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Home My WebLink AboutPermit Building 2010-12-27 . . , CITY OF SPRINGFIELD 225 Fifth SI 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: 811-SPR2010-00842 IVR Number: 811151899748 permitcenter@ci.springfield,or,us PROJECT STATUS: STATUS DATE: Issued 12/27/2010 ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential ~ PROJECT DESCRIPTION: Single family residence ~ same as spr2010-00661 OWNER: ADDRESS: JHD3 llC 2464 SW GLACIER Pl REDMOND OR 97756 Phone Number: CONTRACTOR INFORMATION Contractor Type Plumbing Contractor Mechanical Contractor General Contractor Electrical Contractor Name STUTZMAN SERVICES INC PACIFIC AIR COMFORT INC HAYDEN ENTERPRI~ES INC TOP NOTCH ~LECTRIC INC Lie Type CCB CCB CCB ELECTRICAL BUilDING INFORMATION' JI;pt~r;iy1'5N: Oregon 11aw requires you to lot Size: fHeightlof/Stru_C!lI.!~;ed ~~,3.~,e Oregon UtilitySq Ft 1st Floor: N"'Yp,"oiiHeaBenter. ThF.6rcedIAir;Gas set fortSq Ft 2nd Floor: inWl,1Jl ~ygeP01-001 0 through OAR 9S2-001sq Ft Basement: 008U. y',u may obtain !3.~~i(?S of tile rules b" RangerType: cent (,Electric t I . h Sq Ft Garage: Cd.Jlull:-j u It;' er. I'.lUle: lne .e en or:p rtt~fm~~: for the Oregon Utility 1'!uUi~c" ,01 Sq Ft Carport: Center is 1-800-332-23C). Sq FtOther: Occupancy Load: 4574 1290 # of Units: Occupancy Type Construction Type R-3 Type VB 401 40 # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Path 2A Certified performance-tested . duct system 3 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: 2008 Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Reql.:lired: NOT!c1~. Site Infonmation....-c.;",:.;.". I THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT, COMMENCED OR IS ABANDONED FOR, . ANY 180 DAY PERIOD. \', .' --~.,.: Springfield Building Permit 12/27f201 9:29:49AM Page 1 of6 S~~~N:;EL~. . ~ ~()REGON 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 PERMIT NO: 811-SPR2010-00842 IVR Number: 811151899748 www.ci.springfield.or.us Issued permilce nter@ci.springfield,or.us PROJECT STATUS: STATUS DATE: 12127/2010 ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - same as spr2010-00661 PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 14 5 5.55 22.02 o DEVELOPMENT INFORMATION 1 Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: 2 REQUIRED PARKING Total: 2 Handicapped: Compact: Yes 36.9 18.5 '1 PUBLIC IMPROVEMENTS Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: 1 Valuation Description Descriotion R-3 1 & 2 family U Utility, misc. TVDe of Construction VB VB Springfield Building Permit 12/27/201 9:29:49AM Unit Amount Unit Tvpe 1,290.00 Sq Ft 401.00 Sq Ft Unit Cost 96.83 37.72 Value 124,910.70 15,125.72 140,036.42 Page 2 of6 SPR..I~N...~~IE~ ~". .'. ':'{-;:~. ~ _%",-~,,' OREGON ,-: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00842 IVR Number: 811151899748 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 12/27/2010 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence - same as spr2010-00661 FEES PAID I Description Amount Paid Date Paid Recio! # Same as Plan Review Submittal $250.00 12/07/2010 2010000987 Planning - Major Review - City $211.00 12/27/2010 2010001152 Admin fee (10% of applicable fees) $8.66 12/27/2010 2010001152 Residential Fire (.05 Per Sq Foot) $86.55 12/27/2010 2010001152 One or Two Family Dwelling with Two Bath $374.00 12/27/2010 2010001152 Furnace-upt0100,000BTU $17.00 12/27/2010 2010001152 Range hood/other kitchen equipment $13.00 12/27/2010 2010001152 ~u-;~~n!~~!'ter h,:,,;;;;:-;;g~~';;'-~ $9.00 12/27/2010 __=__'-=-J010~~.5~ ~i~~le-d~x.h.!'.us~ (b~~.':??":.:,,!?i~t compartmentsc~~__ .__ ..!~~__ ~ 2/~:'.2~:~~ _.._.. _. 2~.~ 0001152 First Appliance Fee $79.00 12/27/201 0 .~~~~1l2.1.5~ Residence wiring 1,000 sq. ft. or less $134.00 12/27/2010 2010001152 Each added 500 sq. ft. or portion $50.00 12/27/2010 .201 OD~.1152 Temp services 200 amps or less $63.00 12/27/2010 2010001152 Sidewalk up though 90 Feet $88.00 12/27/2010 2010001152 Curb CuUDriveway 1 st Cut $88.00 12/27/2010 2010001152 Multiple Permit Discount(Max 2) $-30.00 12/27/2010 2010001152 SDC: Reimbursement Cost - Storm Drainage $367.24 12/27/2010 2010001152 SDC: Improvement Cost - Storm Drainage $666.82 12/27/2010 2010001152 SDC: Reimbursement Cost - local Wastewater $2,549.28 1212712010 2010001152 SDC: !'!'e.r~nt ce.~~oc.al Wastewater $1,285.68 12/27/2010 ____.._._ 20_10001.1~? ~p_CReimbursC:rT1~~t:.:r~sportati?~~D~_._.__ ._ .._.~~~______ 12/2~/201_0__ .___. ..... ..2.0.1 000.115~ SDC: Improvement - Transportation SDC $1,597.62 12/27/2010 2010001152 SDC: Reimbursement Cost. MWMC Regiona,-WastewatE -~-._$101.97-~~ 12/27/2010 0"===~ -201 o~~ 15i SDC: Improvement Cost. MWMC Regional Wastewater ~ $1,333.57 12/27/2010 2010001152 SDC: Compliance Cost - MWMC Regional Wastewater SI $22.63 12/27/2010 2010001152 SDC: Administrative Fee - MWMC Regional Wastewater: $10.00 12/27/2010 2010001152 SDC: Total Sewer Administration Fee $295.30 12/27/2010 2010001152 SDC: Total Transportation Administration Fee $122.79 12/27/2010 2010001152 Structural Building Permit Fee $875.62 12/27/2010 2010001152 Gas Piping up to 4 outlets $7.00 12/27/2010 2010001152 ~ddress Assignment, each new or change $38.00 12/27/2010 2010001152 Wil!~ma:ane fee!:._~~gle ~i1y detached $2,072.35 ._..E!~~201 0 __... 2010001152 Willamalane fees. Single family detached $1,395.65 12/27/2010 2010001152 State of Orego-nS;;;:Ci;a~g-; (12%OiaPPiicabieTe~L=-.- - - '-$198:91- - - -----u72ir2010:=-..::...._=~-=2.01..IJ_O:~1 i5~ Technology fee (5% of permit total) $92.08 12/27/2010 2010001152 ------- Total Amount Paid $14,936.64 Springfield Building Permit 12/27/201 9:29:49AM Page 3 of6 .. SP~::~=L~~ Itk;L~ ~~.OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00842 IVR Number: 811151899748 www.ci.springfield.or.us 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Issued pennilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: 12/27/2010 ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 SCOPE: Single Family Residence WORK INVOLVED: New ,TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence - same as spr2010-00661 Plan Review ~ Deoartment Application Acceptance Received Due Date Comoleted Result 1210712010 12/07/2010 12/10/2010 Application Accepted Reviewer David Bowlsby "J \ 'j Planning Review 12/10/2010 12/10/2010 12/14/2010 Add'l info required Deyette Kelly Comments: Plot plan does not show required 3' walkway or extended porch. Left a message for Eric 12/14. On hold until revised plot Rlan received. , . elarinjng~RevieJ,,<::?;:,.;ir.;:. ' ~'12/~1b/20JO':.j, '12l10l20i10:yj'<12i15l2010"{~."APproved;~;' :Jo/,""i' ""',.,-~, DeyetiErReJlY:w : - ~. """ ",,,:.,,,,,,,~~.c'";"..., "~,c,__;~::::;';' ,'; '-:~": ."',' "'_ "'4-r,;,'t"-;"~~'<it~". $,':, ',-~" _':\~.',:,'r... __t, , .." f/:,.-'t:",", ",:',~,- "',," 'Corrim~nts~_ ,Fr9ntelevation,s:ares_ite~pec_ifi~ai1crconfair1'REQUIR-E-D design'!ei'eme-ntS:,,;lnspeciorsiw1l1field:che.ckthat ~ctual: _ < ,?~::i~;~,~:'~) ,j';"elevaIYons:mat~hfslJbmi-tie'd,designs as showri~on the apprO'ved set of plans. "lnspec:tor.toverify:pla-cement'atJime'of:':. \,.~,j,{:.;,.;<..tlfoo'ting.jnsRecti6h~, ~"-,,;,:~,~~~~~, ',?;,;;~_::y,-~>",ti" : ',~_;\ ;o-->';'\.Z; 5- '.~If':;:$::'~'~,;.'~<-;f' . --'~,h.~ '": Structural Review 12/10l2010 12/10l2010 12l17l2010 Waiting Internal Kip Kaufman Comments: Public Works ~r7~ , , Public Works Review 12/10/2010 12/10/2010 12/21/2010 Comments: Storm water to tap, received on 12~15~2010 Approved Kaye Wilson Springfield Building Permit 12/27/201 9:29:49AM ." '~ Page 4 of 6 S;p~~.;~EL~ ll.t..fI!1/J x.".;'" .""',,-cd.,^^ OREGO N 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: 811-SPR2010-00842 IVR Number: 811151899748 perm itcenler@ci. 5 pringfieJd, or, U 5 PROJECT STATUS: STATUS DATE: Issued 12/27/2010 ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - same as spr201 0-00661 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 INSPECTIONS REQUIRED ~ Inspections 1020 Zoning/setbacks 1090 StreetTrees 1110 Footing 1118 Footing Drain 1120 Foundation Footing: After trenches are excavated. 1160 UFER Ground Foundation: After forms are erected but prior to concrete placement. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1220 Underlloor framing 1260 Framing Framing Inspection: Prior to cover and .after all rough in inspections have been J approved. 1370 Masonry Veneer 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. 1520 Interior Shearwall Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior Shearwall 1540 Gypsum Board/Lath/Drywall 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. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Gas: After line is installed and required testing and capped if not attached. to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover 1999 Final Building 2200 Underfloor Mechanical 2210 Underlloor Gas 2260 Gas Service 2300 Rough Mechanical 2995 Final Gas Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 2999.Final Mechanical 3130 Footing/Found~tion Drains Springfield Building Permit 12f27f201 9:29:49AM Page 5 016 SPRIH..GFIE~. D . ~~ <"~ 'rtp -. ",l~ "OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00842 IVR Number: 811151899748 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfieJd.or.us PROJECT STATUS: STATUS DATE: Issued 12/27/2010 ISSUED: APPLIED: 12/27/2010 12/07/2010 EXPIRES: VALUE: 06/25/2011 $140,036.42 SITE ADDRESS: 4859 GLACIER DR, SPRINGFIELD, OR 97477 ASSESOR'S PARCEL NO: 1802051110000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence - same as spr2010-00661 3170 Underlloor Plumbing 3200 Sanitary Sewer 3315 Water line 3400 Storm Sewer Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 3411 Perimeter Rain Drains 3500 Rough Plumbing 3999 Final Plumbing 4000 Temporary Power Service 4225 Service or Feeder Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When 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. 1 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 wjll remain on the site at all times during cfcti07f:: {L-2 =1-10 Owner or Contractor Signature Date Springfield Building Permit 12/27/201 9:29:49AM Page 6 of 6 i ~ b~ willamalane t\mj Park and Recreation District Job. No.8! L-Sf~W-S/f'2, SYSTEM DEVELOPMENT CHARGEWORKSHEET July i-December 31, 2010 NAME: f!A Yi'E,Il/ PHONE: 2Z~ &7 J S- ADDRESs,:::;>V/W SiAl 7~<o-..e.cCITY ,t>P,N'P STATE:~IP: <:J17~ LOCATION OF PROPOSED BUILDING SITE: Street Address: 1- 85 '1 G;/_Jd':-tP.::R pRr{~ Plat Name:JV&.5l WpljD.)" Tax Lot Number: 1,,~~Z.051..li9~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. Sinole-Family Detached NO. OF UNITS f X $3,468 per unit = I $ '] Y {p~ B. Sino Ie-Family Attached NO. OF UNITS X $3,538 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $2,906 per unit = $ D. Sinole Room OccupancY NO. OF UNITS X $1,453 per unit = .$ E. Accessory Dwellino Unit NO. OF UNITS X $1,734 per unit = $ $ WILLAMALANE SDC 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) $ ':]L(C,? 1-.2-- 1M I Ie Date d1 ~ 5 ~v Development Services Department City of Springfield ~AfMe ~ 6(.Jtc..1&l. ~/O.(.'" t{gSI.{ L~ t (l\( Pei !lIlt .-\pplicntion L'F.~,:'.\I-~TI\/IF('!: U::::r: C:l"~L\' .h>_1... 'td..'t --';~ia. iOI6-6~ '81.\ i- f :-'11"';1 n.:, ' ~~:-.~f;~lm:;!~_A~~A1q f:c ~ ''-=:'';'~~ _ _""'?~~~_L""''''=-~''~~~~'''--'':;''';-%~~~:-~~-;'~"'So_;:&~- =:~ FifJo Sue,':! I S8r:,~j-iCid.CF','?i-i(!. p~....1,(S:.!!)7?6.~:5~ t F.-\...\()c.:l)!16.~tS'? -",.-=,,; DOie: I Z-7- (D T\\is pt.'rnl\\ \50 lss~]t'd under OAR 918-'-160-0030. Permils e\pire if\\"orh is no! slJr1eJ \\irhin 1St') d~'>'51)ri5Su:lnCE: or if work 15 suspended for I SO d3V5. LOCAL GOVERNM~NT APPROVAL I I \Oale: \ DOle DNo FEE SCHEDULE 1. V,1Iu8'tion inform3 lion , 'I Tllis projeci h3' fl1l3i 13110 lise appro\'al SignJIUrc: This project 1125- DEQ c:pprO\'31. , Sign8.ture: .~ I, I o ResidtnliJI JOB SjT-~ CATEGORY OF CONSTRUCTION Square feeT ....../ Z0,,',ng 3PP ,-,v~l VerdlerJ'. DYes (8) Job descriplion' Oc:upancy Proptrf)' IS '.',;;:~::, fie.cd plain' 0 Yes ~" U I'~O Con::.lrilClic.i: :;,'PE: o Government OCOiTir1,Gci::;! J':lb Silc 3rJdre:,c' I C'l" </' i. JIl , ' re;.L.lLl-O...\ ,~- Subdivi'sion'.-LJCS I Reference / 802-0 ANDLd.CATIO~j Oihti information' Type of Bt'"3.I: f.-v. .s. ZIP: '77f'7S t)\ DOO C> /-Ic....\,dc-"r,~ !-Ion,,", '" 1 Address'. ;;.;J-/(O( \ ('it),. Q - I I ~ i,("( r'\on / i Fe.one' svr-S':,'(p- 5~ ! [-mC\i!: This iliSlJJlalion is being made on residential or farm property owned by me or 11 member of my immediate family, rind is exempt from licensing require~nenIS_ undc~~ 701.010. Sign here:? /f'. .CLJ (;/a .\-",,( Energy P:!!!1: .]}-\ CZI new 0 alteration (b) Foundation only permit? Tot::d vRluation: ),iilhiIMhiree.s: (aj Pemlit fee (use valU{\lion table)' (b) lll"vestigative fee (equal iO pa})- (c) Reinspeclion ($ lJer hour)' (number of hours x fee; per hO!Jr] o 3ddillon Dyes 01'0 () PROPERTY OWNER' Name: , , State: 0' Q Fax: i (d) Enter 12% surcharge (. \2 x [2:,,-;-2b+2c]): (e) Subtotal of fees above (2a through 2d): $ CONTRACTOR INST, 'LAil.ON, ;J01 (8) Plan review (65% x permit fee [23))' (b) Fire and life safety (40% x pefmit fee [28]). (c) Subtotal of fees 3bove (33 and Jb): $ , Business name: )1 -.d.Lc.-'-- Address:,;l!, i-/ S (..AJ Ciry, R,.. rYlonol. Fhone)'!!.A . ("'i E-mail: ~~\c.t:..~tll~ CCB license no.: 'i Print name: Etl,A,C- ~ Sign2Iu,e: $. (ace r Slale.oK_ (3) Seismic fee, 1%,(.01 x permit fee [2(1) TOTAL fetS ::JTlcl surch:ngr.s (2e+3c+1la)' , . J "'~' I I N';\me S U BCOI~iiRA'tl;()R INF()R~,t6;ri'6N" , \ CCti Lice!lse Nl!mbe'r \ PhonE.' Number i J7J'rl:1o I 1317'17 1 I 3'1:;.37 I EleClric~1 Plumbing ( Mech:lni(;j] ~ 225 Fifth Strcct+Springfield, OR 97477. PI-I(541)726-3753+ F'AX(S41)726-J689 t~~~~i~~:~it~ "f .' i' DEPARTMENT, USE ONL,Y".: , . f ' , _,' i' -. . ,'- ,'~.. 8 JL - S7"P- U7 J...8 - Permit no.: - <"'> A '"' Date: .lc1-- 2-J - j..~ . Electrical Permit Application This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if worl< is nol slarted wilhinl80 days of issuance or if work is suspended for 180 days. . Address: City: Phone: E-mail:, CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ZIP: _!~&~I~:~,~r~~~.t{{~ Residential, per unit, service included: 1,000 sq. ft. or less (4) \ $134.00 $ I a.tl . Each additional 500 sq. ft. or portion I ry~ $ 25.00 $~ thereof Limited energy (2) $ 32.00 $ Each manufactmcd home or modular $,63.00 dwelling service or feed~r (2) $ Sci'viccs or feeders: in;igllatiol1, ai/era/ion, re/aeolian 200 amps or less (2) $ 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: ins/allation, alteration, relocation 200 amps or less (2) \ $ 63.00 $1 J.~ 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps Of 1,000 volts, see services or feeders section above Branch circuits: new, alteration, ex/ensioll per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder 110/ included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limitedMenergy panel, $ 63.00 $ .alteration, or extension (2) Each additional inspection: (1) $58.00 $ t~Kt~~~Jlf.~~~Jfu~{#t~~~~~~'g:gJ~.u~~~:N.ili~j,f!j~.~~~M!1~Y~~i~htr~t~fm~~~1~!~1~~ kJ (A) Enter subtotal of above fees ~1 (Minimum Permit Fce $58,00) $) I. (B) Enter 12% surcharge (.12 x [A]) sf). C1.lc rt (e) Technology Fee (5% of[A]) $1' rJ~ ,'" I TOTAL fees and surcharges (A ilJrough C): ( ~ . cP (j) ~~~t~~~~~~~i~~Q,Q'~.rg~~GJ~s(i;):{~:~t~N"iff;f~J~J~~,_R.9V~,~~1}~#i~t~~;t1~;A%~~~ Zoning approval verified? 0 Yes 0 No ~l~~<<~J~n)~;n~tQ~ill~_G~~~j'RX~\G.Fi:~[(::~QN.$;t.g1)~illJ:(fJ~?~r;;~J:Wt~i~W~\.\f~t~ Residential 0 Government 0 Commercial ifttfi\a&i;J9~~.$['r~t;If:.iKOBMAIIQNf);'AN[)hJio.8'Atl<:!N!~~:;i;;;Wi: Job site address City: <;f'~..V':'''''Hd.() Subdivision: ZIP: ~~~1~~~{i~~~i};1~:*;~D~:_t:~,~G'r{I_8mfQ~N:~~~l{)(V:Q}~-K};~;r%;\~?E~i~~~\~r.tig:!f:;~.~.g:; [~~~t*t0:}f~~~~',o/~f}i~;~~~H?_~oJ~;~.B:Wf!GW~..~J{!_i~t'l. Name: /.4tI(O~ I'-i...~ Address: Zl(lR ~ ~ Ci ty: (2.,-0 M<:>N '1> Phone: sq/.::>"'SU 6"1Slo E-mail: This installation is being made on residential or farm property owned by me or a member ormy immediate family. This property is not intended fOf sale, exchange, lease, or rent. OAR 479540(1) ~ 47:.;t1) SIgnature: ('- . *~~~t~w~t~i~{i[~QNm~~;t:C:>~8i~;(f~tSWAii;W~tlTCQ'NEf~~~NJ.~~Y}f~~?~J~reH{~:r;~' S'L>.'lc- II\) ZIP: <nlSt.. cP Business name: e~~~ ~~ \0\) ~ t)Jztt ~ ~D'S\q ~~tx '\. . \:)~ 0(2- .' ~, ,,^,"",rm" 5'\-\ '3\\ \qq5 s.p. RING.'.fIE.L~.. . ... .- ;-....~ ~.~ OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00842 4859 GLACIER DR CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 permitcenler@ci.springfield.or.us RECORD NO: 8] ]-SPR20IO-00842 DATE: 12/27/2010 ;. '1';::'<,>i~',?t.:f\!lz0;::P ";; f\)""~'~!-' :;-"":~' :i~-'ACcbUNT t60E ,~;-~:BJi~~ ;?-:': ':AMOUNJ-'DUE ;,~ ~:"'-~~T: ':;;~: - '1 ." - ," _." u..=...... .. .... .__"-,--..~_.._.....__._._~........~___ -. ". _ 1 00-00000-425002 $211.00 224-00000-426605 $8.66 100-00000-424005 $8655 .------.-.-.---. ~-_...- ~_.---- 224-00000-425603 $374.00 _"'-_~___.___.____.___ -""__'___4 224-00000-425604 $17.00 "'---'--~- 224-00000-425604 $13.00 -',.---- 224-00000-425604 $9.00 -"'--'--'''''-'-''-'". ,,--.. -.----..-..-.,..-. _..__.._._..._-- 224-00000-425604 $36.00 224-00000-425604 $79.00 224-00000-426102 $134.00 224-00000-426102 $50.00 .- --~'-""'- 224-00000-426102 $63.00 ----'_._- "'--~"--'-'-"---"'- 201-00000-428060 $88.00 -_._-~-. ""--..- 201-00000-428060 $88.00 ----"--~~.__.~-- ...-...---".-,.-........-....., 201-00000-428060 $-30.00 -~----,~- -'----- 441-00000-448029 $367.24 #.___._______,._",_w_______ 440-00000-448028 $666.82 -'_._--~.__.,_._-_._---"-_."_.- 442-00000-448024 $2.549.28 ~M_~___'_ 443-00000-448025 $1,285.68 446-00000-448026 ------. $42692- 447-00000-448027 ---~59762 444-00000,448024 --$10'.-97 415-00000-448025 $1,33357-' ----"---- ---~_.,------ SD~_C_o~~i1ance Cos~WM~_~_"_glona] Wastewater E.!?~"~4~:~gOOO-~26607_________ _._~2.6~ S~C.:!'-9ministrative Fee - MWMC Re9!Ona] WastewaterSDC . ' 611-00000-426604 $10.00 "._____.__ _.__.~~____M_..~_.____~____ _.._~ _~_~. ~I2S TE-laL?ewer Administration Fee 719-0c;?_00-42~604_....:_~....__.__.E.9520. .?!2~: Tota] Transportati,?n Ad_ministration FE~e 719-00000-426604 $122.79 . _ . _..________w.__..._ ~tr':c~u_r~Ill_~ding_~ermit Fee 224-00000-425602 $875.62 .S'as,=ipi~g.'!P~4 out]ets._ 224-00000-425~~.r________~=~ $70~ Adr;Jress Assig~ll1e~ each n~",-"rcha,,-ge 224-00~-425602. ... $38.00 WiI]ama]ane fees - Sing]~fami]y detached 821-00000~215023-~.::..__====~=--$2:OiLlj- Willama]ane fees - Single family detached 821-00000-215023 _____~~~.65_ State of Oregon Sur,,-harge (12% of applicab]e fees) 821:0?000-215004 _.!1~J1_:_. Ie,,-hno]I?gy fee (5% of permit total) 100-00000-425605 $92.08 TOTAL DUE: $14,686.64 ~f;1AyMENft'(PE.r~"if,jg.EAy6R:.:.....c;;:sHlsRJk[<Aul~.;~CJ~MMgNJ_sJljg~~" ;#i,:.;,~?':..:e.}.'!QlJ.~J:p~IR...;:';:2:l~sl RECEIPT NO: 20]0001152 fDES'CRIPTlbN,,{~,':'---I'" '''; f,-_'_~.,~.---l'",",,-_,._ E'~.anning_ - M~)or Review - City ~~min fee (10% of applicabl~_feesJ. ~~ia] Fire (.05 Per Sg F~ot) _ One or Two Family" OweJli~~.o-w~!.~?n~~th Furnace - up to 100,000 BTU Range hood/other kitchen equipment Flue vent for water heater or ~as fireplace Single.duct exhaust (bathrooms, toilet compartments, utility rooms) First A~pliance Fee Residence wiring 1,000 sq. ft. or less Each added 529-s9 ft. or portioD__ I~~p service:s 200 amps or less Sidewa]~E.t!'.I?LJg.h 90 Feet E~~E~,~uUOrive~.~y","~ st Cut ___~_ Mu]~p]e Permit Discount (Max 2) SOC: Reimbursement Cost.: Storm Oraina~e SOC:, Improvement Cost - Storm Oraina~e ~~Reimbu~~}_S;2..st - Local Wastewater ~SOC:~provement~;?~.!ocal Wastewater ~12EJ3~imb~:!~e~~. Transportation SOC SOC: Improvement - Transportation SOC SOS Reimbursement Cost. M~C Regional Wastewater SOC SDC: ]",provement Cost - MV\iM.C_ Regional Waste!,ater SDC Check Hayden 32313 $13,000.00 Credit Card 034767 Hayden $1,686.64 $14,686.64 - SPRING.F,I E~.. . ~.~~"'" .(1* ..::;<1 . OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00842 4859 GLACIER DR CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 . permitcenler@ci.springfield.or.us RECEIPT NO: 2010000987 RECORD NO: 81 I.SPR2010-00842 DATE: 12/07/2010 tQ.ESCI!IPT-lg>i!'C ':Z".S:...--i:rv"z ;.'l)i;~:'''''-;;!' ?:;';-,.'-;; .;[<,,, "AC::J::.0Jjijt.C_QDl:~.v"*-i" -'c_8.M.Q.@IJ~_UE ....-< c, "d Same as Plan Review Submittal 224-00000-425602 $250.00 TOTAL DUE: $250,00 ~~PAYMENfTYPE\j-_ry!F1AYOR~ ....CASHIER]DBO:wCSBY:.;,..."COf<1MENU; . '.: li'!> : :'AMOUNl':PAIDJ Credit Card 074773 hayden homes lot 81 $250.00 $250.00