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Home My WebLink AboutPermit Electrical 2005-2-4 ~o '" ~" 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-36~/ q"JQ'~.9.ol"o ELECTRICAL PERMIT APPLICATION ..<1 Oqt61 . ~. O'o&,/'&C'/'~ . _ . v,,/, . 0 _"Jo/, \(>\5' City Job Number LOVlA UY04- 0 I ~ (., Date~o",. 'lii. ') 1"&1. V6~. & ~I"& 1"1'& 3. COMPLEI'E FEE SCHEJ)~L' , 0 ~&;?q\5'/, v,,%~ / ... ~C' ~61 "'& ~r:> ~., "O~ ~.....c. O'",~o~", pc ~ . 0 unit.& ;9 1. LOCAII0N OF INSI'ALLA110N h2.5 \A 1Jl C\' LEGAL DESCRIPTION (70377'-(] Sr~d, 1\} S;i. 00700 JOB DESCRIPTION SU (S PA-NC.,-L ~ :> C(v'2-cv~~ l:s Permits are non-transfera.!te and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CO~RACTOR INSTALLATION ONLY E]ectrica] C~tractor lhu-<. (j/~/ . Address ,6 ~ I. J{l d- tV s. i City <;t'ff:l: \. Phone 7Y'/--/2f?:3 Supe",iw Lieen,e Num~ \ \ \ Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising E]ectrician Owners Nam~ .4,-+ ~ (' 6b~(\ Address {goq ~(\' City Syt'd. Phone W 51'. '?'('(-/2$3. OVVNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. ~~~~ -:/ Inspection Request: 726-3769 SPRINGFIELD' A. . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modu]ar Dwelling Service or Feeder $ 19.00 $50.00 B. Services or Feeders - Installation, A]terations or Relocation: f j b") $ 63.00 $ 75.00 ;$125.00 $]63.00 $375.00 $ 50.00 200 Amps or less 201 Amps to 400 Amps i'J~"':d ,'W)'.'Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 AmpsN olts Reconn(5t Onbn law requires YOUlQ ATTENTION: reg d by the Oregon Utility fO\lO'(ll.rul~~j~2'~~~~;:HamsRltlilMt fort\'t Notification Cen~~~1 0 through OAR 952-001- in OAR ~awa~iorBuiYn;~o1ltaed'M\%~ by 0090. YR}b ~ay ~s{Note: the telepho~e cal\if2~ f~tcot~ennP\li\ity Noti1icc:diOR numt.tnr~twell$ (\O~~2-2344). Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit Each Additiona] Circuit or with S.ervice or Feeder Permit $ 43.00 $ 3.00 s- J) E. Miscellaneous (SerViC~{ewtVtiW\Nbl:~~ed) -Each Installation ~cril~t~:. \,\~ll E'J\\'\ \\\'J\\\ \S \\\0 \\-\\SP?Wp.%>\\~~~\\ \\'\\S \'E \\\ED fOR $ 50.00 . l\\n~\gW~~e&w~~n~'O~\\\DO $ 5.0.00 CO\\Dimft~~r~~~~tia] $ 25.00 l\~ilMl:&H~~~rgy/commerCia] $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 7t ';L((o 780 9/26 7% State Surcharge ]0% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Pennit Application I-03.doc Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: NOTICE: I """'\" nr-_.. ..._ I .. . . I PUP~~.'1MPROV.:EMH:/RE IF. THE W " ,JI1/LCU UJlJU THIS P .. I ORK. Partially Impro~~MMENCED OR IS ABANDOE~fA~'f~ ~tff. k~Y 180 DAY PERIOD. ~G.fs'P~tslDrains: _'~iiU~~!i~9J;:'~~I! , I I' :j \ c Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 623 W N ST ASSESSOR'S PARCEL NO.: 1703274300700 PROJECT DESCRIPTION: Detached garage Owner: ROBERT JACOBSON Address: 609 W N ST SPRINGFIELD OR 97477 Contractor Type General Electrical Contractor OVVNER OWNER # of Units: Primary Occupancy Group: U Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 81.00 37.00 33.00 15.00 81.00 Street Improvements: Storm Sewer Available: Special Instruction: CITY OF SPRINGFIELD Building/Combination Permit' PERMIT NO: COM2004-01517 ISSUED: 01111/2005 APPLIED: 12/10/2004 EXPIRES: 08/04/2005 VALUE: $ 23,328.00 Springfield TYPE OF WORK: Garage TYPE OF USE: New Residential Phone Number: 541-913-0306 I CONTRACTOR INFORMATION I :',: .. .... License Expiration Date Phone " , . ^...,..-...._. I Bu~i)j~G~f~N1'FeN fquires you to Notif;ca~'on C u uy IIle Oregon Uti"i in dA9f' ! srnter. Those rules ar~ set ize: 00 e\l8~~1-iltQ1~ through ~PP952- Ist Floor: c91!~~Re wm~t9btam copies of the rU/e'~ t 2nd Floor: n ~~~~!~p&nter. (Note: the te/epho ~~~t Basement: LJ}tllllig~l/fy~ Oregon Utility Notiticat~~ Ft Garage/Carport Enert;ePtftlilS 1-800-332-2344' 'S'4 Ft Other: Sprinkled Building: n/it. Occupant Load: 960 --. I DEVELOPMENT INFORMATION I REQUIRED PARKING No 16.00 Total: Handicapped: Compact: Drywell - Provide Drywell Engineering Notes: Owner must show drywelllocation on site plan, verified soil type(119) and ground water table okay for drywell, DEQ application in building review package. Per phone conversation with owner. Paperwork must be completed before permit issue. 12/16/2004 Pae:e 1 of3 --~~IS\I"~~,~~9p,; . ~. .~ . , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Garae:e Garae:e Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Fixture Garage/Carport Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Initial Review Plan nine: Review . Public Works Review Structural Review " CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01517 ISSUED: 01111/2005 APPLIED: 12/10/2004 EXPIRES: 08/04/2005 VALUE: $ 23,328.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $24.30 Square Footage or Bid Amount 960.00 Value Date Calculated Total Value of Project ~ $23,328.00 $23,328.00 12/10/2004 Amount Paid Date Paid Receipt Number $140.79 12/10/04 2200400000000001502 $27.56 1/11/05 1200500000000000046 $19.29 1/11/05 1200500000000000046 $14.00 1/11/05 1200500000000000046 $216.60 1/11/05 1200500000000000046 $59.00 1/11/05 1200500000000000046 $8.43 1/11/05 1200500000000000046 $168.64 1/11/05 1200500000000000046 $45.00 1/11/05 1200500000000000046 $7.80 2/4/05 2200500000000000136 $5.46 2/4/05 2200500000000000136 $15.00 2/4/05 2200500000000000136 $63.00 2/4/05 2200500000000000136 L..JleouirerUnsnections' Detached garage cannot be taller than primary structure. Drywell location to be noted on site plan, DEQ application included in building package. 12/16/2004 CAS See documents for plan review comments 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. 12/13/2004 12/14/2004 $790.57 I Plan Reviews I 12/14/2004 APP LLH 12/21/2004 APP EMM. 12/16/2004 APP CAS 01/05/2005 APP DLM 12/14/2004 12/14/2004 Vfer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Foundation: After forms are erected but prior to concrete placement. Pae:e 2 of3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01517 ISSUED: 01/11/2005 APPLIED: 12110/2004 EXPIRES: 08/04/2005 VALUE: $ 23,328.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. Storm Sewer Line: Prior to filling trench. Drywell: Engineered Drywell is Required. Provide the City with a copy of the DEQ application to keep on file. 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 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 Pae:e 3 of 3 225 Fifth Street Sp'rihgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1517 COM2004-01517 COM2004-0 1517 COM2004-0] 5] 7 Payments: Type of Payment Cash Change Job/Journal Number COM2004-0] 5] 7 COM2004-0] 5] 7 COM2004-0] 5] 7 COM2004-0] 5] 7 Payments: Type of Payment Cash Change 2/4/2005 RECEIPT #: Description Perm ServIFdr 200 amps or less Add, A]ter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By ROBERT JACOBSON ROBERT JACOBSON Description Perm ServIFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By ROBERT JACOBSON ROBERT JACOBSON ~J~~f;~iiI""':.""": '.~' IlL, f'". . . ~ ...~_. "- .. ~ . - -' !' " \ ....l~ 1;.' _;_ ;r '.. ""_!4.','~'u,_.,,,,.,....~.._" ,'. City of Springfield Official Receipt velopment Services Department Public Works Department 2200500000000000136 Date: 02/04/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Page 1 of I 10:41:10AM Amount Due 63.00 ]5.00 5.46 7.80 $91.26 Amount Paid $100.00 ($8.74) $91.26 Amount Due 63.00 15,00 5.46 7.80 $91.26 Amount Paid $]00.00 ($8.74) $91.26