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Home My WebLink AboutPermit Electrical 2005-8-9 9PI:;'INQFIe.L.D ~~'1::'!...'ji" ~ . ~ ~ ::," <<:",".<\1-, &. ~ L",.e'l'l\'~w';f.pei\! 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(~41)726.3753 . FAX; (541)726-3689 ~"i~~o~0~~~ ELECTRICAL PERMIT APPLICATION ~"~~~~~ 'l!iQJ' ~ ( 0 0 G / .., Date r-..r7:. =.\'~'~ 6'\'-'7/1/"">",",./ City Job Number 0 J'Vl ZO'o Q"- {o L. VQ)'-=' C-Uf..~ . . c$.Y.~- 0.\./' - /" ". ~"" ..... . ,~. ~." ~.. ~..' ,". "p':"' .... ~"-"'l.......lM.~'~O\e~\,\.f!',.:_.... '.-4' !'''~-'j;'';'I'''':;Y:t\;':''~.'1 1. :;!-d~~hQN9FfNSTAL'i.t1TIp!l/{{;:;}i 3.,COlllI~LETE FEE;:S()H~s~UL~V?"'3.:~",;'i\0'g, I[;)(IT..... .iI-A;T~~.."..'b.rL".. ,"," ........,..~,:"0~:..,0~QOC~.. .~"., ;. ..' po ".<."",.,>'..:1 _, ,t".-:; .::.~,' '''!I.':'~'{~lJ~?\'''<,:'~t..~~\~'''';'' '~'.,:~?'l", - .J"J.~~~';'::':1.!I';'.''';\'..\.\'. ~~..':;.-~ A. ;>,New Residential;::-~S~ngl~':Cir _ .ulti-F.' {p~r,:dwelling u'nit:;:l\"t: ...:'_, ,,_' .....~,' '"...."......' .'~'_-:-.~.".... .~',f,.~~.~/ ~~.~......:....'l.::':',,~ .,.......,,'...I.~~ \~\ Service Included \e.... S\~(\?J. \)1: .,1> 1000 sq. ft. or less ,J". Each addilional 500'sq. ft. or portion lhereof LEGAL DESCRiPTION }<Z.OS.D2s 2 JOB DESCRIPTION A'pJ) j f'JLRwrtS IN fi/fW (jIrfU&f!. 02:2..00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, ;~~ "..." ."'''., 'n ,..,..t.,\;,....I;;t'. ')."",j"~''- ......'", ~.' -, ~., ':'~'-"7<.~>l;.::"".';"__.' ''''' CONTRActOR 'm$i ALL;"TioN O!{L yJ, 2. I~~....;*l..:!.:.:.l>'(:.,;.":'.~;....,;\)'.:r.~'a..:.",~.~.::.:..:,1.::..., F;::t~htcl.~;...o,(-~-"'t:..:..~ Electrical Contractor Address (7 Cily / .' .", ~ho'ne ... " / / Supervisor License Number ... Expiralion Date ,/ Constr}onlr. Number Expiration Date Signature of Supervising Electrician Owners Name NANfll\ ~ G\\IIJ/J Address J1p4\ ~(ll3oe... DQ..\ \Ie City f)OI2H,.l(,-AaQ Phone 7LN-Q4<61 - f OWNER INSTALLATION The installation j's being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~(~ Inspection Request: 726-3769 , , , . $106.00 $ 19.00 Each Manufacl'd Home or Modular Dwelling Service or Feeder $50.00 .~ ..~..I:':'l..\J>:.,~,t:'~~P:':'''''''H ~;' ""i~~~'tl~~~:P'...,.~;\,..."p~~~."l'."';;rt~~~. .,.. .1,'~~:'"i~~.W"'~~.;>J:'~ B. i:Services"o,r: f eed~r~.:~' ~ ~~t;l.lIa tif?~;';Alterations"or" R~locatio n)~~ .......s:.~..',;4:d...2:.;.....~A..,,;.rr-.~J.;...;.;uh':....lt".....j:;..?:~,~.t.)J:::1L-.t'Ii'r.u...~.~")o.I:a1':!J..a.;~';.r':"\;~ 200 Amps odess , $ 63.00 201 Amps to 400 Amps ~t. \N\)~'~ $ 75.00 401 Amps to 600 An~'\l.t. \t 1\\~c;~\.i . $125.00 ~Amps~~~I\'{5?t.~ ~~~\\ $163.00 v.~''\' ~~11t~\\'i)'i)\\tl $375.00 \~\c;, ~~~~\c;,. "'~ $ 50.00 . ~~'~~:l<\Clij#~~~~\~;t:~"'''>'''l...~",\)",ti~~~'' !l. ~ :G.~~l~n\ r'f'Sl-r\'lces or'jFeeders~.~1.f.t.itf.~~1i1t";i~~ r ....tl ' C\)'~ \~\) _..._,..,...,.e"",,"".'~"~" ,. ..... ,.. "~nstallation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps 10 400 Amps $ 69.00 401 Amps to 600 Amps ' $100.00' \)\0 o,~~~_60~,~~,~s,,~'.W?'~'.~'~~~1~~~~~~b~~~\)}~;l\'\~'J.\"'~I~>!,{;:i'~m. D. ";,Br.nc~ C,rcult~,rl""~?>1f7>'t!$~en$,,,,'oIl"'\O\'"';'.r"'~11'!l:~ti<'!?%''' I 'N.~:"~\t~~;~9;E~~~-;-;~~\\::;p-i'~~~"~~~aCi'Ci\,~,"2i_"",",,''''''' , "1"1-\"" 001'" OS6' 01"0"'" S 0'01 Circuit\e~ '(). "e(. ,\""I 0\)0\""1 . ,~o (1$'ii,.0 "G>I" ,- ","" ,nt,.. , ne EacH "'ddilional'eircuit'o'P\V~h c\,eS 0' . \e~\""IO" , S~rvi~"{6).'F~ede{.P,\;!fuiti'l' co\"" ,,",,, \e .~$c;).1j)01' \'- p..\'.9"'- '(). ou' ~O\,,'... ~Ol;\\ ,\l' O";<"~o\l'~~~'phW("''':~' ;-' ,,\j\\\I1\.l;;'J-~\ ;':"~"','n',c;' ~,' ',r-""~, E. .. i\lisccll.neuU,~\(~er.vice(f!idt\l'.poti!""I,8'd..~q).'':~:i~h, lnstall"ti?"';' ~~':.\' ~... \\~ "'_. ,.. ..~eX;.I_I>'''' ~nri~:J _~..,.",.....,..r..i.t'".~" ..,. ~,...U:.. ......,..:h"" ..~ ca: E>' \0\ . S \-'Cl Pump q,r,Jrfigaii<ael'\e( ~ $ 50.00 SignlOulline Lighling $ 50.00 Limited EnergylResidential $ 25.00 Limilcd Energy/Commercial' $ 45.00 .Minimum Electric Permit Inspection Fee is $45.00 + Surcharges . ;; :,~.,t.;_,..L~ ~.~..'-': ....,:.... ,..J:...~:r~-"'!.~.7:.:.:'!,; ;'i:.:!t'':'f.i''i!;,::t~:~it 4. : SUBTOTAL Or: ABOVE,:;~ i',;"'..:~~,;,"f"-.\'~ ~, ", ~~ " . . :':;'""'-:':::".~ ~~. ~. ::.; ....~ ...l'i ,,,..t~~,~..:t ..X,'.;:,;;,;;y,;o ",,~.;:..., .?:,../~ lie, '5yJ 1/"0 S7~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Bu;lding FonnslE1ecuical Pennit Application I-03.doc . Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1641 HARBOR DR ASSESSOR'S PARCEL NO.: 1803023202200 PROJECT DESCRIPTION: Detached garage Owner: Address: NANCY QUINN 1641 HARBOR DR SPRINGFIELD OR 97477 Contractor Type General Electrical # of Units: PrImary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: VN Front yard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 28.00 8.40 0.00 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00962 ISSUED: 08/16/2005 APPLIED: 07/25/2005 EXPIRES: 06/07/2006 VALUE: $ 13,200.00 Springfield TYPE OF Garage TYPE OF USE: New ,() U n/a I DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: Urban Fringe OV .~'\ '" '\ \j~' ~:~ ,~ie o~ :<..,0 V ;oil ~e~~eq; ~e "'~".>'l:1:)1:) 'Q'\ \~ ..c>. ,'3' _ Oi . ~c, _(\.0' V'\.-.\ "'. (..;),.... r\'r' '" \V' ')~'O I CONTRi\c:rORINFORMATION'Ii'-\O~ (\\v' 'l>ov'e~' 'I:)'S'" ~l,-,'(\e':"'o'~'~ Contractor -<..-<"'~~ ,.s.e'" c,e~~ 5:)1:)'\ \~ <:,0 o,eCic~nse;\" Expiration Date WEST VIEW ENTI(~Rt~ES;!1tco'Q''3' ~ ~'i58s19'''' 0212512006 OWNER ,0 _,~\c,~ q,".>7; ((\'1>'\, c>~,e~,e'0o~(\;o'Ov ,... -,-" .~~ -- ~- ~.- IrBUlLDING'INFORMA TlON. ~v ().\\\. ..,\ ,- ^'v r.V' V','U ,.e,'- # of. StorieS: ,",v Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled REQUIRED PARKING Total: 2 Handicapped: Compact: 27.90 \)~'/-. . ,(. "\\\'t: ~ ~\)\ . IPUBLIC IMPROVEMENTSI \. 'i:.'j..'\l\'I'~'t:~~~ ~\)~ i: Q~~ (\'t,~<;)~~ Street Partiallv Improved ~'\\t . ~~ ~~~'C!I< ~\W'- Storm Sewer Available: Yes ~ ~\t:O ~'i:.~ ~'i:.~~'6b~rabts Special Instruction: 1: ~'\~~~ ~~'i:.~ ~~~ . tol ~~~ ~~ Notes: Reptace existing carport with garage; storm drainage piped lJJ~.Q~gto curb face 7/2712005 CAS ,,~, 1 of 4 Residential Phone Number: 541-744-0481 Phone 541-953-5341 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 528 Curb and Gutter . Status: Issued 225 Flfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Type of Construction Gara!!e Gara!!e " Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Garage/Carport Storm Sewer - 1st SO Feet + 10% Administrative Fee + 7% State Surcharge Add, Aller, Extend Circ Add, Aller, Extend Circ Ea Add Total Amount Initial Review LDAP Review 07/26n005 08/04/2005 LDAP Review 07/25n005 Plannin!! Review 08/05/2005 Plannln!! Review 07/26n005 I Valuation Descriotion I $ Per Sq Ft or multlp6er $25.00 Square Footage or Bid Amount 528.00 Total Value of Project F....s tiWU Amount Paid $90.09 $18.36 $12.85 $138.60 $45.00 $4.90 $3.43 $43.00 $6.00 $362.23 Date Paid 7/25/05 8/16/05 8/16/05 8/16/05 8/16/05 l2n/05 l2n/05 l2n/05 l2n/05 I Plan Reviews I 07/26n005 08/04n005 08/05/2005 08/03/2005 APP SKG DONE VRJ 10 APP TAJ WI TAJ 2 of 4 . CITY OF SPRINGFIELD Building/Combination Permit PERMITNO: COM2005-00962 ISSUED: 08/16/2005 APPLIED: 07/25/2005 EXPIRES: 06/07/2006 VALUE: $ 13,200.00 Value Date Calculated 07n5/2005 $13,200.00 $13,200.00 Receipt Number 2200500000000000973 2200500000000001103 2200500000000001103 2200500000000001103 2200500000000001103 1200500000000001788 1200500000000001788 1200500000000001788 1200500000000001788 LDAP is ready to Issue, applicant has been contacted. We are walling on Floodplain approval through planning before releasing LDAP. LDAP permit fee Is $300.00. Permit Is located at the front counter, LDAP tag is to remain on parcel until Issuance of LDAP. Applicant has submitted for LDAP, LDP200S-00147. Full review permit, $300.00 fee due at issuance. Floodplain overlay has been submitted to planning 7/25/05. LDAP tag placed on parcel. Floop plain overlay SHR200S-00007 approved for construction of garage in f100dway on 8/5/05. Awaiting approval of Flood Plain Overlay application SHR200S-00962. . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00962 ISSUED: 08/16/2005 APPLIED: 07/25/2005 EXPIRES: 06/07/2006 VALUE: $ 13,200.00 Status: Issued 225 F1fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Public Works Review 07/26/2005 07/27/2005 APP CAS Structural Review 07/26/2005 07/28/2005 WI DLM Structural Review 08/02/2005 08/02/2005 APP DLM . Storm drainage piped Into existing to curb face 7/27/2005 CAS Estimated base Dood elevation at the site is 447.25 (fema)Certllied at 447.4 (Branch Eng.) This property is located In the Dood plain - waiting for BFE from P.W. 7/28/2005 dim Received BFE from P.W. & completed my review.8/2/05 dim Separate electrical permit required for any electrical work to be done. dim See Documents for plan review comments. 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. Fooling: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required Inspections have been requested and approved and the building is complete. Hold Downs Instailed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Storm Sewer Line: Prior to filling trench. Drywall: Prior to taping. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. . 3 of 4 . . CITYOFSPRII"lljt<IELD' Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00962 ISSUED: 08/16/2005 APPLIED: 07/25/2005 EXPIRES: 06/07/2006 VALUE: $ 13,200.00 . By signature, I state and agree, that 1 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 wlII 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 at all times during construction. Owner or Contractors Signature Date 4 of 4 . Permit#: COl'l1zo!- 00962 e. . . \, .i ". .,' ", .." Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Address: Issued by: /(?L{ ( 1M.!.,,"^- ~tL '1::.((' Date: I Z. -7-a ~- 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 befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ~l. f 2. 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. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. r7l3B. OR I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor. I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I bereby certify tbat tbe above information is correct and tbat I bave read and do understand tbe Information Notice to Property Owners about Construction Responsibilities on tbe reverse side of tbis form. O)~~erm~~ ~Z:Jt56 (Uate) (White copy to issuing agency permit file, pink copy to applicant,) Property_owner .doc 06-01-04 - . " . Adnll1l~ '~~ 1{({))UllJr OWIIn (Qtell1leJr~ll C({))ll1ltJr~(Ct({))Jr? INFORIVlATIONNOTICE TO :PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES .J . . }1' ., 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 Legis/atura. . , 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. Empnoyer !Responsibilities You will, in most instances, be ruled to be an "employer" and the contractors you.contrac,t 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 tbe employer, you must comply witb tbe following: Oregon's Witbbolding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable f<?r the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-3784988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes .. 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 nwnber for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.hfmll for the aJ-''''IJ.Upl~ate forms. 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 a~d 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 Conswner and Business Services at 503-947-7815. U.s. Internal 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. ' OtD"neIr Responsibilities aimd Areas of COIl1Cell'lIllS ' Code Compliance: As the permit holder for this 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 Insurance: 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 owri geri~nil 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 Springfield, Oregon 97477 541-726-3759 Phone . a~ wr Jeb/Joumal Number COM2005-00962 COM2005-00962 COM2005-00962 COM2005-00962 P~yments: Type of Payment Check Cash Job/Journal Number COM2005-00962 COM2005-00962 COM2005-00962 , COM2005-00962 ~~yments: TWe of Payment Check Cash . " :h " . ,. , . " 1; " " 12/7/2005 RECEIPT #: .ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000001788 Date: 12/07/2005 Descrlpllon Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 7% Slate Surcharge + 10% Administrative Fee Paid By NANCY QUiNN NANCY QUiNN Received By DJB DJB Descrlpllon Add, Alter, Extend Circ Add, Alter. Extend Circ Ea Add + 7% Slate Surcharge + 10% Administrative Fee Paid By NANCY QUiNN NANCY QUiNN Received By DJB DJB I of 1 lIem Total: l;hecl< Number AuUlorlzatlon Batch Number Number How Received 5028 In Person In Person ' Payment Total: lIem Total: {;hecl< Number AuUlorlzation Batch Number Number How Received 5028 In Person In Person Payment Totat: 2:07:24PM Amount Due 43.00 6.00 3.43 4.90 $57.33 Amount Paid $56.33 $1.00 $57.33 Am...nt Due 43.00 6.00 3.43 4.90 $57.33 Amount Paid $56.33 $1.00 . $57.33