HomeMy WebLinkAboutPermit Building 2010-12-2
Structural Permit Application
DEPARTMENT USEbNL Y
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225 Fifth Street. Spdngfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
Date: J
- Z -/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.
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This project has final land-use approval.
Signature: Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verified: DYes D No
Property is within flood plain: DYes D No
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Resid"entiaJ/ D Government D Commercial
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\ . Job.site.address:: _'fI _c./YMI!< /II A s:
City: 'S Il./ ~\'"
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State:
Fax:
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I E-mail:
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(<.: 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 u~ 701.0
Sign bere: ..-, ~
CONTRACiI;Q . A~1n:Al,LA1l9Nf. ,,'
Business name: OW #lFfL
Address:
.\
City:
Phone:
E-mail:
CCB license no.:
Print name:
State:
Fax:
ZIP:
Signature:
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Name CCB License Number Phone Number
Electrical ....n}...
Plumbing '"
Mechanical
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(a) Job description:,j.....
Occupancy e. "1
Construction type: cr
Square feet:
Cost per square foot:
Other information:
Type of Heat: (!t.(t'C.. T
Energy Path:
o new ~teration
(b) Foundation-only permit?
~l."-
D addition
D Yes ~o
Total valuation:
~l~~JJ.~U~Ing:JeA~~t~lfu~~:tfli~iir~G:0g1~k~~$it11.~~t:';,:i~h~);~:!~J:;i3Aji:i~,_A-~';I' ,>.
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
$
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]): $
(e) Subtotal of fees above (2a through 2d): $
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(a) Plan review (65% x permit fee [2a]):
(b) Fire and life safety (40% x permit fee [2a]):
(c) Subtotal of fees above (3a and 3b):
'"
(a) Seismic fee, 1% (.01 x permit fee [2a]): $
TOTAL fees and surcharges (2e+3c+4a): _S
CITY OF SPRINGFIELD
Building [ Residential Permit
PERMIT NO: 811-SPR2010-00816
IVR Number: 811144660639
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/09/2010
ISSUED:
APPLIED:
12/09/2010
12/02/2010
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
. permitcenter@cLspringfield.or.us
EXPIRES:
VALUE:
06/07/2011
$3,000.00
SITE ADDRESS: 4146 CAMELLIA ST, Springfield, OR 97478-5951
ASSESOR'S PARCEL NO: 1702323303000
SCOPE: Interior
WORK INVOLVED: Remodel
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Interior remodel
Phone Number:
OWNER:
ADDRESS:
JONES THOMAS
4140 CAMELLIA ST
SPRINGFIELD OR 97478-5951
Contractor Type
Contractor Name
CONTRACTOR INFORMATION I
Lie Type'
Lie No
Lie Exp
Phone
# of Units:
BUILDING INFORMATION I
# of Stories:
Height of Structure:
Type of Heat: Wall Heat
Water Type:
Range Type:
Hazmat: No
o
# 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:
No
No
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
A TTE:~~fjb<ft!~J;~ .
10lJowSq Ft c"r~ort:gon law requires you to
I ules aaopted by th 0 . .
NotllicSn.fi,t Other; Th 1) e regon Utility
\..:;;.~ I VCI Jlvr ose ruI
in OARC!ecu - n t~ d es are set lorth
0090 v ~iU ROv ,'!) fhrough OAR 952-001-
. IOU may obtam copie I h
calling the center. (Note: t~~ t~':;~~~ebY
numberclor the. Oregon Utility Notillcation
enter IS 1-800-332-2344).
2008
Site Information
I
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
No
No
No
No
No
Springfield Building Permit
12/9/2010 1:59:26PM
NOTICE: PIRE \F 1HE \NORK
THIS PERMIT SHJI,l~ ;X\-\\S PERMIT IS NOT
Jl,UTHORIZED UNDES Jl,BJI,NDONED FOR
COMMENCED Op~~IOD.
Jl,NY 180 DJI,Y
Page 1 of 4
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www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00816
IVR Number: 811144660639
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
ISSUED:
APPLIED:
12/09/2010
12/02/2010
EXPIRES:
VALUE:
06/07/2011
$3,000.00
12109/2010
SITE ADDRESS: 4146 CAMELLIA ST, Springfield, OR 97478.5951
ASSESOR'S PARCEL NO: 1702323303000
SCOPE: Interior
WORK INVOLVED: Remodel
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Interior remodel
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
DEVELOPMENT INFORMA TION ~
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:
Sp'eciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Descriotion
Bid
Tvee of Construction
NA
Unit Amount Unit Tvee
3,000.00 Bid
Unit Cost
1.00
Value
3,000.00
3,000.00
FEES PAID
~
Descriotion
Structural Plan Review Fee Residential
_._<< -.
Clothes washer
Water heater
Structural Building Permit Fee
Balance of Minimum Plumbing Permit Fees
First Appliance Fee
State of Oregon Surcharge (12% of applicable fees)
!"echnologtfee (5% of permit total)
Total Amount Paid
Amount Paid
$44.04
$19.00
$19.00
$67.75
$20.00
$79.00
$24.57
$10.24
$283.60
Date Paid
12/02/2010
12/09/2010
12/09/2010
12/09/2010
12/09/2010
12/09/2010
12/09/2010
12/09/2010
Receipt #
375025
375095
-----
375095
375095
~-,._-
375095
375095
375095
375095
Springfield Building Permit
12/9/2010 1:59:26PM
Page 2 of 4
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00816
IVR Number: 811144660639
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
Issued
12/09/2010
12/09/2010
12/02/2010
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci,springfield.or.us
EXPIRES:
VALUE:
06/07/2011
$3,000.00
SITE ADDRESS: 4146 CAMELLIA ST, Springfield, OR 97478-5951
ASSES OR'S PARCEL NO: 1702323303000
SCOPE: Interior
WORK INVOLVED: Remodel
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Interior remodel
Plan Review
I
Deoartment
Application Acceptance
Received Due Date ComDleted
12/02/2010 12/02/2010 12/06/2010
Result
Application Accepted
Reviewer
David Bowlsby
Public Works Review 12/06/2010 12/08/2010 12/07/2010 Approved Todd Singleton
Comments: Received 12/6/10. Interior only, no new fixtures. No PW issues.
Structural Review 12/06/2010 12/06/2010 12/07/2010 Add'llnfo Required Chris Carpenter
Comments: Need information on energy compliance- called owner 1217/10.
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G~~~~:~::e71~te,~1~r~;66?el';~~06~~~;~~,~i~ij~;~"t:3~?6:;0~~.~:' '.., .~,~~c_ 'D.~yette K;I!Y:;;>;:::~::;_~~~:J~':'.i
Permit Issuance 12/08/2010 12/08/2010 12/09/2010 Issued Nancy Machado
INSPECTIONS REQUIRED I
Inspections
1260 Framing
Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
Wall Insulation: Prior to cover.
1430 Insulation Waif
1440 Insulation Ceiling
1999 Final Building
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and
the building is complete.
Rough Mechanical: Prior to Cover
2300 Rough Mecha,nical
2999 Final Mechanical
Final Mechanical: When all mechanical work is complete.
3500 Rough Plumbing
3999 Final Plumbing
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Springfield Building Permit
12/9/2010 1:59:26PM
Page 3 of 4
SP~IN..G..fIEL~
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.}c,;,"C>;"''-" OR,EGON
www.cLspringfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00816
IVR Number: 811144660639
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:
155 ued
12/09/2010
ISSUED:
APPLIED:
12/09/2010
12/02/2010
EXPIRES:
VALUE:
06/07/2011
$3,000.00
SITE ADDRESS: 4146 CAMELLIA ST, Springfield, OR 97478.5951
ASSES OR'S PARCEL NO: 1702323303000
SCOPE: Interior
WORK INVOLVED: Remodel
TYPE OF STRUCTURE: Residential
. PROJECT DESCRIPTION:
Interior remodel
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 1 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
constructi n.
'7
(J o? J{)
Owner or Contractor Sig ature
Date
Springfield Building Permit
12/9/2010 1:59:26PM
Page 4 of 4
www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00816
4146 CAMELLIA ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
pe rmitce nter@ci.springfield.or.us
RECORD NO: SI I-SPR2010-00S16 '
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224-00000-425603
224-00000-425603
224-00000-425602
224-00000-425603
224-00000-425604
821-00000-215004
1 00-00000-425605
--~._--~----
TOTAL DUE: $239,56
~~~;Y;M.E"!:1.:Iy:gE::ZFj ..~M.j')J~~i.CAS~IER"~MACHADO'c:col'v1fviENJcS~~,:1;::1:i~i:&:i!l: Ji6M.ouIiJ~~~.I[);;'.i~~:J
RECEIPT NO: 2010001012
DATE: 12/09/2010
lDESCRlfITfON' ,
Clothes washer
-~-
Water heater
Structural BuildJ!2~ Permit Fee
Balance of Minimum PI:!mbin~ Permit Fees
First Applianc~ Fee
State of Oregon Surcharge (12% of applicable fees)
Technolo~y fee (5% of permit total)
- ~'_AMQQN:ti:D(JE ,-', .,'':'::",;]
$19,00
$19.00
$67,75
$20 00
$79,00
$24.57
$10.24
Check
7892
JONES THOMAS
$239,56
$239,56