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Home My WebLink AboutPermit Electrical 2006-10-11 (3) ;;PRINr-'ELD C:.:::":=:;"~'\ ZON Lpt2. ., ./,.>~1 INITIALS NM. .. ..-'-:... .:" >j '~., .-.------,..,.~,_.' DATE ,\ n --I-:L - ~Cp '" _'.J SOURCE~~~, 0-S Date J()-ll~\.O(1J 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO h1 ~00 .- 002-'lt..o 1. LOCATION OF INSTALLATION 3. CO~IPLETE FEE SCHEDULE BELOlV ~.'lq0 fudf'^-j~ ~e. LEGAL DESCRIPTION 110'3 'Z l.{ "l \ D '3.Cz8.. New Residential - Single or Multi-Family. per dwelling unit. ~D~ t;'e1cl,1 , ()~. 0, f) 4-01] JOB DESCRIPTION ( ~C1L- ~1I- #=- CClYl;J('O~ - fJ-ew W\rl~ IV'\. A~'-\1lY\ CC-;A1U) Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19,00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: Electrical Contractor 200 A\2W~~i'J~".i? ~? . n \a~b\e~ ttl~OO~\1i~L.. I ~E\"iTtO~"~~ 40f~~~"~)~~~ If\''~ " . ,,,/' :p\.-~,~r. ._ '",,11",',("':(:) "":.~'-.:' _ ~c-' ~:\:\./;....:;;;~.:rr . '~O\!\J i;,,'., ,,:"~"~Q,LA~i<<HOOd~ \iC~~ _ ., ,',~l\~~ --~.:\'>.;..>,'<.t;- ,., <','/\ .)",j~.\.0C1 PhoneW,\~~~t.,".,".., :g,Yf\;lPOO \At:rtp,~Z~~tts . '1t~r;~cC~l1!~;<"f~\~l,;G~ " . " \.:.\.~~/,.,./ .\,:t;;~,\\.~~\.'--~~o.-'\J' "" ~~'.'C(j;~~2::4u,~~i;Services or Feeders ~.~ nr;~'. / 5~4':0,,',j'l .. ~~fI'C~':J' C;~,~~:ji \G 'I" :nstallation, Alteration or Relocation " 200 Amps or less $ 50,00 '\. 201 Amps to 400 Amps $ 69.00 \ '401 Amps to 600 Amps $100.00 "\ t~~,', Over 600 Amps or ~ q~~Wt~NQR~" above. ~Q' .,[.Pn\'\'~,",Mll&i)<~mN 1""fj\\i\rr lSN;Ol ,,?U\FY V~',nW\ . 'n-\\~ yt.nw,\, , "" II' ,~~unp\Ci.\ro~}'iilmtlOlJ.. P1'r1t<<,r~~r Panel ~U l' ,,~\~ 1:\=' 'lC~ A\3I-\\\\\.,"W~l;,~ t'I'\r\\j\"N~} QI?- \J\J\\;h l" ~~~a1 Circuit or with 7 '-'<"'~ ;1 /l i, v.2 1'1 r ~N'4 '\ &0 J.Sravice or Feeder Permit $ 3,00 Owners Name .....))\'Y\ ().. l .AJ\ ()S~[} \ y( ( J;<:::, /' Address ::; 11 '7 ~U1L11~f) _ ~lJe -" E. Miscellaneous (Service/feeder not included) -Each Installation City $fri~..fie)d _ Phone 1)41-~O?~ Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 / $ 63.00 $ 75,00 $125.00 $163.00 $375.00 $ 50.00 63 ~ ~ City Sup"";,o>" Licen'7 Expiration Date /' / Constr/6ntr. Number ".- /."~ _Expiration Date Signature of Supervising Electrician $ 43.00 21 OWNER INST ALLA nON The installation is being made on property I own which ::::~~: sale, I~ rent} /ktZ /~J L~' , Inspection Request: 726-3769 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 8(/ 8% State Surcharge b 7 Z- 10% Administrative Fee Bl(O ~~ ~,~ l{lO TofAL t' -- ?~ (.I ...;) ..1_ Shared Drive(T:)/Building Fonns/ElectIical Pennit Ap ication I-06,doc Status Issued ~ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00286 ISSUED: 04/21/2006 APPLIED: 03/09/2006 EXPIRES: 01/03/2007 VALUE: $ 79,398.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2797 BURLINGTON AVE ASSESSOR'S PARCEL NO.: 1703244103026 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Two - story addition Owner: Address: BECK JAMES G & CHRISTINE M 2797 BURLINGTON AVE SPRINGFIELD OR 97477 Afl1)--~ Phone Number: 541-747-8078 .tt fOI1~ ~): , Ii, ~'(IC8,:lJl. ~Pt.'O"Q_ [JlJfJ~"'1o/ J)".""" C """0-011 ~ol) l I CONTRACTOR INFQRMMJ:rOOntJ 6J)/el: ~lY by (1~ ,.&9. ' fJ(J. "'I111I1U .!. rtJl!1 '''00; 110~ tl)e Q 'lJ1I'es Contractor 'lh1:Jt1I€otery 06t~~~tfoD;l~'fgol)fI~JW OWNER e!fh~l)e9I)tet:. (J 'IJ ~,~ q"e Se~IhI/I}7-6638 OWNER 'l'J16"'$ O"9lJO "/vOte: tl- ~ 01 tl- 'J:i BS<.. 'f fOl"ff OWNER 1..8. 'IJ Ut; "e t. "e" OOJ BAXTER PLUMBING & ROOTER LLC 169028 00"aalfll1A116'8oh~/e.ss41-935-6696 I BUILDING INFORMATION. <::~J.I,I'Cq,i~(I ~ /Vo . t'IJ # of Stories;!,ft. llCt. Lot Size: Height ofjfr({8~l . Sq Ft Ist Floor: Type o~~tj?WO.D 194(/l,Wall Heat Sq Ft 2nd Floor: Water Y15~j4" It{.>to $,,~ctric Sq Ft Basement: Range ~lJ:, C4'C~ 0'4'0. /./. !'y,.. Sq Ft Garage/Carport Energy Pat'Ii?O f) /) 011 ~~'Y"III~q Ft Other: Sprinkled BuildiWg:p.l' /S An!lt;$ p. 0€'9',ant Load: c...!)(~ '"119111 ,/:"", 1'11::'\ "Jil' .i~a '>1J1J ~ rv{J. I DEVELOPMENT INFORMATIbN , V4'(='{) 1'1'/8 ~k FOq ~fl"uIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: R-3 401 401 Contractor Type General Electrical Mechanical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 5.20 47.00 I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: Storm to existing system / curbface.JLP 3/27/06 Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwelline:s v Wood Frame Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge Building Permit Fixture Minimum/Adjustment Mechanical Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Initial Review Plan nine: Review 03/10/2006 03/10/2006 ~ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00286 ISSUED: 04/21/2006 APPLIED: 03/09/2006 EXPIRES: 01/03/2007 VALUE: $ 79,398.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $99.00 Square Footage or Bid Amount 802.00 Value Date Calculated $79,398.00 $79,398.00 03/09/2006 Total Value of Project ~ Amount Paid $316.97 $10.00 $58.87 $47.09 $487.65 $56.00 $39.00 $171.63 $225.63 $22.59 $54.59 $6.00 $8.40 $4.20 $6.72 $21.00 $63.00 $1,599.34 Date Paid Receipt Number 3/9/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 4/21/06 10/11/06 10/11/06 10/11/06 10/11/06 10/11/06 1200600000000000282 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000000525 1200600000000001515 1200600000000001515 1200600000000001515 1200600000000001515 1200600000000001515 I Plan Reviews I 03/10/2006 03/28/2006 APP LLH APP TAJ No Planning issues. Pae:e 2 of 4 ~ITY OF SPRINGFIELD Status Iss u ed Building/Combination Permit PERMIT NO: COM2006-00286 ISSUED: 04/21/2006 APPLIED: 03/0912006 EXPIRES: 01/03/2007 VALUE: $ 79,398.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 03/10/2006 03/27/2006 APP JP Owner Vacated (1) one bedroom in main house (see file for letter), Only a "Septic Responsibility Form", is required from Lane County. Owner has provided S.R.F. (see file). Storm to existing system / curbface. 3/27/06JLPOwner to bring in plans showing vacating original master Bdr. Shld only need "Septic Responsiblity Form" from L.C. 3/20/06JLPWaiting for L.C.Sanitary "Authorization Notice" & Storm plan from applicant.3/13/06JLP Structural Review 03/10/2006 04/06/2006 APP RJB To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. l..ReouirecUnsnections. 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. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Pal!e 3 of 4 ~ITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2006-00286 ISSUED: 04/21/2006 APPLIED: 03/09/2006 EXPIRES: 01/03/2007 VALUE: $ 79,398.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 ofany 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 tim?~~ Owner or Contrac~gna~ure 10-11-\ 0(0 Date Page 4 of 4 '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 Permit #: COW121:.---..(J ,- oo2-8'~ ' Address: , 2. (~7 'fJtiflll~,~ . ' De Date: /d/lrjo, I Issued by: ,Statement: Information Notice to Property Owners About Construction Responsibilities, Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.01.0(7), need not submit this statement. This s,tatement will be filed with the permit. , Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~, 1. D 2. 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 offered 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 li~ensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I 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 that I have read and do understand the Information .Notice toPro~.op ,y Owners about Constr on Responsibilities on the reverse side,ofthis form. ~ . K /0-//-0-6 (Signa)ure of permit applicant) (Date) (White copy to issuing' agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 Acting -as' 'r our Own General Contractor? : '. "r.'",J \ ~', .... . -,. - 'INFORMATION NOTICE TO PROPERTY OWNERS ..- ABQ~1:'0>NSTRUCT~ON RESPONSIBILITIES ~~. ." ., '. \ , " ',\ '. .' ...~. - . . - . NOTE: This Information Notice to Property Owners 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 actl~g as yoUr own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many prohlems by being aware of the following responsibilities and concerns. Employer Responsibilities .' . .. '. ' , , You will, in most i!1stances, be ruled tope- an "employer" and the contractors YO!:l contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the ,. \ ~ . " . construction or improvement of a residential structure. As the e~ployer, you must comply with the following: Oregon's Withholding Tax Law: As ~n empl~yer, youmu~t withhold income taxes from etnpl~yee ~ages at the time employees are paid. You will be liable for the tax payments even if you don't actually ~thhold the tax from your employees; For more information, call the Department or Revenue at 503-3784988. " ',' , .,' ," , Unemployment Insurance Tax: As an employer, you are re'qtiired to pay a tax for unemployment'insurance purpose~i_ on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined munber. for both Oregon, Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/fonnsuav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obt~in workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance; you could be subject to penalties and be liable for all claim costs if one of your einployees'is' injured on the job. For more information, call the Workers' Compensation bivlsion'at-the Department of Consumer and Busiriess Services at 503-947-7815. U.S. Internal Revenue Service:' As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800:"829-4933 or visit their web site at w\vw.irs.l!Ov. ' Other Responsibilities and,A..reas ofCoIlcerns, Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requireme~ts that may b~ brought t,o your attention through inspections. .. r , . . . 'Liability and Property Damage Insurance:' Contact your insUrance' agent to see if YOLl have 'adequate insurance" coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees: , ' E~pertise: Make sure you have the skills to ~ct' as your own g~enil cotitr~ctor, t~ c't>orditiate the work of rough~in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. .' Property- owner.doc 06-01-04 Citv "'{ Springfield Official Receipt Dt Jpment Services Department Public Works Department 225 Fifth Street Spripgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00286 COM2006-00286 COM2006-00286 COM2006-00286 COM2006-00286 Payments: Type of Payment Check cReceintl RECEIPT #: 1200600000000001515 9:53:14AM Date: 10/11/2006 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 63,00 21.00 4,20 6,72 8.40 $103.32 Paid By JIM BECK Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb In Person Payment Total: $103,32 $103.32 2912 Page I of I 1011 112006