HomeMy WebLinkAboutPermit Building 2007-8-21
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 02/21/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 300 33RD ST
ASSESSOR'S PARCEL NO.: 1702313103500
Springfield
TYPE OF WORK: Single Family Residence
TYPE OF USE: Remodel
Residential
PROJECT DESCRIPTION: Interior remodel
Owner: LESLIE & B BELL
Address: 868 6TH ST
SPRINGFIELD OR 97477
Phone Number: 541-543-1043
I CONTRACTOR INFORMATION I
Contractor Type
Contractor
License
Expiration Date Phone
BUILDING INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Units: 1 # of Stories:
Primary Occupancy Group: R-3 Height of Structure:
Secondary Occuoancl!.,Gr.1o.uP.: 0 I Type of Heat:
'At n:r" I Ut\!' regon aw . , t
Primary Construe ion Tv.oe . .vB reqUJrefW&'i1\rCifype:
IUJ uw Nt~s adopted 15 th 0 ~TW
Secondary Constrll.diP.H YVD.e: y e regcm.... el.~pe:
-l'4UlIIICl::lI011'tlenter. ThOfle rules arl i
# of Bedrooms;n OAR 952-001-0010 thlough OAR _ ath:... nent Path
0090. You may obtain copies of the ml~s ~ Bmldmg. n/a
"'C111111~1Ifl=f littlllt:lr. (lI4O[e: fl . ,- ""1"\>11:'
number for the Oregon U NT INFORMATlON:~' ,
Center is 1-800-332-2344). I hi:) ERMIT SHALUt](~tR[{HbTtr~OO1(
Overlay Dist: ,~UTHORIZED UNDERrt~p. PERMIT IS NOT
# Street Trees Rqd: COMMENCED OR IS A8&N~~ FOR
Paved Drive Rqd: ANY 180 DAY PERIOKl:ompact:
% of Lot Coverage:
1
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Electric
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
., Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of 3
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 02/21/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Estimate
Estimate
$1.00
35,000.00
$35,000.00
$35,000.00
08/21/2007
Total Value of Project
~
Fee Description Amount Paid Date Paid Receipt Number
+ 10% Administrative Fee $42.37 8/21/07 2200700000000001329
+ 5% Technology Fee $21.19 8/21/07 2200700000000001329
+ 8% State Surcharge $33.90 8/21/07 2200700000000001329
Building Permit $311.74 8/21/07 2200700000000001329
Fixture $112.00 8/21/07 2200700000000001329
Plan Review Residential $202.63 8/21/07 2200700000000001329
Sanitary Sewer - Improvement $244.85 8/21/07 2200700000000001329
Sanitary Sewer - Reimbursement $322.00 8/21/07 2200700000000001329
SDC Sanitary/Storm Admin $28.34 8/21/07 2200700000000001329
Total Amount Paid $1,319.02
I Plan Reviews I
Planninl! Review 08/21/2007 08/21/2007 APP TAJ No Planning issues.
Public Works Review 08/21/2007 08/21/2007 APP EW Sanitary fixtures calculated for
SDC's
Structural Review 08/21/2007 08/21/2007 APP DLM See documents for plan review
comments
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
~eouire~nsnections I
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and the building is complete.
Underfloor Plumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Pal!e 2 of 3
CITY OF SPRINGFIELD.
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 02/21/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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.
~k~~
8/2f/07
Owner or Contractors Signature
Date
Pae:e 3 of 3
Construction Contractors Board
700 Summer St NE Suite 300 .
PO Box 14140
Salem OR 97309-5052
Phone: . 503-378..4621
Web Address: www.ccb.state.or.us
Pemn'#' CV12M7-!J~'
Address. ~t97'J.,.3..3 . sf:
Issued by: NCJrY1Cti p.J Date: g)21/C/7
\_)
Statement: Information Notice to Property Owners
--About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential-construction perin it applicants whoare not
licensed with the Construction Contractors Board to sign the following statement before a building
permit can'.be issued. This statement is requiredfor residential building, 'electrical, mechanical,and."
plumbing permits. Licensed architect and engineer applicants, . exempt from licensing under .
ORS 70 1.0 ~ 0(7), need not submit this statement. This statement will be filed with the permit.
. .
. .
Fill in the appropriate blanks and initial boxes land 2, and either box 3A or 3B:
~
~2.
1. . I own, reside in, or will reside in the completed structure.
I understand that I must become licensed as'a construction contractor if the structure is sold or
offeted for sale before or on completion.
o 3A. My general contractor is
(Name)
(CCB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
OR
~ 3B. I will be my own general contractor.
In hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. In change my mind and hire a general contractor, I will contract with a contractor who is
licensed with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and thati have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
WoNf! IlP
)( . (Signature ofpeJ;rlllt applicant)
~/2/lo/
(Date)
. (White copy to issuing agency permit file, pink copy' to applicant.)
Property _ owner.doc 06-01-04
m f4l.:- ~-' '. ~."
nlg~::as\\' -, r~:ewil Contractor?
"~""~F}~MA1'MOTICE PROPERTY OWNERS
" ASqUT :C9N$r~UCTlqN RESPONSIBILITIES
This Information Notice to Property about Construction Responsibilities was developed by the
Construction Contractors Board in accordance with ORS 701,055(5), passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new or make a substantial improvement to an existing
structure, you can prevent many problems by being aware of the following responsibilities a)"ld concerns. .
Employer
You will, in most ~nstances, be :ruled to be, an
you use contractors not licensed with the Construction
construction or improvement <;>f a residential structure.
contractors you contract with will be "employees" if
to. do labor in constructing or to assist in the
you must comply with the following:
Oregon's
employees are
employees.
I.law: 'As an employer, you must withhold income 'taxes from employee wages at the time
You will be. liable for the tax even if you don't actually withhold the tax from your
more infonnation~ call the Department of Revenue at 503-378-4988. .
1 . c. l' "'l
As an emp oyer, you are to.pay.a tax iorunemp oyment msurance purpOStfs.....
For more information, call Employment Department at 503-947-1488.
" /
'I
is a combin~d number for both Oregon, With~olding and.;
503-945-8091 or \,",ww.dor.state.oLus/formsP3.v.htmll for the
Unemployment
on the wages
The Oregon Identification Number (BIN)
Unemployment Insurance Tax. To file for a BIN,
appropriate forms.
Workers' Insurance: As an employer, you are to the Oregon Workers' Compensation Law,
and must obta~n workers' compensation il1surance your you fail to obtain workers' compensation
insurance, be subject'to penalties 'and be liable cos,fs if one of your employees is injured on the
job, more information, caB the Workers' Compensation Division at 'the Dep~rtmentOf Consumer'and Business
Services at 503-947-7815.
u.s.
You
IRS at
,
Service: As an employer, you must withhold federal income' tax from employees" wag~~t(
tax payment even if you withhold the tax. For a EIN number, call the
or their web site at
ofCOIOlcerns
Code
As the permit holder for this project, you are responsible for resolving any
may be brought to your attention
to' meet code
,< .~-
Damage Insurance:
and omissions such as
.retio.ne\ , '.' .
" ,_\ \ \ Y
sufficient time to supervise your
agent. to see if you have
water damage from
insurance
punctures, or
- --... 1
, . '
; ~ ; ")'
1
,..I
1-,
}
the skills to act as
building officials as
contractor, to coordinate the work of
so they can perform the required inspections.
call the Construction
97309-5052.
(503-378-4621) or 'write the agency at
06-01-04
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: COM2007-01237
NAME OR COMPANY: Robert BeII
LOCATION: 300 33rd St.
TAX LOT NUMBER: 17023 131-03500
DEVELOPMENT TYPE: Residential remodel
NEW DWELLING UNITS. 0 BUILDING SIZE (SF' 0 LOT SIZE (SF):
1. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. CHARGE
I 0.00 I $0.346 I = I $0.00
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. x COST PER S.F. x DISCOUNT RATE
I 0.00 $0346 50%
o
DISCOUNT
$0.00
ITEM 1 TOTAL - STORM DRAINAGE SDC
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's x
12
$0.00
$0.00
COST PER DFU
$26.83
$322.00
B. IMPROVEMENT COST:
NUMBER OF DFU's x
12
COST PER DFU
$20.40
$244.85
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
=, .
$566.85
rfJ
~
Ci
o
u
~
~
t-<
rfJ
>-<
\.:)
ga
1070
1091
11092
..
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUN ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FI.XTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 1 0 3 = 3
IDRINKlNG FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
/INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0
LAUNDRY TUB 1 0 2 = 2
CLOTHESW ASHER / MOP SINK 0 0 3 = 0
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
IRECEPTOR FORREFRIG /WATER STATION /ETe. 0 0 1 = 0
IRECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 3
SHOWER, SINGLE STALL 0 0 2 = 0
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1
IURINAL, STALL / WALL 0 0 5 = 0
/TOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 1 0 3 = 3
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 12
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at ]67 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RATE/$I,OOO
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
BEFORE 1979 $5.29 (Enter 1 for Yes, 2 for No)
]979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2
]980 $5.19 (Enter 1 for Yes, 2 for No)
]98] $5.12 BASE YEAR 1979
]982 $4.98
]983 $4.80 CREDIT FOR LAND (IF APPLICABLE)
]984 $4.63 VALUE / 1000 CREDIT RATE
]985 $4.40 $0.00 x $5.29 = , $0.00 I'
1986 $4.07
1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
]988 $3.22 VALUE / 1000 CREDIT RATE
1989 $2.73 $0.00 x $5.29 0
]990 $2.25
]99] $1.80
]992 $1.59 TOTAL MWMC CREDIT = $0.00
]993 $1.45
]994 $1.25
]995 $1.09
]996 $0.92
]997 $0.72
1998 $0.48
]999 $0.28
2000 $0.09
2001 $0.05
225 F'ifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-0I237
COM2007-01237
COM2007-0I237
CO M2007 -01237
COM2007-0I237
COM2007-0I237
CO M2007 -0123 7
COM2007-0I237
COM2007-0I237
Payments:
Type of Payment
CreditCard
cReceint 1
RECEIPT #:
2200700000000001329
Date: 08/21/2007
Description
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Fixture
Plan Review Residential
Building Permit
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ROBERT E. BELL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 055468 In Person
Payment Total:
Page 1 of 1
2:56:31PM
Amount Due
322.00
244.85
28.34
112.00
202.63
311.74
21.19
33.90
42.37
$1,319.02
Amount Paid
$1,319.02
$1,319.02
8/21/2007
Status
Issued
CITY: OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007,
EXPIRES: 12/23/2009
VALUE: $'35,000.00 '
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 300 33RD ST
ASSESSOR'S PARCEL NO.: 1702313103500
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Rem'odel
Residential
PROJECT DESCRIPTION: Interior remodel
Owner:
Address:
LESLIE & B BELL
868 6TH ST
SPRINGFIELD OR 97477
Phone Number: 541-543-1043
I CONTRACTOR INFO~:'1ATlON .
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
OWNER
OWNER
OWNER
HENRY M PONE DEL
License
Expiration Date Phone
57928
10/06/2009 541-345-1902
I BUILDING INFORMATION I
, 'fl.'" leC\UII"~ '-Utility
# of Units: _I"'" OlegOI'# of\Sto(ies:10n .joltli
El'll 'J\'l. d h'J 11'''' ..0 ~e\
Primary Occupancy Gronp: All R"\3 s adopte Heightof~Sfructure,o'l'
rull I"'D~~'~ ~^Q\Jo"ov
Secondary Occupancy Gronp:iol\o'N , n center. 'rvpe"oJrHear:' ule's b'l
'j'cet1n O,,\n..t\.\.U:;I nhet
Primary. Construction Type Notl \ y'B2._00'l-0 ~Water\(f:yjie:' I plione
^F\~" b\a'''''V~ lee
Secondary Construction Type:n 01" 'IoU (l'Ia'l 0 Ran.l\.eJ'i)''pe: .'j'ICation
090 \el I" ..." NO,I
# of Bedrooms: 0 'I' g3\lie cen 'Ener,g~\\!ath:,~
cal In lie OW\-lv: ' r .'>.."'~ .
, bel jor t , 'I~B~l!'ijllid trod ng:
nUfO _ ~.....tor \5
Electric
Electric
Electric
nent Path
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 211d Floor:
Sq Ft ~.asement:
Sq Ft GaragelCarport
Sq Ft Other:
Occnpa'nt Load:
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
, REQUIRED PARKING
Total:
Handicapped:
. Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS. 'i\-\'C ~O~~
. p~'C W , rikm\\
"Oi\C~. :I S\-\~'-'- tf. 1't,~iiJI~\v~ .'ll'pe:
,filS I't\'ltJ\~O \.l~Ot,\'I ,fI~~OQ"~nWJ1ts/brains:
/l-UiflO\'lI1. 0 0\'1 IS~~I"\ .
COtJ\tJ\t,~Ct,/I-'1' 1't,\'IIOO.
/I-~'1' ~'OO 0
Notes:
Page I of 4
Status
Iss u ed
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-0I237
ISSUED: 08/21/2007
APPLIED: 08/2112007
EXPIRES: 12/23/2009
VALUE: $'35,000.00
I
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuatio," !l~.scrirtio.~ I
Estimate
Tvoe of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
35,000.00
Value'
. Date Calculated
08/2112007
Description
Total Value of Project
$35,00.0.00
$35,000.00
L-F""11 P\i,IU
Fee Description. Amount Paid Date Paid Receipt Number
,
+ 10% Administrative Fee $42.37 8/21107 2200700000000001329
+ 5% Technology Fee $21.19 8/21/07 2200700000000001329
+ 8% State Surcharge $33.90 8/21/07, 220Q700000000001329
Building Permit $311.74 8/21107 2200700000000001329
Fixture $112.00 8/21107 220Q700000000001329
Plan Review Residential $202.63 8/21107 2200700000000001329
Sanitary Sewer - Improvement $244.85 8/21107 2200700000000001329
Sanitary Sewer - Reimbursement $322.00 8/21107 2200700000000001329
SDC Sanitary/Storm Admin $28.34 8/21107 2200700000000001329
+ 10% Administrative Fee $7.00 8/23/07 1200700000000001077
+ 5% Technology Fee $3.50 8123/07 1200700000000001077
+ 8% State Surcbarge $5.60 8/23/07 1200700000000001077
Perm Serv/Fdr 200 amps or less $70.00 8/23/07 1200700000000001077
+ 100/0 Administrative Fee $3.20 8/30/07 2200700000000001363
+ 5% Technology Fee $1.60 8/30/07 2200700000000001363
+ 8% State Surcharge $2.56 8/30/07 220q700000000001363
Add, Alter, Extend Circ Ea Add $32.00 8/30/07 2200700000000001363
+ 100/0 Administrative Fee $5.00 1/11/08 2200800000000000037
+ 12% State Surcharge $6.00 1/11/08 2200800000000000037
+ 5% Technology Fee $2.50 1/11/08 2200800000000000037
Storm Sewer - 1st 50 Feet $50.00 1111108 2200800000000000037
+ 100/0 Administrative Fee $11.20 1122/08 1200800000000000058
+ 12% State Surcharge $13.44 1122/08 1200800000000000058
+ 5% Technology Fee $5.60 1122/08- 1200800000000000058
Fixture $112,00 1/22108 1200800000000000058
+ 10% Administrative Fee $6.60 1125/08 2200800000000000109
+ 12% State Surcharge $7.92 1125108 2200800000000000109
+ 5% Technology Fee $3.30 1125/08 2200800000000000109
Water Line - 1st 50 Feet $50.00 1125/08 2200800000000000109
Water Line - Each AddtllOO' $16.00 112 5/08 2200800000000000109
+ 12% State Surcharge $2.28 6123/09 1200900000000000723
+ 5% Techoology Fee $0.95 6/23/09 1200900000000000723
Fixture $19.00 6123/09 1200900000000000723
~.,
Total Amount Paid $1,756.27
Paee 2 of 4
_~~!1'~~IFI~9:,' .
~" .
"'"~
CITY OF Srt<lJ~GFIELD
.
Status
Iss u ed
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 12/23/2009
VALUE: $:'35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannine Review
Public Works Review
08/2112007
08/21/2007
I Plan Re~iews ,
08/2112007 APP
08/2112007 APP
TAJ
EW
Structural Review
08/2112007
08/2112007 APP
DLM
No Planning issues.
Sanitary'fixtures calculated for
SDC's
See docu'ments for plan review
comments
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. wiW,be made the following
work day.
I J)Donllirp,-lln~,np('tion~.
~I,(~
Framing Inspection: Prior to cover and after all rougb in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and tbe building is complete.
Underlloor Plumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Final Mecbanical: When all mechauical work is. complete.
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Storm Sewer Line: Prior to filling trench.
Water Line: Prior to filling trench and including required testing.
Pa!!e 3' of 4
CITY OF ~rKll~GFIELD .
Building/Combination Permit
,
Status
Iss u ed
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08121/2007
EXPIRES: 12/23/2009
VALUE: $'35,000.00
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,
By signature, I state and agree, tbat I bave carefully examined tbe completed application and do bereby certify tbat all
information hereon is true and correct, and I further certify that any and all work performed shallLbe done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to tbe work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Comm.unity Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 wi\l'be used on this project.
I further agree to ensure that allreqnired inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at tbe front of the property, and the approved set of plans will remain on the site at all
times during construction.
~e-/-w?~ bl2s /09
Owner 01' Contractors Signature
/
Date
Paee 4 of 4
225 Fifth Street
Springfield, Oregon 97477
541- '726-3759 Phone
Job/Journal Number
COM2007-01237
COM2007-0 1237
COM2007-01237
Payments:
Type of Payment
CreditCard
cReceitltl
RECEIPT #:
Description
Fixture
+ 5% Technology Fee
+ 12% State Surcharge
raid By
ROBERT BELL
City of Springfield Official Receipt
Development Services Department,
Public Works Department
1200900000000000723
Date: 06/i3/2009
Item Total:
t.:heck Number Authorization
Received By Batch Number Number How Received
djb.
05553d In Person
,
Payment Total:
Page 1 of 1
II :57:02AM
Amount Due
19,00
0,95
2,28
. $22.23
Amount Paid
$22.23
$22.23
6/23/2009
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES; 07/]412008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 300 33RD ST
ASSESSOR'S PARCEL NO,: 1702313103500
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Remodel
Residential
PROJECT DESCRIPTION: Interior remodel
Owner: LESLIE & B BELL
Address: 868 6TH ST
SPRINGFIELD OR 97477
Phone Nnmber: 541-543-1043
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
OWNER'
OWNER
OWNER
HENRY M PONEDEL
License
Expiration Date Phone
57928
10/06/2007 541-345-1902
BUILDING INFORMATION'
3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
1
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
1
R-3
VB
Electric
Electric
, Electric
nent Path
nla
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
^TTr'''TIr-.''-I. 1"'\..-3...... I...... "''''<:1''1.0- y" r
I PUBLIC IMPROVEMENiifS;les adopted by the Oregon Utility
,,,,,,,,va,,un Center, ThOle rules are set forth
, '" in OAFl952-00f-ilb'm'!hrbll~ OAR 952-001-
, 0090. You maYIAA<<lIq,GOOAAfilIJJle rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
i"
Storm Sewer Available:
Specia\~1JM'C'2?n:
Notes: THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Page 1 of 3
_~~~!~~!'JI~LI?I
~j
;J;'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-,726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
. + 8% State Surcharge
Building Permit
Fixture
Plan Review Residential
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
+ 10% Administrative Fee
+ 5% Tecbnology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
+ 100/0 Administrative Fee
+ 5% Tecbnology Fee
+ 8% State Surcbarge
Add, Alter, Extend Circ Ea Add
+ 100/0 Administrative Fce
+ 12% State Surcharge
+ 5% Technology Fee
Storm Sewer - 1st 50 Feet
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Fixture
Total Amonnt Paid
I Valuation Description ,I
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
35,000.00
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 07/14/2008
VALUE: $ 35,000.00
Value
Date Calculated
Total Valne of Project
Fppr'~
Amount Paid
Date Paid
$35,000.00
$35,000,00
08/21/2007
$42.37
$21.19
$33,90
$311.74
$112,00
$202,63
$244,85
$322,00
$28.34
$7.00
$3,50
$5,60
$70,00
$3.20
$1.60
$2,56
$32.00
$5,00
$6,00
$2.50
$50.00
$11.20
$13.44
$5.60
$112,00
8/21/07
8/21/07
8/21/07
8/21/07
8/21/07
8/21/07
8/21/07
8/21/07
8/21/07
8/23/07
8/23/07
8/23/07
.8/23/07
8/30/07
8/30/07
8/30/07
8/30/07
1/11/08
1/11/08
1/11/08
1/11/08
, 1/22/08
1/22/08
1/22/08
1/22/08
Receipt Number
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
2200700000000001329
1200700000000001077
1200700000000001077
1200700000000001077
1200700000000001077
2200700000000001363
2200700000000001363
2200700000000001363
2200700000000001363
2200800000000000037
, 2200800000000000037
2200800000000000037
2200800000000000037
1200800000000000058
1200800000000000058
1200800000000000058
1200800000000000058
I Plan Reviews I
08/21/2007 08/21/2007 APP TAJ No Planning issues.
08/21/2007 08/21/2007 APP EW Sanitary fixtures calculated for
SDC's
08/21/2007 08/21/2007 APP DLM See documents for plan review
comments
Plannin2 Review
Public Works Review
Structural Review
$1,650,22
Pa2e 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-0I237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 07/14/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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,
I Reollired Insnections ,
Framing Inspection: Prior to cover and after all rongh in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and the building is complete,
Underlloor Plumbing: Prior to insulation or decking,
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete,
Electric Service: Approval required prior to utility company energizing service,
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
Storm Sewer Line: Prior to filling trench.
By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 durin Dction.
"(':2:d.-/Of)
Date
Pa2e3 of 3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01237
COM2007-0 1237
COM2007-0 1237
COM2007-01237
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Fixture
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
ANDERS HARSTAD BELL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dim 04560C In Person
Payment Total:
ap.~."!NQOFl.llLDOO'_O" ',.'
. - :
. ' .
=. .
..'
1200800000000000058
Page I of I
City of Springfield Official Receipt
Development Services Department
Pnblic Works Department
Date: 01/22/2008
8:47:31AM
Amount Due
112.00
5,60
13.44
11.20
$] 42.24
Amount Paid
$142.24
$]42,24
1/22/2008
CITY OF ~rKll"l>FIELD '
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-0I237
ISSUED: 08/2112007
APPLIED: 0812112007
EXPIRES: 07/14/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
'541-726-3769 Inspection Line
SITE ADDRESS: 300 33RD ST
ASSESSOR'S PARCEL NO.: 1702313103500
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Remodel
Residential
PROJECT DESCRIPTION: Interior remodel
Owner: LESLIE & B BELL
Address: 868 6TH ST
SPRINGFIELD OR 97477
Phone Number: 541-543-1043
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mecbanical
Plumhing
Contractor
OWNER
OWNER
. OWNER
HENRY M PONEDEL
License
Expiration Date Phone
57928
10/06/2007 541-345.1902
BUILDING INFORM A nON I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
I
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:'
Occupant Load:
I
R-3
VB
Electric
Electric
Electric
nent Path
nla
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Sethack:
Solar Sethacks:
..,.I"U' .
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
, ,I PUBLIC IMPROVEMENTS'
~'M'~nN' Oregon law requlre~ J -. ..
Street 1m 'O\' IS. . d t d by the Oregon Utility ,
, ollow ru es a op e
Storm S~~fia-ll~~nter. Those rules are set fort~ ' , '
, Special IlI1iWJlRli062-001-0010 through OAR 952-001-
0090. YC'lJ may obtain copies of the rules by
Notes: <. "'''..' ,'<:,1.,',,',1, (Note: the telephone
n ^,,,,:O: ' '. ".J Cregon Utility Notll.rcation
0"",8, is 1-800.332.2344).
Sidewalk Type:
DownspoutslDrains:
NOTICE: EXPIRE If THE WORK
THIS PERMIT S~~~~ THIS PERMIT IS NOT
AUTHORIZED UOR IS ABANDONED fOR
COMMENCED
ANY 180 DAY PERIOO.
Pa2e 1 of 4
Sta tus
Issued
CITY OF SPRINGFIELD
Building/Combination .Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 07/14/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone'
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Desc~iDtio~ I
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
35,000.00
Value
Date Calculated
Description
Total Value of Project
$35,000.00
$35,000.00
08/21/2007
!..Fee< P~i~ J
Fee Description Amount Paid Date Paid Receipt Number
+ 10% Administrative Fee $42.37 8/21/07 2200700000000001329
+ 5% Technology Fee $21.19 8/21/07 2200700000000001329
+ 8% State Surcharge $33.90 8/21/07 2200700000000001329
Building Permit $311.74 8/21/07 2200700000000001329
Fixture $112.00 8/21/07 2200700000000001329
Plan Review Residential $202.63 8/21/07 2200700000000001329
Sanitary Sewer - Improvement $244.85 8/21/07 2200700000000001329
Sanitary Sewer - Reimbursement $322.00 8/21/07 2200700000000001329
SDC Sanitary/Storm Admin $28.34 8/21/07 2200700000000001329
+ 10% Administrative Fee $7.00 8/23/07 1200700000000001077
+ 5% Technology Fee $3.50 8/23/07 1200700000000001077
+ 8% State Surcharge $5.60 8/23/07 1200700000000001077
Perm Serv/Fdr 200 amps or less $70.00 8/23/07 1200700000000001077
+ 10% Administrative Fee $3.20 8/30/07 2200700000000001363
+ 5% Technology Fee $1.60 8/30/07 2200700000000001363
+ 8% State Surcharge $2.56 8/30/07 2200700000000001363
Add, Alter, Extend Circ Ea Add $32.00 8/30/07 2200700000000001363
+ 100/0 Administrative Fee $5.00 1/11/08 2200800000000000037
+ 12% State Surcharge $6.00 1/ll/08 2200800000000000037
+ 5% Technology Fee $2.50 1/11/08 2200800000000000037
Storm Sewer - 1st 50 Feet $50.00 1/11/08 2200800000000000037
+ 10% Administrative Fee $11.20 1/22/08 1200800000000000058
+ 12% State Surcharge $13.44 1/22/08 1200800000000000058
+ 5% Technology Fee $5.60 1/22/08 1200800000000000058
Fixture $112.00 1/22/08 1200800000000000058
+ 10% Administrative Fee $6.60 1/25/08 2200800000000000109
+ 12% State Surcharge $7.92 1/25/08 2200800000000000109
+ 5% Technology Fee $3.30 1/25/08 2200800000000000109
Water Line - 1st 50 Feet $50.00 1/25/08 2200800000000000109
W'ater'Line - Each Addtll00' $16.00 1/25/08 2200800000000000109
Total Amonnt Paid $1,734.04
Pa2e 2 of 4
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01237
ISSUED: 08/21/2007
APPLIED: 08/21/2007
EXPIRES: 07/1412008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannin2 Review
Public Works Review
08/21/2007
08121/2007
Plan Reviews I
08/21/2007 APP
08/21/2007 APP
TAJ
EW
Structnral Review
08/21/2007
08/21/2007 APP
DLM
No Planning issues.
Sanitary fixtures calculated for
SDC's
See documents for plan review
comments
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
u.eoll ire1.' n~~P.ftrjon\l
Framing Inspe~tion: Prior to cover and after all rough in inspections have been approved.
Wall Insnlation: Prior to covel'.
Ceiling Insulation: Prior to covel'.
Final Building: After all required inspections have been requested and approved and the building is complete.
UnderOoor Plnmbing: Prior to insulation 01' decking.
Rough Plumbing: Prior to covel' and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Covel'
Final Mechanical: When all mechanical work is complete.
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Covel'
Final Electric: When all electrical work is complete.
Storm Sewer Line: Prior to filling trench.
Water Line: Prior to filling trench and including required testing.
Pa2e 3 of 4
Status
Issued
CITY OF ~rJ:<.1j~GFIELD .
Building/Combination Permit
PERMIT NO: COM2007-0I237
ISSUED:' 08/21/2007
APPLIED: 08121/2007
EXPIRES: 07/14/2008
VALUE: $ 35,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax'
541-726-3769 Inspection Line
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 berein, and
tbat NO OCCUPANCY will be made of any structure withont 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 propel' 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
t~eSZ~i~st~ (( Z \ r ()?
- /
Owner 01' Contractors Signature! Date
Pa2e 4 of4
225 Fifth s,treet
SprfDgfi~Id, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01237
COM2007-0l237
COM2007-01237
COM2007-01237
COM2007-01237
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Water Line - 1 st 50 Peet
Water Line - Each Addtl 100'
+ 5% Technology Pee
+ 12% State Surcharge
+ ] 0% Administrative Fee
Paid By
ROBERT BELL
~.t~~~;."i\i._:...
...%....,.......~.,..~...-._..._1..-;....' ~~ "',}
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000000109
Date: 01125/2008
2:42:00PM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
IIh 4511 B In Person
Payment Total:
Amount Due
50.00
16.00
3.30
7.92
6.60
$83.82
Amount Paid
$83.82
$83.82
, .
Page 1 of 1
1/25/2008