HomeMy WebLinkAboutPermit Sidewalk 2014-09-22SPRINGFIELD,
L�
OREGON
%�.springfield-orgov
CITY OF SPRINGFIELD
Building / Public Works Permit
PERMIT NO: 811-PW2014-00155
225 Fifth St
Springfield,OR 97477
Phone: 641-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitmnter@spd ngfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/22/2014 EXPIRES: 03/21/2015
STATUS DATE: 09/22/2014 APPLIED: 09/22/2014
SITE ADDRESS: 5773 D ST, Springfield, OR 97478
ASSESOR'S PARCEL NO: 1702331405620
PROJECT DESCRIPTION: City sidewalk repair
OWNER: ROMERO VLADIMIR A & YANARIS
ADDRESS: 5773 D ST
SPRINGFIELD OR 97478
SCOPE:
TYPE OF STRUCTURE:
Phone Number:
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
ROGGE CONCRETE LLC CCB 183518 08/11/2016 541-513-1075
INSPECTIONS REQUIRED
Inspectlons
9506 Sidewalk - Setback Sidewalk - Setback: After forms are erected but prior to placement of concrete.
By signature, I stale 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 Slate or 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 limes during
construction.
Owner or Contractor Signature
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952.001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
/6-2-1(1
Date
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AO I-11ORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Springfield Building Permit 9/22/2014 11:54:22AM Page 1 of 1
i
SPRINGFIELD
�"' OaEGON
vNme pringrield-or.gov
PROJECT STATUS: Issued
CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SPR2014-02157
STATUS DATE: 10/03/2014
SITE ADDRESS: 1601 7TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703264202000
PROJECT DESCRIPTION: Install meter main
OWNER: DUMONT ANTHONY LEE
ADDRESS: 47841 COMMERCIAL ST
ISSUED: 10/03/2014
APPLIED: 10/03/2014
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
perm itwnter@springfield-or.gov
EXPIRES: 04/01/2015
SCOPE: Electrical Only
TYPE OF STRUCTURE: Residential
Phone Number:
OAKRIDGE OR 97463
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Typo Lie No Lie Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
4220 Electrical - Service
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 or 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 C ntractor Signature Date
OU t0
v� tufo\JOSoo�tiCd!
N'•0t00
\ )tih0Osa05 1
P�CFt��to'a
6, \A �hOi her°ten Y
vN k o\� pe
too, ,00 0t �oP\ee e tete�h g\°�
N°a{\ � 052.oav °uta\� N°�e•. �h N°l\C\c
e9p°
th eo
�cmget �e�t°t \s
430\
��G '•�NGSEp �Vgyp.oo�N M'E
4\C�S
F\sN
oy
V01ON
0\- -?%
Mv0op
URc
off/
Springfield Building Permit 10/3/2014 2:05:05PM Page 1 of 1
SPRINGFIELD — CITY OF SPRINGFIELD
TRANSACTION RECEIPT Fifth St
Spriingfield,OR 97477
� 541-7263753
OREGON 811-SPR2014-02157
www.spdn9field-or,gov 1601 7TH ST permitcenter@spnngfield-ocgov
RECEIPT NO: 2014002189
RECORD NO: 811-SPR2014.02157
DATE: 10/03/2014
DESCRIPTION
ACCOUNT CODE/TRANS CODE
AMOUNT DUE`
Electrical Continuing Education fee
224-00000-425606
1032
2.50
Services 200 amps or less
224-00000-426102
1004
91.00
State of Oregon Surcharge (12% of applicable
fees) 821-00000-215004
1099
10.92
Technology fee (5% of permit total)
100-00000-425605
2099
4.55
TOTAL DUE:
108.97
Credit Card DUMONT CHAD
62152b
108.97
TOTAL PAID: 108.97
Electrical Permit Application SPRINGFIELD L
a
225 Fifth Street* Springfield, OR 97477*PH(541)726-3753+FAX(541)726-3689
DEPARTMENT USE ONLY
Permitno.: S/((PoZ(S 7
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT 'APPROVAL,
Zoning approval verified? ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
Residential
10 Government
❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 160 4 '? AI S F
City:
State: Ok
ZIP: h?Y 7'7
Reference: 6 f(?—
Tax1ot.
DESCRIPTION OF WORK
"
U a (c h> t ew ?06 � iic f 04,
PROPERTY OWNER
Name: 6`-4a. lL/ e•I'
Address: A 0i 1Tlr S1
City: Sp -;^f F" e tj
State: 09
ZIP: w y? 2
Phone: 5V-93` C)IJ
Fax:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(l).
Signature: hr� Ui/Ii1
CONTRACTOR INSTALLATION '
Business name: b (Ao, a 07Vt._
Address:
City:
State:
ZIP:
Phone:
Fax:
E-mail:
CCB license no.:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
FEE SCHEDULE
Number of inspections per iO
tem
Qty,
Cost
ea,
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4)
$151.00
$
Each additional 500 sq. ft. or portion
thereof
$ 28.00
$
Limited energy (2)
$ 36.00
$
Each manufactured home or modular
dwelling service or feeder (2)
$ 71.00
$
Services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 91.00
$
201 to 400 amps (2)
$106.00
$
401 to 600 amps (2)
$178.00
$
601 to 1,000 amps (2)
$230.00
$
Over 1,000 amps or volts (2)
$527.00
$
Reconnect only (2)
$ 71.00
$
Temporary services or feeders: installalion, alteration, relocation
200 amps or less (2)
$ 71.00
$
201 to 400 amps (2)
$ 98.00
$
401 to 600 amps (2)
$142.00
$
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension perpanel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit 1
1 $ 7.00
1 $ -
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
$ 62.00
$
Each additional branch circuit
$ 7.00
$
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
$ 71.00
$
Each sign or outline lighting (2)
$ 71.00
$
Signal circuit or a limited -energy panel,
alteration, or extension (2),
$ 82,00
$
Each additional inspection: (1)
$82.00
$
APPLICANT USE '
(A) Enter subtotal of above fees
(Minimum Permit Fee $82.00)
$
(B) Enter 12% surcharge(.12 x [A])
$
(C) Technology Fee (15% of [A])
$
(D) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (A through D):
$
t'
440-2584-J (5/21/2014/COM)
a