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Home My WebLink AboutPermit Building 2011-7-13 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 Issued 07/13/2011 07f13f2011 06/17/2011 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci,springfield.or.us EXPIRES: VALUE: 01f08f2012 $153,861.72 ISSUED: APPLIED: SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97471 ASSESOR'S PARCEL NO: 1802051108500 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - same as S11-00670 - 585 S 48th Phone Number: OWNER: ADDRESS: JHD3 LLC. 2464 SW GLACIER PL REDMOND OR 97156 Contractor Type Electrical Contractor General Contractor Plumbing Contractor Mechanical Contractor CONTRACTOR INFORMATION Contractor Name GARNER ELECTRIC CO HA YDEN HOMES llC GO PLUMBING & HEATING LLC PACIFIC AIR COMFORT INC Lic Type CCB CCB CCB CCB Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: 3 Municipal I Development Code: No Plumbing Specialty Code Edition: No Residential Specialty Code Edition: Path 2A Certified Structural Specialty Code Edition: performance-tested duct sy ,. aon law requires y?~}~.. fOllOW' rules adopted y ll~. '::~ o"~ii.'!,!~19.rll1ation Engineered Fill: Notifi~ion cent~~'16~hrOugh OAR 952-00 - Fill Volume: in OAR 952-001- btain copies at the rules by Flood Hazard Area: 0090. You may 0 (Note: the telephone Land Hazard Area: callmg the C~;~~~gon Utiliiy Notification Retaining Wall: . nUrrmJ3r lor t 's 1_800-332-2344). Soils Report Required: No Center I # of Units: Occupancy Type Construction Type Occupancy Type Construction Type # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: Springfield Building Permit BUILDING INFORMATION R-3 Type VB U Type VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Gas Electric No 1 18.5 Forced Air Gas 7f13f2011 12:09:56PM Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: 4487 1408 403 24 2008 ..; ..:.",-+ NOTICE: P\RE',f1I1EYJOBK TH\S PERMIT S1-\p.,~~ ~\S PEBMlT 'p N01 AUTHORIZED UNO co. ABANDONED F9R ;<,. COMMENCED OR laD . ,.,:-:1 ANY 180 DAY PERI.' i , Page 1 'of 6 I 5Pl~N...:-..FIE.~ 1Df~~ ;;!.'BS\, ~REGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 225 Fifth St Springfield, OR 97477 Phone: 541.726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfleld.or.us PROJECT STATUS: STATUS DATE: Issued 07/13/2011 ISSUED: APPLIED: 07/13/2011 06/17/2011 EXPIRES: VALUE: 01/08/2012 $153,861,72 SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051108500 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - same as S11-00670 - 585 S 48th Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 14 6.77 5 20.78 DEVELOPMENT INFORMA TION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Yes REQUIRED PARKING Total: 2 Handicapped: Compact: 18.5 PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I DescriDtion R-3 1 & 2 family U UtiIlty, misc. Tvoe of Construction VB VB Unit Amount Unit Tvoe 1,432.00 Sq Ft 403.00 Sq Ft Unit Cost 96.83 37.72 , Value 138,660.56 15,201.1'6 153,861.72 Springfield Building Permit 7/13/2011 12:09:56PM Page 2 'of 6 I i I SPR...INGFIE~.o.m ~~ i,;: :'~ i!!!D ':J"..- 'OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726.3769 Fax: 541-726-3676 pe rm itceriler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/13/2011 ISSUED: APPLIED: 07/13/2011 06/17/2011 EXPIRES: VALUE: 01/08/2012 $153,861.72 SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051108500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence. same as 511.00670. 585 S 48th FEES PAID ~ Description Amount Paid Date Paid Recio! # Same as Plan Review Submittal $250.00 06/17/2011 2011001668 Multiple Permit Discount (Max 2) ____. $-30.00 07113/2011 2011002015 SDC: Reimbursement Cost - Storm Drainage $553.01 07/13/2011 2011 002015 SDC.I';;~o~e"2.;:nt Co~~-Si~0..Qr~na~e -=------.:- ~ ~~-$_~62 __.::...__.~7/~_ 2011002015 SDC: Reimbursement - Transportation SDC $497.07 07/13/2011 2011002015 ~.~.s:.: l';:;p~C;;:,iie;;; ~Tran~poiatio~_~~~=-=====~--$1,81'-51----o7ii312011-- 2011002015 SDC: Reimbursement Cost - Local Wastewater $3,161.28 07/13/2011 2011002015 - - . ~DC: Improvement Cost - Local Wastewater $1,542.96 07/13/2011 2011002015 SDC: R"imbursement Cost - MWMC ~:,~ional Waste",at. ._____..!101.97 07113/2011 2011002015 SDC: Improvement Cost. MWMC Regional Wastewater ~ $1,333.57 07113/2011 2011002015 SDC: Compliance Cost. MWMC Regional Wastewater SI $22.63 07113/2011 2011002015 SDC: Total Sewer Administration Fee $356.26 07/13/2011 2011002015 SDC: Total Transportation Administration Fee $135.67 07/13/2011 2011002015 Residential Fire (.05 Per Sq Foot) $91.75 07/13/2011 2011002015 St,.".:tural BUilding Permit Fee $928.53 07/13/2011 2011002015 !:Id..d_~es~ A.~ijJ.".f1l"nt~"ac~e~ or ch~n!1" .___. $38.00 07/13/2011 2011002015 WiHama~n.. fe..~ - Sin_\l.le_f~mi!Y ,c:Ie!ached .__.___ .!3,4~900 07113/2011 __ __.__._. .~1_~02015 Oneor_Tw'?!:~f1li't'p:v"llir1g.",!l!' ~~ Bat~.___ _ $374.00 9.~~~201 ~_._.....___. ~011.90202.~ Furnace. up to 100,000BTU $17.00 07/13/2011 __.29.12992015 Air conditioner $17.00 07/13/2011 2011002015 '--~ Range hood/other kitchen equipment $13.00 07/13/2011 2011002015 s;;;gl~-duct exhaust (bathrooms. toil~t.;;-;;;p;;rt~~ni;;,~iiii---$36.00--"-"'--"07ji"3j2iii"'1"""' .- -----2011 002015 Gas Piping up to 4 outlets $14.00 07/13/2011 2011002015 Fi,stAppliance Fee $79.00 07/13/2011 2011002015 Residence wiring 1,000 sq. ft. or less $134.00 07/13/2011 2011002015 ~a.c~ a~d"d_ 5.0q,~ ft. or portion $50.00 _. 07/13/2011 2011002015 ,=Ianni~ Major Review. City,... ....__... .....___________ $21~ .00 07/13/2011 2011002015 l"e.chr:o~~y fee. (5'1,..~.!":':'i! t~!~_._____ _.__ __ ___$~5.48 _.__ 07/13/2011 2011002015 State of Oregon Surcharge (12% of applicable fees) $207.06 07/13/2011 2011002015 M'C.~tiOri;';;ay 1 st C-,:;;---- -- -- -- -'- .. -- -."""'"'$8a:-OO----~077i3i2011--. -- 2011002015 Temp services 200 ~~Ps"Q"; I~--"----------- ------$6ioE.___._07ii~i2011-- ---.~-_~ 201.29~9.15 Admin fee (10% of a~~licable fees) $9.18 07/13/2011 2011002015 Sidewalk up though 90 Feet $88.00 07/13/2011 2011002015 SDC: Administrative Fee.:.I\'1WMC Regional Wastey,;;;;;;,: $10.00 07/13/2011 "Z0110iii015 Total Amount Paid $16,513.55 Springfield Building Permit 7/13/2011 12:09:56PM , , Page 3 IOf 6 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/13/2011 06/17/2011 Issued 07/13/2011 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: 01/08/2012 $153,861.72 SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051108500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence - same as 511-00670 - 585 S 48th Plan Review Deoartment Application Acceptance Received Due Date 06/17/2011 06/1712011 Completed 06/23/2011 Result Application Accepted I Reviewer David Bowlsby Structural Review '. ,. ,F Planning Review 06/23/2011 06/23/2011 07/05/2011 Approved Tara Jones Comments: *3' walkway is required. -Front elevations are site specific and contain required design elements, Inspectors will field check that actual elevations rnatchsubmitted designs as shown on the approved set of plan~-, (StrU'cturafRe'vTe~' - ~~; ,;::: ~ ""T^:06123i25i'(:::06h31201H: o7io6iior1f ..~:.Apploved~::r/,__~,- M," 'Chr1Scarpente(~ L~,~~~~~', "<::_~:-~:~;+~;~!", . ::j;~ ::(~::?~..: ,~}~~".:/:~-~{~~.:~=~;~~,,~0~" - ~,:::::.~: _ ^", Permit Issuance 07/06/2011 07/06/2011 07/13/2011 Issued David Bowlsby Springfield Building Permit 7f13f2D11 12:D9:56PM I I I ---^.,~-"". . .! f , , .1;0-\ ~.'-.:+ "'.'-""~~ I Page 4 :01 6 I www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/13/2011 ISSUED: APPLIED: 07/13/2011 06/17/2011 EXPIRES: VALUE: 01/08/2012 $153,861.72 SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051108500 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - same as S11-00670 - 585 S 48th INSPECTIONS REQUIRED ~ Inspections 1020 Zon ing/setbacks 1090 Street Trees 1110 Footing 1120 Foundation Footing: After trenches are excavated. 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. 1160 UFER Ground 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 1520 Interior Shearwall Ceiling Insulation: Prior to cover. Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior ShearwaU 1540 Gypsum Board/Lath/Drywall 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. 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 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 1999 Final Building 2200 Underfloor Mechanical 2210 Underfloor Gas 2260 Gas Service 2300 Rough Mechanical 2310 Rough Gas 2995 Final Gas 2999 Final Mechanical 3130 Footing/Foundation Drains Springfield Building Permit 7/13/2011 12:09:56PM Page5, f6 I . , SP:,';,G,:EL?ij .(~ (f;b .....<II':Oi;;&. .OREGON www.cj.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01486 IVR Number: 811184012916 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 07/13/2011 ISSUED: APPLIED: 07/13/2011 06/17/2011 EXPIRES: VALUE: 01/08/2012 $153,861,72 SITE ADDRESS: 4907 GLACIER DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051108500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Single family residence. same as 511-00670 - 585 S 48th 3170 Underlloor Plumbing 3200 Sanitary Sewer 3315 Water Line 3400 Storm Sewer 3500 Rough Plumbing 3999 Final Plumbing 4000 Temporary Power Service 4120 UFER Ground Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 4225 Service or Feeder 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. c1 ~d' ?- /{. ~-I'J'I( Owner or Contractor Signature Date Springfield Building Permit 7/13/2011 12:09:56PM Page6of6 .2.?,willamalane . t~. Park and Recreation District Job. No. ,$'/1-/71 a PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET , January 1-December 31, 2011 . ..... ',t1It'1bEtJ'ffl-yV\t.-:5 -,---_ -- -----_NAME,.___,_____ _ _ _ . _ ~ _ -________ .. ------____.________ ADDRESS:..:2~(:8's'W ~/"ALI c.7L-- CITY:,~7)M.awD .. _ . PHONE: 550 -!;I( S-" STATE:O;L.ZIP: 977n . LotATI9N,OFPRQPQ_Sm_BUJ!:.D!.NG~i:rE:. . _ _._. _' _ . _ - StieetAd~~ess:''I1!J7 .1~e:"A--,-',-~::, Plat Na'me: tJE<;Twi/V"~S Tax L~t Nun'1ber: (toz ,z; r-jfO?''5{JL) -, ' ,1. 'DEVELOPMENT TYPE(Ref~rio development type definitions on the revers~.). _ A, Single-Fam i1v. Detached .' r " 310 / NO, OF UNITS, . X $3,409 per unit = , $ B. Single-Familv Attached NO:, OF UNITS ' , X $3~404per unit: $ C. Multi-Familv Apartment NO, OF UNITS X $2,800 per unit = $ D, Single Room Occupancy ,..... \' . ~ ;NO, OF UNITS , X~1'~80 ~e~,unit;" '$ .. .u ._.. . . -, -.. . , . E:Accessorv Dweiiin"g Unit }IiO, OF UNITS . '. + '~-:' ',- --.. ~. +.- X $1,705 perunit =' '$ " ... ~,2; SDC CREDIT (Ii applicable: SDC payermustfurnishproof of . . credit a'pp~oval.)', -. . " .. , . 3. TOTAL PARK AND. RECREATION SDC ASSESSED .,.(;:.,-~- ._'--c-.~.--~~ .'. ":jL(07 .=~. ~':":'--:;"'.7" _::;~._-..,._-----;;,~,.;__. ", _..'-um~' -.. ~., ~. City of Springfield -, ~~ ~I/?I jf Date of building permit submittal 7 1'131 .// Date of building permit issuance City, of Springfield DEPARTMENT USE ONLY'- 225 Fifth Streett Springfield, OR 9'7477. PH(S41 )726-3753. FA..X(541)7"J SPRINCFIELD . . --.---. &I, Pemlit no.: ?"c,: - Date; II This permit is issued under OAR 918-309.0000. Permits are nontransferable. Permits expire if warli is not started within 180 d.ays of issuance or if worli: is suspended for 180 days. . LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No . .CATEGORYOFCONsT'~UCTION ~Residentiar 0 Government..- 0 Commercial JOB SITE INFORMA;fIOr:L 'ANti''t:OcAT'ioN 'Job site address:-i{.9ol- (-.)(.1\Ci(:'1<. ~a... City: ~"l?-\"" r''''LD State: blQ.. ZIP; q"lL("l-tj Reference: \ /.;t/ I;Z t; CbJLL-~ /f0 ZIP: "1'n..,,-lo Signing supervisor's license no.: Print name of signing supervis Signature of signing supervis r: ~~~ }~ 4-10-2584-1 (9/0R/COM) .. FEE SCHEpULE' ..ct::.::,>.'",-,:",,'.: . .. Cost Total - Number orinspections per item () Qty, ea, cost Residential, per unit, scnoice included: 1,000 sq. ft. or less {4}". I $134.00' $/'5.'( Each additionol 500 sq. ft. or portion 1- $ 25.00 $50 thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling sen'icc or feeder (2) Sen'iccs or fceders: installation, alteration. relocatioll 200 amps or less (2) ~ 1-$ 81.00 fif;}I 20tto 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 60110 1,000 amps (2) $205.00 $ Over \,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Tempornry services or fceders: installaliolt, alteratiolt, relocation 200 amps or less (2) / $ 63.00 $t.,Y 20 I to 400 amps (2) $ 87.00 $ . 40 Ito 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section nbove Bronch circuits: ne'll', alleralion, extension pel' panel a. Fcc for branch circuits with purch:J:se ora se'rvice or [ceder fee: E:J:ch branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchElSe of a service or feeder fee: First branch circuit (2) $ 55.00 $ Each ilddilionalbranch circuit $ 6.00 S Miscellaneous fees: service or feeder /tal incblded Each pump or irrigation circle (2) S 63.00 $ Enc:h sign or outline lighting (2) $ 63.00 $ Signal circuit or D limited-energy panel, $ 63.00 $ alteration, or e~lension (2) Euch nddHionaJ inspection: (I) $58.00 $ : >:>:. ,,:,.;>. APPLICANT USE' .... (A) En\er subtotal of above fees $ 2 't? (Minimum Permit Fce S58.00) (B) Enter \2% surcharge (.12 x lAD $2'~ (C) Technology Fee (5% of [A]) $ /.2- ~ TOTAL fees and surcharges (A through C): s22!tr S \ P , \.. I~ ; s sri' {,70 - S. I{gi\.. tructura enmt App Icatwn S/W'\.... 95'::> ._.L"",di;_", '.'..:>0; "'J 9"" ""_".:'~..."""'. 5PFUNGFIEL.Dr.;J';'~.., ~~;.~ ~~lii::.t~$JJ DEPARTMENT USE ONLY Pelmit 110$/(_0 It.{ sC:, Date - /7 - ( This permit is issued under OAR 9]8-460-0030. Permits expire if work is not started within 180 d.ays of issuance or if work is suspended for 180 days. 1;0c'AL GQVE~!,ME:NTAP'~RQ:VM;;~;. This project has final land-use approval. Signature: This project has DEQ approval., Signature: Zoning approval verified: Property is within flood plain: 0 Yes 0 ~1fr~i1~;,~:<~.:1c~~~~~~:GAr~'~Q~~0J~ttFi~iGQ.N~;TR_W.Gfr;lQ~~;~~f::Jn~)i~~~!~:~;i~:~ esidential D Government 0 Commercial . .~.. jj!JB:}SJ!i:t .iNi;0RMAT(t5N~AN Q!'t.o:cMIQN{.J;~R~g'iJ;Jg; Job site address: (c,oi- C, ~1(,-"'lL C) IL City: S(,~-1N(- >'I..""LCI fL Subdivision:V..J.CS~l.-''':;l~ ~~ Refere"ce goZ 0 Sf PROPERTY QWNER; Name: ~O ,or...s ik>,,,-c">. Address: 2. '1& i{ <; \.,) C/O... '\c "''- P,-- Ii 0 City: ;2-{>0^-O<-.l;,; State: D ZIP: Cf7-~ Phone: ~;'11 - 57:>~ - 51-':\(;:) Fax:o/1{.... '0'1- O'H.L... E-mail: C/i-G--.J'<>L'<:..i:...>.(J, J+<wO>e'>.J..... Hc,"-t'b.6[;) \. 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 ~S 701.010. Sign here: [ -f ( - Date: Date: zrpet ).ijqg Lv 08500 CONTRAC)"QR ;iN:STALLAl'l~:)N;. : ..... Business name: JI\"..{Dt.:i'0 t{o\'^"'L~ Address' City: Phone: State: Fax: ZIP: E-mail: CCBlicemeno.: 1':f252i.c Print name: EL...e-.. }kf~{' Q.lL~. ~~ Signature' ~, ~ . . ....r~SUEl-C;0N:fI3AC::r:QR:INf.6RIv1j>.:fIQt'j~J;yf:'i(~i:.f.iiy::~;:i;1} Name CCB License Number Phone Number Electrical (;i~.J...J~ Plumbing Mechanical "" ,':n .. SCH~DU.LE . '.'::\::'Y~~~~;fi.p6fl~.(ot~1Jj_q-~:,:.:~{;'~ (a) Job descriptio": Sf'b Occupancy lLel.- ~ Construction type: (5 t:~ Squarefeet: l. b 8 Cost per square foot: it ~ Other information: Type' of Heat: (; Energy Path: 2. I?:. new 0 alteration 0 addition (b) Foundation-only permit? 0 Yes Total valuation: 5'3 ?t:./. -?2 ~;7}!:~.Q!i# ~r{~\t e-~Si0}WlJfi:~t~jt~~~;,1:'~:!~0::!-~f ;~~\,~!_~~,:' (a) Permit fee (use valuati9n table): (b) I"vestigative 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 (2a through 2d): $ z.. (a) Plan review (65% x permit fee [Za]): (b) Fire a"d life safety (40% x permit fee [2a]): (c) Subtotal of fees above (3a and 3b): \;4:hM~_~s~H~~n~Q"~'~rt~~~1-~11_::;~}~;:':~A;-::' ,<,"\ ,",.. :,t .,'"'~, (a) Seismic fee, 1% (.01 x permit fee [2a])' $ TOTAL fees and surcharges (2e+3c+4a): $ ~. ;- Gre> ft.(.<.h&l~ TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fffth 81 Springfield,QR 97477 541-726-3753 www.cLspringfield.or.us 811-SPR2011-01486 4907 GLACIER DR permitcenter@ci.springfield.or.us :, " pAYMENt tyPE"" .. . pAVOR" , " .cASillER, DBOWlSBY "', _ ~,. ......-_ ~__",.~.,""""._'_ ,___~~,~,~_ ~_____ "'_",,,_. ,-... ,_ 0 "^,,~'0 Check HAYDEN HOMES LLC RECEIPT NO: 2011002015 RECORD NO: 611.SPR2011.01466 DATE: 07/13/2011 :DESCRIf>TI()NP..-"?:::';2.i::~~~c';<22f::":::.22::'''~22'~:!.:.;: .-2'..-AccoUNf,C0DEciZ" ,-,' {. ';;:;:.jAM()UNT.DUE~:;'j.! ___A9-d~:~ Assig~~~~~h ne~~r chang~._._._.~. _,_~__ 224-9Q~OO-4~?02..,,_ . ~_'"._..'.".'._."__ 38.00 Admin fee (1E.~~applicable fe,:~) 224.00000..426605 9,16 Air conditioner 224-00000-425604 17.00 Curb Cut/Driveway 1 st Cut 201-00000-426060 66,00 Each added 500 sq, ft or portion 224-00000-426102 50,00 First Appliance Fee 224-00000-425604 79.00 Furnace - up to 100,000 BTU 224-00000-425604 17.00 Gas Piping up to 4 outlets 224-00000-425604 14.00 Multiple Permit Discount (Max 2) 201-00000-426060 -30.00 __.One or Two Family DweJlin~ with Two Bath 224-00000-425603 374,00 Planning.~M~jor Review..:. City 100-00000-425002 211,00 Hangehoo"u~ther ki!.c~~ equipment 224-00000-425604 _ ..___ .____~_ ".,..1.3,00 _. . Res~den~,: wiring 1,000 sq, ft. or less _.____._~~-00000-4~~. ______~3400 _____ _ Residentia~ Fire (.05 Per Sq Foot)' 100-00000-424005 91,75 SDC: Administrative Fee - MWMC Regional Wastewater SDC 611-00000-426604 10.00 SDC: Compliance Cost - MWMC Regional Wastewater SDC 444-00000-426607 22,63 SDC: Improvement - Transportation SDC 447-00000-446027 1,611,51 SDC: Improvement Cost - Local Wastewater 443-00000-446025 1,542.96 SDC: Improvement Cost - MWMC Regional Wastewater SDC 445-00000-446025 1,333.57 SDC: Improvement Cost - Storm Drainage. 440-00000-446028 604,62 __.~pC: Reimbur~"'t - Tr~nsportation SDC 446-000EO-446026,___, ___,,____ 497.07 .__....~,l?.~:"~~imbu~~e.n..!..~~~_Loc~ Was~wc:~:r_ ____.___ ._ _4~3:.0E009-~4802~"~_____,,_ _~_3,161.28_.__,,_. __> SDC Reimbursemen~~o.:;~~~~_ F<~g.io-"-,,.I W--,,!tew--,,~e~ ~P.s:~4-00_000-4460?~____.~__ __.. 101,97 SDC: Reimbursement Cost - Storm Drain~~_____._ 441-00000-44603-9__.______ 553,01 SDC: Total Sewer Administration Fee 719-00000-426604 356,26 SDC: Total Transportation Administration Fee 719-00000-426604 135,67 -~---,~." Sidewal'S.."l'though 90 Feet 201-00000-426060 66,00 Single-duct exhaust (bathrooms, toilet compartments, utility roor 224-00000-425604 36,00 State of Oregon Surcharge (12% of applicable fees) 621-00000-215004 207.06 Structural Building Permit Fee 224-00000-425602 926,53 Technol".gy fee (5% of permit total) ,.______. 100-00000-425605 95.46 Temp services..?OO amps or~!~___"",___, 224-00000-426102 63,00 'Mllamalane fees - Single family detached 621-00000-215023 3,409,00 -.-._------_._.._--_._--_.~ ._"...~----_.. ----"".----.~_.. TOTAL DUE: 16,263.55 ,COMMENTS, --_; 1."":' ". AMoUNTPA1tJ,':' ,,'''' , , ~ _'''__~_''~'''_'''__~.__''__'' .__" ,. ."_. ,~"._"..J..___ ..__ ..__. _. __ "_ _"'_ ..~"". _~_..... _ $16,263.55 177 TOTAL PAID: $16,263.55 SP.RING.FIEL~ . .~ .i . ~_. OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-01486 4907 GLACIER DR CITY OF SPRJNGFTELD 225 Fifth 81 Springfield,OR 97477 541-726~3753 permilcenter@cLspringfield.or.us RECEIPT NO: 2011001668 lOESC:;RIIWON ;i;'~i0"" ~" !;* ,;.::~ " , ,- Same as Plan Review Submittal RECORD NO: 811.SPR2011.01486 ~'" ::~~;'",":" < ACCOI!iN:ricOOE '. .:.",' ,'~, 224.00000-425602 TOTAL DUE: :j~ .C'OMM~Ni$'~'\'7~;7~:;6~," ""~' ,. DATE: 06/17/2011 "AIViOUNToDlJE"'.".::.....J 250.00 250.00 ; AMOUNT'PAID ",'!F', ..... ',',' 250.00 1 U~'(MEN:rifYPi:~~&(QB ,.. CASHIE";OBOW'LSSY' ,};.- Credit Card HAYDEN HOMES LLC 021411 TOTAL PAID: 250.00 \e \e 65 . •;- • 4,835 S.F. ,' •,�� :.. \ •.! .�Io DW�\ f 66 4/ EDGEWOOD 1408 S.F. \ \ 4,4 S.F. 67 705 S F 0 X?d) I STREET TREES ARE REQUIRED. Please refer to attached Development Code N Section regarding the placement and types of allowable trees. SCALE: 1" = 20' HAYDEN HOMES 2464 SW GLACIER PLACE, SUITE 110 REDMOND, OR 97756 (541) 923-6607 \\1 i MINIMUM SETBACKS - INTERIOR LOTS All measurements are from Property Lines -Front yard to House 10 feet -Front yard to Garage 18 feet -Side yard to House or Garage 5 feet -Rear yard to House or Garage 10 feet P.U.E. MAY CEIANGE SETBACKS LOT 66 ADDRESS: 4907 GLACIER DR WESTWINDS SUBDIVISION SPRINGFIELD, OREGON SPRINGFIELD CLUSTER DEVELOPMENT REQUIREMENTS: — 6/2 ROOF PITCH — 12 INCH OVERHANGS — 2 DIFFERENT MATERIALS — 15% WINDOW GLAZING L FRONT COVERED PORCH STANDARD W/POSTS — RECESSED FRONT ENTRY — GARAGE 4 FT. BEHIND COVERED PORCH — OFF SETS IN BUILDING FACE & ROOF ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001- 0010 through OAR 952-001-0090. 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). AEU/ElyEDFOiq CODECOMPL/gNCE ATE RECEIVED 16 �/ - Q,u p/ ..ONE LI1Q Joe No. -// F4 LINIT(S) OCCUPANCY GROUP L4 OCCUPANCY LOAD STORIES/TT Ty PE y4J LEGAL DESCRIPTION / CONSTRUCTION ADDRESS 0 /' OWNER , r AL [J THE CONTENTS HERE ON HAVE BEEN REVIEWED, WITH ALTERATIONS INDICATED ON COLORED PENCIL, CHANGES OR ALTERATIONS MADE TO THE APPROVED DRAWINGS OR PROJECT AFTER THE DATE BELOW SHALL BE APPROVED BY THE BUILDING OFFICIAL. CITY OF ;; 2rNGF1 , OREGON APPROVED BY DATE G !/ • • • • f R f f • ! • f • f R f f • • • R • • f ! R • • R • \e \e 65 . •;- • 4,835 S.F. ,' •,�� :.. \ •.! .�Io DW�\ f 66 4/ EDGEWOOD 1408 S.F. \ \ 4,4 S.F. 67 705 S F 0 X?d) I STREET TREES ARE REQUIRED. Please refer to attached Development Code N Section regarding the placement and types of allowable trees. SCALE: 1" = 20' HAYDEN HOMES 2464 SW GLACIER PLACE, SUITE 110 REDMOND, OR 97756 (541) 923-6607 \\1 i MINIMUM SETBACKS - INTERIOR LOTS All measurements are from Property Lines -Front yard to House 10 feet -Front yard to Garage 18 feet -Side yard to House or Garage 5 feet -Rear yard to House or Garage 10 feet P.U.E. MAY CEIANGE SETBACKS LOT 66 ADDRESS: 4907 GLACIER DR WESTWINDS SUBDIVISION SPRINGFIELD, OREGON SPRINGFIELD CLUSTER DEVELOPMENT REQUIREMENTS: — 6/2 ROOF PITCH — 12 INCH OVERHANGS — 2 DIFFERENT MATERIALS — 15% WINDOW GLAZING L FRONT COVERED PORCH STANDARD W/POSTS — RECESSED FRONT ENTRY — GARAGE 4 FT. BEHIND COVERED PORCH — OFF SETS IN BUILDING FACE & ROOF ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001- 0010 through OAR 952-001-0090. 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). AEU/ElyEDFOiq CODECOMPL/gNCE ATE RECEIVED 16 �/ - Q,u p/ ..ONE LI1Q Joe No. -// F4 LINIT(S) OCCUPANCY GROUP L4 OCCUPANCY LOAD STORIES/TT Ty PE y4J LEGAL DESCRIPTION / CONSTRUCTION ADDRESS 0 /' OWNER , r AL [J THE CONTENTS HERE ON HAVE BEEN REVIEWED, WITH ALTERATIONS INDICATED ON COLORED PENCIL, CHANGES OR ALTERATIONS MADE TO THE APPROVED DRAWINGS OR PROJECT AFTER THE DATE BELOW SHALL BE APPROVED BY THE BUILDING OFFICIAL. CITY OF ;; 2rNGF1 , OREGON APPROVED BY DATE G !/