HomeMy WebLinkAboutPermit Electrical 2004-5-19
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225 FIFtH STREET. SPRINGFIELD, OR 97417 .. PH:(S41)726-3753 . FAXll
ELECTRICAL PERMIT APPLICATION
CityJob~umber COiMzoC:J..I-0030o Dote Date
< 'rr,'f-.
In,t.lI.tion;Alteratlon or Relocation It: irlc \NO 0....
. "n\rr,t:.r If ,~~ ,\
200 AmP~lfi'" 'rlt>-'-'- t"r -,~~,~\I\Oll'
. 201 ~~\ltc\l! ~1 S (rr, 11-\\':> r.:: ~Q6)"
.' . 401 Am1ih~ ~p'O.\l~~ IS '~\XM~Vv\lOO,OO
o.~~ ~~~~~~\~~~i~'l!~:~>~':~.:,,,,.,,: .~"1f;;7' ~<'''~''
D. ~.B, ~l'C'~~Kt !!Jti'Q,t};~tq~ "t::';;':~;::'t" ;.,'~?;;:;; :;f';;,/t~i;fi':~)~f:-~ :!(?:1[tu:iJ;,'~~f:i\i~
"' ".....~., ,\-.. "',,\'Ul&~}f:. .""" ~l;'" '. .",.""",, ~''''\''' .~'""""~~ _'L . '~H~V:~~,
New Alter ion Or Extension Per PAnel: ('"
Onc Circuit I; S 43.00 (~
Each Additional Circuit or with L i, b
Service Or Feeder Permil S 3.00
OwnersNnme i3ty 1Mf::--u Fo<L~ ,
Address z.ss-b MCIV1 ~ ....,,~ ~1;imf~~'\tiW~}~i~~;i~~jj~i:~;i'ir;~lliJ~'.irRi:~~b\fijnlii'tl~~:l
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City 5> :P P1J 'a\lreoT~OI'I \a'N ;6re90n ~~r irrigation : $ 50.00
,..ii'E.~\ ~es ~dopteo U~se tU\8S are :5~tline Lighting's 50.00
OWNER INSTAL~~~ center. 1\'1 thtOUgh oto.R n!ll!;D:i1all EnergylResidential S 25.00
The instaUation is 1t.llil~\~~~p}~-c09~ ~.1_ 01 th~e...bi!llllld Energy/Commercial'S 45.00
" i'. ~ 'C)bUl"h the tel I'''-"at\
IS not ontended for S\IIe~05'1fIl-V tet. ~ote: '\it'i~\l'Jeelrie Permit In,peetion Fee is S~5.00 + Surchnges
O 00 1I'1~n the ~nO' renon UtI ""AAY,-''';'':'''~ ; ,"""" tV:" ;..~". "", "" "".' 'J'q~ .':0 ;"~
wners SignnlUre: call"" rthe "~..az'~"4', '!''StmTOTAL'OPABOv.E~:.:~.:t'':'-i:';~ ::iP;;!c':. ' u Co
...:oet 10 . ",-..oO\r'o' .i\ .,:;~,;~ l'~ ';~_~'..f.<, .,:'.-', ~~..,.....~:...: ;:,~~,."...~:,. '::' (-~.o:..= ;;~r: I', ~:-~\ ~ -, I
nU\" cen\et \S , u ""..,~ -~.;:.",:,~,,- -..-""., ."'-....- - .".1.'. -:': f"\'<:;'7' --..,~.=...., ..
. 7% Stale Surcharge ' '5 Lf J
10% Admini,trative Fee l( tV
TOTAL 57 E
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable And expIre if work I,
nol.brted withIn 18~ day, of Issuance or If worl, Is
SUJpendec1lor 180 dAy..
2. ~gg~~2}~~~~~~-[~~l~i~
Electrical Conlrllctor j \-'\ L:::, 0 .P ( .tV 10
Address ZJ~1 ~n ~CJgl
City ~Y-1()1rbJchhone ,4b-4hS'L-,'
'-. I' .
. Supervisor License Number
<.fg15 S
. Expil1llion Da~
10 - I ~ 0'+
W-1..rrC
ID-I-O'-f
t C:;:~m$tr. Contr. Number
Expiration Date:
Signature of Supervi,ing Electrici<1n
~.
L:/
. ,
lriipection Request: 726-3769
3.
A. ~~tt~~~~?K1Ht,~:~!~~'~f.-~i~,~[~~1\mtp.~i~~., :::"L:::~1f,:iI;
Scrvlce Incl~ded
1000 .q. n. or les.. S106,00
Each additionol 500 'q. ft. or
, ponioll dmeof S 19.00
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder
S50.00
D. [i~~~f~tii~~l~~~!~~~~~itr~!~[J~;.~EM~~im~l~~i
200 Amp. or les.
20 [ Amp. to 400 Amp.
40 I Amp. 10 600 Amp' .
601 Amp. 10 1000 Amp'
Over 1000 AmpsIVollS
Reconnect Only
S 63.00
$ 75.00
S125.00
$163.00
$375.00
S 50,00
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Shared Oriv"e( r:YBuildins FomtvEleetrical )mrrit App)jc~tion ).o3.doc
I
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2556 DUMAS DR
ASSESSOR'S PARCEL NO.: 1703234400122
.
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00308
ISSUED: 05/14/2004
APPLIED: 03/19/2004
EXPIRES: 11/14/2004
VALUE: $ 38,992.00
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION: Addition to existing SFR
Owner: BEV MEDFORD
Address: 2556 DUMAS DR SPRINGFIELD OR 97477
Phone Number: 541-726-6957
I CONTRACTOR INFORMATION I
Contractor Type
Architect
Electrical
Contractor
APAZ
J K GUCKENBERGER ELECTRIC INC
Expiration Date Phone
541-744-2046
04/24/2006 541-746-4656
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Vlhr
Frontyard Setback:
Side 1 Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
5.40
0.00
License
45129
BUILDING INFORMATION I
R-3
# of Stories: 1 Lot Size:
Height of Structure 14.50 Sq Ft 1st Floor: 422
Type of Heat: Forced Air Elect Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garaj:~rt
Energy Path: Path 1 Sq J',~'t: ~\a\
Sprinkled Buildin~: ... nla \.. ~'i--~WnPAll~'Ao\\it~~
_....,-r1". ....d~\ .,e'" Ot'J'\\ ~')Q.
I DEVELOPMENT If{fGWl1I9N'\\\)t.~ ~~~\)a~'t.v" .!I'
"~\\-\I.)"\~-t.\) a? \S REQUIRED PARKING
Overlay Dist: ~aw-W-t.~~~~R'Ii'Fth~~' Total:
# Street Trees Rf!\~i \ ~\) Handicapped:
Paved Drive Rqd:' Compact:
% of Lot Coverage: 21.80
\O~l' Oregon laW ~i~ROVEMENTS I
liENi "". 'the~I\';.'1
Street ImprovellienWrules adoPte~.Lr"">tJ$.r set10rlll
10\\0, enter. [1"""'- '/'. . r,. 952-001-
Storm Sewer +''tl\~\On C -0010 through laS bY
Special Instru~fi'l!11\P. 952-001 btain copies ot the ru one
0090 '(au may 0 lNote' the teleph .
Notes: cailing the center. on Utility NotiticatiOn
_, ,...hl}r tor the ore~^~/)344).
1 'centel''''..J. -
I Valuation Descrintion I
Description
. _ Tvpe of Construction
Sidewalk Type:
DownspoutslDrains:
Setback 5'
To Storm Sewer
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Dwellin!!s
V Wood Frame
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Fixture
Minimum/Adjustment Mechanical
Not Covered Mechanical
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Vent Fan
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
Initial Review
Plannin!! Review
Plannin!! Review
Public Works Review
Structural Review
03/22/2004
03/23/2004
04/3012004
03123/2004
03/23/2004
.
Amount Paid
$199.10
$10.00
$43.83
$30.68
$306.30
$42.00
$24.00
$15.00
$71.00
$6.15
$122.96
$45.00
$6.00
$4.90
$3.43
$43.00
$6.00
$979.35
$92.40
Total Value of Project
Fpp< PililLI
I Plan Reviews I
03123/2004
04/30/2004
03/24/2004
04/07/2004
Date Paid
3/19/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/14/04
5/18/04
5/18/04
5/18/04
5/18/04
APP LLH
WI
APP TAJ
APP SB
WE DLM
Pa!!e 2 of3
. Lll:r' OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00308
ISSUED: 05/14/2004
APPLIED: 03/19/2004
EXPIRES: 11/14/2004
VALUE: $ 38,992.00
422.00
$38,992.80
$38,992.80
03/19/2004
Receipt Number
1200400000000000351
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
3200400000000000075
1200400000000000759
1200400000000000759
1200400000000000759
1200400000000000759
Do not issue permit until the
property line adjustment on the
property is recorded
(SUB2004-00009).
Final recorded PLA survey received
on 4/30/04. The PLA
SUB2004-00009 is complete.
Outside city limits. Needs note from
Lane County to add bedroom and
bathroom to septic system?
Need additional information from
architect and engineer to complete
the plan review. See documents for
letter to architect.
.
. CITY OF ~rK1I"I\jn]<;LD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-00308
ISSUED: 05/14/2004
APPLIED: 03/19/2004
EXPIRES: 11/14/2004
VALUE: $ 38,992.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Structural Review
04/28/2004
05/14/2004
APP DLM
Received revised drawings and
calculations responding to request
from architect. Still waiting for
calculations on snow build-up in
existing and new roofs. 4/28/2004
dim Received revised information
from engineer 5/12/04 dim
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.
I Rf'nui~f'ctions I
7 Footing: After trenches are excavated.
8 Foundation: After forms are erected but prior to concrete placement.
II Post and Beam: Prior to floor insulation or decking.
6 Floor Insulation: Prior to decking.
13 Shear Wall Nailing: Before covering sheathing with finish materials.
9 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
19 Wall Insulation: Prior to cover.
4 Ceiling Insulation: Prior to cover.
5 Drywall: Prior to taping.
I Final Building: After all required inspections have been requested and approved and the building is complete.
16 Underfloor Drain: Prior to cover or placement of concrete.
10 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
18 Underfloor Plumbing: Prior to insulation or decking.
14 Shower Pan. Prior to covering and including required testing.
15 Storm Sewer Line: Prior to filling trench.
3 Final Plumbing: When all plumbing work is complete.
12 Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
17 Underfloor Mechanical. Prior to insulation or decking and including required testing.
20 Rough Electric: Prior to Cover
21 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
Paee 3 00
225 Fifth Street
Springlreld, Oregon 97477
54i-726-3759 Phone
.
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JiiilY of Springfield Official Receipt
"elopment Services Department
Public Works Department
RECEIPT #:
1200400000000000759
Date: 05/18/2004
2:1I:44PM
Job/Journal Number
COM2004-00308
COM2004-00308
COM2004-00308
COM2004-00308
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment Paid By
CreditCard JEFFREY GUCKENBERGER
lIem Total:
Check Number AuthoriZation
Received By Batch Number Number How Received
djb 000386 063510 In Person
Payment Total:
Amount Due
43.00
6.00
3.43
4.90
$57.33
Amount Paid
$57.33
$57.33
5/18/2004
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