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Home My WebLink AboutPermit Electrical 2007-10-17 ZON "'-1)2,. INITIALS /1.....) ~ DATE 1 0 -' \' - 0, SOURCE ~(\?..; Date \ 0- \ I - 07 225 nJ' ul STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job NumberC 9J0') rrilt " C1JCt 4 2- 1. LEGAL DESCRIPTION: \Ln)~.~() SLfO(o~ JOB DESCRIPTION: N~0 s s+:2-vt ~ 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. Electrical Contractor Addres:i, ~ City Supervisor License ".",/" Expiration pate /'/ /,/ " ber ~ ~ ~ Copsb-. Contr. Number / / ~ / Expiration Date Signature of Supervising Electrician I ..----. OwnersNam&n~~~ \\n~A~ Address~~Zol, C\~ ~\ City ~\ 0 (9.-, Phone q \ ~ - So !f Cfl ' 't'\XV' OWNER mi'~LATION !he in.stallation is.being made on. pro~~wn which IS not mtended for sale, lease or rent: / / .// /" ". 6- ,./' own.e..rs.s. ignature:. ..."......-.-. ~.4-, I ..... /' ' Inspection Request: 726-3769 3. A. Service Included 1000 sq. ft. or less $117.00 Each additional 500 sq. ft. or portion thereof $ 21.00 . es yOU to Each Manufact'd Home W" OreQon law requlr urnv Modular DwtMIiIg~fr~lg8oPted by the oreJ~~@o~~rth Feeder fo\\?~ t' II Center. lnu;:,0 ~ 952-001. B. '. the center. (No e:.. t!. ~icat~ o-V 200 Amps or le~\"ng f the oreaort Utlllt~ '/B { u . IWmber or 00 3~~-2.a~ 4 . 201 Amps to 4WAinPtenter is 1-8 - "$lU. 0 401 Amps to 600 Amps $138.00 601 Amps to 1000 Amps $180.00 Over 1000 AmpsNolts $413.00 Reconnect Only $ 55.00 c. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48.00 $ 4.00 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 ( 0 . c-<" :) .50 ~ . (nO t. \JV 4. 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL ~ Dln" i 0 Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00942 ISSUED: 07/13/2007 APPLIED: 06/26/2007 EXPIRES: 04/15/2008 VALUE: $ 188,374.00 SITE ADDRESS: 1189 32ND ST ASSESSOR'S PARCEL NO.: 1702303406200 SPRINGFIE TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Same As State Master Plan Owner: KENNETH THOMAS Address: 2266 9TH ST SPRINGFIELD OR 97477 Residential Phone Number: 541-913-5086 I CONTRACTOR INFORMATION I License 593 136298 136298 147077 Expiration Date 03/19/2008 08/06/2009 08/06/2009 03/02/2009 Phone 503-645-1156 541-741-8844 541-953-6747 503-932-2719 Contractor Type General Electrical Mechanical Plumbing Contractor ADAIR HOMES INC BEAR MOUNTAIN ELECTRIC LLC BEAR MOUNTAIN ELECTRIC LLC 3T PLUMBING INC # 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: 20.00 5.00 5.00 65,00 0.00 BUILDING INFORMATION I 1 R-3 U VB # of Stories: 1 Lot Size: Height of Structure: 18.00 Sq Ft 1st Floor: Type of Heat: Wall Heat Sq Ft 2nd Floor: Water Type: EI~ ~~-G88~1Iln~! P~r~w:, Range Type: . UO!lBO*. I !mn ~1;~Jf. l~ej&l~J~~51nu Ene.rgy Path:. .. eU04d 1M l :8l~~lt.Q b~fi 8Yl 5U!lIBO Sprmkled BuddmgAq sa(nJ aQi'o s8!d<2f~.P~.q$ ~;o^ '0600 -, ~ 'I r-r~ ~'HJ45"VA4f u~uU-~UU-6~O ClI7U U! I DEVELOPMENT INFO~ SalnJ 8S041 'J8lU8a UO!leO!l!lON ~JO 8lH Aq pald~lH-J:Mar~p.KING Overlay Dist: Ol nOft. S&JlnbaJ Mil u06a~it\!t911N311V 2 # Street Trees Rqd: 2 Handicapped: Paved Drive Rqd: Yes Compact: % of Lot Coverage: 22.50 1,702 484 3 . I PUBLIC IMPROVEMENTS I Street Improvements: NOr~CIE: THIS PERMRu%~If~IRE IF Tf.IE WORK Storm Sewer Available: II 'T Special Instruction: AUTHORIZED UNDER fs PERMIT IS NO COMMENCED OR IS ABANDONED FOR Notes: Stormwater t9\Wa 8@OA't4ijjRIOD. Sidewalk Type: Downspouts/Drains: Curb and Gutter Paee 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 DweIlinl!s Garal!e V Wood Frame Garal!e Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 2 Baths One or Two Family Addressing Assignment Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Minimum/Adjustment Mechanical Plan Review Major - Planning Plan Review Same As Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Vent Fan + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00942 ISSUED: 07/1312007 APPLIED: 06/26/2007 EXPIRES: 04/15/2008 VALUE: $ 188,374.00 I Valuation Description I $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount 1,702.00 484.00 Value Date Calculated $175,306.00 $13,068.00 $188,374.00 06/26/2007 06/26/2007 Total Value of Project ~ Amount Paid $5.00 $2.50 $4.00 $50.00 $10.00 $139.12 $79.75 $105.35 $254.00 $31.00 $854.90 $80.00 $6.00 $9.00 $74.30 $18.00 $198.00 $200.00 $106.00 $57.00 $19.79 $26.03 $10.00 $961.52 $91.61 $83.69 $76.72 $836.32 $189.58 $838.37 $12.00 $7.00 $3.50 $5.60 $70.00 Date Paid Receipt Number 6/27/07 6/27/07 6/27/07 6/27/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 7/13/07 10/17/07 10/17/07 10/17/07 10/17/07 1200700000000000831 1200700000000000831 1200700000000000831 1200700000000000831 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 1200700000000000912 3200700000000000686 3200700000000000686 3200700000000000686 3200700000000000686 Pal!e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00942 ISSUED: 07/13/2007 APPLIED: 06/26/2007 EXPIRES: 04/15/2008 VALUE: $ 188,374.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Amount Paid $5,515.65 I Plan Reviews I Initial Review 06/29/2007 APP LLH 06/29/2007 Initial Review 06/26/2007 06/26/2007 WE LLH Plannin{! Review 06/26/2007 APP T AJ 06/26/2007 Public Works Review 07/09/2007 07/10/2007 APP BRC Structural Review 06/26/2007 06/26/2007 APP DLM Received information on previous structure for credit to Fire Fee. 700 square feet was the size of the previous structure. This structure is responsible for 1486 square feet on the Fire Fee. "Express process". Need information on structure that has recently been demolished to provide credit for the fire fee. Survey required because of minimum side setbacks. Stormwater to weep hole in gutter. Site received SDC credits for previous moble home structure. BC Same as State Master Plan reviewed 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. ~eouiredJnsnections I Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. 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. Pa{!e 3 of 4 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2007-00942 ISSUED: 07/13/2007 APPLIED: 06/26/2007 EXPIRES: 04/15/2008 VALUE: $ 188,374.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line, 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. Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. 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 4 of 4 Construction' Contractors Board Permit#:~('Yil~-=rl)'"'7 - t:CR lf~ 700 Summer St NE Suite 300 Address: \ \ 1SL\ _ ~ 2 ~& 6~ W"\ PO Box 14140 i\ Salem OR 97309-5052 .,Issued ~y: rr XV\-.' Date: l 0 -- 17 - O( Phone: 503-378-4621 Web Address: www.ccb.state.or.us Statement: Information Notice to Lperty Owners About Construction Responsibilities Note: Or.ego.n Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Con~ractors Board Ii)' 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 701.010(!), need not submit this statement; This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, :and either box3A or 3B: '~ L o I own, reside In,or.will r~side in the completed structure., 2.. 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 lic~nsed with the Construction Contractors Board. . OR .Jdi ~ 3.8. I w:~ll be my own general contractor. I If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change mymind and hire a general contractor, I will contract with a contractor who is licensed with the CCBand will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above informa . n' correct and that I have read and do understand the Information . . . Notice toPrope~ Owners about str tion Responsibilities on the reverse side ofthis form~ ~/ I /0-/7- 0.7 (Siguature of permit applicant) ,CD ate) (White copy to issuing agency permit file, pin~ copy to applicant.) Property_owner. doc 06-01;-04 Acting as Your wn General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners ab~ut Constructi;n Responsibilities was developed by th~ 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 home'or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer Responsibilities You will, most instances, be ruled to be an "employer" and the contractors you 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 strucnrre, As tbe employer, you must comply witb the following: Oregon's Withholding Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are ,required to.pay a tax for unemployment insurance purposes 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. number for both Oregon Withholding and . . . Unemployment Insurance Tax. To file for a BIN, can 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to ()btain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if Clne of your employees is injured on the job. For more information, can the Workers' Compensation Division at the Department of Consumer and Business 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 ww\v.irs.IWv.' Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any' failure to meet code requi~ements th'!tt may ?e brought t? your attention through inspections. Liability and Propert'y Damage Insurance: Contact your insurance agent to see if you 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. Expertise: Make sure you 'have' the skills to act as your own general contractor:' to coordinate 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 (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner .doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00942 COM2007-00942 COM2007-00942 COM2007-00942 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 3200700000000000686 Date: 10/17/2007 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By KENNETH THOMAS Item Total: Check Number Authorization Received By Batch Number Number How Received njm 172331 In Person Payment Total: Page 1 of 1 11:24:02AM Amount Due 70.00 3.50 5.60 7.00 $86.10 Amount Paid $86.10 $86.10 10/17/2007