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Home My WebLink AboutPermit Building 2011-5-11 . " CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00590 IVR Number: 811175420898 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 05/11/2011 04/13/2011 Issued 05/11/2011 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 11/06/2011 $85,597.72 SITE ADDRESS: 2380 D ST. Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361413200 SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential Remodel and addition to existing single family residence PROJECT DESCRIPTION: Phone Number: 541-505-7543 OWNER: ADDRESS: CORBIN SHAWN M 2380 D ST SPRINGFIELD DR 97477 CONTRACTOR INFORMATION I Contractor Name Lie Type Lie No Lie Exp Phone OWNER OWNER 0000000 08/12/2025 OWNER OWNER 0000000 08/12/2025 OWNER OWNER 0000000 08/12/2025 OWNER OWNER 0000000 08/12/2025 BUILDING INFORMATION I Contractor Type General Contractor Mechanical Contractor Plumbing Contractor Electrical Contractor # of Units: o 1 25 Wall Heat # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Electric Electric No Occupancy Type Construction Type R-3 Type VB # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal! Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: . Structural Specialty Code Edition: No No Path 4A Zonal heat with 75% permanent fixtures fitted with CF Ii hts I A 1/ j I follow rules ~dopted by the 6ill! l(j~ !lUll! , Site Information EngineerN!l6llcation Cenm. Those rlj'El~.!lr set 01,,_ Fill VoluJWl:OAR 952-0.0.1-0.0.10. through ~1\~@.9$-~~:, Flood HaOOlll).rolrou may IlJiltain cOPlesLo:t1~frule~:~y land Hazar<tallimg the ceiM@r. (Note"thjll\",:~M1;\,<;;'l Retaining ~tnber for thEN9regon UtlllW liQJ!fc!nlon Soils Report RequirQllnter rl.% :h8Q(k3..3~,-~ilrll' lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy load: 7200 884 o 2008 NOTICE: " ' , 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 5/11/2011 12:42:18PM Page 1 016 ~ SP.RIN...G: IE~Du- ~Ml ..' ~ .ak 0~^tt.0 ~ .;::~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00590 , IVR Number: 811175420898 225 Fifth SI 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 05/11/2011 ISSUED: APPLIED: 05/11/2011 04/13/2011 EXPIRES: VALUE: 11/06/2011 $85,597.72 SITE ADDRESS: 23800 ST, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703361413200 SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential Frontyard Setback: 20 Interior Setback: 9.9 Sideyard Setback: 9.6 Rearyard Setback: 57 Solar Setback: 32.5 Remodel and addition to existing single family residence DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: No REQUIRED PARKING Total: Handicapped: Compact: PROJECT DESCRIPTION: % of Lot Coverage: Highest point on structure to north property line: 23.3 25 . PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspoutlDrains: I Valuation Description ~ Descriotion R-3 1 & 2 family Tvee of Construction VB Unit Amount Unit Tvoe 884.00 Sq Ft Unit Cost 96.83 Value 85,597.72 85,597.72 Springfield Building Permit 5/11/2011 12:42:18PM Page2of6 , 0 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00590 IVR Number: 811175420898 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or,U5 PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 05/11/2011 04/13/2011 EXPIRES: VALUE: 11/06/2011 $85,597.72 05/11/2011 SITE ADDRESS: 2380 D ST, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703361413200 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential Remodel and addition to existing single family residence FEES PAID , Descriotion Amount Paid Date Paid Recio! # Structural Plan Review Fee Residential $231.04 04/13/2011 2011000702 - -- -. - -- ~- -.--._~-~ -._---- ----,-~_.._--_._---,~.._._"..._.~--_._-_.._. Water heater $19.00 05/11/2011 2011000922 ----.-~~-" -,-,_.",~_.,---_.,.. ~"'--""'._------"._'- Admin fee (10% of applicable fees) $4.42 05/11/2011 2011000922 Firsti\ppliance Fe~_.__ $79.00 05/11/2011 2011000922 Single-du.."t exhaust (bathrooms, toilet compartments, utili $27.00 05/11/2011 2011000922 Each added 500 sq. ft. or portion $50.00 05/11/2011 2011000922 Residence wiring 1,000 sq. ft. or less $134.00 05/11/2011 2011000922 Water closet $1900 05/11/2011 2011000922 Show"r~Shower pan $19.00 05/11/2011 "'___ 2011000922, Sink!l:~sin/lavatory $38.00 05/11/2011 2011000922 Clothes washer $19.00 05/11/2011 2011000922 Structural Plan Review Fee Residential $416.37 05/11/2011 2011000922 _.*_.---- ._-..._,."~._.~_._..._-~ Residential Fire (.05 Per Sq Foot) $44.20 05/11/2011 2011000922 ~t"t~ ~~"-g.':~:S--".~~h,,r!!.ei1j~/o' of ;ppii~;;bi;;-;eesi---~ --==:}1'32!..9 -==::::::::::::::o5Ti1i201~::::_-=_,__~!..!..~~922 Technology fee (5% .of permit total) $55.08 05/11/2011 2011000922 Structural Plan Review Fee Residential $-231.04 05/11/2011 2011000922 Technology fee (5% of permit total) $-0.95 05/11/2()_12...__ 2011000922 State of Oregon Surcharge (12% of applicable fees) $-2.28 05/11/2011 2011000922 SDC: Reimbursement Cost. Local Wastewater $790.32 05/11/2011 2011000922 SDC: Improvement Cost. Local Wastewater $385.74 05/11/2011 2011000922 SDC: Total Sewer Administration Fee $58.80 05/11/2011 2011000922 Structu~.suilding ~.:~~lt Fee____~.~,____._~_~640.57-- 05/11/201i-~_~._,__ 2011000922 Planning - Minor Review - City $119.00 05/11/2011 2011000922 SDC: Improvement Cost - Storm Drainage $290.39 05/11/2011 2011000922 . SD,c Reim~~eme~ICO..t:sto;;;:;Drainage---------}i' 9958==___=_-'05/11/2011 201i'00692'2 Hose bibb $38.00 05/11/2011 2011000922 _._~-- TOla,1 Amount Paid $3,575.43 Springfield Building Permit 5f11f2011 12:42:18PM Page 3 af6 . . CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00590 IVR Number: 811175420898 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 05/11/2011 04/13/2011 05/11/2011 SITE ADDRESS: 2380 D ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361413200 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci,springfield.or.us EXPIRES: VALUE: 11/06/2011 $85,597,72 SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Remodel and addition to existing single family residence Plan Review DeDartment Application Acceptance Received 04/13/2011 Due Date 04/13/2011 Comoleted 04/19/2011 Result Application Accepted I Reviewer David Bowlsby Planning Review 04/19/2011 04/19/2011 04/22/2011 Approved Tara Jones {~ct~Or~I_:~~_~ieW:\7-~j~v.~; '~~~-:~~"~2~~;1}~ O~l~~.;~~f'~:~- ?~~~~?!.~?:,J:-"~~:" - A~~'~:I_nfo:R,~qU.j~e'dtr. ,.' :~.'cr.,~..~i~;~9._::_~,rp.~try._:0;t:~;:_~.~;~ ." , .~;::72~.";'i'r '1 !' Comm'ents':Stairframing:detailsand~revision-of:south,waILframing'required ::,;-' .~:t.~,~.;,;:. ,:;';_'A<~~": ':~'::"'j/;:r~'" t;+ J7,~"t; '"f~,!-'~:" ::"'.:-" cp'; .,~~-,:"" ..;;,_c"^ ^"" ::._ ";.2~ ~ ~~::..~~-~ .~',,'" "" ""~,;;,,;'::-"Il'.::.~,-,-:~~~ '~j'-*-:' t..(t-, --~,,- c_~.-,.;, "- - f -~",___"":._,_~"':'~..--..i!"J.,~~.___......;........",:"":_::,,, . Public Works Review 04/19/2011 04/19/2011 04/25/2011 Add'l info required Todd Singleton Comments: Received 4/2512011. Spoke to architect and requested updated plans that reflect accurate existing vs proposed drainage Public Works Review 04/19/2011 04/19/2011 Comments: Stormwater to existing eaves. ~~_~~~I..~C~i~V!~~-~_-';P'~::"~;T :~'p~j~/~9:J ~>~-kQ;~1~(~1,1 ~;;s,q.t~~{$g,~-:l~i~~-:;A~~'~~~f~,,~,~~g~-~ ,~~q,~d~+9~rp~rt?(~:{_;__?~= :~~.~.. ~ '~~::~~yco',," [~lrl~s: ,~e_e,9' ~~S~~~t';~1l!lJF~QQ~P~,Il!r.e.:f2mY,n!:;>lP~_cnanlc~Litt3ri,;!,~c6g!1~;:~.le~Jr_tca!!appJl~~lo"n, -h~ats_~tJrce'type'aiid -ene'r9~r6p"~ion. ' Structural Review 04/19/2011 04/19/2011 05/06/2011 Approved Chris Carpenter Springfield Building Permit 5/11/2011 12:42:18PM Page 4 of 6 << www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00590 IVR Number: 811175420898 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe nnitcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/11/2011 ISSUED: APPLIED: 05/11/2011 04/13/2011 EXPIRES: VALUE: 11/06/2011 $85,597.72 SITE ADDRESS: 2380 D ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361413200 SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Remodel and addition to existing single family residence INSPECTIONS REQUIRED ~ Inspections 1020 Zoning/setbacks 1110 Footing Footing: After trenches are excavated. 11.18 Footing Drain 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 1220 Underfloor framing 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling 1520 Interior Shearwall Ceiling Insulation: Prior to cover Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior Shearwall 1540 Gypsum Board/lathlDrywall 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. Rough Mechanical: Prior to Cover 1999 Final Building 2200 Underlloor Mechanical 2300 Rough Mechanical 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. 3170 Underfloor Plumbing 3500 Rough Plumbing 3999 Final Plumbing Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Springfield Building Permit 5/11/2011 12:42:18PM Page 5 of6 .. SP~~N:::~~ ~~ ~OREGON 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-SPR2011-00590 IVR Number: 811175420898 perm itcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/11/2011 ISSUED: APPLIED: 05/11/2011 04/13/2011 EXPIRES: VALUE: 11/06/2011 $85,597.72 SITE ADDRESS: 2380 D ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361413200 SCOPE: Single Family Residence WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Remodel and addition to existing single family residence 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 o.n 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. L-~hfJJJrL7I/l. r{Jh~u0 -5-- /1 - rf Owner or C~ctor Signature Date Springfield Building Permit 5/11/2011 12:42:18PM Page 6 016 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753+FAX(541)726-3689 . - . DEPARTMENT USE ONt. Y .' .1".,' 5 PrLWl! - ()O 590 Penmt no.: Electrical Permit Application . D Date: s,-//-// This permit is issued under OAR 9]8-309-0000. Permits are uontransferable. Permits expire if work is not started within ]80 days of issuance or if work is suspended for ]80 days. . .. , ';'I{OCAL;: GOVERNMENT";6;BP.ROVA13'-hl1j It]',i''\'t: 0l)~;';;::'~;~f0ti\;~l~f-;y;!,~~~~q1F.;EE~SCH E_b.U LSEs~~~~1~~~tt):~1~L~~~:}}Fl "j- Zoning approval verified? D Yes DNa . ,-, " ,. '. ',',-' . ',,,C" _',' -,~ . Cost Total: ,Nu"!~er ;;f:in;p'ectio'risp'~ritein-( );.<;Q'ty. -" ~".::\"" ./,."(CATEGOR,,,;iol;)rCONS'fRLJCTIONI;;II/:;'; . \. ,,i . . '.;.- ,'...., "7"___>'_"..,' ',-" ..1<.,.,.,.', .". ! ", . t~ ,- '. ";". ... ',', .'.f'?~;l,;tt.'.:. .:" c.ost,_/: ~sidential I D Government I D Commercial Residential, per unit, service included: 1,000 sq. ft. or less (4) 1 $iSLf it:lii~'Yj;JOB;;;SITE(:INF_ORMATlONliJi.NI)~ltrO.C'A;rION~:if.,~KF $134.00 Job site address: :23,5/0 i> S"/ Each additional 500 sq. ft. or portion Z $ 25.00 $ SO thereof City: ...J ,t<? /-iJ I State: 0/2. I ZIP: 975/7- Limited energy (2) $ 32.00 $ Reference:/70 ?:Jb/L( I Taxlot.Is 2. 0 0 Each manufactured home or modular $ 63.00 $ . ,Ji,"','" '.. . .-DESCRIPTION OF' ,wORK;i-':\Y:,,,'."[;';<'/;,' dwelling service or feeder (2) .4/7 j) j 7-/#4/ Services or feeders: installation, alteration, reLocation 200 amps or less (2) $ 81.00 $ :PROPERTYOWNER 201 to 400 amps (2) $ 95.00 $ Name: ?t//L / /-1;<.4 -.,- 401 to 600 amps (2) $158.00 $ t:. / A YL.C',-z.. Address: 2- J' 90 j) ..J ~ 601 to 1,000 amps (2) $205.00 $ City: 0/"'/ U I State: o,z. I ZIP "7/''/7 Over 1,000 amps or volts (2) $469.00 $ Phone0'o/'/ J:O.5- 75/V..? I Fax: - Reconnect only (2) $ 63.00 $ - E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). ,tl..Avi~('fI1#A 401 to 600 amps (2) $126.00 $ ~ V -j U Over 600 amps or 1,000 volts, see services or feeders section above Signature: L-----/ ;r 011 :;CONTRACr<fR" INSTALLAT ON v ., Branch circuits: new, alteration. extension per panel Business name: hJ tJ.3lZ.. a. Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit $ 6.00 $ City: I State: I ZIP: b. Fee for branch circuits without purchase of a serviceor feeder fee: Phone: - - I Fax: - - First branch circuit (2) $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: I BCD license no.: Miscellaneous fees: service or feeder ~ot included Signing supervisor's license no.: Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) \~~ Each additional inspection: (I) $58.00 $ fill~~f;~r~jf~~~f~~%kt~AR~i1lc'pt~f~-USEt~it;~i%'~ltf~1i~~~F{F. ;~'.~ (A) Enter subtotal of above fees cgL( (Minimum Permit Fee $58.00) $ J l<0=:'. (B) Enter 12% surcharge (.12 x [A]) $ '2"2--0 ~ (C) Technology Fee (5% of [A]) $ 9 in TOTAL fees and surcharges (A through C): $ '''71" Z-- - V -/ 440-2584-J (9/08/COM) Structural Permit Application - 225 Fifth Street. Springfield, OR 97477. PH(54 1)726.3753 . FAX(54 1)726-3689 DEPARTMENT USEONL y. St>/LZOI/-OOS,!O Permit no.: Date: This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days ofiss~ance or if work is suspended for 180 days. .- ,..,;;;l;';;116c:A{cq'QYERHM~N'tJ;'AeR[9xi,\~t:!~~1;;;i.f~gti~J~;1 This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval verified: DYes 0 No Property is within flood plain: 0 Yes 0 No ~.1!,\~!?(i~~1~19AtEq1)~g~0f;J;<::oNsfBUC[I.QN~l~)~~~1iI;4'i4l&i/ Residential 0 Government 0 Commercial ~'?jii;~:::,~~:~qgB;~:,S.lJt$l ,fN'.~9f.{r~rA~f9~,2~Nj~l~9P~j!9N~~~~4~~'::;~t!~ Job site address: :z 3 7 cJ S r: City: P/~ ,i) ZIP: 97 V 7 Subdivision: Reference: I',> . Name: State: {) IZ Fax: ZIP:9lY71 E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements u der ORS 701.010. Sign here: ,.... ,". Business name: Address: City: Phone: E-mail: CCB license no.: State: Fax: ZIP: Print name: Signature: rtr~q~t~~;; ~1;:t~)~'4%'b'S,~'_B'~,G_0'NftI~ACitQR,J. N~,Q:RM!\~I-QJ~Tt%~l;;$g~i~~1L?Z:;}~ Name CCB License Number Phone Number Electrical 0 WM ~ Plumbing 0 ~N -<L Mechanical " " :"'\',"',.-;:;. ::';"~S;:~'O:EE qSCHEOiiLE' ::":. ;1:'~,'Y~'.I~~.t~~'hVi~fod;nWi.~:~\~\~~~~1~~1.~~t~:~~;~t~~~W.;~:I,!t(.i~'bFY',~,t~,~]1~tt,t.tk l'-ew he(.. S (a) Job description: Occupancy blrtll"N Construction type: I/fS Square feet: Cost per square foot: Other infonnation: Type of Heat: [t.t!"Gtd/C Energy Path: o new 0 alteration (b) Foundation-only permit? addition Total valuation: 0No (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2. through 2d): $ $ $ ~~"~.~1~~i;eyj~I{~~s~~1lt:*~~~~$~~0~~01ffi'~~~~;J~~}~1~;'i;:~6!~~~; c..f (a) Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ (cj Subtotal of fees above (3a and 3b): $ (a) Seismic fee, 1% (.01 x permit fee [2a]): TOTAL fees and surcharges (2e+3c+4a): ~ .. , ,. , . Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: D I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date D' I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or -ro I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permi!. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. .-- ~cWl\ Wi, C-nrbV) Print Name of Permit Applicant ~~cant~~tfij -' -- S-/q'- II Date Permit #: 3/1-570 '23'8'0 D SPfLi'> sr Address: ()(L 0,,/ '-f 7'7 Issuedby:~Date: 5/i'1fl( I f This Copy for Permit Offices ~ TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 81 Springfield,OR 97477 541-726-3753 811-SPR2011-00590 2380 D ST permitcenter@ci.springfield.or.us www.ci.springfield.or.us DATE: 05/11/2011 ;'y"",S'.F":'i'AMQUN{bi.H(.:C <:::' ".' j 4.42 19.00 50.00 79.00 38.00 119.00 134.00 44.20 385.74 290.39 790.32 199.58 58.80 19.00 27.00 38.00 129.91 640.57 185.33 54.13 19.00 ------- 19.00 RECEIPT NO: 2011000922 RECORD NO: 811-SPR2011-00590 tDESC.RII'1.TION" ); i':1:;::~' ,'T ".- ''t'''f:/'!:'Yf'' "-"'t;'l5?;;:~"//cSir~""ii_';;:/'Aci:;O:UN'J;j::;ODEWC.} Admin fee (10% of applicable fees) 224-00000-426605 Clothes washer 224-00000-425603 Each added 500 sq. ft, or portion 224-00000-426102 First Appliance Fee 224-00000-425604 Hose bibb 224-00000-425603 Planning - Minor Review - City 100-00000-425002 Residence 1 ft. or less 224-00000-426102 Reside~tial !ire (.05 Per Sq Foot)._. 100-00000-424005 ____~"lprovement Cost - Local Wastewater 443-00000-448025 SDC: Improvement Cost - Storm Drainage 440-00000-448028 SDC: Reimbursement Cost - Local Wastewater 442-00000-448024 SDC: Reimbursement Cost - Storm Drainage 441-00000-448029 SDC: Total Sewer Administration Fee 719-00000-426604 Shower/Shower pan 224-00000-425603 Single-duct exhaust (bathrooms, toilet compartments, utility roar 224.00000-425604 Sink/basin/lavatory 224-00000-425602-", State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 ~':'.".!".~~I__B.uilding Permit Fee 224-00000-4??.602 . Structural Plan Review Fee Residential 224-00000-425602 _!!,_chn~~y fe:J~::' of permit total) 100-00000-425605 Water closet 224-00000-425603 ~_~~.~M.____"__ Water heater 224-00000-425603 ....__"",_00,,,.___.-.-' __".__~__..__,.._._",." __.._____...._.._____._ TOTAL DUE: 3,344.39 tt~~ylVf~NftijLE~t<-~;~~AY9.Rr;icAsi.M:R':jDBowLsByt~;1~.11~g.~;; :'~C6MME-N<f$::;7Z!~,~~':,,'t\{f.,,;,'\""";t\:' ~i::: AMOUNT'P A1D~"":';."" ~~'J~1~ ,,~ ,t Credit Card shawn corbin 3,344.39 508 TOTAL PAID: 3,344.39 s::~~. G~. fl~ ~;Lb'~ illJ;,;~ .-,~,"'.'.'.' OREGON www.cLspringfield.or.us TRANSACTION RECEIPT 811-SPR2011-00590 2380 D ST CITY OF SPRINGFIELD 225 Fifth 8t Springfield, OR 97477 541-726-3753 permitcenler@cLspringfield.or.us RECEIPT NO: 2011000702 RECORD NO: 811-SPR2011-00590 rDESCRIe,tltjN~i~~9;,"~j~'~"~~;;Y;;;'?'"1ju;,~~'~:~i:.~~~i.p~i.I;\:~j.,,:~tiiff.9":~ ,~..;"'< fACC.o.UNf~cobE~:;~'; Slructural Plan Review Fee Residential 224-00000-425602 TOTAL DUE: DATE: 04/13/2011 .-,,,.,..,", . .. . ... ...... "';] '>'cle, AMOUNT.D.UE'-'.J.."". 231.04 231.04 }f;j'~AYMI;~.t 'TYPg~~~R4iQ8~:rCA'SHJER:~DBowt~~W~:~~~E~'~~LGQMME~-rs.1~J1tit"S '''~<{,l;t ,;;:t:2IV1qlJ~,l~~AI~tjJ::~~-:fLf, ';':J Check shawn corbin 231.04 507 TOTAL PAID: 231.04 \ \ \ ---