begwo s: o~'{?t;.
Ra~':{ "leG
Registration #
Expiration Date
Phone
541-726-5470
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769, All inspections requeS~\bbefore 7:00
a.m, will be ma<;le the same working day, inspections requested after 7:00 a,m. ~{~l!%l'ffi~~\\'ihe following
working day. \8.'l'Jta~te<}O~ ~\o(\"
. J'\te~ ~ \"e '" ate 5e n.C\O'\-
, ReqUired 1~~It1~8'-~'setJ,t ~'f\.jJ- sl>'i
I Wii~ ;~9'j~"~t~C)"~\ \"e t~~~e
- After trenches are excav~1c&\\O~ ~~~~~ CO\l\~~"e \e\e~\ca\\O~
-After forms are erected 1AA3'ii.~~~~\lt~R~\\'l"'O~
- Prior to decking. \~ 9O,~O\) ~8ce~\! ~'e9,O'(\ 'J ~?/1.ry.,A~'
-Prior to cover. 00 ~\\~C)\ot\"e?\.~oO-'3
- Prior to cover. C\)((\'06t ce(\\8t \9 '
-Prior to Cover ~
-Prior to taping,
- To be made after insulation and required vapor barriers are in place, but prior to any wall coveri
- When all required inspections have been approved and the building is complete.
Footing
Foundation
Floor Insulation
Ceiling Insulation
Framing ,
Wall Insulation
Drywall
Vapor Barrier/Insulation
Final Building
Rough Electrical
Final Electrical
Electrical
~ Prior to cover,
- When all electrical work is complete.
I Job# 02-00187-01 I
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Page 2 of 2
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Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plan Check
02/19/2002 8080
03/19/2002 8341
Value/Quantity
Fee Amount
Residential Plan Check
Hourly Plan Review
Total Plan Check
5,000
1
$44.46
$45.00
$89,46
Building Permit
State Surcharge For Building Permit
8% Building Administrative Fee
Total Building
Building
03/19/2002 8341
03/19/2002 8341
03/19/2002 8341
5,000
$68.40
$4,79
$5.47
$78.66
Minimum Electrical Permit Fee
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
8% Admin Fee - Electrical
Total Electrical
Grand Total
Plan Check Type
Electrical
03/19/2002 8341
03/19/2002 8341
03/19/2002 8341
03/19/2002 8341
2
$.00
$46.00
$3,22
$3,68
$52.90
$221.02
Checked By
Date Completed
Comment
Structural-Res
Bob Barnhart
03/18/2002
Mr. Slaymaker has brought in plans on three
different dates the latest being 03/14/02 which
was a revision to the previous set. So the ten
working days started on 03/14/02,
By signature, I state and agree, that I have carefLilly 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 701.055 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
ap roved set of plans will remain on the'site at all times during construction.
~1~
BJj0)02
" c.-' v
Date
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759,
ELE,- ..JCAL PERMIT APPLICATION
City Job Number' 6 Z - 00 It! 7 -0 I
3, COMPLETE FEE SCHEDULE BELOW
1. LOCATI()N OF IN.STALLATION , ".
0011 PCJr?xJ"~' Diffie fol/owino n;~'jec! a<: A... NewResidentia1~Single or
zoning ~ SUumltfed has ~f' I'''''''; . ..
and does no! require spec'f' 1ft ":1"uft9lily per dwellIng umt.
approval I IC and .use.
LEGAL DESCRIPTION /\?r""v"~ Lbr/t. ervlce-mcluded:
I gOz. 04'C-2- u~&clng_ ' ~ Items Cost
Date ~ -- i: t;) -=--0 <'4) ",,'- --====
4_ t r (/"
JOB~~~\.C~Jl~~ flUlllfJrlzerl SIt1Flr,-L , . 1001j '''l'ft. et:-less
r:::ruu ITMTI c::-"'L. ., W ; fl}l'" 9~- 'P<ll;h additional 500
/ sq. ft ~r p~n
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manufd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. ;' ".J . ~'I Service or Feeder
'OIICI 'Ii"
'/0-" '. '1ft i (llr --'oJ'if-JrF.1
2. CONTRACTOR INSTALLATIOij'!QW~f;:'-, '''~n]/#C:I~{a>n;. pr Feeders
"j,( f:.. oJ,',~ ~f?fj/5:" "'lI7/t)P.il,
:]09 . '7 ,~", :, <I!'ll' , ' tG(5)J}st'a'lfa't!m, Alterations or
Electrical Contractor _ O. Yo~'<~O[h'.r ~f: rf-iff~1f/a~fi~!fe8]A..
J}'.l"'Ci//ifjo .t:, rti<:Jy ~ j~YfJ ih'J~(y flJle regOtt 'OlJ to,
Pho!:>,""' ::;: "'1'\ fjeLjl(~ rOO!~1PS~ojv1<>
.... C 'A'..J0J" VV f;--:Jo ~7!lI U~ I/J(::}
".'}"". ,.,:~;;-~, "1'~~n:qsi5J
-{':;"""'111rn.0 ~'O' i
City Phone (" /' I.; .Y,~, ;;;;:O)';":"UiWP~~ "
Supervisor License' Number t(J,;'( " "i, ;;'OtJ,~':;~~' a
. l:r ;1t;
Expiration Date ,'./
Constr Contr. ~er ' \
SUlJl
$106.00
$ 19.00
$ 50.00
Address
$ 63.00
$ 75.00
$125.00
$163,00
$375.00
$ 50.00
C. Temporary Services or Feedets
Installation, AlteratIon or Relocation
Expiration Date
200 amps. or less
201 amps. t0400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above '
$50.00
$69.00
$100,00
Signature of supe"Visin~~~~an
life A ~o
/JlJrJj(J. ~IJ/!;;Ir
.~~">_ ~Su--
I\. \ 'I: , .""t!f} L ' D. Branch Circuits
Owners Name [\\ 'b .v" ,'1(P/RE' New Alteration or Extension Per Panel
S (\ ..l.' ... '. ,'H I' Ii/S p. IF '1/. '.", ' I
Address. · U1, fOrD\) , ilJ/ ~Atufa 'fflli1l,'€JrWtJi},9Pit $43.00
SpY, LA11 I., ~I:l"\ ~tff!) /$/l.I.iF;
City . .. \ r1ttWtl?I_Phone 1 Z-la /"../"11 () . f"08ac1{Jl'dditional Circuit or with Service ?
U or Feeder Penuit I $ 3.00 ....>
OWNER INSTALLATION i
The installation is being made on E. Miscellaneous (Service/fceder not included)
property I o\vn which is not intended -Each installation
for sale, lease or rent. Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Liinited Energy/Comm
L(S
:;?\a;:;;;~~
~ J'
$50.00
$50,00
$25.00
$45.00
Minimum Electric Permit Inspection Fee is S45.00 + Surcharges
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4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL
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