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Home My WebLink AboutPermit Building 2011-6-27 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01596 IVR Number: 811161035835 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/27/2011 ISSUED: APPLIED: 06/27/2011 06/27/2011 225 Fifth St Springfteld,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or,us EXPIRES: VALUE: 12/23/2011 $20,000.00 SITE ADDRESS: 3905 HAYDEN BRIDGE RD, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1702194102700 SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bathroom Remodel~ no new drainage fixtures, relocate only. Phone Number: OWNER: ADDRESS: KEELER KENNETH D & M EILEEN 3905 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ~ Contractor Type Plumbing Contractor Mechanical Contractor General Contractor Contractor Name DOUG HAXBY PLUMBING COMPANY JOE ELLIS CONSTRUCTION INC JOE ELLIS CONSTRUCTION INC Lie Type CCB CCB CCB Lie No 140768 186756 186756 Lie Exp 03/01/2012 Q511512013 05/15/2013 Phone 541-517-6620 541-543-7764 541-543-7764 # of Units: o BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # 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 Specially 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 6/27/2011 12:09:09PM lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy load: ~ t.....-r'lP-I()N.O ,. . '.' . regon law requires you to .. ! ': es adopted by the Oregon Utility I"~ '. <:'.;'~'n Center. Those rules are set forth ~01,1" ~ co2-I)01-001 0 through OAR 952-001- ~o6d;. You may obtalll copies of the rules b v"idng the center. (Note: the telephone y nun,ber TOr the Oregon Utilitv NotificAtion '-'~lIler IS l-tsUO-332-2344). NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR M~Y 180 DAY PERIOD. Page 1 of 4 SPRINGFIElD ~~ ~O.EGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01596 IVR Number: 811161035835 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: Issued 06/27/2011 06/27/2011 06/27/2011 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: 12/23/2011 $20,000,00 SITE ADDRESS: 3905 HAYDEN BRIDGE RD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702194102700 SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bathroom Remodel- no new drainage fixtures, relocate only. DEVELOPMENT INFORMA TION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Valuation Description Descriotion Tvoe of Construction Unit Amount Unit Tvoe Sidewalk Type: Downspout/Drains: ~ Unit Cost Value FEES PAID ~ Descriotion Sink/basin/lavatory Shower/Shower pan Water heater First Appliance Fee State of Oregon Surcharge (12% of applicable fees) Technolo~y fee (5% of.~ermit total) Structural Building Permit F_ee Water closet Total Amount Paid Amount Paid $19.00 $19.00 $19.00 $79.00 $46.62 $19.43 $233.50 $19.00 $454.55 Date Paid 06/27/2011 06/27/2011 06/27/2011 06/27/2011 06/27/2011 06/27/2011 06/27/2011 06/27/2011 Springfield Building Permit 612712011 12:09:09PM Reciot # 2011001803 2011001803 2011001803 2011001803 2011001803 2011001803 2011001803 2011001803 Page 2 of4 SPRINGFIElD a\ 4'T2l: ~ . f€r" OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01596 IVR Number: 811161035835 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 06/27/2011 06/27/2011 Issued 06/27/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitce nter@ci.springfield.or.us EXPIRES: VALUE: 12/23/2011 $20,000.00 SITE ADDRESS: 3905 HAYDEN BRIDGE RD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702194102700 SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bathroom Remodel~ no new drainage fixtures, relocate only. Plan Review ~ Deoartment Received Due Date Application Acceptance 06/27/2011 06/27/2011 Comments: provided smoke and CO alarm information Result Over the Counter Comoleted 06/27/2011 Issuance 06/27/2011 06/27/2011 06/27/2011 Issued Reviewer Chris Carpenter Chris Carpenter rpUbIIC'\iV6rk7~Yiew'';'':-0~'- '06/~~201.1 '~P,6!:1~~?1}~,.' 06/27~." . ~~oi,H~~u,ited~;; ;t'i/;~;:' Ghris,'Carp~enter ~ ,.- rcommentS: Overthecounterperrnjtf~. "'F';~<" .-' ""," . -;,--~;{":-,*yr'./:'-. ~_'~_ ....._.>_..- --,>,,,,,_ .._ '_~M'_.._.......'-...______--....".<w;~__' "",lm~,~_~_~_~___.._.~.._~-"'-~ Structural Review 06/27/2011 Comments: Over the counter permit r.-~-~~..,....... Pla~nin~- R~vie~ " .;,,_~,::.:_,_ - ,0?/27/~9t1 +,Comment~,: ;:-;9Y;~,rA~~'9~~nter,permit- Not Required 06/27/2011 06/27/2011 Chris Carpenter '! 02/2,712.01 t:""66127/2011~.': 'Not ~e,qUired~': ~, ~ ','~C.hris Carpenter- ~ - - ", ~, ';'=k_*i'~:\f' \"~Z;j t:'~~':7i~-"-c,"~{ ". f ~ .., INSPECTIONS REQUIRED ~ Inspections 1220 Underfloor framing 1260 Framing j ';""''''2'''''' Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underiloor insulation Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Underiloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete, 1999 Final Building 2300 Rough Mechanical 2999 Final Mechanical 3170 Underiloor Plumbing 3500 Rough Plumbing 3999 Final Plumbing Springfield Building Permit 6/27/2011 12:09:09PM Page 3of4 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01596 IVR Number: 811161035835 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/27/2011 ISSUED: APPLIED: 06/27/2011 06/27/2011 EXPIRES: VALUE: 12/23/2011 $20,000.00 SITE ADDRESS: 3905 HAYDEN BRIDGE RD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702194102700 SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bathroom Remodel- no new drainage fixtures, relocate only. 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 1 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 construction. ~-Z1~/( Date ) \ Springfield Building Permit 6/27/2011 12:09:09PM Page 4 of4 " , ~J . Structural Permit Application I @ruW@j1~(g1:~R~l!J 225 Fifth Street. Springfield, OR 97477. PH(541)726*3753. FAX(54 1)726-3689 DEPARTMENT USE ONLY I r~ pennilno.:SI)-/Jtt~ Date: This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days 0 issuance orif work is suspended for 180 days. lOCAL GOVERNMENT APPROVAL 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: DYes 0 No CATEGORY OF CONSTRUCTION D Residential o Government o Commercial JOB SITE INFORMATION AND lOCATION Job site address: .3 90 S- cI. City: -> >-",,' /l,e/. Subdivision: Reference: \ PROPERTY OWNER Name: Address: City: Phone. -"fll- )<x>'f Fax: E-mail: oV..lt.eei<- 0;-.-.e.....L This installation is being made on residential or fann property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.0 J O. Sign here: CONTRACTOR INSTAllATION ~~ "I"uL State: mz. ZIP:77\1J, Fax: Phone Number Plumbing Mechanical FEE SCHEDULE 1. Valuation information (n) Job description: .e~ Oc II-. ~ fITt+/LOO ""- Occupancy ~ Construction type: V'lS Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: o new .E:J3lteration o addition (b) Foundation.only permit? DYes DNo Total valuation: $ 2. Building rees , (a) Permit fee (use valuation lable): $ ?J'"?~ (b) Investigalive fee (equal to [2a]): $ (c) Rcinspcction ($ per hour): $ (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): $ za u_ (e) Subtotal of fees above (2a through 2d): $ 3. Plan revicw fecs (a) Plan review (65%x permil fee [2a]): $ (b) Fire nod life safety (40% x pennit fee [2aD: $ (c) Sublolal orrees above (3a nud 3b): $ 4. Miscellaneous fccs II fI.Q. (a) Seismic fee, 1% (.01 x penn it fee [2a]): $ TOTAL. fees and surcharges (2c+3c+4a): $21'1'2-':;:' - !JoI.<.S /'''t/..lntc '7L L::btf./'o rVrTJ.J2!II l:O/A.<7 !f1W3'{ t,t:~ CalVI. Plumb.ing Permit Application ,'.-,. ',-' "', ""~'.".."'...,...; ;',."', ,~.', .'-.' ,""i ..<c-", -,""j' "'"r,,,;,~ "':':"'!r 'i, ", ',"DEPARTMENT USE ONLy;?t',,;> . .' _ _ ". ~,~.J Permit no.: 5/) - I S'1~ Date: r:;J20 225 Fifth Street. Springfield. OR 97477 . PH(54I)726-3753 . FAX(54I)726-3689 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. "c~:iiYt:,:;',: iilfOCAL;c;OVERNI\IIEN'[,t.APP R(jVAI!\i.\j':11~0"{!~!i:l Zoning approval verified? DYes DNo Sanitation approval verified? DYes DNo CATEGORY OF CONSTRUCTION o Residential I 0 Government I 0 Commercial '..;!\!t(\JOB'$I'[E INFORMMION;,'ANO;,LbCATION:;l:J:.~'.';,. Job site address:?,? 0 )' Ifrl '10E/'/' i3t2IIX,-t.. ~ City: I State: I ZIP:. Reference: I r; D2- ('1 '-( I I Taxlot.: b2-?CX/ ~ TION'O!'"' 0 K....'p.,....y"cv,. :,',p,'DESCRII? . m . c' ..',oW' R.'.!"!')T::':;,,' .,i",','{"'; I2tMSlJ D'f:L 'iM--7Iir<-eD fI./'- . t. . PROPERfY,;OWNER'l\;L;'. '.:i Namett:~~t= J~c:~A1 JL R'L-c. -r-- Address:J'1tl U rtYl'lDtiVRrL City:<;;!>Pul I State: O'n.-- I ZIP:C;71f7 I Phone: - - I Fax: - - 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 OAR 918-695-0020. Signature: CONTRACl'OR INSTALLATION ..,.,"'..,; . '. Business name: T>u Vt-Lc rhtx: f3 L( Address::334"<1(" MO/A..IVC 7ZJl"\ptZ.. City: d.. A bfJ1Ju;{,1~ I State: Dil- I ZIP:q'7 '-11I& Phone: cn)- ,/19 L I Fax: - - E-mail: CCB license no.:)l.(O'161 I BCD license no.: Plumbing license no.: Print name: Signature: 440-2500-J (II/08/COM) ~:_~,~:i:~!0~;.;._;_:1~~1~~:;f:;{;~f}i:-EEEfJS.CH EQU l{E!;'j;;'l~t',_:-':~;)?-r;~~:Wf!~..'-;i~!~fif,~/{) ;1R;~~.9:'~t~!,(~,~~1{:~t~~~;~~1~.~ii~~~).;;~5:~"i~~i;:~:'i;:~\~ 2~~, <~;-~;,;~~;~i~i.;t.' ~~~~(~~j~'E~: New residential I bathroom/I kitchen (includes: first 100!eet of water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/l kitchen $374.00 $ 3 bathrooms/I kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $95.00 $ Residential fire sprinklers (includes plan review) o to 2,000 square feet $58.00 $ 2,001 to 3,600 square feet $116.00 $ 3,601 to 7,200 square feet $174.00 $ 7,201 square feet and greater $232.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and $58.00 $ water supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee $58.00 $ Each fixture .kJL $19.00 $'7&~ "- Miscellaneous fees 100' storm, sewer, water line $76.00 $ Each fix~re, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ svstems exceedinl! the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. of hrs. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr.) Each additional inspection: (1) $58.00 $ ~M~'~:i~~'i]tl~;s':'pf~i~-g~f;'f:~;11i1(~{~'~;~)d;"j~:k$~~; Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. I $ ~~~~it_~1~JXFj~~B~iCWNjt~i!J~:g~~~~ (A) Enter subtotal of above fees $1Jfi: (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ q'; (D) Technology Fee (5% of [A]) $ J'i9- TOTAL fees and surcharges (A through D): $ "J1)( <; -z.- - SP~~~~E~ ~ ~OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-01596 3905 HAYDEN BRIDGE RD CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 permitcenter@cLspringfield.or.us ;, ACC011iNJ~C6DE';" '.,c'A,"AMOUNLDUE-" 224-00000-425604 79.00 ---..-- 224-00000-425603 19.00 224-00000-425603 19.00 821-00000-215004 46.62 224-00000-425602 233.50 100-00000-425605 19.43 224-00000-425603 19.00 224-00000-425603 19.00 TOTAL DUE: 454.55 LE.t..Yi\ii.Et<lf;;T:'o~g'?::,Yi~ii:~i~lacAlli1g~'CCARf>ENTER:'';:'!2.1ilL~QII'IIIII~,Is.~,,',":' 'cr ,~,'T'~i";?;f:~,,_2~Q,(JNT:RAID .:~~';:t' :;-, '.1 Check JOE ELLIS CONSTRUCTION INC 454.55 2154 RECEIPT NO: 2011001803 LOEse RI~TI0N.'~ ~;t;' ",'1;;;,,,-, ;i:f~: -:J:-:Y~'; J<,.'~V?,:' _ ; +'~s'\~~~> y;",' 't> . _~irs0Epli~,~ce Fee ShowerISho,::,~yan_,.___ Sink/basinllavalory State of Oregon Surchar.~e (12% of applicable fees) Structural Building Permit Fee Technology fee (5% of permit lotal) Water closet Water heater RECORD NO: 811-SPR2011-01596 DATE: 06/27/2011 TOTAL PAID: 454.55