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Home My WebLink AboutPermit Electrical 2008-4-24 ZON Ll( INITIALS t' V- DATE ~,...V;--O< SOURCE f'r...nc ()r"J , / / .. vr-'\,V '1/ t'f / L' ? I 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number C ~ e.cc::> 7 - D I (J 1 Date 1. LOCATION OF INSTALLATION: 70 g ()I l.\.t116i OV0 e '" 3. COMPLETE FEE SCHEDULE BEWW LEGAL DESCRIPTION. J 70.3 Z 3SL( A. New Residentia~ - Single or Multi-Family per dwelling unit. I Z l{ 00 Service Included JOB DESCR1P~I N 1000 sq ft. or less r r Each addItional 500 sq. ft. or A c( J. N L TE-<.. / D L \ .r t..\..." +s portion thereof Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling ServIce or Suspended for 180 days. Feeder $117.00 $ 21.00 $55.00 Address 2. CONTRAl-l. oR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: ElectrIcal Contractor {(l V & leol' tCl 'i-u lll.\C 200 Amps or less $ 70.00 \ l 201 Amps to 400 Amps $ 83.00 Address '3 9- ~ \ b R ~ e. V CYYV2 401 Amps to 600 Amps $138 00 (j \ M 601 Amps to 1000 Amps $180.00 City Lot -o..4.V - t~~,;<~dM~UI;;J1: AmpsNolts $413 00 . t;j . { A . - .- d pted by the Oregcm Only $ 55.00 follow rules a 0 e rules are 88 Notlf~?-\Ion Center. Thos gh O~ 962..001- Supervisor LIcense Numbern O~~~~~00.19 thro~ es oi\he dI~"'9:,Services or Feeders I 10090 You may'OLlQIl.:: the telephone Expiration Date I <9 '-1- ~lf1g the c~n~r. (on Utility No\~n, Alteration or Relocation numoer fUI llle Qreg 21.lAA.'l rOenter is 1-800..a32- ~.4~0 Amps or less Constr Contr Number f>? 5' Vb 201 Amps to 400 Amps J J I '1-- 0 401 Amps to 600 Amps Expiration Date t :2 0 , if CC ~( , . Over 600 Amps or 1000 Volts see "B" above SIgnature of SupervIsing Electif\an, D. Branch Circuits o (\ n ~ 1\ i ) j () I New Alteration or Extension Per Panel ~ k)'~ One CIrcuit , $ 48.00 q <t ~ NO'i1CE: EachAI~~ith 7 $ 400 3b Owners Name C(tMe M~fi4SfPERM~ ~~~~~~S PERMffnbt 2J b Z jL0 C((6v c= 6~ ~_m _ice/feeder not included)-Each Installation City sw-'h Phone ANY 180 DAY PER\P~p or lITigation $ 55.00 SIgn/Outline LIghtmg $ 55 00 Limited Energy/Resldential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges <is L( /00 r BqO l(Zo b8 /Ob ---- $ 55 00 $ 76.00 $110 00 OWNER INSTALLATION The installation is being made on property I own WhICh is not intended for sale, lease or rent Owners Signature: 4. SUBTOTAL OFABOVE 12% State Surcharge 10% AdminIstrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL Shared Dnve(T )/BUlldmg FormsfElectncal Permit Application 1-08 doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 708 BLACKSTONE ST ASSESSOR'S PARCEL NO.: 1703233412400 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01189 ISSUED: 09/05/2007 APPLIED: 08/13/2007 EXPIRES: 06/27/2008 VALUE: $ 12,875.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition PROJECT DESCRIPTION: Addition to existing single family residence Owner: CHASE FAMILY TRUST Address: 862 MCKENZIE CREST DR SPRINGFIELD OR 97477 Residential I CONTRACTOR INFORMATION I Contractor JAMES HANNUM OWNER TBD \0 JOHN THE PLUMBER I~~c& '1~~\\\\\'I _ 107810 ~'t~:'5t \~-Il-l HUI MATION. O\0~O~ '0'1 w~\)\0S ~ ~ e' # of Units: l\\O~'~O~\0~~OS0 ~tO~~~o~e Primary Occupancy Gri~~ \)\ec& .:~~~. O\~'O~\iJrg\{0\6~j.t\o1\-e Secondary Occupancy ~~:t ~\o~ ~()\-O()~(\ vo~~~~: Primary Construction ~\\c'3: <i)1O'l.~~ O'{j ~. ~o.. \}'il~~: Secondary Construction ... ~~ ~O\) ~ ve~\~\e~O~~ype: # of Bedrooms: O()<i)()~X$\~ ~ f,<<,e \" ,\~()'i;";;~;gy Path: ~~~\ ~~(\\,et Sprinkled Building _ 'CJ(~, - I DEVELOPMENT,INFORMA TION I REQUIRED PARKING Overlay Dist: , ~~tal: # Street Trees Rqd: "'\\\~ ~~\Mttndicapped: Paved Drive Rqd: I\~~ \~ ~,,~ 'CO \"~ompact: % of Lot Coverage: \, ~ Vt.~\'l\ ~~~ f'~. ~~\." \~,<o ~t.~ l ..\\~-f..\VI "'\~\\~ ~r\\?~~ Lt~~$ I PUBLIC Il\f~~~~~. F II I d ~ t.\\"I\t.~ t\,1 V'e Sidewalk Type: u V mprove C\)\'l\\'l\ ~~' Y es t-.~'{ '\ ~ru Downspouts/Drains: Contractor Type General Electrical Mechanical Plumbing Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 8.00 25.00 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Stormwater to tie into existing gutter drains. Paee 1 of 3 License 151279 Expiration Date 04/30/2008 Phone 541-554-8728 07/24/2009 541-686-4888 1 14.00 Gas Gas Gas Path 1 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 125 Curb and Gutter Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01189 ISSUED: 09/05/2007 APPLIED: 08/13/2007 EXPIRES: 06/27/2008 VALUE: $ 12,875.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwellinl!:s v Wood Frame $ Per Sq Ft or multiplier $103.00 Square Footage or Bid Amount 125.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $12,875.00 $12,875.00 08/13/2007 ~ Fee Description Amount Paid Date PaId Receipt Number Plan Review Residential $93.85 8/13/07 1200700000000001029 + 10% Administrative Fee $20.06 9/5/07 2200700000000001396 + 5% Technology Fee $9.72 9/5/07 2200700000000001396 + 8% State Surcharge $15.55 9/5/07 2200700000000001396 Building Permit $144.38 9/5/07 2200700000000001396 Fire SF Fee - Residential $6.25 9/5/07 2200700000000001396 Fixture $16.00 9/5/07 2200700000000001396 Minimum/Adjustment Plumbing $34.00 9/5/07 2200700000000001396 SDC Sanitary/Storm Admin $2.65 9/5/07 2200700000000001396 Storm Drainage Impervious Area $52.94 9/5/07 2200700000000001396 + 10% Administrative Fee $5.00 9/24/07 2200700000000001490 + 5% Technology Fee $2.50 9/24/07 2200700000000001490 + 8% State Surcharge $4.00 9/24/07 2200700000000001490 Add, Alter, Extend Circ $48.00 9/24/07 2200700000000001490 Minimum/Adjustment Electrical $2.00 9/24/07 2200700000000001490 + 10% Administrative Fee $8.40 4/24/08 2200800000000000514 + 12% State Surcharge $10.08 4/24/08 2200800000000000514 + 5% Technology Fee $4.20 4/24/08 2200800000000000514 Add, Alter, Extend Circ $48.00 4/24/08 2200800000000000514 Add, Alter, Extend Circ Ea Add $36.00 4/24/08 2200800000000000514 Total Amount Paid $563.58 I Plan Reviews I Initial Review 08/13/2007 08/13/2007 APP NJM Public Works Review 08/13/2007 08/20/2007 APP BRC Stormwater to tie into existing gutter drains. Structural Review 08/13/2007 09/04/2007 APP DLM See documents for Plan review comments. A mechanical permit may be needed if existing ductwork is extended into addition. Planninl!: Review 08/13/2007 09/05/2007 APP TAJ No Planning issues Pal!:e 2 of3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01189 ISSUED: 09/05/2007 APPLIED: 08/13/2007 EXPIRES: 06/27/2008 VALUE: $ 12,875.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. LReouired Insoections I 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. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover 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 Pal!:e 3 of3 22~ F.ifth -Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01189 COM2007-01189 COM2007-01189 COM2007-01189 COM2007-01189 Payments: Type of Payment Cred ItCard cRecemtl RECEIPT #: 2200800000000000514 Date: 04/24/2008 DescrIptIOn Add, Alter, Extend Clrc Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstratIve Fee Paid By EDW ARD GUIDRY Item Total: Check Number AuthorIzatIOn Received By Batch Number Number How Received dJb 10803A In Person Payment Total: Page 1 of 1 11 :26:54AM Amount Due 4800 3600 420 10 08 840 $106.68 Amount Paid $106 68 $106.68 4/24/2008