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Home My WebLink AboutPermit Building 2004-1-29 ~.~--~ /' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01/12/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line :r. SITE ADDRESS: 862 S ST ASSESSOR'S PARCEL NO.: 1703261309400 SPRINGFIE TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: SFR, Lot 33, Mimosa 2nd Addition. Adjust plumbing permit to include 3rd bath, 033004 DB. 14.00 ~~ Overlay Dist: 10.60 ~\J R)'\# Street Trees Rqd: 2 12t~~~ ~c- ~ Paved Drive Rqd: Y ~ ~~ ~ Rearyard Setback: -&.~~~ ~ ~\:)~ % of Lot Coverage: 27.70 you to Solar Setbacks: \, ~r-,*,~~~\\~ ....-rENTION:Oregon laW reqUires Utility . 0~\,; ~ '\. '-' r~'V A.I I _.. _... uv l..,: ~~dnQ Oreaon ~\fV<i.' ~'\ "O'\)\\\)Y.; S tr.~'i' I PUBLIC IMPR~~Wf~nt;r Those rules are set ~; ~t\ ~~~\) \j~ '\ R)\)' . ~vul~......l.!r O~i1IJ thrf(4Qh OAR 952- Street ~~~ -A\J~~'"":R.J~\) ~~~ Fullv Improved 10 OAR 952-001- Q{ai~'opieReOf the rules \ Setback 5' Storm sew~ti' =<v~ Yes 0090. You may oltE~w~\y'Smeat8LephO~Eturb and Gutter Special Instrt~ ~<o~ calling the cen e. n Utility Notification tr.\\~ numper for the:?~~~~rV~~?_2344). !"'_.-....."..,.,... . Owner: HIATT BERNARD D Address: 836 R ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Electrical Plumbing Contractor MICHAEL HIATT CONSTRUCTION REYNOLDS ELECTRIC SHAD CHASAN SURRETT License 152009 17252 158295 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U-l VN # of Stories: 2 Height of Structure 25.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Energy Path: Path 1 3 SETBACKS I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: " Notes: Paee 1 of 4 Expiration Date 06/2812004 02/0812005 01114/2006 Phone 741-0384 541-343-7297 541-741-3553 Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 7,481 1,683 1,070 396 REQUIRED PARKING Total: Handicapped: Compact: 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwellines Garaee V Wood Frame Garaee Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge 2 Baths One or Two Family Addressing Assignment Annexed 1979 or Before Appliance Vent Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Heat Pump Plan Review - Planning PW Mult Disc - 2nd Permit Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family + 10% Administrative Fee + 7% State Surcharge Minimum/Adjustment Plumbing I Valuation Descriotion I $ Per Sq Ft or multiplier $92.40 $24.30 Square Footage or Bid Amount 2,753.00 396.00 Total Value of Project ~ Amount Paid $714.12 $10.00 $147.87 $103.51 $254.00 $31.00 $-14.71 $6.00 $1,098.65 $75.00 $6.00 $9.00 $12.00 $15.00 $4.00 $12.00 $59.00 $-30.00 $344.20 $452.80 $10.00 $214.23 $314.63 $108.45 $53.25 $727.42 $164.89 $75.00 $1,020.51 $50.00 $12.00 $1,000.00 $5.20 $3.64 $52.00 Date Paid 1/12/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 1/29/04 3/30/04 3/30/04 3/30/04 Paee 2 of4 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01112/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 Value Date Calculated $254,377.20 $9,622.80 $264,000.00 01/12/2004 01/12/2004 Receipt Number 1200400000000000042 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000133 1200400000000000404 1200400000000000404 1200400000000000404 '-u;:; .. CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01112/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Amount Paid $7,120.66 ~ I Plan Reviews I Initial Review 01/13/2004 01/13/2004 APP LLH Planninl.!: Review 01/13/2004 01/26/2004 APP TAJ Public Works Review 01/13/2004 01/14/2004 APP VRJ Structural Review 01/13/2004 01/28/2004 APP TCM To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. L...ReouiredJnsnections I 'io 1 Curbcut - Standard: After forms are erected but prior to placement of concrete. 2 Sidewalk - Setback: After forms are erected but prior to placement of concrete. 3 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 4 Footing: After trenches are excavated. 5 Foundation: After forms are erected but prior to concrete placement. 6 Post and Beam: Prior to floor insulation or decking. 7 Floor Insulation: Prior to decking. 8 Shear Wall Nailing: Before covering sheathing with finish materials. 9 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 10 Wall Insulation: Prior to cover. 11 Ceiling Insulation: Prior to cover. 12 Drywall: Prior to taping. 13 Final Building: After all required inspections have been requested and approved and the building is complete. 14 Underfloor Plumbing: Prior to insulation or decking. 15 Underfloor Drain: Prior to cover or placement of concrete. 16 Rough Plumbing: Prior to cover and including required testing. 17 Water Line: Prior to filling trench and including required testing. 18 Sanitary Sewer Line: Prior to filling trench and including required testing. 19 Storm Sewer Line: Prior to filling trench. 20 Final Plumbing: When all plumbing work is complete. 21 Underfloor Mechanical. Prior to insulation or decking and including required testing. 22 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 23 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. 24 Rough Mechanical: Prior to Cover 25 Final Gas: When all gas work is complete. 26 Final Mechanical: When all mechanical work is complete. 27 Temporary Electric: Approval required prior to Utility Company energizing pole. 28 Rough Electric: Prior to Cover 29 Electric Service: Approval required prior to utility company energizing service. 30 Final Electric: When all electrical work is complete. .~ Pal.!:e 3 of 4 '-Wli:S~A,JiNGl~JELD .-~' , .,." -'. . ,- ~_..' .--- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01112/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 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 of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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 construction. ~ ~ -------- Owner or Contractors Signature Pal!:e 4 of 4 )-)0) -Cf)f Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00042 COM2004-00042 COM2004-00042 Payments: Type of Payment Check Receipt #: 1200400000000000404 Description Minimum! Adjustment Plumbing + 10% Administrative Fee + 7% State Surcharge Received By djb Check Number Batch Number Authorization Number Paid By MICHAEL HIATT CONSTR 1272 ,}...J City of Springfield Offichil Rec~ipt Development Services Department Public Works Department Date: 03/30/2004 1:07:15PM Amount Paid Item Total: 52.00 5,20 3,64 $60.84 How Received In Person Payment Total: Amount Paid $60,84 $60.84 225 FIFTH STREET l!l SPRlNGFIEL , OR 97477 ill PH:(541)726-3753 l!l FAX: (5 ELECTRICAL PERMIT APPliCATION City Job Number CQMzcc:.4 - OOOLA Z Date 1. ~fQ~~~ <gbZ- S s . LEGAL DESCRIPTION '703 Zb'3 '~lro~t( /"m:~( _,.,"-,""""",~",,,,,,,~,,,,,,,,,, , .'.,," ,"",.,,'!!I'l!fi',U ",,:"'!.!:!!t~. 3. itCOMPLeH:~/FEESCHEDrJLE'11ELO ~~~~~"~~~f.~~..ili~:,~l",:l<.;'~ -. ..,....... "-h ,.~.. ~"-:t~~~i}]~~~ JOB DESCRIPTION A. ri~~~~~~i~1tl.tr o 7 1(00 Se~ij~~Bed . '\\eO na: \ (10 US . eC\ as SU'O~~ s~a1:OOO ~q. ft. or less S);:::f) \\O'tJi(l~ 9~O\ (10\ {e~U\ Each additi 00 sq. ft. or ,"-- ~~e\~, a(lo ooes . .-n(L . ereof 7.0"\' g \ V Permits are non-transferable and eiptPtii ~~ Jf:: ~ anufac ' orne or not started within 180 days of issuance or u work' welling Service or Suspended for 180 days. Oa.\e itl(\e.\llte ~~,l;o-<;.'~tc,.wr",'~;".l.";",j~~<<f~i':~,,' :;"'~,~r":N~i~'*,'!it~,-:Tdl~,~'"..4,' ~;:'';~1:',... i1' t::CON.TR1f.CXOR1NSTJ . c',' '1:"IJ;lNs'ONL, 2. i.l;,1tiiii',;;.l;:~~~~':'.\.' ,"''1.' ......c.,' . ,~."IF.'" ~l~~~p!p~~~D~' J ~ $ 19.00 J06 '7b $106,00 $50.00 B. City El-ft'lene V Phone 3 cf3 -72-'1 7 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN 0115 Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Electrical Contractor A'cw";olt:!s Qed. 4<:.. ~ . Address .:J / 75" LM L It t;/ Ave. Supervisor License Number ~ 5 ~ t) - 5 /o/~Y ~ Expiration Date Installation, Alteration or Relocation Constr. Contr. Number 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps Expiration Date a 2-/ 0 ~ f "0'/' ~I\I.,.. Over 600 Amps or 1000 Volts see "S" above. /10 'v, 10 ~",..,..,.,,,.., H Signature of Supervising Electrici~t/~' "." rut. '!\f..O D. '(~r~nc II] 0 lCl!lt.. 98 li 'I'&{): Q _ ~O ,...'..qA ~~I].9& dO/)t& 01] lcJt:w Alteration or Extension Per Panel ~~:~~lfltSI". .,.%6Ytt~}J)t $43.00 ownti=e ~3b~~ :;~;;lli~;~:~~Zg~~:::: _:~'~:'::*'~_"'M',;.~.;;:"~,,,. Address ,0 1'- S j-.." rSn....,., Ot&: . ( . ',~~:1P.~.l:s!~q~~~ii"~..:~~~~t~!l;t~~~~:' . ~ ~ f!\ ~ Q;"~'/ Utili1-..S tSle lJ/~8 -- -.--,---.. City ~ il UJ Phone -~'b 'Y~~dmgalion $ 50.00 [vUT/CE. '"-?,14~p~l}ffi~ Lighting $ 50.00 OWNER INST1J.fj.s.~1T Limited En~rgyfResidential $ 25.00 ;me in.stallation tJ~JfAJil}rJJJ~~~/dryEIX:Pr1?rWCh Limited Energy/Commercial $ 45.00 IS not mtended W/Vy 11, fif~E!() fJR '{)ER THIS PE F THE .um Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: 80 DAY PER:gD:BANDON~~/JO'SR~Cfti~j~t~?li!ili:.::ty, ..,~..~.",7.~......., -~ 10 Z . __.. _ . _ .,___.~_.. _~~_. ._"",,,,~".' D 7% State Surcharge I ~ 7'1 10% Administrative Fee 1 ~zo 'z. 12- 'Ci / 7 z.-s- 2- $ 50.00 $ 69.00 $100.00 Inspection Request: 726-3769 TOTAL Shared Drive(T:)IBuilding Forms/E!ectrical Permit Application l-03,doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01/29/2004 APPLIED: 01/12/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 862 S ST ASSESSOR'S PARCEL NO.: 1703261309400 SPRINGFIE TYPE OF WORK: Single Family Residence " ~ TYPE OF USE: New Residential PROJECT DESCRIPTION: SFR, Lot 33, Mimosa 2nd Addition. Adjust plumbing permit to include 3rd bath, 033004 DB. Owner: HIATT BERNARD D Address: 836 R ST SPRINGFIELD OR 97477 I BUILDING INFORMATION I \0 # of Units: 1 # ofS~~~:.~" 2 Primary Occupancy Group: R-3 I:I..~~~~~(Ure 25.00 Secondary Occupancy Group: U-l ,\0~~"g1l.P\: J:)() Forced Air Gas Primary Construction Type VN ~ \'().~ ~9Wa~0-~~'2.: .eS \. Gas Secondary Construction Type: O,\0~0 6 '0" \'l ~~IO~&~~~ ~0 Gas # of Bedrooms: O~. ~\0 ~'~..o~0 ~g~\~'{\O i\O~ Path 1 ~~~~ fO'().~"'0'\' C~,\.O <\\0':1 0\~ i~\C0' .A'~ ~\0 ...'(ow" r.." ,.O,"",~ ..\0 ~~\\O~ \~\o~ ~~C\ 'h~~0j:~~~ORMATION I SETBACKS i~\C~ 9>~'2.: t<''().~ ~\16' ~O\' n,f?-if'ii ~O ~'{. ~ C0 0,\0 ('.\'.,. \~ 0 O.~i>4 (}lJ\0 ~0 ',f"'''' eJverlay Dist: ccg ~~~o'\ .,,' # Street Trees Rqd: ' ~~~~o r"'~ Paved Drive Rqd: 36.90 % of Lot Coverage: \)~'& 32.50 ~ 0;. ,\\t. ~ ~\)\ I PURL,s: ,.;;~_ n:{\C~:..,,~\\ 'O~l~t.~ \t ~\)\i \\~ F~t\ffllI!~~V t:-.'O~ ,\\\'0 C)~\tt; ~~~ \'0 ~ ~~\~ ~t.~C~ C(t.~\fJ. C\)~ \fQ\) \)~ ~\\'{ Contractor Type General Electrical Plumbing i} Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: '~ Storm Sewer Available: Special Instruction: Notes: I CONTRACTOR INFORMATION I Contractor MICHAEL HIATT CONSTRUCTION REYNOLDS ELECTRIC SHAD CHASAN SURRETT License 152009 17252 158295 Expiration Date 06/28/2004 02/08/2005 01/14/2006 Phone 741-0384 541-343-7297 541-741-3553 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 7,481 1,683 1,070 396 REQUIRED PARKING 2 Total: Handicapped: Compact: 2 Yes 27.70 Sidewalk Type: Setback 5' Curb and Gutter Downspouts/Drains: Pal!:e 1 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01/12/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft Square Footage Value Date Calculated or multiplier or Bid Amount Dwelline:s V Wood Frame $92.40 2,753.00 $254,377.20 01/12/2004 Garaee Garaee $24.30 396.00 $9,622.80 01/12/2004 Total Value of Project $264,000.00 ~ Fee Description Amount Paid Date Paid Receipt Number ~ Plan Review Residential $714.12 1/12/04 1200400000000000042 -Mechanical Issuance Fee- $10.00 1/29/04 1200400000000000133 + 10% Administrative Fee $147.87 1/29/04 1200400000000000133 + 7% State Surcharge $103.51 1/29/04 1200400000000000133 2 Baths One or Two Family $254.00 1/29/04 1200400000000000133 Addressing Assignment $31.00 1/29/04 1200400000000000133 Annexed 1979 or Before $-14.71 1/29/04 1200400000000000133 Appliance Vent $6.00 1/29/04 1200400000000000133 Building Permit $1,098.65 1/29/04 1200400000000000133 Curbcut Permit $75.00 1/29/04 1200400000000000133 Dryer Vent $6.00 1/29/04 1200400000000000133 Exhaust Hoods $9.00 1/29/04 1200400000000000133 Furnace - up to 100,000 btu $12.00 1/29/04 1200400000000000133 Gas Fireplace $15.00 1/29/04 1200400000000000133 Gas Outlets 1-4 $4.00 1/29/04 1200400000000000133 Heat Pump $12.00 1/29/04 1200400000000000133 Plan Review - Planning $59.00 1/29/04 1200400000000000133 'Ii PW Mult Disc - 2nd Permit $-30.00 1/29/04 1200400000000000133 Sanitary Sewer - Improvement $344.20 1/29/04 1200400000000000133 Sanitary Sewer - Reimbursement $452.80 1/29/04 1200400000000000133 SDC MWMC Administration $10.00 1/29/04 1200400000000000133 SDC MWMC Improvement $214.23 1/29/04 1200400000000000133 SDC MWMC Reimbursement $314.63 1/29/04 1200400000000000133 SDC Sanitary/Storm Admin $108.45 1/29/04 1200400000000000133 SDC Transpo Admin $53.25 1/29/04 1200400000000000133 SDC Transpo Improvement $727.42 1/29/04 1200400000000000133 SDC Transpo Reimbursement $164.89 1/29/04 1200400000000000133 Sidewalk Permit $75.00 1/29/04 1200400000000000133 Storm Drainage Impervious Area $1,020.51 1/29/04 1200400000000000133 Temp Power 200 amps or less $50.00 1/29/04 1200400000000000133 Vent Fan $12.00 1/29/04 1200400000000000133 Willamalane Single Family $1,000.00 1/29/04 1200400000000000133 + 10% Administrative Fee $5.20 3/30/04 1200400000000000404 + 10% Administrative Fee $18.20 3/30/04 2200400000000000301 + 7% State Surcharge $3.64 3/30/04 1200400000000000404 Paee 2 of 4 t: Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 0112912004 APPLIED: 0111212004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 7% State Surcharge Minimum/Adjustment Plumbing Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 $12.74 $52.00 $106.00 $76.00 3/30/04 3/30/04 3/30/04 3/30/04 2200400000000000301 1200400000000000404 2200400000000000301 2200400000000000301 '" Total Amount Paid $7,333.60 I Plan Reviews I Initial Review 0111312004 01113/2004 APP LLH PlanniDl.! Review 01113/2004 01126/2004 APP TAJ Public Works Review 0111312004 0111412004 APP VRJ Structural Review 0111312004 01128/2004 APP TCM To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. 1 Curbcut - Standard: After forms are erected but prior to placement of concrete. 2 Sidewalk - Setback: After forms are erected but prior to placement of concrete. 3 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 4 Footing: After trenches are excavated. 5 Foundation: After forms are erected but prior to concrete placement. 6 Post and Beam: Prior to floor insulation or decking. 7 Floor Insulation: Prior to decking. 8 Shear Wall Nailing: Before covering sheathing with finish materials. 9 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 10 Wall Insulation: Prior to cover. 11 Ceiling Insulation: Prior to cover. 12 Drywall: Prior to taping. 13 Final Building: After all required inspections have been requested and approved and the building is complete. 14 Underfloor Plumbing: Prior to insulation or decking. 15 Underfloor Drain: Prior to cover or placement of concrete. 16 Rough Plumbing: Prior to cover and including required testing. 17 Water Line: Prior to filling trench and including required testing. 18 Sanitary Sewer Line: Prior to filling trench and including required testing. 19 Storm Sewer Line: Prior to filling trench. 20 Final Plumbing: When all plumbing work is complete. 21 Underfloor Mechanical. Prior to insulation or decking and including required testing. 22 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 23 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. 24 Rough Mechanical: Prior to Cover 25 Final Gas: When all gas work is complete. 26 Final Mechanical: When all mechanical work is complete. 27 Temporary Electric: Approval required prior to Utility Company energizing pole. Pa2e 3 of 4 ._~.eIl!!J:~~~I!I_~'?I? 't I i t CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2004-00042 ISSUED: 01129/2004 APPLIED: 01112/2004 EXPIRES: 08/18/2004 VALUE: $ 264,000.00 ~t 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726,-3769 Inspection Line 28 Rough Electric: Prior to Cover 29 Electric Service: Approval required prior to utility company energizing service. 30 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 of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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 construction. Owner or Contractors Signature Date ;'J Pa!!e 4 of 4 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00042 COM2004-00042 COM2004-00042 COM2004-00042 Payments: Type of Payment CreditCard it... Receipt #: 2200400000000000301 Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 7% State Surcharge + 10% Administrative Fee Paid By ELLEN REYNOLDS Received By djb Check Number Batch Number Authorization Number 000339 030631 City of Springfield Officiaf Receipt Development Services Department Public Works Department. Date: 03/30/2004 , . 3:32:21PM Amount Paid 106,00 76.00 12,74 18,20 $212.94 Item Total: How Received In Person Payment Total: Amount Paid $212,94 $212.94