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Home My WebLink AboutPermit Electrical 2007-10-11 Date ZON b~ . lNITIALsN~ DATE-", . ~. ro~\ l- 0( SOURCE'0('-~t' ..,) /0 r//~ Or .>:'<:" ',ctf~Y OF ,SP~NGFIEtD~'QREGON ".' r ~t, . - . 225 FIFIlI STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICALt;:;IT APPLICATION City Job Number ') --{flL7 - aL/ 7 8:' 3. LEGAL DESCRIPTION: /'70.;535 3~ QI3UV JOB DESCRIPTION: (ldd (JrJ(1I<{ tJ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. / / Phonl / / // Supervisor License Numb~I;/' Address City Expiration Date Constr. Contr. Number Expiration D~te / Signature/6f Supervising Electrician / Owners Name -jf>R. / If N Address ') 4'3 ~ b City <Sf? ;:((1 tm (<- ~I'- <,-T 7V6 -ct+: 6 <g Phone OWNER INST ALLA TlON The installation is being made on property I own which is not intended for sale, lease or rent. O~ners Signature: {; ,// ~ !J>-n~ A __ /YV" ~ .{/P- Inspection Request: 726-3769 A. Service Included 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 $ 21. 00 $55.00 B. . 200 Amps '(1.. ~[952-001-001 ~ thro~gh ~~ij@~-o01. 20 I A )b 11 YQ.l!rnay obtalll WtJ'~" VI JttA MeaDJ mps.o 1Ti~Wt'e center. (Nate: t~9 fE!f~pW9flQ 401 Amps t<tlB9R~mr the Oregon I Jtility ~~~ 601 Amps to 1000 AGt}nter is 1-800-332-2344).0.00 Over 1000 AmpsNolts $413.00 Reconnect Only $ 55.00 c. InstaIlN"'Fle,!:"ation or Relocation 200 Amsrf!lfRMIT SHAll S RK 20 I A~P1~tefpllNDER THIS P~P.MI 1 rOT 40 1 At;tfl~~~CElJlJR IS ABANDONED ~O() Over qAN\{~OOof)A\O' D. New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with J Service or Feeder Permit $ 48.00 $ 4.00 .2j r-... cro -<..f _ OIJ E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited Energy/Residential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges ~,. oU ~ 0~- d- GJ 0 .Aj.;(p ~ ~-, 'd-O 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOT ALJ/ (()3. 90 Shared Drive(T:)fBuilding FormslElectrical Permit Application 7.07.doc 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 I , .Permit#:-~/'- 0)/75 'Address: 3& q 5 ,\ .J) -5/-. ~ 'IssUedbY:~~.' k./ Date: !CJ-II-07 / / \ I G I..... Statement: Information Notice to Prop.e\rty Owners About Construction Responsibil,ities . 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 ltatement before a building . I permit can be issued. This statement is required for residential building, electrical, mechanical and plumbi~g permits. Licensed architect and engineer applica,nts, exempt Aom licensing under '. ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. .Fill in the al-'l-'J.Vl-'J.~ate blanks and initial boxes 1 and 2; and either box 3A or3BJ ~\ 1. .0 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor ifthestructure is sold or . offered for sale before .or on completion. . 0 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. If I 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 contrkct with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the . I . name of the contractor. . . . .' .'" 1 I hereby certify that.the above information is correct and that I have read and do junderstand the Information Notice to Property Owners about Construction Responsi~ilities on the reverse side ofthis form. . ~:- ~ .. olr II, 2od( (Signaturt of permit applicant) '- " \ (Dat~) (WJ:zite copy to issuing agf!ncy permit file, pink copy to ap;licant.) Property- owner.doc 06-01-04 This Information Notice to Owners about Construction Contractors Board in accordance with ORS 701.055(5), t. J '''. .1 \. you are as your O\VTI you can to by. being' . a not on .~ I. . - . , . . .1" 1'./ is a corvbi:Qed 503-945-8091 or 'j- . '\~ . tax. For a are Code ~ ,'" .- .r -_ to. I. or ---:'-. .~...: ;' ~- to your .:.~. ":. .>.... - )or at 06-01-04 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 369 S D ST ASSESSOR'S PARCEL NO.: 1703353401300 Springfield PROJECT DESCRIPTION: Change roof design on residence Owner: BRIAN FRIEDKIN Address: 369 SOUTH D STREET SPRINGFIELD OR 97477 Contractor Type General Electrical Contractor OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01178 ISSUED: 08/24/2007 APPLIED: 08/09/2007 EXPIRES: 04/11/2008 VALUE: $ 15,000.00 TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential Phone Number: 541-746-9608 I CONTRACTOR INFORMATION I BUILDING INFORMATION I R-3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VB License Expiration Date Phone n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Pa2e 1 of 3 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01178 ISSUED: 08/24/2007 APPLIED: 08/09/2007 EXPIRES: 04/11/2008 VALUE: $ 15,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description ~ Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 15,000.00 Value Date Calculated Description Total Value of Project $15,000.00 $15,000.00 08/09/2007 ~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Plan Review Residential + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $16.15 8/24/07 1200700000000001085 $8.08 8/24/07 1200700000000001085 $12.92 8/24/07 1200700000000001085 $161.54 8/24/07 1200700000000001085 $105.00 8/24/07 1200700000000001085 $5.20 10/11/07 2200700000000001573 $2.60 10/11/07 2200700000000001573 $4.16 10/11/07 2200700000000001573 $48.00 10/11/07 2200700000000001573 $4.00 10/11/07 2200700000000001573 Total Amount Paid $367.65 I Plan Reviews I Initial Review Plan nine: Review Public Works Review Structural Review 08/09/2007 08/09/2007 08/09/2007 08/09/2007 08/09/2007 08/21/2007 08/14/2007 08/24/2007 APP APP APP APP LLH TAJ BRC RWC No Planning issues. No SDC charges. BC Approved as submitted, field verify. 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. l..ReouireCUnsnections I Framing Inspection: Prior to cover and after all rough in inspections have been approved. Ceiling Insulation: Prior to cover. I J Final Building: After all required inspections have been requested and approved an~ the building is complete. Rough Electric: Prior to Cover . i Final Electric: When all electrical work is complete. Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01178 ISSUED: 08/24/2007 APPLIED: 08/09/2007 EXPIRES: 04/11/2008 VALUE: $ 15,000.00 225 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 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 Pal!e 3 of 3 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01538 COM2007-01538 COM2007-01538 COM2007-01538 Payments: Type of Payment ONLINE CHGS cReceint I RECEIPT #: Date: 10/11/2007 3200700000000000678 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ONLINE PERMIT CHGS Item Total: Check Number Authorization Received By Batch Number Number How Received NJM . ONLINE ROSE Online CORP Payment Total: Page 1 of 1 7:22:14AM Amount Due 70.00 3.50 5.60 7.00 $86.10 Amount Paid $86.10 $86.10 10/1112007