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Home My WebLink AboutPermit Building 2010-12-30 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2009-003B7 IVR Number: 811000051734 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 12/30/2010 03/24/2009 Issued 12/30/2010 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci.springfield.or.us EXPIRES: VALUE: 06/28/2011 $272,851.00 SITE ADDRESS: 756 28TH sT 758, Springfield AssEsOR's PARCEL NO: 1703361111300 SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTil DPA has been paid - SEE CASE 811-5PR2010-00298 FOR PERMIT EXTENSION. PROJECT DESCRIPTION: Phone Number: OWNER: ADDRESS: DUKES & DUKES CONSTRUCTION PO BOX 71095 EUGENE OR 97401-0182 CONTRACTOR INFORMATION Contractor Type Plumbing Contractor Mechanical Contractor Contractor Name DENNIS SCOTT EGGERS PACIFIC AIR CONTROL INC EASTSIDE ELECTRIC INC DUKES & DUKES CONSTRUCTION CO Lie Type CCB CCB ELECTRICAL CCB Electrical General Contractor ~ lie No lie Exp Phone 142776 05/05/2012 541-459-0110 164092 04/18J2011 206-682-6393 20-405C 07/0112011 541-741-1499 .65060 03/16f2011 541-747-3130 BUilDING INFORMATION ~ # of Units: o #"of Stories: Height of Structure: Type lof Heat: \ Waler Type: Range Type: Hazmat: \. , \ , 2 24.50 FE Construction Type Occupancy Type Occupancy Comments U E E # of Bedrooms: Sprinkled BUilding: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical s~ecialty Code Edition: Municipal I DeJelopment C~de: plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: 6 004A Lot Size: sq FI 1 sl Floor: sq Ft 2nd Floor: Sq Ft Basement: sq FI Garage: sq FI Carport: sq Ft Olher: Occupancy Load: 990 1490 480 o Site Information ~ Engineered Fill: Fill Volume: Flood Hazard ArCa1'TENTION: Oregon law requires you to land Hazard Art.!low rules adopted by the Oregon Utility Retaining WauNotification Center. Those rules are set forth Soils Report R~q&M;li': 952-001-001 0 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). NOTICE: . ,..' .." K THIS PERMIT SHAll EXPIRE IF THE W~~T AUTHORIZED UNDER THIS PERMIT \S COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Bui!ding Permit 12/30/201 3:04:29PM . Page1of7 SP~I~N. ..~fIE~ .~~~ -/ff".' ~ :,'~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2009-00387 IVR Number: 811000051734 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: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 12/30/2010 SITE ADDRESS: 756 28TH ST 758, Springfield ASSESOR'S PARCEL NO: 1703361111300 SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTIL DPA has been paid - SEE CASE 811-SPR2010-00298 FOR PERMIT EXTENSION, I DEVELOPMENTlNFORMA TION ~ PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 12.20 12.75 31.80 Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: 3 Yes 26.70 REQUIRED PARKING Total: 4 Handicapped: Compact: 19.00 PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted:' Notes; Roof drains connect to private 10" storm. Impervious to private bio swale via valley gutters. Sidewalk Type: Downspout/Drains: Valuation Description , Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value Springfield Building Permit 12/30/201 3;04:29PM Page 2 of 7 .- www.ci.springfield.or.l.Is CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2009-00387 IVR Number: 811000051734 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Issued 12/30/2010 ISSUED: APPLIED: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 SITE ADDRESS: 756 28TH ST 758, Springfietd ASSESOR'S PARCEL NO: 1703361111300 PROJECT DESCRIPTION: SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTil DPA has been paid - SEE CASE 811-SPR2010-00298 FOR PERMIT EXTENSION. FEES PAID I Descriotion Amount Paid Date Paid Recio! # SDC MWMC Reimbursement $195.80 0812512009 1200900000000000983 .~.- ------ SDC MWMC Improvement $2,018.34 0812512009 1200900000000000983 SDC MWMC Administration $10.00 08125/2009 1200900000000000983 -~-~.._....,~- .-..".,.-.---....-.---- '-"-""-~-''''- ---~ + 12% State Surcharge $45.72 02/22/2010 1201000000000000157 Residence Wiring Ea Addtl500 $50.00 02/22/2010 1201000000000000157 Residence Wiring 1000 Sq Ft $288.00 02/22/2010 1201000000000000157 + 5% Technology Fee $19.05 02/22/2010 1201000000000000157 Temp Power 200 amps or less $63.00 02/22/2010 1201000000000000157 Refund - Surcharge $6.05 03/1212010 160859 Refund - Electrical $50.40 03/1212010 160859 ,----~------_.__. ,~-_._-, ~_Bath... ~~_~!.wo_;=,,~L_ ._~8.!l~~1!..._____.__ 12/30/2010 202l!,001187 Plan Review Residential $918.36 12/3012010 2010001187 .--,---_.- -_.---- -_.- -'-"~-'-~"-'-~'-'-'--~---- ._._---~ .'.- -.---- -- + 5% Technology Fee $133.49 12/3012010 2010001187 Plan Rev.!.~:-:,_ Major - Planning $211.00 12/30/201--O------~-20~000~ 187 SDC SanitarylStorm Admin $272.62 ___._._1~~0~!l1.!l_..._._. _~O!..OOO1.2!!!_ SDC Transpo Reimbursement $403.08 1213012010 2010001187 - - Sanitary Sewer-Improvement $1,135.98 1213012010 2010001187 Sanitary Sewer - Reimbursement $1,493.92 12130/2010 2010001187 Storm Drainage Impervious Area $1,381.68 12130/2010 2010001187 SDC Transportation Admin $148.22 12/30/2010 2010001187 SDC Transpo Improvement $1,777.96 12130/2010 2010001187 + 12% State Surcharge ___.___ _____...!~______ 12/30/2010 ___.~_ 2010001187 Willamalane Attache~ex) .__~__~____ $6,2EO'00 .12/30/21!2Q.. _ ______~I!}OOE1187 Addressing Assignment $76.00 12/30/2010 2010001187 --"._----~_.-.~...-~--_._._..~~----'---_._-----_......- '--'-- - ----. --- Gas Outlets 1-4 $7.00 12/3012010 2010001187 ----'""~---,_._..._--_.- -- .-- - -- Firepla~J!:isted) _____.. $40.00 . 12130/2010 ...3E_l000l!87 Dryer Vent.._ . .~___ $18.00 12130/2010 2010001187 Exhaust Hoods $2600 12130/2010 -----2010601187 Vent Fan $72.00 12/30/2010 2010001187 1st Appliance $79.00 12/30/201 0 2010001187 Building Permit $1,412.86 12/30/2010 2010001187 Fire SF Fee - Residential $148.00 12/30/2010 2010001187 Total Amount Paid $19,780.59 Springfield Building Permit. 12/30/201 3:04:29PM Page 3 of 7 ...::-;~~. <;. ....~.....-...... . ..>- 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 CITY OF SPRINGFIELD Building I-Residential Permit www.ci.springfield.or.us PERMIT NO: COM2009-00387 IVR Number: 811000051734 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 12/30/2010 PROJECT DESCRIPTION: SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTIL DPA has been paid - SEE CASE 811-SPR2010-00298 FOR PERMIT EXTENSION. I Plan~view ~ SITE ADDRESS: 756 28TH ST 758, Springfield ASSESOR'S PARCEL NO: 1703361111300 Department Initial Review Received Due Date Completed 03/24/2009 Result APP Reviewer LLH ?t~C}9r\~I.~~~+~;Yit:$~;:~~~~,:f'b~~::~t4k~~,?~h~4"~':'_.~ :.: ~-:~~~:- ~ 6~g!!~02.~ .~ .::. ~~ ~- (~;Jt~ 0~~ ~~}"~';~':* ~~~:;9;; ::~:.>gt; ;~*;---:J~"2*~~~S "'~'ffj~ ,." ";Commerts:, ...Need :ne\'~ls~ealW~lJ:engineerin~~ 'Callec'David:pukes.1 qAM3/27f09jEn~in~erilig'Re-cieved'~f2f09-: fleeds wefstamp- and :i~ ,~~.'-!ili "'~c.9f~Pt~5-tdie_~~.(~hgpri1~tea~Dg!!le.~r;'11~[Qj3~WiTI ~~RRrO~ftP..~.rIJ1.l!J:lpJ}n Hfc~p.u <,:: _'.'.' .'< ~, . . t, "0" <: ~ ," - i ,. "1<' ' '.~ Public Works Review 03/30/2009 APP TSS ~ Comments: Roof drains connect to private 10" storm. Impervious to private bio swale via valley gutters. [Pianning"Revie'vt .., c',".~'T:~""" '..". ;:<--::'~'7-"~ r,'G~~~+~<03/3112009'..' "APP - t,..-.... ~--:-:.~.. :"'"~DDK ,; ~,~;" --~---:-~ ;"1"".' ('., '.' ! ..' . .w.o~: .. -- ., "."~.'__'.. '. ... ,'.". e.'","(;'-- ',.". .:. ".".' " . . '__ ~.' .. ._' '.. .," . __"'" ',' ~ . ~. i" ~oi11i11ents: ,:"p.r()j~cUo.~'e'con,structed:as s~own onfinaj:4ite.p.tans fo~ q~~2995..00072:. Oq:9.11Pc,kNCY WILU~~:nBS9}YI;f'J;UNTIL ,'., ( . '" ,. );rHE SITE,;MP..BO. V~MENTSA.~E.Ii'J ",N2"IN,S.PE.C;TED BY J'LANNINGo EJJ~,9~~~lteK""Y~@~,45-4.g;~fo",fin~ls;te . 't.' ",'d~:insp..~.f1Lon:'jtJ7Le__q~g~g~y.e....18 hg.ur~j}J()Jlq~~ "7 ",.. ,0 '-.' ~. r . .l~~~~~~~"",,:,:::~~______ ~_ ___J Structural Review 04f24/2009 APP CJC Comments: As noted on plans I conditions letter ..~ ~, .., ". _ -,,~'.='t':"-"""""~'~ App~c~tLon,e..cceptan.c~:-:,;>iL~~,;:c -:., "iOB/.12/2010 "OBf25f~009-(. ,O~fe.~re?{~~~I])~Qt f.~ ""~ R~vlc:i.E3,2y.'I?by ~, _....P,.".,.."":(:,_+:i",".".~,:!";".','.~i~7: i;~;' -- h'::~1f~;::J~ 't,};_. -- .....-,..,;;,. "':,C< " 'iii. ;.-..1!c;y,., :;.;.~,~~"~ ~ '\ ''''':'-~'<~v,':~:c'", ..",0;1 .'J ., i " " ':J Deferred Payment Agreement 08/25/2009 OK DJB 02/22/2010 OK DJB Print Permit Comments: issue electrical only ~E~@'i~D~n-ce~ : ":~~lj1t-~;~?~<:..:~.:.;s,~:,:,\.-- ~. ,. ..', __~:~98(r:i?~~:r[5'~f~~~~~1~~;;~,~::,:"'_t,'" S~:~~a~ni~~rge~~::;r ~,~:~~ .~ .:~~"~. -':~-~.-;:--T,~-' r~C~?m m:n~? . AII'inSP~~1~0~:+~X.~~pt. ~ina~, ~can'~e~o-n'~Y~!~.2,~~~,; qf.P' ca~n9t~ qej~S,lJ~,d:U~t!I~~ttjn~p~~~ons are comple.tt;.':a~d,~d~fe!r:~c1 . ~ b '. '.' " ",'p':ayment,!s,recelved. ;~>,,;, . :~~ .~;' .>'7J1Gmt__ ~'.' -\ , l~.l:.:.:~ ,,_:. ___:':;J-~..;,",__ _'_ Inspection 11/05/2010 In Process Guy Dixon Comments: Inspection in process -- ""~ ~ Inspection Comments: Inspection in process 11/05/2010 In Process Robert Castile Inspection Comments: Inspection in process 12/20/2010 In Process Guy Dixon ",+' S [Fm Springfield Building Permit 12/30/201 3:04:29PM Page4of7 SPR. IN.G..FIE L~.D . . ~~ -., .~ i ~'I' "~K,, OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building' Residential Permit PERMIT NO: COM2009-00387 IVR Number: 811000051734 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: 155 ued 12/30/2010 ISSUED: APPLIED: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 SITE ADDRESS: 756 28TH ST 758, Springfield ASSESOR'S PARCEL NO: 1703361111300 PROJECT DESCRIPTION: SCOPE: OUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex. DO NOT FINAL UNTIL DPA has been paid - SEE CASE 811-SPR2010-00298 FOR PERMIT EXTENSION. Inspection Comments: Inspection in process 12/29/2010 In Process Guy Dixon Springfield Building Permit 12/30/201 3:04:29PM. Page 5 of 7 .. SPR..I..~G,=?ij ~.,\.., "'""OV -,"< ". '.-.,,,"':,;;;1 ,~I,,>- ~'_ O~EGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Residential Permit PERMIT NO: COM2009-00387 IVR Number: 81.1000051734 pe rmitce nter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 12/30/2010 PROJECT DESCRIPTION: SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTil DPA has been paid - SEE CASE 811.SPR2010.00298 FOR PERMIT EXTENSION. SITE ADDRESS: 756 28TH ST 758, Springfield ASSESOR'S PARCEL NO: 1703361111300 INSPECTIONS REQUIRED ~ Inspections 1120 Foundation 1170 Post & Beam Foundation: After forms are erected but prior to concrete placement. 1110 Footing 4120 UFER Ground Post and Beam: Prior to floor insulation or decking. Footing: After trenches are excavated. 3500 Rough Plumbing 3200 Sanitary Sewer 2300 Rough Mechanical 4220 Electrical - Service Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Rough Mechanical: Prior to Cover 1410 Underfloor insulation 1260 Framing Framing Inspecti';ln: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. 1430 Insulation Wall 3170 Underlloor Plumbing 4500 Rough Electrical 1110 Footing 3400 Storm Sewer Underfloor Plumbing: Prior to insulation or decking. 2300 Rough Mechanical 1020 Zoning/setbacks 1170 Post & Seam Rough Electric: Prior to Cover Footing: After trenches are excavated. Storm Sewer Line: Prior to filling trench. Rough Mechanical: Prior to Cover 1170 Post & Beam Post and Beam: Prior to floor insulation or decking. Post and Beam: Prior to floor insulation or deck!ng. 1410 Underfloor insulation 3200 Sanitary Sewer 4220 Electrical - Service Sanitary Sewer Line: Prior to filling trench and including required testing. 4220 Electrical - Service 1996 Final Inspection - Planning 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. Final Plumbing: When all plumbing work is complete. 3999 Final Plumbing Springfield Building Permit 12/30/201 3:04:29PM Page 6 of? www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2009-00387 IVR Number: 811000051734 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: Issued 12/30/2010 ISSUED: APPLIED: 12/30/2010 03/24/2009 EXPIRES: VALUE: 06/28/2011 $272,851.00 SITE ADDRESS: 756 28TH ST 758, Springfield ASSES OR'S PARCEL NO: 1703361111300 PROJECT DESCRIPTION: SCOPE: DUP WORK INVOLVED: NEW TYPE OF STRUCTURE: RES Duplex - DO NOT FINAL UNTIL DPA has been paid - SEE CASE 811-5PR2010-00298 FOR PERMIT EXTENSION. 4999 Final Electrical Final Electric: When all electrical work is complete. . Final Electric: When all electrical work is complete. Final Electric: When all electrical work is complete. Final Electric: When all electrical work is complete. Final Electric: When all electrical work is complete. 4999 Final Electrical 4999 Final Electrical 4999 Final Electrical 4999 Final Electrical 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 loc~ted at the front of the property., and the approved set of plans will remain on the site at all times during construction. )"2< ~~t~" Owner or Contraelignature 'j€J. J ! -=:2 -3 c ~<D / 0 Date Springfield Building Permit 12/30/201 3:04:29PM Page 7 of 7 $FRlhiGFlEL.P _,,"'~l:~;;&8i ji...J/.)N . 005 ~":,"'~"-:k~,,~., . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689' ~ :. . .;.:::: / BUILDING DE\'r.l{1 MEN! City Job umber' 20&(; b Date /ij ~/1-76 . . 1 & 2 Family Dwelling or Accessory / 0 Demolition o Multi-Family 0 Addition/Alteration/Replacement 0 Other o Commercialllndustrial' n T",nn,nt Imp~overnent JLOobt Address 7 .~~/ 7 '7 f? /U, 2 f1"#' $7: Subdivision .. .-- RC:---- 1 Project Name . Description of Work/location on premises/special conditions o ~:-rp/ir~~'~ty".:tt7oiZh~~:1~~~f~~~~:'~f~~~.~~~J:t~)1:;.~i;%1f2~~~~~:;i~:: Na~~'~ t/,.j~(;;;;;~."Jal<!';'-'~'.' Mailing' Address 2y_t;"7 t//)uJ.4 4/~ City P-/"1/"d ../' Slate f)~ Zip q 77"77 Phone' ~/~ 1111- 0 'lOt, Fax /"/7~ 3/"? 0 Owner Representative ~ VI tI dKl' (" Phone 77"'7- y?a Fax 7t/7- Y OCJ t'",4C.:f:;;'a.-:.:2. ?;/;:;:...."...",..< .....!iF;~.", o ~W~Pli~1~rt{r~~I~i~1~~~~~~jii~f~~1~%~~~~~Jf~ Name Mailing Address City Phone Zip State Fax o Name Address City Contact Person Zip State Phone Fax CCB# t,t) ~at i~;c:ig~n;r~:::;o~i~1tttt2)~rE;;;~~;i~~:~~~;;ii~;o/!h;{"(~~';~6;n:;. Water Heater I::!- Range f!- Energy Path Do you require any of the following for this project? . Over-width or Second Driveway 0 Yes ~o Temporary Power 0 Yes ~o Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon under rovisions ofORS 701 and mav be re uired to be licensed in the .urisdiction where work is bein erformed. :For Office Use:Only" I.' PLAN CHECK FEE 70 RCPT# DATE o General Plumbing Mechanical El;ctrical e. . a:.-C:; '" o ~fCo;;i;;,e,.Ci(lliliui""h:iizlP:rojeci{;; Has site review application been submitted? DYes 0 No 0 N/A Ifso, Name of Planner Journal Number Bldg No. Tax Maprr ax Lot Suite No. IIO'3J 61 ( 11-:30 C) Value ZlfS"':) ZD I ZI{ EO New Dwelling Area GarageiCarport Area Other Structure Area So Ft X $/SO Ft Z\{ 80 9 9- ~ 'Z,'=- ~ 4eo Total Value ~S8 OClc..:> .. ~IB~&ffi~if~~Jf!I~~ij~~tB~lz1fl~r~~ f.'i~j~~.I~~~}Q~~~~t:;_ii~~~lfij&2\~ SO Ft. X $/SO Ft = Value Existing Building Area _ - . New Building Area ~~\' Total Value Existing New 'Occupancy GrOlip(s) Const. Type(s) Number of Stories ~ J3f!ILDING PERMIT APPLICATION ~6 .vi) m.~\!J ~ d-(~ s~~r:~i1ditdt+. pli,";oo 1O-02.d" This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire jfwork is not started within 180 _.._.__~ysofissuanceorjfworkissuspendedforI80days. c ._._._.___ ._. .__ _llB[Qc;];!8[c;i!ZiYE~NMEl\lif'~e~RQYAL".ir~"I!:ili?"; Zoning approval verified? DYes D No ~(:;~mE(:{Q~YAIQitKQQNsttR(!j~mI0Nflll!;IIIEla:1fi IDesidential 0 Government 0 Commercial _~~!ZiBlsl'IfE~iN~&RfvIjl;mi()NI~Nr[lirQ6~tr:lQN"IIi!'iilt1j1\n Job site address: 7 S b 7 S& . 2g-f(... 'So City: Sl>F~' Slate:o.L. ZIP: <77477 Reference: //03.3 bl I Taxlot.: 1/100 ElectricalPermit Application 'i'~~ , ~ ,,-'.' ,;~ _"",,-.:.4' . ,-", '.4' ~lif, ,{ ..~" ."~' -,~ .~. .\),'....~~l :CITY~,OF SPRINGFIELD"OREGONe:" '. M'ijOl'.....,~'.~..::~_,_ '-, ,. td'~',,,,,~. ~*' ,~.,;."+"'''r>''-.- .jtT....,.M":.,;;J/if:-<J'fI 225 FifthStreet.Sp";,Dgfield, OR 97477.PH(541)726-3753+FAX(541)726-3689 1)..4\1"( ~ Address: c) IS 6 City: 'f:::rr.AG~e?VC;.- 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: "'.""_""'.'_."" ".--..'.'.r......... '. ...."....---..-1I- '..-----.'.Yi!J1i.'-l"'$j'ch "'''''''''''.''''._.'--'' 1~~C;el\lilj~c]T[QRiill\l$iI'Jl,lEI;l'NmQI\I~r~.iV:"".",iI!! Business name: E" 57 <; J () E ELf (,((; C Address: 3~lSJ 13oscA6'f U..lJJt City: 5 P ~ CD Slate: 0 ZIP: q 7 V 7 Phone: 5 / - 7'1/ -/ '1"19 Fax: - 7"){;, - '1(,0 E-mail: RK/C~JU75JOf 6' Y(lJjvD,r.O/i1 CCB license no.: J I"] 7 "2 () BCD license no.:.;l. 0 -VO.r ( ~7)7s OG-fj( Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440-2584-J '(9!08/COM) LDW, -z.OO <; - 003 F>7 Peront no.: Date: 2-1'7-10 Residential, per unit, service.included: . 1,000 sq. ft, or less (4) Each additional 500 sq. ft. or portion thereof z $134.00 $2~ ! $.5.0 $ z $ 25.00 Limited energy (2) $ 32.00 Each manufactured home or modular dwelling service or feeder (2) $. 63.00 $ Services. or feeders: installation, alteration. relocation 200 amps or less (2) . 201 to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 amps or vnlts (2) Reconnect only (2) $ 81.00 $ $ 95.00 $ $158.00 $ $205.00 $ $469.00 $ $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) $ 63.00 $ b3 $ 87.00 $ $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: ne-w, alteration, eXtension per panel a Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) Each additional brooch circuit $ 55.00 $ $ 6.00 $ Miscellaneous fees': service or feeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alleration, or exlension (2) Ea.cb,additinnal.inspection: (I) $58.00 $. ::;;:'...."flil""K~lT-"..SE'-- . ,,~.r;:J;f&: ,9~1~11;w.":"....:.~~~maj'~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ 63,00 $ 63.00 $ $ $ 63.00 $ (B) Enter 12% surcbarge (.12 x [A]) (C)Technology Fee (5% of [A]) TOTAL fees and surcharges (A through C): $:s'iS1 $1/57t $/'fl>S' $/.flf S f7 Willamalane Park & Recreation District' . , . Job. No.' illl.P€51 . . SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009 NAME: . \l\ \Ja. \:)\J'(oD . ADDRESS:t%~ \b\a.rd.-PcITY ~ LOCATION OF PROPOSED BUILDING SITE: Street Address: \ '5 \.0. . + \ 5r? . '21.:i't\.. .!Jt; . Tax Lot Number: 1JO~\ \ \~ PHONE: C\<6~{:AC(o STAT~IP:~ Plat Name: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. Sinole-Familli Detached NO. OF UNITS X $2,858 per unit = $ . B. Sino Ie-Family Attached ~ X $3,100 per unit = $ (O'21n~ . NO. OF UNITS C. Multi-Family Apartment NO. OF UNITS X $2,641 per unit = $ D. Sinole Room Occupancy NO.OF'UNITS X $1 ,321 per unit = $ E. Accessory Dwellino Unit NO. OF UNITS X $1,550 per unit = $ WILLAMALANE SDC $ lo9JX.~ fb ff $ \s/lWrv ~J11I~(10 Date $ 2. SDC CREDIT (If applicable) SDC payer must furnish proof of '. Willamalane Credit approvaL) 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) Development Services City of Springfield 5 iIr..I.N...~L~.D . .. '.(!JJ M. . OReGON www.cLspringfield.or.us TRANSACTION RECEIPT COM2009-00387 756 28TH ST 758 CITY OF SPRINGFIELD 225 Fifth 5t Springfield, OR 97477 541-726-3753 pennitcenter@ci.springfield.or.U5 RECEIPT NO: 20\0001187 RECORD NO: COM2009-00387 DATE: 12/30/2010 mESQRjp..illfQ~~]jfM~1it~~~GCQl:iNJ~C'oD-ELWA"iif;,Y~MQQ}ltl1Qj.rE~~ Building Permit 224-00000-425602 $1,412.86 . .... ...,~ . -. .-.' ........--.- ...-.-, .. . .- .'. _. - -. .... _. . Fire SF Fee - Residential 100-00000-424005 $148.00 .. .. - -.", . 1 st Appliance . . ___ .2_24;9~~~~:4.~5~0.4 $7900 Vent Fan 224-00000-425604 $72.00 ,."~..........,.,_ T ......" _, ...""___.___.. _. ....._..__._-,____,^._._'.___.....~. ....._ .'.,+ '.. _.", Exhaust Hoods 224-00000-425604 $26.00 "-~...__.._..--~_._._,.__.__.._'"_.+_..--,,----~-, ...,.....-..-.... ......-.-...-....... .,.--'.. ....--.-..-"....-....".. _...__.~_._.- ..---...- -- - -.-.. - -.. .. Qryer Ve~.____________.___.._.___..____._ ...____~~4-D?900-42~~~~_.___ .__.... $1~:0~. !.:~r~pla:~JI,i~~<!)_.____.__.____.__._. . ..._____._m._.._.._ . _._.._...~3_4:~0~0.?_~4~~~~~...___.. ....._ ._ _$_~O~O Gas Outlets 1_4 224-00000-425604 $7.00 -~--_._------ -_'_--'~-----'-'----,. A.-~cJ.,-essing .A.-.ssig_nment_______..____. _._.__. .___ ___ ___._.__...~~~:~_00?:::~~~2_._.. _. _. __.______...._ $76.0?. w.;li~rna lan"..~ta-"_hed J~upl..xL._ _____. ____ _ _..______ u _ .. _.u_.. __ ~.z.: ::..~~?.ll:~~5..0~~________ .. .... ___ $6,~~?~~. + 12%~tate_ Surchar~". ... .._...m 821.:00.~~.~:315004_._._. _. __.$2.9_5:0~ SDC Transpo Improvem.ent .. _ 447-00.000-448027 $1.777.96 SDC Transportation Admin 719-00000-426604 $14822 Storn: D,-ain~g".!rnperyious A.rea ~4.0'00000-448028 $1.381.68 S~nitary 5.e:"er. :il.e~m~urs."rn~nt.. .~42.-.o.0000-4~8024 $1,493.92 s.anJ~ar,:..S.".:"_er.:.I.mJ'.ro~"rT1.e.n.t_ .._ __.._ ._..____.._ _~_ .~43:.00_0O'O':::48O'~~_. $1,135.98 S.Q_C;:r!.~.n~p~~"il11burselT1e~t__.. ..___.______._... ____ _. ___.____446~D.9?0.c>.:".481!313..__. __ _ $403~8 SDS; Sanitary/Storm Admin _____________7_1.:a~O"000-4~660~__________....~~2.6.~ !:~a.n_~"view Major :.!:!annin!l..___.___.____.__.___._~._____1.00-0~~0-425.c>.o.z.______.__ $211.00 +_s.~._~_"""~IcJl!Y..!:ee .________________---.!~0-00000-4256O'~_____ _.._ __..___~2.33.4~ ~_B"-th~_()~."..&_~:"?Y."I11.i!L____ ._...___. ____.._____...____.__2~:::.~0_O'~9.:~25~.~~___.. _.____ __ .._.___.~~~~~~o.O_ Plan Re_~i"w~.".~i9"Dti."-I__...__.___..__._. ._._.....__.. ____ _...._ .2~4;.o.?_o.~~:~_5..6_0~__.__.__..____ $918.36 TOTAL DUE: $17,054.23 ~~~AYMEI-:i;i:StygE?~,y~~A,Y.6.Bi!~~9t,;~~1!KR1R~q~~:cJ;\%i:)KoMMEN;fs~~~'1i~~1\lij!J'!1!,~~&"_~fifQO-NfjRt:It>7,i!~~lJt~~-W Check 1003 ab mcguire trust $17,054.23 :"., ,,- - . .........." -,. ,'~'\,.. 225;Fifth Street Springfield', Oregon 97477 541-726-3759 Phone 6IPQ...~fl.~.~..~ii. ."....L. :..~.. wr:.. ... ,'~'. "-" "-.. :;; ... .."M....,. ............. ..,,~ .." ,.' ; City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1200900000000000983 . Date: 08/25/2009 1 :14:2IPM Paid By Item Total: Check Number Author!zation Received By Batch Number Number How Received Amount Due 195.80 2,018.34 10.00 $2,224.14 Job/Journal Number COM2009-00387 COM2009-00387 COM2009-00387 Description SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration Payments: Type of Payment Check Amount Paid DUKES AND DUKES CONSTR DJB 16274 In Person Payment Total: $2,224.14 $2,224.14 cReceintl . Page I of I 8/25/2009 !