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Home My WebLink AboutPermit Electrical 2007-9-17 ZON \~ INITIALS vV ~ DATE 0... -\. t' - crt SOURCE \.A..oS",jO ./ . . - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION r City Job Number C6wt eoo7 -00 7 S-.) Q -,.., Date \. \..,- 0-' I. LOCATION OF INSTALLATION: ~3'-I-LA\M.~ io_<,o\p--, LEGAL DESCRIPTION: {70l/c;7t{ 3. COMPLETE FEE SCHEDULE. BELOW 07000 A...~ewRe~identiaI7 Single or Multi-Family per dwelling unit. Service Included JOB DESCRIPTION: 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 M\.~'D,^-/et;2 ~pJ - , . $ 21.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $55.00 CONTRACTOR INSTALLATION ONLY 2. Electrical Contractor~('\~t(("'a.1 tC1 ~/G 200 Amps or less ~v-l' ce- 20 I Amps to 400 Amps Address 6DtJ-'-I- LL>rCL\AY2.- +/ltlj 401 A~o 600 Amps ~~)1~~~~00 Amps City J;5L{j 0:J.Ae- Phone '-I~-r;:::....7~ II. ~~e~e@P"~f$.)~Nolts ~ - ot<\f6. ~e.~~~~" Cj /S--bfl~~ 6'0'4 e~~ O~~Jc ~e ~. e~:e ~~o~ ~,~~ ~~~~~o. ~ Supervisor License Number L/ /j, ,.?i.~. ~~'C;}.Q~~\\{~vices or Feeders .:\\- (~ 0 "0\0 GO~. ~e ~o"S O /~?'" .ot< ~\,V ~t< ....\o\e.~~ ~ ~" / () / /_~~~~?,.J;J (t~~~. ~o~rU..~~"!.~n, Alteration or Relocation ( 0 "tOU \\ e cJaf' O~e%~~ f\mps or less Constr. Contr. Number 1('1 7 ~~j~(\~ ~o~ ~~.~ \ 20 I Amps to 400 Amps I o~e\ Cef' 40 I Amps to 600 Amps Expiration Date I -, 2. I '\ 0 /- / .d.... Over 600 Amps or 1000 Volts see "B" above. ( { ..,', . .,,' ".. . SignaMe nf Supends;ng Electr;ci~ D. "Bri"ichC;"'uits ~ ..tJ..J)1,~:J-1?"~ ~~: ~:::~t;on or Extension Per panel..~~ /' Each Additional Circuit or with ~~? L/ <i( ~;;::: N;~~~~~ ~~ ~~ E. se:;:::.~e:::.;;:;~e/~~~~:eh Inst~llation City ~(::~ Phone 747 -1117 Pump or irr~~n # <o~~~<v~ ~~ $ 55.00 Sign/Ottl~~t~~<v~ \::)<(.. Q.~\J $ 55.00 OWNER INST ALLA nON Limited E\~~~~~~ ~~ $ 28.00 The installation is being made on property I own which Limited Ene~/~)>11 $ 50.00 is not intended for sale, lease or rent. Minimum~.lect~ic ~~~t'lnspection Fee is $50.00 + Surcharges Owners Signature: 4. 'SUBTOTALO~A.BOVB /1 ! '1 fir fl80 '5,/0 /l{)" !!i B. Services or Feeders - Installation, Alterations or Relocation: $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 70 Expiration Date $ 55.00 $ 76.00 $110.00 8% State Surcharge 10% Administrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00755 ISSUED: 06/20/2007 APPLIED: OS/25/2007 EXPIRES: 03/11/2008 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3342 Ambleside Dr ASSESSOR'S PARCEL NO.: 1702193407000 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing single family residence Owner: MARK GILMAN Address: 3342 AMBLES IDE DR SPRINGFIELD OR 97477 Phone Number: 541-747-7717 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing License Expiration Date 11/04/2007 01/22/2008 03/10/2008 06/05/2008 Phone 541.463-1410 541-485-7311 (541) 915-9202 541.344-0411 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Path 1 Sq Ft Other: n/a Occupant Load: 400 I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicap~~ Paved Drive Rqd: C.9~)N\J\Q1 % of Lot Coverage: 23.00 ~?\~t. \\' ~\\ \~ ~ ...,~\f~' -(. C.\-\f>..~~7' "f\o\\S ~~~ft) ~O~ I PUBLIC IMPROVEM~~J~ 't.~~~\) \)~\)~S f.\'Oft..~\J ~\)\\\~~~~~~~ C.a~ "\ ~W~spoutS/Drains: ~~, Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 6.70 40.40 5.00 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Storm tied to existing system. JLP APP 5/25/07 Paee 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-00755 ISSUED: 06120/2007 APPLIED: OS/25/2007 EXPIRES: 03/11/2008 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 50,000.00 Value Date Calculated Description Total Value of Project $50,000.00 $50,000.00 OS/25/2007 ~ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $10.00 6/20/07 3200700000000000413 + 10% Administrative Fee $54.47 6/20/07 3200700000000000413 + 5% Technology Fee $32.83 6/20/07 3200700000000000413 + 8% State Surcharge $43.57 6/20/07 3200700000000000413 Building Permit $370.65 6/20/07 3200700000000000413 Fixture $84.00 6/20/07 3200700000000000413 Minimum/Adjustment Mechanical $39.00 6/20/07 3200700000000000413 Plan Review Minor - Planning $112.00 6/20/07 3200700000000000413 Plan Review Residential $240.92 6/20/07 3200700000000000413 Sanitary Sewer - Improvement $197.91 6/20/07 3200700000000000413 Sanitary Sewer - Reimbursement $260.27 6/20/07 3200700000000000413 SDC Sanitary/Storm Admin $31.18 6/20/07 3200700000000000413 Storm Drainage Impervious Area $165.46 6/20/07 3200700000000000413 Storm Sewer - 1st 50 Feet $45.00 6/20/07 3200700000000000413 Vent Fan $6.00 6/20/07 3200700000000000413 + 10% Administrative Fee $11.80 9/17/07 1200700000000001203 + 5% Technology Fee $5.90 9/17/07 1200700000000001203 + 8% State Surcharge $9.44 9/17/07 1200700000000001203 Add, Alter, Extend Circ Ea Add $48.00 9/17/07 1200700000000001203 Perm Serv/Fdr 200 amps or less $70.00 9/17/07 1200700000000001203 Total Amount Paid $1,838.40 I Plan Reviews I Plannine Review Public Works Review OS/25/2007 OS/25/2007 OS/25/2007 OS/25/2007 APP TAJ APP JLP Storm tied to existing system. SDC fees include credit for existing tub included in remodel area.JLP APP 5/25/07 Approved as noted on plans. Structural Review OS/25/2007 OS/25/2007 APP DLM 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. Paee 2 of3 epmlN~l1PliIILDi '-1. . "lII!If~ ~} ~ +' CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-00755 ISSUED: 06/20/2007 APPLIED: OS/25/2007 EXPIRES: 03/11/2008 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Reouired InsDections I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering 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 Final Electric: When all electrical work is complete. Storm Sewer Line: Prior to filling trench. Underfloor Mechanical. Prior to insulation or decking and including required testing. 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. Owner or Contractors Signature Date Page 3 of3 225 Fifth Street Spri!lg,fi~ld, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00755 COM2007-00755 COM2007-00755 CO M2007 -007 55 COM2007-00755 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000001203 Date: 09117/2007 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By RICHARD GROSHONG Item Total: . Check Number Authorization Received By Batch Number Number How Received djb 069458 In Person Payment Total: Page 1 of 1 2:27:24PM Amount Due 70.00 48.00 5.90 9.44 11.80 $145.14 Amount Paid $145.14 $145.J4 9/17/2007