HomeMy WebLinkAboutPermit Electrical 2008-6-12
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, DATE .0~
225 FIITH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 . ."""- SOURCE . ()2./
ELECTRICAA PERMIT APPLICATION I J
CIty Job NumberUlr'() 2rm/"" nI:7C1, Date \.0 11;2 o?:
(l2 (7CATIONOFIN~~tT~
LEGAL DE~:dJ 1\. - -
\ ~tJ7 ,0.P \ L.l;1 S \ \]7)
108_ DESCRIPTION /
OOcidt~--{)(},t rOp dlf
Permits are non-transferable and expire If work IS
not started wlthm 180 days of Issuance or If work IS
Suspended for 180 days
2.
CONTRACl'OR INSTALLATION ONLY
Electrical Contractor GMD Electrlc In("'.
- ----
Address
957 Northrldge Ave
City Spfld
Phone 726-8601
Supervisor License Number
4874S
Expiration Date
10/2007
Constr Contr Number 1 62 1 91
ExpiratIOn Date
11/2008
SIgnature of Supervising Electrician
w1!.I/1
/" - ~
ownc.,";~ \..\.l. ,vI. II , \
Address q 'U..o \A{\ J 0.1 (\{A-l-
CltA-nI,J) (~ - Phone
\ \.r ()f2J
OWNER INST ALLA nON
The installatIOn IS being made on property I own which
IS not Intended for sale, lease or rent
Owners Signature
InspectIon Request 726-3769
3.
I
COMPLETE FEE SCHEDULE BELOW
..
A l New Resldenlml- Smgle or MultI-Family per dwellmg UUlI
ServIce locluded
1000 sq ft or less
Each addItIOnal 500 sq ft or
portIOn thereof
Each Manufact'd Home or
Modular Dwellmg Service or
Feeder
$] 1700
$ 2100
$55 00
B
Services or Feeders -InstallatIon, Alterations or Relocation.
In . JO
C
200_ Amps or less I $ 70 00
20 I Amps to 400 Amps $ 83 00
40] Amps to 600 Amps $13800
60] Amps to 1000 Amps $180 00
Over 1000 ~,$.VN OreqOn low rO'1~f\-!ilJo,'bll In
Reconnect ~w rules ar.oliocll'" tho r:$E?JJ19 Uhl,'y
Notlheatlor. C61ltl" 1 hDse I ules at e set fOI th
TempokllGl&EhlIii!s~1'&delis"hrough OA.R 852-001-
0090 You may olJtam caples of the rules by
10stallatlOn~llIrriltlli1ilOl€Rerucattoiite the telephone
200 Amps Jl.4wer for the Oregon Utility ~'S"\9atlon
201 Amps to 400 ArIf~snter IS 1.800-33Z.214fJ'00
40] Amps to 600 Amps $110 00
Over 600 Amps or 1000 Volts see "8" above
D I BflO1'reE'?"IS
Ne"f~~q~'I!'~ll'!l!e'F THE WORK
OneJl!Jrpf'I!lRIZED UNDER THI~ D~D''''II$ ~ %T
Eac", Add,lIonal-C'<CUll,or WIth _
S 'IJI\' I'F"r-.!.~1 tpfT I jL1 t:-- J P f: }dr 1\ r $ 4;>'0
ervlce or ecuer emllt .,. , - , " ~ "U
A~~Y ~~' r .", pr- c '1
E MIScellaneous (ServIce/feeder oot IOcluded) -Each 10stanalIon
Pump or Imgat'on $ 55 00
Slgn/Outhne LIghting $ 55 00
LImIted EnergylResldenllal $ 28 00
Limited Energy/Commercial $ 50 00
Mm,mum ElectrIC PermIt Inspecllon Fee IS $50 00 + Surcharges
4 SUBTOTAL OF ABOVE d 10 JD
8% State Surcharge 7 {)(j
10% AdminIstratIve Fee K 4b
5% Technology Fee =:l ;-;'1\
TOTAL (1IlX,,( _ -CF U
Shared Dnve(T )!BUlldmg FormslElectncal Perrmt Applicatlon 7-07 doc
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01297
ISSUED. 12/12/2007
APPLIED' 08/29/2007
EXPIRES. 06/12/2008
VALUE: $ 36,462.00
-ii:~
Status
Issued
225 F,fth Street, Sprmgfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 InspectIon Lme
SITE ADDRESS 926 HAZELNUT LN
ASSESSOR'S PARCEL NO 1802061415100
Sprmgfield TYPE OF WORK Smgle FaUllly ResIdence
Overlay Dlst
# Street Trees Rqll
Paved Dnve Rqd
% of Lot Cov"I."lig~NTION O.n'1o" I",
folIo I "C1r ',rr~ \ '1l; t'1
11.1_....' ~ ~u e~ aC!Orht.:, !J~ T .... U 1\ J(,', J',
I PUBLIC IMPRO~O'''cl I 'J ;se rulPJ ar" sellorth
"', ~i11" 1-0010 th, ough OAR 952-001
vvov IOU may t"\i-t'" ~
Street Imllfovements F II I d call th ":;,ll'.!,,,iill":;liype:' the rules by
IV O~',. r:. u V mprove Ing e center (Note!tw tele
Storm Ser&; Wihrble Yes number for the <<>~\l'{J\lmy~ainsDhone To Storm Sewer
Spec..1 'AnI'D RJillMIT S,lfAfrtx~!:(.l"11I dram to eXlStmg Center IS 1-800-332'23;~ Iflcatlon
UTHORIZED UNO flit IF THE WORK .
Notes COMMENCED OR I~R THIS PERMIT IS NOT
ANY 180 DAY PERIO~BANDONED FOR
TYPE OF USE
PROJECT DESCRIPTION AddItIon over eXIstIng garage
Owner PATRICK HURLEY
Alldress 926 HAZELNUT LN
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION i
Contractor Type
General
Electncdl
MechaUlcal
Plumbmg
Contractor
CHALUS CONSTRUCTION L TD
GMD ELECTRIC INC
COMFORT FLOW
DOUG HAXBY PLUMBING COMPANY
LIcense
113083
162191
460
140768
BUILDING INFORMATION'
# of UOIts
Pnmary Occupancy Group
Seconllary Occupancy Group
Pnmary ConslrucllOn Type
Secondary ConstructIOn Type
# of Bedrooms
# of Stones 2
HeIght of Slructure 22 00
Type of Heat orcell AIf Electnc
Water Type Electnc
Range Type
Energy Path Path I
Sprmkled BUlldmg n/a
R-3
VB
I
I DEVELOPMENT INFO~ATlON I
Frontyard Setback
SllIe I Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
2000
1800
1150
Page 1 of 3
AlldltlOn
ReSIdentIal
Phone Number 541-221-2106
ExpiratIon Date
04/24/2008
11/19/2008
06/27/2009
03/0112010
Phone
541-461-1932
541-726-860 I
541-726-0100
541-995-4725
Lot SIze
Sq Fl 1st Floor
Sq Ft 2nd Floor
Sq FI Basemenl
Sq Ft Garage/Carport
Sq Ft Other
Occupant Load
354
REQUIRED PARKING
Totdl
HandIcapped
Compact
-:~.":u' jj
WIr., i
Status
Issued
225 F,lth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
DescriptIOn
Tvpe of ConstructIOn
Dwelhngs
V WoolI Frame
Fee Description
Plan RevIew ResldenlIal
+ 10% AdmlmstratlVe Fee
+ 5% Technology Fee
+ 8% State Surcharge
Bulldmg Permll
Fixture
Furnace - up to 100,000 btu
M.mmum/AdJustment Mechamcal
Mlmmum/AdJustment Plumbmg
Plan RevIew Mmor - Plannmg
+ 10% AdmmlstralIve Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Orc
Add, Alter, Extend Orc Ea Add
+ 10% AdmmlstralIve Fee
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Total Amount PaId
Pldnnme: Review
Pubhc Works RevIew
08/29/2007
08/29/2007
Structural RevlCw
08/29/2007
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO' COM2007-01297
ISSUED. 12/12/2007
APPLIED. 08/29/2007
EXPIRES' 06/12/2008
VALUE' $ 36,462 00
I ValuatJon DescrlOtJon I
$ Per Sq Ft
or mullIpher
$10300
Square Footage
or B.d Amount
354 00
Value
Date Calculated
Total Value of Project
$36,462 00
$36,462 00
08/29/2007
Fpp<. I.:Ai.lIJ
Amount PaId
Date PaId
ReceIpt Number
$211 00
$42 46
$27 03
$33 97
$324 62
$1600
$1400
$36 00
$34 00
$11600
$600
$300
$480
$48 00
$12 00
$700
$840
$350
$70 00
8/29/07
9/5/07
9/5/07
9/5/07
9/5/07
9/5/07
9/5/07
9/5/07
9/5/07
9/5/07
11/1107
1111107
11/1107
1111/07
11/1/07
6/12108
6/12/08
6/12108
6/12/08
1200700000000001118
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
1200700000000001162
2200700000000001663
2200700000000001663
2200700000000001663
2200700000000001663
2200700000000001663
2200800000000000890
2200800000000000890
2200800000000000890
2200800000000000890
$1,017 78
I Plan Reviews I
08/29/2007
08/29/2007
APP TAJ
APP MS
Storm dramage to eXlstmg No new
.mpervlOus, so no SDC charges -
MS 8/29107
08/30/2007
Neell engr's Ictter ou adequacy of
ex.stmg ftg for the add.lIon
Contractor WIll prov.de 8/29/07dlm
ReceIved engmeerlng 8/30/07dlm
APP DLM
Page 2 of 3
-~~
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO. COM2007-01297
ISSUED' 12/12/2007
APPLIED: 08/29/2007
EXPIRES 06/12/2008
VALUE. $ 36,462.00
225 F,fth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
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.
I ReQUIred T nsne,chons I
Frammg InspectIOn Pnor to cover anll after all rough 10 mspectIons have been approvell
Wall InsulatIOn Pnor to cover
Floor InsulatIOn Pnor to lIeckmg
Cetlmg InsulatIon Pnor to cover
Fmal BUlldmg After all reqUIred mspectIons have been requested and approved aud the butldmg IS complele
Rough Plumbmg PrIOr to cover and mcludmg reqUIred testmg
Fmal Plumbmg When all plumbmg work IS complete
Rough Mechamcal Pnor to Cover
Fm.1 Mechamcal When all mechamcal work IS complete
Rough Electnc Pnor to Cover
Fmal Electnc When all electncal work IS complete
Drywall Pnor to tapmg
By slgnalure, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certIfy thaI all
mformatlOn hereon IS true and correct, and I further certIfy that any and all work performed sh.1l be done 10 accordance wIth
the Ordmances of the CIty of Sprmgfielll and the Laws of the State of Oregon pertalllmg to the work descnbed herem, and
that NO OCCUPANCY WIll be made of any struclure wIthout permIssIOn of the Commumty ServIces DIVIsIOn, Butldmg Safety
I further certIfy that only contractors and employees who are 10 comphance wllh ORS 701 005 will be used on lhls proJect
I furthcr agree to ensure that all reqUlrell mspectlOns are requested .t the proper tlUle, lhat each addrcss IS rea II able from tbe
streel, Ihat Ihe permIt card IS located at the frout of the property, anll the approved set of plans WIll remam on the slle at all
times dunng constructIOn
Owner or Contractors SIgnature
Date
Paee 3 of3
225 FIfth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
CIty of Sprmgfield OffiCIal ReceIpt
Development ServIces Department
PublIc Works Department
Job/Journal Number
COM2007-0 1297
COM2007-0 1297
COM2007-0 1297
COM2007-0 1297
Payments
Type of Payment
CredltCard
cRecelOtl
RECEIPT #.
2200800000000000890
Date. 06/12/2008
Descnptlon
Penn Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ ] 2% State Surcharge
+ 10% AdmlUlstratlve Fee
PaId By
MICHAEL K GOWINS
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
nJm 52298b In Person
Payment Total
Page] of I
12 51 20PM
Amount Due
7000
350
840
700
$88 90
Amount Paid
$88 90
$88 9U
6/12/2008