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Home My WebLink AboutPermit Building 2011-6-14 ~~truct~ral Permit Application DEPARTMENT USE ONLY. '-, r;i{~:i:Gf~:&IKs-~~iN6FiE~Dl[QitGtstJ~.::;~J.:#~~~~~i~At:: ::I~( .;,"'E-. ~:d::t:IJ.~.....,,,,-. Th :.t: .~~. r ~A '" < "" ,,~"~, ," "'*" .""'-_, ....~~ ~" '"' "~~2t'., .~~".,.....~.~-:~ ~"-'. -'. 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 Penn it no. S II - / t.f J :z.- Date: ti II This permit is issued under OAR 918-460-0030, Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days: ...ti0CA~ . 99ygRNM~NT~(AeifB(:jYA~';tthf;,,"~~,i~1).~,; This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No ~:\'J~A\!~!~Wi;'~<c:AtEc,;9.riX:~(:j~~;C.QN~J"*iJc::m@N~~i!i,\;(:);!J~"i,*il!" '. Residential D Government 0 Commercial 'ii'):~~}f...:;:.fj9'B<.SITE; fN~ptiMAtfCZlN\\ANp(!~i:itMi9N;'j2ii;lf;':!:;:' Job site address: \~ 7) ~'S . City: Subdivision: Reference: zlpkly77 ,PROPERTY OWNER Name. City: Phone: State: Fax: ZIP. 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 under ORS 701.010. Sign here: ", CONTRACT-OR, II\iSTALLA')]9N'. ' Print name: Signature: Name Electrical Plumbing Mechanical .0N;T;~(;;tQf{.IN176.RNI.Ai;IQN~'\'i~?"~S';1~~, CCB License Number Phone Number . .:'?))".FEES'CHE15i.rL€"," ,'!'i~~$:~~ ~~'#Q~~'.I~r9rDi~.Hp~#~}~ti~~:lM;t~0~~;;~~::i::~ i. :i_~~'~ :,}'i;i,~!~,::~;'_;','/;:' ;~_,;~,!..:~~_~~ ~..~.;--: (a) Job description: Occupancy Construction type: Square feet: . Cost per square foot: Other information: Type of Heat: Energy Path: o new c;a-afteration 0 addition (b) Foundation-only permit? Yes 0 No Total valuation: :,~~):,)J,u:t14 ift g-.;te~sjJ~;~eH.~,~~?;:,~~~i':f;;!lf;:fMi",:~";':~'::~~.t'.; :;. ~-";t;;; ,,'.. (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ 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~~r~;y.i.~w~f1~~1~~{ii~~~,i'~~{(<'~~~~W:~~1\t~~~~~~~1WlJ;~~~p (a) Plan review (65% x permit fee [2a]): (b) Fire and life safety (40% x permit fee [2a]): (c) Subtotal of fees above (3_ and 3b): (a) Seismicfee, 1 % (.01 x permit fee [2a]): TOTAL fees and surcharges (2e+3C+4a): $ $ $ ;7J . ,".;~. $ $.::u7~ SP:~~:;~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01432 IVR Number: 811139543941 www.cLspringfield.or.U5 225 Fifth SI 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 06/14/2011 ISSUED: APPLIED: 06/14/2011 06/14/2011 EXPIRES: VALUE: 12/10/2011 $16,000.00 SITE ADDRESS: 537 4TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703352406000 SCOPE: Foundation WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace existing foundation Phone Number: OWNER: ADDRESS: CRAMBLIT PERRY SCOTT & VIRGINIA A 537 4TH ST SPRINGFIELD OR 97477 Contractor Type General Contractor Contractor Name FOREST V GRISWOLD CONTRACTOR INFORMATION ~ lie Type eeB BUILDING INFORMATION ~ # of Stories: Height of Structure: Type 01 Heat: Water Type: Range Type: Hazmat: # 01 Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: 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: Site Information Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 6/14/2011 2:32:07PM Lic No 95545 Lic Exp 12/15/2012 Phone 541~935.5024 Lot Size: Sq Ft1 st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: ATJaENTION: Oregon law requires you to f&fiJ"." rules adopted by the Oregon Utilit .NotlflCatlon Center. Those rules are sel fnrfh ~IA OAf; &...2-"" j -UU)U through OAR 952-001_ 0090.. You may obtain copies of the rules b calling the center. (Note: the telephone Y number for the. Oregon Utility Notification Center IS 1-800-332-2344). . '-"~ ""'t I" E' ." . ,CIS PERMIT SHALL EXPIRE IF THE WORK . .UTHORIZED UNDER THIS PERMf,I IS h1GlT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. . SP"~IN.G.r.~.ELD. ., ~1i.! .... ,u~ c~ OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01432 IVR Number: 811139543941 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 06/14/2011 ISSUED: APPLIED: 06/14/2011 06/14/2011 EXPIRES: VALUE: 12/10/2011 $16,000.00 SITE ADDRESS: 5374TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703352406000 SCOPE: Foundation WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace existing foundation DEVELOPMENT INFORMA nON ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downsp6utfDrains: Valuation Description ~ Description Bid Tvoe of Construction NA Unit Amount Unit TVDe 16,000.00 Bid Unit Cost 1.00 Value 16,000.00 16,000.00 FEES PAID ~ Descriotion Amount Paid !'05'.I2.no1ogy fee (5_'I,."f permit total) ~____ $9.73 Foundation Only $194.50 ~i~e o(c5r~~i~i~~~~~~i1.?%;i-~;;Pii~-f;;'-i---- ----.-$2:l34----- - Total Amount Paid $227.57 Date Paid 06/14/2011 06/14/2011 06/14/2011 ReciD! # 2011001612 2011001612 - --_.- ---_._-- 2011001612 Springfield Building Permit 6/1412011 2:32:07PM Page 2of4 SPRIN. G..F. IE.L.;.ii ~. ; ,~ "','"",, OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01432 IVR Number: 811139543941 www.ci.springfiefd.or.U5 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: 06/14/2011 06/14/2011 Issued 06/14/2011 ISSUED: APPLIED: EXPIRES: VALUE: 12/10/2011 $16,000.00 SITE ADDRESS; 537 4TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703352406000 SCOPE: Foundation WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace existing foundation Plan Review ~ Planning Review 06/14/2011 06/14/2011 06/14/2011 Comments: Over the counter permit Petmi~ Is,~af1f~.:~_~'t;,"rs, ') :', :d6f1fI20~t~'O~'1~Lt:91_t,~ q~!~N~Oi~?&,f,/lssue.q...:d;~:::-~it1::;~~hri:.,~~r~e~t,e,r ,,' ~':,r.' .\-Cp~ lTl~'nt_~:':::.::J~~t}O~cU.FS~~Uh~-'~~pa.r~~_:'~:_:"7 -':i~:2~~::>;- ~:'" ._-i~:~tC \'!ri~drA~-''':~~ >"S\:l:,,-~: ~': :,. ,; ;''','''' .)' -'.~ .,;..; ,', :.. Public Works Review 06/14/2011 06/14/2011 06/14/2011 Not Required Chris Carpenter Comments: Over the counter permit f~ergy 9odeR.e. Vi~~ 1.'. . ..,,:. <, ~O?I.,J f..12...oOt1;:~~b6...I;t.4.'.f61t;.:>..9;6J.14I?,?tt -' ,,~.~;'.N,~R~~Ulf:,~~ >"':~~G:!'f.,.iS(C~~~~f~t~~-~'~~~ . ",C_?mrry~nts:". Ov~r;!!Jf;o_unter,perQ:l't>.", ~_~u"U-~%":'H'U:'/:' ''1'~,_:~~<T~'~?''-'~~~:f. <"I'\1''0'<''d'<,:'''' , Structural Review 06/14/2011 06/14/2011 06/14/2011 Not Required Chris Carpenter Comments: Over the counter permit F~r~ Re\d~~~:"F'?'/~ ~";-"":'~:-;: ,., ,f:~~,91~.,~t.?'~~1, ; 'j$:~~~l?Of.1~;"~:2.~!.~,if2?).,\_'~-.' ;N}~S~~~~ L~:~rnmEH~ts:':, O~~r. ~,h~'count~riRe:fm~t<F,-";~",,::'I':>~" _~,-" .~; L'~:},'" '0 ""We,,,,}.: I Deoartment Application Acceptance Received Due Date Completed Result 06/14/2011 06/14/2011 06/14/2011 Over Ihe Counter Not Required INSPECTIONS REQUIRED Reviewer Chris Carpenter Chris Carpenter j "'t j~~~1:~;~h_ri~:'fe-,~~~',~le~,;::: . 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. Final Building: After all required inspections have been requested and approved and the building is complete. Inspections 1110 Footing 1120 Foundation Footing: After trenches are excavated. 1160 UFER Ground 1999 Final Building Springfield Building Permit 6/14/2011 2:32:07PM --.,'"-' . . , ,I ""~ ,J;"" Page 3 of 4 S::~,N~=~ l~a'; ~C>REGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01432 IVR Number: 811139543941 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Issued 06/14/2011 ISSUED: APPLIED: 06/14/2011 06/14/2011 EXPIRES: VALUE: 12/10/2011 $16,000.00 SITE ADDRESS: 537 4TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703352406000 SCOPE: Foundation WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace existing foundation 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 aU 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 construction. b-1Lt-I/ Date Springfield Building Permit 6/14/2011 2:32:07PM Page 4 of 4 S~1~lN;~:~~. L~~ ~'OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01432 537 4TH ST pe rmitce nter@ci.springfield,or.us RECEIPT NO: 2011001612 RECORD NO: 811-SPR2011-01432 DATE: 06/14/2011 lDi:S.CRIP-TION/",+cL, ."; ~,"i'7:;";;/',>J\i:...:!:f...};:.:.[; .''':.2.il.cCOlif.l;(CODi::''::....t'' ,';..O:"...:.-::::AMOlJNi~[)UE '-'...:..J Foundation Only 224-00000-425602 194.50 State of Ore90n Surcharge (12% of applicable fees) 821-00000-215004 23.34 Technology fee (5% of permit total) 100-00000-425605. _ ___. ..... .9..7]. TOTAL DUE: 227.57 ~"",. t""0;PAYO~:.,jCAS-HIER:'CCA'^RPENT~:!~~~;\?COMME,~iJ~;~:~f -X~').~'_: .~'"\>. 'AMOl!~T PAID ~ 'it;:':;';" FOREST V GRISWOLD 227.57 1'''AYl'/i~NI TYPE: Check 12894 :;. - ---"'--"~'-'--'-'_."""- '"-- --~--"----'-~--'_.-'"'~-~--'-'-_._-"'-------"-"----_.'" TOTAL PAID: 227.57