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Home My WebLink AboutPermit Electrical 2005-12-6 Service Included JOB DESCRlPTION 1000 sq. ft. or less ( ~ j ~ I 'Z EaCh~e~.ft.Or', t).,p~,Adc.r ZOO S(lX"c. ,'I-~" porti~ ~~'U.... " Permits are noo-transferable and apIre ifwork Is q.~~ome or not started within ISO days Ofissnan~\'(,;r,.OrlJ. ~~\.\.o..... g Service or $5000 Suspended for ISO days. \\~, rt.~~'\\ ~f\)r.\> . ,_ '_'_'_'~_~_~--'____ 0. ,(!. ~ <<" """"""'~_,_=~=,.-'w-'_..~-~--_.-- " ':' coNriiAcroit:jj.jST;"" ' . " ,1'U\> ,~ ~~~6i:F~e~-<1\'~IJiiti~~Ai~iliti.i;;ro~'ifel-;jgtioh;":' 'i 2. ,:.. > .,.,,'" , ~ . '" . ,.~, ,~~,:;,_._.;"",T,l""" .,-.""",-."Ji.' __.,,~~ .. O'(I;!l\~!i,.,..-, ~......,.,.~,...,~~ .., 'i-'''''"C......~,7'':' "-' "-fir ''''-'''- ~ ("~ 'i>. ,,~~~>~ '" "'..;'~~,~_.., ~~..' a' ...., _, _ .___'" -....-----~".---.r 1t/' ~'{\\'iJY .. -~~,~ .----..--~.-- ..~ ElectricalContractor .l?Yi\1fATI,M~{\ ..:\ '0 Goo Amps or less / $63.00 b3 (" ;' -' , ~~ - !Jf!C 201Ampsto400Amps $75.00 Address",\'..(13 \ Iun',t:;b\..,\{. 401Ampsto600Amps $125.00 _ I (\1''/'\1 (', L.(). \,'~,)Z_ 601 Amps to 1000 Amps $163.00 Ci~\J\'\ttiOY\U .JPhone '-'Iq~ -"11<6, ~::.~~=s/VOIlS ~3;:': " -. 1. ~;XBgfi~~ef~t!~!~Ni1i;m~ 8D G.t-~'.I\/,4("'- 'p ,1. ... LEGAL DESCRIPTION I7D<,Z.3J~ 08'300 Expiration Date ,!) ODlo S lD-\-bL? \~ \ q \ \ lD-2\- O~ Supervisor License Number Constr. Contr. Nwnber Expiration Dale Signature of Supervising Electrician ?U/"P a;;?~ /' / owneJSName"':pc;.... ~!fow,~.." Address <g 0 G. t"'~ v*1E:'" f ~ a... City 5>? p~ Phone SSlf- Sf I ") OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or renL OwneJS Signature: InspectIon Request: 726-3769 /2-6-0S- 0,0 .,,:.'0-"- 3, ~~1~W~~!l{ilf~!5t~W-~i~t{~}1~]ill 'r,)\.\' A. ~~~~liiil~fsr~1l~Miiift~F~1i~~~\:aWiiliii~~~€&~~3 i:;li:\.~~::.:.:;.~~~~;::.;:-.;-.'....;._'.lIO~""'~"'~'z.6J:.'..'~":z,~ $106.00 $ 19.00 c. ?E~fil~~~@f]t~~4~]~tt1~~~~~~~~~~f~~:U~~B , . _ o\}\O InstaUation, Alh",,, , or ReJocatio~\~e'" 'I 0\\\\\'1 200 Amps or less \\ \\l.\II ~e~<eC;O"$a!iJW'(\ 20IAmpsto400~C;0 'o,!\'(\~:no,\l.\l:lt~.oo')'\, 401 Ami!cs,!<1~~\l\e~'(\o",e \V~ Op.."'$~09:oo\J' ~:0 'Co 'eo' '" ,\ C\\-'''' \ _"e e Over600.AJnP~'of I(loO'VoIls~de\"B'\abOve: e :\\0\\ ,".,.."''''....'''fa'' - .:~""""l\:"'~.""i<iItro\l~;~~,?~~~'7.c""";C,'f D. ~Bra~~1i . j',1l\~~ ~~ooij}~~'lf,;.'\\~~"~',:C1t'"c".',',',l :;::~--. ,..... ~~~ ' .. _....~.tr~ - ~" \~:;~:~~\\.'f~"'-""'~;'i:.-(,:1ii:;",;;,;.~:.r.:ii<..1~e0i. New ~ntion{~)EVp~~"'per ~anel\ .'2.,:/,,0.)' One Circyii3() ;\' \lC; \'(\e _:\Ie O\e~C\C\.~~'2. $ 43.00 Each Additional\Circmt\';:witlb '\-~ Service or F~'PC;~t"\<>' 7 $ 3.00 h E. i~~~:i(sr~~i~~~:'~l1Wc,ai~'~~a?:rJ~iii~~~'~'~i J.:.,;::::.it.',;,;,.;:~.iJii<'[;"~:"_-i:...';;s.:->:'!r~'X.,-'.;:;,-~::.i!'~-;'_M':....;:;;,:J.:..;.-"'~S'~ii;;.:::;'~;;,;~:l;,. ~-,),:..:'F Pump or irrigation $ 50.00 SignfOutline Lighting $ 50.00 Limited EnetgyfResidential $ 25.00 Limited EnetgyfC"_~..__ .:01 $ 45.00 MInimnm EJec:trle Permit Inspectiou Fee is $45,00 + Surcbarges 4. ~~~~~~gr~~1i~~if~IiJf~ b '7 lf8::I. bFb ~O~ 7% State Surcharge 10% Administrative Fee TOTAL _...... "' ~,__ ""._11:1____....1 v........., A ""lirl'lhnn ,..o3.doc . . CITY OF SPRINGFIELD" Building/Combination Permit PERMIT NO: COM2005-01598 ISSUED: 12/06/2005 APPLIED: 11/12/2005 EXPIRES: 06/06/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax : 541-726-3769 Inspection Line .. SITE ADDRESS: 80 GREENV ALE DR ASSESSOR'S PARCEL NO,:' 1703233308300 Springfield TYPE OF Heating System TYPE OF USE: New PROJECT DESCRIPTION: Replace air handler and install heat pump Residential Owner: DONALD ALLOWAY Address: 80 GREENV ALE DR SPRINGFIELD OR 97477 Phone Number: 541-554-5119 I CONTRACTOR INFORMATION I Contractor Type Electrical , Mechanical Contractor License BATEMAN ELECTRIC INC 151911 ASSOCIATED HEATING & AIR CONDITIONI06275 I BUILDING INFORMATION. Expiration Date 06/2112008 08/31/2006 Phone 541-995-4757 541-683-2590 . # of Units: #ofS!?r;i~O\\~ : Primary Occupancy Group: R-3 ~etllJrttllJ: c:. ~O\ Secondary Occupancy . \. ~?~ 1l\~1I~1I . Primary constructio~D\\:'~' NI\1~~~ \\ i~~ , ~1)'pl*~ Secondary Constructi~\~ ?~?\ l~\) U~tl\ ~?It>ll\hl!e)'ype: # of Bedrooms: ~U\\\O\\\ C~\) 0\\ ~ "1.) Energy Path: "NI~~~ ~~ i'~\\\'v ' Sprinkled r,u (.~ n.., p..~' v IDEVELOPMENTINFORMATION I Lot Size: Sq' Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla Notes: REQUIRED PARKING Overlay Dist: J,:.-o~I: # Street Trees ," ,\leS 'l Handicapped: e'-"v (\\.J-.".l(n Paved Drive Rqd: \\l.\!'I I Ole<;lO Compact: o~ st>. ,,\- % of Lot Coverage: .O\eg 'O'l \ne ~es \l.le S,/:'01.J A~~\\O~~oO?\e~nose \~n O~~~ \u\es ~'l IPUBLIC IMPROYEMENis,,,~~~~O\'0 W~~?les ~~ ~e\e?~~\l.~IO" ~; \IW- G.'t-';)'0 !;>'\l.I" , ,_~'. 'I ~O\I\ ,~o ~?- g'~ -"\l.'l Sli:le?,,'\.lIhyp,f!.:~ A', .~ 0 'lou \.. Co~\e' o~ V' ,?,?,A" I '0'0g'0, ,,\ne CDo,!nS~utlltljfams i:>\I~'" \0\ \n"', v'O\J\J C :oel \e\ IS "u~ ce~ Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: c. Solar Setbacks: , Street Storm Sewer Available: Special Instruction: I of 3 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction " Fee Description -Mechanical Issuance Fee-- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less ~ Total Amount c, . I eIT 1: VI' ~rKINGFIELD: . Building/Combination Permit PERMIT NO: COM2005-01598 ISSUED: 12/06/2005 APPLIED: 11112/2005 EXPIRES: 06/06/2006 VALUE: I Valuation Desc,rintion I $ Per Sq Ft Square Footage or multiplier or Bid Amount Value Date Calculated Total Value of Project , FP.e~ Paid' Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $6.90 $4.83 $6.00 $63.00 lII15/05 lII15/05 ll/15/05 ll/15/05 ll/IS/OS lII15/05 1216/05 12/6/05 1216/05 1216/05 3200500000000000644 3200500000000000644 3200500000000000644 3200500000000000644 3200500000000000644 3200500000000000644 1200500000000001784 1200500000000001784 1200500000000001784 1200500000000001784 $143.38 " Plan Reviews I 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. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover ~ Final Electric: When all electrical work is complete. Electric Service: Approval required prior to utility company energizing service, " 2 of 3 . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax , 541-726-37691nspection Line Building/Combination Permit PERMIT NO: COM2005-01598 ISSUED: 12/06/2005 APPLIED: 11/12/2005 EXPIRES: 06/06/2006 VALUE: '. 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 wiD 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 wiD remain on the site -J!!.:'II times dUrinystructiolL \ '\ ~AW'~ r1~OfHY"_l. \1'61n'('f\ Owner or Contractors Signature O~ Date 3 of 3 . Pennit#: C.OWlZ-O_ - OlF7 8' Address: 8> 0 G-n::ClA v A- / r::= ~ t1.. Issued by: ~ ":t Date: /2 - 6 -O~- -' , . \. ../ ", ." , . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.eeb.state.or.us Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed With the Construction Contractors Board to 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(7), need not submit this statement. This statement will be filed with the permit. Fill in the "pp,vp,;ate blanks and initial boxes I and 2, and either box 3A or 3B: ~l. 82. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~( 3A. My~ealJf8l contractor is -g~kM.4-AI' (Name) 2/Gc- h:L /'5/<JI/ (CCB #) D I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR D 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immedia1ely notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about C uction Responsibilities on the reverse side of this form, ~ ~~--- ,Y:k ~ (S~tGre ot'permit ~ant) I (Date) / (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doe 06-01-04 Acting as ~Q.r Own General C~tractor? ~ INFORMATION NOTICE TO PROPERTY OWNERS ABQUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the 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, in 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 structure. As the employer, you must compiy with the following: Oregon's Withholding Tax 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 purpose5-., 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, call 503-945-8091 or www,dor,state,oLus/formsnav,htmlJ for the appropriate forms..J . 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 obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U,S. InternaJ 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 www.irs,l!ov. Other Responsibilities and Areas of Concerns Code Compliance: As the permit bolder for 1his project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections, Liability and Property Damage Insurauce: 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 Iipringfield, Oregon 97477 541-726-3759 Phone " Job/Joornal Number COM2005-01598 COM2005-01598 COM2005-01598 COM2005-0 1598 Payments: TWe of Payment ' CreditCard , :c :c , :c '( " .c c 12/6/2005 . RECEIPT #: .J:~~~ft ~'.': (" Wi:. , . . ' ...... i IllliitJ.ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000001784 Description Penn ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By DONALD ALLOWAY Received By djb I of I Date: 12/06/2005 Item Total: cneek Number Aumorization Balcb Number Number How Received 402154 In Person Payment Total: 1:S8:13PM Amoout Due 63.00 6.00 4,83 6.90 $80.73 Amount Paid 580.73 $80.73