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Home My WebLink AboutPermit Building 2011-1-19 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 Issued ISSUED: APPLIED: 01/19/2011 12/28/2010 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 . permi1cenler@ci.springfield.or.l.Js EXPIRES: VALUE: 07/18/2011 $391,936.00 01/19/2011 SITE ADDRESS: 6154 FOREST RIDGE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343406200 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential New Single Family Dwelling Phone Number: OWNER: ADDRESS: ODONNEll R SHON & AMY l 6154 FOREST RIDGE DR SPRINGFIELD OR 97476 Contractor Type G~C'ontractor CONTRACTOR INFORMATION ~ Contractor Name RS PLUMBING CONTRACTOR INC BEAR MOUNTAIN ELECTRIC lLC THOMAS WALTER CUSTOM HOMES LLC MARS HALLS INC Lie Type CCB CCB CCB CCB lic No 103816 136298 160287 25790 Lic Exp 01/04/2012 08/1212011 Phone 541-461-4714 541-741-8844 08/12/2012 541-683-6355 541-747-7445 12/23f2011 # of Units: Construction Type Occupancy Comments Occupancy Type Occupancy Comments Occupancy Type Construction Type # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Type VB 3588 s.f. BUilDING INFORMATION ~ # of Stories: 2 Height of Structure: Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Hazmat: Lot Size: Sq Ft1st Floor: 2109 Sq Ft 2nd Floor: Sq Ft Basement: 1479 Sq Ft Garage: 851 Sq Ft Carport: Sq Ft Other: 429 Occupancy Load: 2008 R-3 851 sJ. U Type VB 4 Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal/Development Code: ~ Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Path 1 A Gas-fired furnace. with min. AFUE of 90% ! Site Information Enginee'Atft!liITION: Oregon law requIres you,t,O Fill Vol"IBRow rules adopted by the Oregon Utility Flood 'M5~~h Center. Those rules are set forth land HIH~S52-001.0010 through OAR 952-001- Retainill'll~."You may obtain copies of the rules by Soils Repetll!!t1!f'll'!lllcenter. (Note: the tele~ho~e number for the Oregon Utility Notlllcallon Center is 1-800-332-2344). Springfield Building Permit ~ ,~;;'". ':.1;<~~'\:~/~t{;;ifi;4~~.!iJih~;1:'~.' ,'" CE" " ," ~~IlpE~M1T S~ALL EXHP\lSR~J~~~i,~~~~' AUTHORIZED UNDER T COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. 1/19/2011 11:39:02AM Page 1 ofB S~~~N... .G.=~ L~~ ~.OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itce nler@ci.springfield.or,us PROJECT STATUS: STATUS DATE: Issued 01/19/2011 ISSUED: APPLIED: 01/19/2011 12/28/2010 EXPIRES: VALUE: 07/18/2011 $391,936.00 SITE ADDRESS: 61S4 FOREST RIDGE DR, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1702343408200 PROJECT DESCRIPTION: Frontyard Setback: 14 Interior Setback: 6 Sid.yard Setback: 10 Rearyard Setback: 10 Solar Setback: 57.5 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential New Single Family Dwelling DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of lot Coverage: Highest point on structure to north property line: Hillside 5 Yes 33.29 28 REQUIRED PARKING Total: 2 Handicapped: Compact: Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Description R-3 1 & 2 family U Utility, mise U Utility, misc. Springfield BUilding Permit PUBLIC IMPROVEMENTS ~ Valuation Description Tvoe of Construction VB VB VB 1/19/2011 11:39:02AM Unit Amount Unit Tvoe 3,588.00 Sq Ft 851.00 Sq Ft 329.00 Sq Ft Sidewalk Type: Downspout/Drains: I Unit Cost 96.83 37.72 37.72 Value 347,426.04 32,099.72 12,409.88 391,935.64 Page 2of6 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 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 01/19/2011 ISSUED: APPLIED: 01/19/2011 12/28/2010 EXPIRES: VALUE: 07/18/2011 $391,936.00 SITE ADDRESS: 6154 FOREST RIDGE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343408200 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Single Family Dwelling FEES PAID ~ DescriDtion Amount Paid Date Paid ReciDt # Structural Plan Review Fee Residential $812.54 12/28/2010 2010001162 .~!,nge hood/other kitc.~e.n,equipment $13.00 01/19/2011 2011000120 Flu"e, vent for water heater or g~~fireplace $27.00 .._''.. 01/19/20~_...._._".~2:DOO~:z.CJ. ~I~.",.duct exhaust (b.athro.o.llls, toilet compartments, uu'!._."...$4~~.~_---9y19/?Oll 2011000120 F~~tAppl~~~_._.__._. ,____.__..__~9~.IJ....____~:.?/2011 _,29110o.OE.c:. Re~de~ce wiring 1,000 sq:.!t or less $134.00 ..____...~1!19/2O'1.:1.__.___,_ . ,.2.0: 1 o.~:.~ Each added 500 sq.l1.:.~r portion $__175.00 01119/2011 __~2.:.000120 Temp services 200 amps or less $63.00 01/19/2011 ,___.__201.1.~!l012.o.. l:Ie:a.!.pump ,..".....___.___._,. $17.00 01/19/2011 .2.o.1..1~001?g. Gas Piping - each additional above 4 $8.00 01/19/2011 2011000120 Sidewalk up though 90 Feet $88.00 01/19/2011 2011000120 Curb CuUDriveway 1 st Cut $88.00 01/19/2011 2011000120 Multiple Permit Discount (Max 2) $-3000 01/19/2011 2011000120 Structural Building Permit Fee $1,897.19 01/19/2011 2011000120 Admin fee (10% of aep,!i,cable fees) $24.34 01/19/2011 2011000120 SDC: Reimbursement Cost - Storm Drainage .....!70~~..._~0ii2011 ._.~~0120 ~DC ImP.:?~e:me'2!..Cost~ S!or,!, Drai~-"g~ _.__ _._ .__.$.1;22.~_ .._.___ 01/19/~.12_____.-.-l011 00~120. SDC: Rei'!'I:>':""',~n.!..:.T!"n~p'ort~tion S!2~_.__,____.._. $426.92 01/19/2011 ____._ 20~~g23.0. Fur,,-a.c.e:..:.~t~ OO,~~..B-T,IJ $17.00 ____ ....o.l/1_~_,._..,,,,___??2. ~ 000:.2,0. Each Additional Bath $95.00 01/19/2011 2011000120 One or Tw;;'Family Dwelling with Three Bath $439.00 "--'Oi'/1912011 2011000120 s;;,k/baSiri{i;,~-;Y-:~'--- $'190CJ------...oiii 9/2011 ----Z011Oo0120 Residential Fire (.05 Per Sq Foot) $243.40 01/19/2011 2011000120 Planning -- Major Review - Cit~, $211.00 01119/2011 2011000120 SDC: Reimbursement Cost - Local Wastewater $1,84040 01/19/2011 2011000120 SDC: Improvement -.Tran~p,ortation SDC $1.597.62 01/19/2011 2011000120 SDC,!"2pr'O':'':.~~~s.!.:..!:oc,!.I, Wastew~~r__,,,___~._. $2,303..5.1__.___. 01/19/2011 2011000120 SDC: Reimbursement Cost - MWMC Regional WastewatE $101.97 01/19/2011 2011000120 SDC:-lmp~o~;;-me~tCost:MWMC--Regional- Wa~tewat;':T'---""i1:333.57--- ---'01r1912011------"Z01100CJ120 'SDC:c;mPiT;;;-c~ Cost - MWMCRe9i;n-alWast;:;~te7ST-~' $2-2~3-~ -~-'.~----:-01n9/2011--u- -~.. 20~11'OOO'120 SDC: Administrative Fee - MWMC' R~gi~nal Wast~~~~T' ---$10~60------- 01"119i"2011--' - _n_ -~ .-- 201~1060120 SDC: Total Sew~;"M;;:;j~tratiMF~---~-~'------"-$502AO'---- 01/19/2011-- _. -- -. --.----.. 201'1000120 .-,---.-- -..---------" .-- '--' SDC: Total Transportation Administration Fee $114.89 01/19/2011 .3~09120 Address Assignment, each new or change $38.00 01/19/2011 2011000120 . \/Villamalane fees.. Single family detached $3,468.00 01/19/2011 2011000120 Gas Piping up to 4 outlets $700 01/19/2011 2011000120 f'I,,-,,!,~~:^, Adju-"~rTlenr: Residential ...... ....___. $420.63. __ 01/19/2.Q1.1.....____.. 2011000120 Springfield Building Permit 1/19/2011 11:39:02AM Page 3of6 ~~ '" S.PRING..... F.IE~ .\?. ,- !/!i! . ,Coo?, OREGON www.ci.springfield.or.U5 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 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 01/19/2011 ISSUED: APPLIED: 01/19/2011 12/28/2010 EXPIRES: VALUE: 07/18/2011 $391,936.00 SITE ADDRESS: 6154 FOREST RIDGE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343408200 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Single Family Dwelling State of Oreg?~n Surcha~geJ12% of applicable fees} Tec~~9Iog~~~ (5% o~ permit total) SDC: Reimbursement Cost - Local Wastewater -'-~"'-'-~--'-'--' Total Amount Paid $414.70 01/19/2011 -~._-~..~-,~, $181.99 01/19/2011 '_."_'_~__'_._.m~_.~_ $2,727,06 01/19/2011 $21,958.89 2011000120 2011000120 2011000120 Plan Review ~ Deoartment Initial Review Received Due Date Comoleted 12/28/2010 12/28/2010 12/28/2010 Result Approved Reviewer Kip Kaufman Plannin9 Review 01/05/2011 12/28/2010 01/05/2011 Waiting internal Deyette Kelly Comments: Forwarded to Public Works for their review first to determine/verify impervious surface. ~~f1in~..'R;~e~~~;;~./ i?':~,"'~1i~g~Q1~[':: 1'~'~28/?~1 ?;,.~o:t?:Oj20!,1j",.' .~~ppr~.ye1~;;~::~':~~f ~ '. ::~'~y~tte,K~IIY,,'.' e.~ ,'"- "-;I~:':'.' "~~:r :<(5~,' ", '~~)":~I I :-:co~m'ent~";, '"" ~h~r~is ~ vege.~~.n6~:~,~'s~~;rneni;orjhi~ )4t:~Jace1or~]9.'~f~gUs~t~~~l6rjl!.~:6Eln'~,~lon_g the ,b?Li~da~~,':lhere~JsL~,~e~no,<:~:_:~ ,i.' .~':,,' ~"'.. ~"""."_', .-4.constructlon~~~tlvltleswlthln.theyegetation Easeme~t,-'Rrantnallve:streettrees.from the'hlllslde"'st.i~,theStreet,Tree ~.~. ..".'_ _ .'_ ':~ .'.:~.:~':;\';;'..:-4isi~!}~~~qut: .C~9r?i~a!~',~itb}heJbAp in,s.Eef~~r,;r~garqin'iftr~~ ~~'r1)'oval:'~or~q~;!r.~~;Pcf~s~rYati~n 9.ui.'ge\rn~s'.'i~;itw'ai\aCh~d'~ :: : :';;_;, . -'1 .;" ~,i~ " ~.?"". ~'.'HllIslde,DeveloRment Plan" Any trees;t9J'-~:Ple_s_erved are:to,b~fencedJothe'd~IR1Jne~J!t.~~D9~;Lc.2ngm~!!9DJ~n.~1[!9 ~.i:.~..:....2.::~~~,.:.-; Structural Review 12/28/2010 12/28/2010 01/10/2011 Waiting Internal Kip Kaufman Structural Review Approved Kip Kaufman 12/28/2010 12/28/2010 01/12/2011 Springfield Building Permit 1119/2011 11:39:02AM Page 4 of 6 www.ci.springfieJd.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 01/19/2011 12/28/2010 EXPIRES: VALUE: 07/18/2011 $391,936.00 01/19/2011 SITE ADDRESS: 6154 FOREST RIDGE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343408200 SCOPE: Single ,Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Single Family Dwelling INSPECTIONS REQUIRED I Inspections 1020 Zoning/setbacks 1090 StreetT rees 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 Underfloor framing 1260 Framing Framing Inspection: .Prior to cover and after all rough in inspections have been 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/LathlDrywall Drywall: Prior to taping. Lath/Pfaster: To be made after aI/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 Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 1999 Final Building 2200 Underfloor Mechanical 2210 Underlloor Gas 2260 Gas Service 2300 ROU9h Mechanical 2995 Final Gas 299~ Final Mechanical 3130 Footing/Foundation Drains Springfield Building Permit 1/19/2011 11 :39:02AM Page5of6 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00987 IVR Number: 811159302411 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 ISSUED: APPLIED: 01/19/2011 12/28/2010 EXPIRES: VALUE: 07/18/2011 $391,936.00 01/1912011 SITE ADDRESS: 6154 FOREST RIDGE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343408200 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residenlial PROJECT DESCRIPTION: 3170 Under/looT Plumbing 3200 Sanitary Sewer New Single Family Dwelling Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. 3315 Water Line 3400 Storm Sewer Storm Sewer Line: Prior to filling trench, 3411 Perimeter Rain Drains 3500 ROU9h Plumbing 3999 Final Plumbing Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 4000 Temporary Power Service 4225 Service or Feeder 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. 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 ~ ~Ck)({Z~ f(ICjI-zo~\ Owner or Contractor Signature Date Springfield Building Permit 1/19/2011 11:39:02AM Page 6 of6 b~ willamalane t\gj Park and Recreation District Job. NOW · 518 -Glt" SYSTEM DEVELOPMENT CHARGE WORKSHEET July 1-December 31, 2010 NAME: () tJ>oJJ,Jeu. . PHONES1i' ?-:2--'1 -4:3.51' ADDRESS: +4- b -:; J{QUY s;'T. CITY Sf'R Pr-PG1i3-f_17 ST A TEOR.. ZIP: '1 ::r4-r8 LOCATION OF PROPOSED BUILDING SITE: Street Address: 1;1--54- - PofI2-E5T R-:i:::-7A':7-r:= j;:>kD/~ Plat Name: MD IAN-rA-W <=-A-1"e Tax Lot Number: L:f8-2- s4--:S 4-98. LBB- 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) . A. . Sinale-Family Detached NO. OF UNITS \ X $3,468 per unit = $ 3,4-':'"8. C3&- B. Sinale-Family Attached NO. OF UNITS X $3,538 per unit = $ C. Multi-Family Apartmerit NO. OF UNITS X $2,906 per unit = $ D. Sinale Room Occupancy NO. OF UNITS X $1,453 per unit = . $. E. Accessory Dwellina Unit NO. OF UNITS X $1,734 per unit = $ . $ '3/1-68 .Q9- 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) $ .. . \.?(5 Development Services. Department City of Springfield .. f ,fl.J ze>l f Date 5 City of Springfield Community Services Division 225 Fifth Street Springlleld, OfZ 97477 Telephone: (541) 726-3759 Fax: (541) 726-3689 Sto . 0 0 ,!"7 Buildiilg Pemlit # COP:j~::i~e hI S- t.( I"'-"C' ..1 Project Address 2..Jj, ~ . Special Inspection and Testing To 3pplic3nts of projects requiring speci31 inspectioll or testing as per Section 1704 nfthe Oregon Structuni.1 Specially Code Please review the infonnation helow. When you have finished. acknowledge an understanding of the)nform.1tion by signing below, and return this fonn to the City. BEFORE A PER~llT CAN BE ISSlJED: The owner or owner's representative, on the advice of the responsible Project Engineer or Architect. sh.111 complete, sign, and submit to the City for review and approval this foml completed on both the front and back The o\\'ner and General Contmctor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing ]. Contractor is responsible for proper notification for tIle Inspection or Testing of items listed 2. Testing laboratory shall take .1ppropriate samples <Ind tmnsport them l(l their l<lbomtor.y for proper eV<lluation or testing. . Copies of all laboratory reports and inspections are to be sent to the Cit)' by the Testing Agency. 3. Special Inspection Agency is to submit names and qualifications of on-site Special Inspcctors to the City for approval. 4. Special Inspector shall provide inspection reports to the building official of all inspection activities. 5. Contractor is responsible to review the City approved plansfor additional inspection or testing requirements that may be noted. BEFORE A CERTIFICATE OF OCCUPANCY WILL BE ISSUED: The Special Insp~ction Agency shall submit to the Building Official a statement that all itcms requiring inspection have been fulfilled and reported and were to the best of the inspector's knowledge, in confonnance with the approved plans. specifications and applicable workmanship prOVISIons Those items not tested and/or inspected shall be noted in the Slalement. The report is to be submitted to the City prior to a request for final inspections. ~ J!ie~ a: t~ ,~ Gen. Contractor Fiml Name (Printed) General Contractor Signature . ,... ~ ~.~~ 0\\ ignature Engmeer or A tteet SIgnature ~'-'\~ 0&:;::, J'e>llllg abor1ltory Rep S'gnatuce Special lnspection Agency Name (Printed) SpeciallllSp. Ag,e~cy Rep Sign. Building Official Name (Printed), l3uilding Official Signature \ , , '~) ~ J' Structural Permit Application - 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(54 1)726-3689 DEPARTMENT USE ONLY 8/1- .5:i'f?.z.8Jh!- Perrmt no.: '18 't- Dale: II ""Z--Z;?-l( This permit is issued under OAR 918-.460-0030. Permits expire if work is not'startcd'within 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL This project has final land-use approval. Signature: Date: lbis prl?ject has DEQ approval. Signature: Date: Zoning approval verified: D"Yes 0 No Property is within flood plain: 0 Yes 0 No CATEGORY OF CONSTRUCTION FEE SCHEDULE 1. Valuation information (a) Job description: Occupancy Square feet: Cost per square foot: Other ,infonnation: Residential o Government D Commercial s. Type of HeM: Energy Path: / {-t1'&H 1'3 F new 0 alteration D nddition (b) Foundation-only permit? 0 Yes "0 No Total valuation: 2.. 3 2_ 2. Building fees (a) Penllit fee (use valuaLion table): (b) Investigative fee (equal to [2a])~ ( c) Reinspection ($ per hour): (number of hours x feeper hOllr~ (d) Enlerl2% surcharge (, 12 x [2a+2b+2c]): (e) Subtotal offees aho,,"c (2a through 2d): 3. Plan review fees, (n) Plan review (65%x penn it fee [2a)):'" (b) Fire and'life, safety (40%x pen]1il fee fla]): (c),Sublotal orfces abovc(3a and 3b): 4. Miscellaneolls fees (a) Seismic fee, 1% (.01 x permit fee [2a]): , ."" Name: 5~ ... ^ Address: '-,I.{ 61 City; S I..J... ZIP: '11" 18 Phone: "7'2..,7 "3S 7 F.-mail: A.^Q.\~~k./o.>(.W 0 t" ......... This installation is being made on residential or farm property owned by me or a member army immediate family, and is exempt from lict;nsing requiremenls under ORS 701.010, Sign here: W 1lc:/V6f1J .Cr!..: $ $ $ $ $ Business name: $ $ $ $ E~mail: CCB license no.: TOTAL fees :'Ind sUicharges,(2e+3c-f-4a): S Priht name: Signature: . .SUB-CONTRACTOR INFORMATION Name Electrical Plumbing Mccb:mical ~,.. t\W~-\h fil...S rt-...Lo.~ M_~IIS. ., , " j "'-". , i .1 225 Fifth StreettSpringfidd, OR 97477. PH(541)726-3753t FAX(541)726-3689 SPRINGFIELD'i.."::l:..'<.!i.-':l ~ , ", ~ R tJ1.,...,r:;"-"bJ ,1(.}f.".t. ~}~~i:::~&;'.~~t~' 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF .CONSTRUCTION City: Reference: Name: Address: City: 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 479560(1). Signature: Print name of signing supervisor: Signature of signing supervisor: ~k~~. ~~~ . ~~ 440-2584-J (9/08/COM) FEE SCHEOULE-- . .. t Number of inspections per item () Qty. Cost Total ea. cost Residential, per unit, service included: 1,000 sq. ft. or less (4) I $134.00 $ I"]V Each additional 500 sq. ft. or portion 71 S 25.00 S /7, thereof Limited energy (2) S 32.00 I $ Each manufactured home or modular $ 63.00 I $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) T S 61.00 I $ 20 I ta 400 amps (2) I S 95.00 I S 40 Ita 600 amps (2) I $158.00 I $ 601 10 1,000 amps (2) I $205.00 I $ Over 1,000 amps or volts (2) I $469.00 I $ Reconnect only (2) $ 63.00 I $ Temporary services or feeders: installation, alteration, relocatio'!. 200 amps or less (2) r S 63.00 S b: ~ 20 I to 400 amps (2) $ 87.00 $ 40lta 600 amps (2) $126.00 I $ Over 600 amps or 1,000 volls, see services or feeders section above Branch circuits: new, alteration, ex/ens ion per panel a. Fce for branch circuits with purchase ofa service or fecdt:r fee; Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee; FirST branch circuit (2) $ 55.00 I s Each additional branch circuit $ 6.00 S Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) S 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited.energy paneL I $ 63.00 I $ alteration, or extension (2) Each additional inspection: (I) I $56.00 I S . '~.~~ ,~.. '.. '.... AP.PLlCANT USE. . (A) Enter subtotal of above fees $J72.. (Minimum Permit Fee S58.00) (8) Enter 12% surcharge (.12 x [A]) I $ l(yr'l (e) Technology Fee (5% of [A]) I S IP'c r TOTAL fees and surcharges (A through C): S ' ~'1 '1~~ SPfl;G~.FIE.L~- '. ~Cl...~ ,;,;;; "~ .. '.. 'OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2010-00987 6154 FOREST RIDGE DR permitcenler@ci.springfield.OLIJS RECEIPT NO: 2011000120 RECORD NO: 811-SPR2010-00987 DATE: 01/19/2011 lO' ESCR"lp..'IO' 'N'iC, ;,"",," ':,.:, :.,l.r:.i'lY",' tf';"'.'.',,, "'7,.;i"; )"',,I''',l:7;;:;;(;''A-C'C'O: i'N' 'I' 'C'OO'E',' i Y" -,f.":" ' . ,'~"'A'M' . o' i 'N'I'onE:". '.: :,,,; , '.J . .. ~)l', .. _;:':;::,",.~~*'I'" ~~.~_,*_._._--"~~=""__,,-,,,,,,,,,U, "". _~__~""........~d?<' , ,U, '_ U __~t~."_'.* Address Assignment, ea_ch new or change 224-0~000-4~5602 _ _._._ _, ___3~cD~__,.. __~rT1in fee (10% of applicable fees) .__3~~:_(JOO_o.O:~?66~.~__.__._.____..,___._ ___~4]~ _" __ Curb Cut/Drivew~y 1st Cut 201-00000:428060 8~00 Each Additional Bath 224-00000-425603 95.00 --_.._,..._~.- Each added 500 sq. ft, .or portion 224-00000-426102 175,00 First Appliance Fee 224-00000-425604 79,00 Flue v~nt for water he,~ter or gas fireplace 224-00000-425604 27.00 .~~nace - up to 100,0.00 BTU 224-00000-425604 17,00 Gas PiEing - each_additional above 4 224100000-425604 8,00 __~~~.Pip!,g up to ~-".lJ~ets 224-00000-425604:. 700 Heat pump ,,_224:000D~.::4256~4 17,00 Multiple Permit Discount (Max 2) ._...3E.~:<J9~~-42806.Q.. "_~"~__ ____,__2~;00 _'_ One or Two Family Dwelling with Three Bath 224-9.o90.Q,~?~~~.~_~,__.. 439.00 Plan Review Adjustment - Residential 224-~9.Q~~-~2560~___ __ ~~,63__ Planning - Major Review - City "_.2.D0-~0"o,oO-42~~~2"_,_~_,,,,,,,, 211,00 Range hood/other kitchen equipment ___ 224-00000-425604 ,_,__ ,_1~Q..._._ Residence wiring 1,000 sq, ft, or less ___--Et~0000:42.?,~02_"",,______ 13~cOO ____ Residential Fire (.05 Per Sq Foot) 100-00000-424005 243.40 SDC: Administrative Fee - MWMC Wastewater SDC 611-00000-426604 10,00 SDC: Compliance Cosl - MWMC Regional Wastewater S~~~,~,:00900:~~6607 _ 22,63 ----2,i).s;,C'.mprovement - :r~ansportation SDC _,,,.__,,__~:!!~..o9_1!.-448027 ~.'597~___ __~g_C:Imyro-,!ement Cost:..Local Wastewater 443-00000-448025 ._,_______?~9351 _,,_~Dgc,lmprovement Cost :..~WMc.5egiona!..Was.tewater SDC 445-00000-448025 1,333.57 _ SDC:.improvement Cost - Storm Drainage 440-00000-448028 1 ,278;~__ SDC: Reimbursement - Transportation SDC 446-00000-448026 _~_ 426,92 SDC: Reimbursement Cost - Local W~tewater 442-00000-446024 4,567.46 SDC: Reimbursement Cost - MWMC Regional Wastewater SDC 444-00000-~~13_~~___ J.Q2.2?_ SDC: Reimbursement Cost - Storm Drainage 441-00000-448029 7039~_____ SDC: Sewer Administration Fee 719-00000-426604 _".J'P,<::,,,,Total Transpo,rtation Administration Fee 719-00000-426604 114.89 Sidewalk 90 Feet 201-00000-428060 88,00 Single-duct exhaust (bathrooms, toilet compartments, utility roor 224-00000-425604 ___,___,___~_.__~,OO_ Sink/basin/lavatory 224-00000-425603 19.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 __.::1~J,2,_______ Structural BuildingPermit Fee _,_,,_______?3tOOOOO-4:.~5602 ___~ll719 Technology fee (5% ~!_permit total) _______~,,_,..2.0'O:00000:::2~~~,______,__ 181, 99 Temp services 20~ amps or !~ss ...,__,__,..,_,~-OOOOO-42610~,_ ,______~.22-___,___ Willamalane fees - Single family detached 821-00000-215023 3,468,00 - ----.--.. TOTAL DUE: 21,146,35 F ':PAYMENTTYPE'\~'';;:'Pc.~X9B,S,,~:::,$;~lSHfER,sSE8AN;~'i,'I:?;~C9:M!'II_E"ttS,,~",..~,; ';~" ':'::~:'i..t\!'IIol[l'li;l'?gl!l':':. ,,' ',,- Credit Card THOMAS WALTER CUSTOM $9.500,00 HOMES LLC ;;:5-:11 "<i Check 12763 THOMAS WALTER $11,646,35 S;~~N.~_.FIE..~. ~_..~ .~.~.{ .'~'" , ."'ff:f.~ OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00987 6154 FOREST RIDGE DR CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 pe rmilcenter@ci.springfield.or.us RECEIPT NO: 2010001162 RECORD NO: 811-SPR2010-00987 DATE: 12/28/2010 !&ESCR.IPTION;+2iY::&; '. !";:~~;"+':. ""i ';;'-'<I.!(;:::~#;r!,;rJ\'i+:..,g)5to.:tJNifiCOi:fE:ii:~:*",-~M<:,-@f.l[)JJE', ","~1.0"1 Structural Plan Review Fee Residential 224-00000-425602 $812.54 TOTAL DUE: $812.54 l'~PAVMENt:t'L!1J ';;-i;pAvOR, ::.~iSA2!tE.R'BtQ.YF~6N~~i[()M]lnENis;&{il2..~;:~::li~: · '~':~~:..~M.Q.I.!ll.I.!'MiL":-':"'-' ~. :.J --Select-- 024945 Walter Custom Homes LLC $812.54 , \ $812.54 .'\t/ " f' , . ,-,.,J _ �. , �,, f � 'c ;-, '�� . :� ?" «�" _ � � r �?-.ISL ��'TF.-�.,: ,�`�'"" t ` t, { c� <..: 5 � i.��- � a.�-"t:•-'� `_. , � �%-PC� T � R >✓f C 7.�o�j ` P etfVGZJ'✓G— DrG-oniC� tt 1'-'- `(, r �t :� sem.` r,- G � ~ti Ri✓ 2," REV WED FOR ODE COMPLIaNcr p!!-rP�e7�ete PEt tiIVE.L? - Is, i ' t_ -< .. .�„M._, ...w _... _ - _--------_-, ,:.� _..,....,c.. -•--__.o P.U.E. MAY CHANGE SETBACKS %t S THE CONTENTSEtD=FS? RE\!EWEP, W_1 Of Ti�R ir RE (J PE:CIL. L:1'1.ANGES OR AL ?r�Tit�'d � MADE TO i'Hl APPROVED I�RAIIa'f��GS OR /l i { A-9 � P 7TAC�G Mi V=6 r,5 PROJECT,A T F R THE DATE- BELOW SHALL 8'E APPROVED BY THE BUILDING OFFICIAL. Work shall beinstalled in accordance with l IEW®TY O Cq� the approved construction documents and 3) _ s ' any changes made during construction that N� r ry D,ar 1"11 mv are not in -cads compliance with the r ' approved �i� G>;O. 7�ff ��1�2Pt1E-�2s` R-E�o,2� pp oved construction documents shall be ;r resubmitted x ., •'" -for approval as an amended S -• •��-�S (�( c-7Z--un1 i .�— - t 3 :z: set of construction documents. ossc los. � a/oRsc ios.aa� $ i o#3584 #3584 1 OJ DONNELL RE50EN " , f ;''"'J, l L. NN. 'SIEN"y- Wi r �1 H y � i"fI .,� R.'t4 FC/bit (�(+� (�� 7 iY 7 i. 1 9 44 �jp �jj s.� + r , ^•U ,:dmf+,%3�,F .._._- T r d ....< ; +eF e vas p K , , t3 gj # + ? Pi =1 if g§ i Hi;t{ Y N Nf �2 PAA'o 1'� o/c. , tt _ r �..2 t 1 t wo M.,, , f 1'1fi? 1 tl, t 1, 1, W W2 _ i t i a r ll {h . r irra. { �. i'c�rtal �hPar ova �t e�[u 38 ��j .. T .: :�� 1�Y_. t t C r s 4 , �__ Ile '2 �%' �•. t #f.�r r P 4A J. t 3 <" J F ,r� LCOR �* AIN 4 ray v v {' a _ ,;, '� � -- ta1.. �'2 r ±oto �i fro }!rsacit�r t+cr , , r . � - { i (.� � ��;Y'JA�.�..� r��i.. �=�1{ ze ��l�s l�f.e;. I f � �. �� { .. _. �._ w t3;�r.>: �:R, ?.x flat blocking if required, , r '•.-o- n " 2,.,_ S' .,. .,.,,{iia ?13[ - ..'Tp ra'r. r•ry n, sYrin' r • a t .rri stra lt,all n�il1n c• 1-tr*,i. t'F Elt~E�; �'l• zF.t,. a p, ' ; '; _.:_, : ': .,: . s o .r-.•: ,.,, .1 1. �)r:er-£'•i rPP'+ls°l.F fJ'` f)ilC.nidP..+acatR4 :;S1,'•b'" - !'-0 -.. c>+c,. '+y,-'.,. C"n^.Kuitfri{'sn{7is<•tte.- : _ .; ,. � s rr,•r wet:: t� 45(:�i��!€ii..l.f�'F..31GCPi�;1 dxte.itf,t! t7 c, t Pfd 1. c I r { - + • uerrtG� '37hsJi , .. `+ C a { 1 e ' These electricalla p ns are NOT prior to -ft neeElec Electrical work comply with _current codes and will be field - ATTENTION: Oregon law requires you to inspected for compliance. .........._.: follow rules adopted by the Oregon Utllrta Notification Center. Those rules are set!orth- in OAR 852-001-0010 through OAR 952•OCZ- 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). , � :. � � � -°,pis :.».-�,�'°` -. , _., -, .. - _.. ,. � .:.. ,w. ... ... ., ... .. .. .: ... :... .. ..._ --;`-'�`�FA�:`'4�`?-�"'�'a `� -.. ., .x`�.��:>`..._n�a ,..._'fin -s ass.. �ia��'i •�` � n-^� - - . :. ] . ;F � ar .: _ ..�'•.`r�_��_. « -$ �. ,.... i�. "v". �, VT `.� � �. ,v NaTtcE. .;. r THIS PERMIT SHALL EXPIRE � THE WORK ATTENTION: Oregon law requires you to AUIHQRlZED UN THIS ! ISND T recon Utility follow rules adopted by the O y COMMENCED OR IS ABANDONED FORNot Notification Center. Thos rules are set fo rth s '-j 952-001-0010 h AR952-001- n OAR throuG 0 ANY PERIOD. 180 DAY � _ �. , �,, f � 'c ;-, '�� . :� ?" «�" _ � � r �?-.ISL ��'TF.-�.,: ,�`�'"" t ` t, { c� <..: 5 � i.��- � a.�-"t:•-'� `_. , � �%-PC� T � R >✓f C 7.�o�j ` P etfVGZJ'✓G— DrG-oniC� tt 1'-'- `(, r �t :� sem.` r,- G � ~ti Ri✓ 2," REV WED FOR ODE COMPLIaNcr p!!-rP�e7�ete PEt tiIVE.L? - Is, i ' t_ -< .. .�„M._, ...w _... _ - _--------_-, ,:.� _..,....,c.. -•--__.o P.U.E. MAY CHANGE SETBACKS %t S THE CONTENTSEtD=FS? RE\!EWEP, W_1 Of Ti�R ir RE (J PE:CIL. L:1'1.ANGES OR AL ?r�Tit�'d � MADE TO i'Hl APPROVED I�RAIIa'f��GS OR /l i { A-9 � P 7TAC�G Mi V=6 r,5 PROJECT,A T F R THE DATE- BELOW SHALL 8'E APPROVED BY THE BUILDING OFFICIAL. Work shall beinstalled in accordance with l IEW®TY O Cq� the approved construction documents and 3) _ s ' any changes made during construction that N� r ry D,ar 1"11 mv are not in -cads compliance with the r ' approved �i� G>;O. 7�ff ��1�2Pt1E-�2s` R-E�o,2� pp oved construction documents shall be ;r resubmitted x ., •'" -for approval as an amended S -• •��-�S (�( c-7Z--un1 i .�— - t 3 :z: set of construction documents. ossc los. � a/oRsc ios.aa� $ i o#3584 #3584 1 OJ DONNELL RE50EN " , f ;''"'J, l L. NN. 'SIEN"y- Wi r �1 H y � i"fI .,� R.'t4 FC/bit (�(+� (�� 7 iY 7 i. 1 9 44 �jp �jj s.� + r , ^•U ,:dmf+,%3�,F .._._- T r d ....< ; +eF e vas p K , , t3 gj # + ? Pi =1 if g§ i Hi;t{ Y N Nf �2 PAA'o 1'� o/c. , tt _ r �..2 t 1 t wo M.,, , f 1'1fi? 1 tl, t 1, 1, W W2 _ i t i a r ll {h . r irra. { �. i'c�rtal �hPar ova �t e�[u 38 ��j .. T .: :�� 1�Y_. t t C r s 4 , �__ Ile '2 �%' �•. t #f.�r r P 4A J. t 3 <" J F ,r� LCOR �* AIN 4 ray v v {' a _ ,;, '� � -- ta1.. �'2 r ±oto �i fro }!rsacit�r t+cr , , r . � - { i (.� � ��;Y'JA�.�..� r��i.. �=�1{ ze ��l�s l�f.e;. I f � �. �� { .. _. �._ w t3;�r.>: �:R, ?.x flat blocking if required, , r '•.-o- n " 2,.,_ S' .,. .,.,,{iia ?13[ - ..'Tp ra'r. r•ry n, sYrin' r • a t .rri stra lt,all n�il1n c• 1-tr*,i. t'F Elt~E�; �'l• zF.t,. a p, ' ; '; _.:_, : ': .,: . s o .r-.•: ,.,, .1 1. �)r:er-£'•i rPP'+ls°l.F fJ'` f)ilC.nidP..+acatR4 :;S1,'•b'" - !'-0 -.. c>+c,. '+y,-'.,. C"n^.Kuitfri{'sn{7is<•tte.- : _ .; ,. � s rr,•r wet:: t� 45(:�i��!€ii..l.f�'F..31GCPi�;1 dxte.itf,t! t7 c, t Pfd 1. c I r { - + • uerrtG� '37hsJi , .. `+ C a { 1 e ' These electricalla p ns are NOT prior to -ft neeElec Electrical work comply with _current codes and will be field - ATTENTION: Oregon law requires you to inspected for compliance. .........._.: follow rules adopted by the Oregon Utllrta Notification Center. Those rules are set!orth- in OAR 852-001-0010 through OAR 952•OCZ- 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).