HomeMy WebLinkAboutPermit Electrical 2005-7-22
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
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ELECTRI~ P~RMIT APPLICATION .
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LEGAL DESCRIPTION
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JOB DESCRJPTION
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, Permits are non-transferable and eiire i~ ~ork is
." not started within 180 days of issuance or if work is
Suspended for 180 days.
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3. 'l<COMl'LETE'FEESCHEDULE BELOl
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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
$106.00
$ 19.00
$50.00
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B.
City ~~A.r\.l'
S;~LA:rc.L p;i ec -h-tc .]:\1c. 200 Amps or less
20 I Amps to400 Amps
S~rJc: 51-. 401 Amps to 600 Amps
60 I Amps to 1000 Amps
Phone 52 0 - (g L/ (; ~ Over 1000 AmpsIV olts
Reconnect Only
I
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
03
Electrical Contractor
Address~q~S
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Supervisor License Number
'3'2- <65'-5
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Expiration Date
7-J - 0(;
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps o~ 1000 Volts see "B" above.
D.
$ 50.00
$ 69.00
$100.00
Expiration Date
! 6-1- 0'1-
. Constr. Contr. Number ~8"
Signature of Supervising Electrician
U;~ It ~.~
;' Each Additional Circuit or with
p~ L _ . .L 1/.0 /1" ~ '\ ,1 ~ Service or Feeder Permit
OwnersName.~JJQJl ~ n< O~CA
Address0:8 /" I (k;ry~./ I ZJe E. '~~~~IlS e~J~'~ii~~i..tJ;~g:!:;~S',llii~:iii
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City~jJ/,V Phone 7S/7-7'U'O
OWNER INSTALLATION
New Alteration or Extension Per Panel
One Circuit
$ 43.00
,..)
$ 3.00
~
The installation is being made on property I own which
is not intended for sale, lease or rent.
. Pump or irrigation $ 50.00
Sign/Outline Lighting . $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Owners Signature:
4.
7% State Surcharge
10% Administrative Fee
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Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00437
ISSUED: 07/22/2005
APPLIED: 04/18/2005
EXPIRES: 01/22/2006
VALUE: $ 31,880.00
Status . Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
. 541-726-3769 Inspection Line
SITE ADDRESS: 2377 CORRAL DR Springfield TYPE OF WORK: Single Family Residence
, ASSESSOR'S PARCEL NO.: 1703244305800 '~4;'hC'?-;>C'C'_
UCI~ :T,YP-~,OF, 'USE~oe"Ad'di'tioilel"\ Residential
. 1'+VI'l IIJ /l'n u 6 v
PROJECT DESCRIPTION: Addition to existing single family reside_nc~; :ci~'c)1 8 . ': 0 810 841 101 lEJqwnu
. . 11\.4. ~~3/n'J ::l/~' f,I"'> ~~..~!ON) '18W80 8lll 6U1I1P'l
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I. CONTRACTOR INFORMATION I' 0 .NOllN3UV
Owner:
Address:
.
ROBERT KOPCZENSKI
2377 CORRAL DR
SPRINGFIELD OR 97477
Contractor Type
General
Electrical
Contractor
OWNER
SOURCE ELECTRICAL INC'
License
Expiration Date Phone
160918
07/28/2006 541-520-6466
BUILDING INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: , ." : ''':. Sq Ft 2nd Floor:
Water Type: ", "" .,~,~o. '1'1 SHALL E)~q\F.f.Basehi~rtNORK
Range Type: "ThIS ~C~~\~D UNOER 1~9y~,g~Mg)/ea~p'Oft
Energy Path: ,l\llTHq~lL. n A!:-~q:f~6W~_eS:FOR
Sprinkled Builjlmg:;lIltNCED n/i\ IS Ol:cupant Load:
"'," .. on nilV PI=RHlO. .
R-3
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1 DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
19.60
8.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Urban Fringe
REQUIRED PARKING
Total:
Handicapped:
. Compact:
0.00 .
.
1 PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
.\
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Pal!e lof 3
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
. . CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00437
ISSUED: '07/22/2005
APPLIED: 04/18/2005
EXPIRES: 01/22/2006
VALUE: $ 31,880.00
LValuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
.. .
Total Value of Project
~
Amount Paid
Fee Description .
Plan Review Residential
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Dryer Vent
Fixture
Minimum/Adjustment Mechanical
Minimum/Adjustment Plumbing
Plan Review Minor - Planning
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Vent Fan
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
. ,'> '. .
Total A:mount Paid
. Initial Review
Plannine: Review
Public Works Review
04/19/2005
04/19/2005
04/19/2005
.t.,
Structural Review
04/19/2005
Date Paid'
Receipt Number
1200500000000000462
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
2200500000000000529
. 2200500000000000529
2200500000000000529
2200500000000000971
. ~~00500000000000971
2200500000000000971
2200500000000000971
~
$172.48
$10.00
$35.53
$24.87
$265.35
$6.00
. $42.00
$27.00
$3.00
$59.00
$36.56
$48.08
$12.29
$161.20
$12.00
$6;90
$4.83
$6.00
: $63.00
4/18/05
5/3/05
5/3/05
5/3/05
5/3/05 .
5/3/05
5/3/05
5/3/05
5/3/05
5/3/05
5/3/05
5/3/05
5/3/05 .
5/3/05
5/3/05
7/22/05
. 7/22/05
7/22/05
7/22/05
~ , ,', '
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$996.09
"I. .'
, '1 .. Plan Reviews I.'
. 04/19/2005 APP
04/28/2005 APP
04/20/2005 APP
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TAJ
'CAS
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storm drainage piped to existing
curb weep hole 4/20/2005 CAS
. 05/02/2005
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 7:00a.m. will be made the following work
day. . . . .' ",
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_ CITY OF SPRINGFIELD
Building/Combination Permit
1
Status .' Issued
225 fifth Street, Springfield, OR
541-726-3753Phorie
541-726-3676 Fax
541-726-3769 Inspection Line
. PERMIT NO:' COM2005-00437
ISSUED: 07/22/2005
APPLIED: . 04/18/2005'"
EXPIRES: >'01122/2006'
VALUE: $ 31,880.00
.', .'
., ReQ.uiredllInspection~
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. .
Drywall: Prior to taping.
Final Building:' After all required inspections have been requested and approved and the building is complete.
UnderOoor Plumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When. all plumbing work is complete.
. Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: . W~en all electrical work is complete. ..
Final Electric: When all electrical work is complete.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing 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 aoy 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 COQ1munity Services Division, Building Safety.,
, I furthe'r 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; " .
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225 ~.ift!t Street .
Springn~ld, Oregon 97477
541-726-37~9 Phone
Job/Journal Number
COM2005-00437
. COM2005-00437
COM2005-00437
COM2005-00437
Payments:
Type of Payment
CreditCard
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7/22/2005
.
RECEIPT #:
2200500000000000971
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JIMMY RIGGS
Received By
Check Number
Batch Number
. .
nJm.
Page 1 of 1
.J;lty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Date: 07/22/2005
2:17:49PM
Item Total:
Authorization
Number How Received
Amount Due
63.00
6.00
4.83
.6.90
$80.73
Amount Paid
142421 In Person
Payment Total:
. $80.73
$80.73