HomeMy WebLinkAboutPermit Electrical 2019-10-21SPRINGFIELD
,lrt
OREGON
Web Address: www.springfield-or. gov
Building Permit
Residential Electrical
Permit Number: 811-19-OO2386-ELEC-O1
IVR Number: 811057513788
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR97477
54L-726-3753
Email Address : permitcenter@springfield-or.gov
Permit Issued: October 2L, 2OL9
TYPE OF WORK
Category of Construction: None Specified Type of Work: None Specified
Submitted Job Value: $0.00
Description of Work: Relocate dry vent and kitchen hood, install new HVAC system
JOB SITE INFORMATION
worksite Address
1858 G ST
Springfield, OR 97477
Parcel
1703362 1 1 1900
Owner:
Address:
LAWSON EDNA C &
KENNETH E
1858 G ST
SPRINGFIELD, OR 97477
LICENSED PROFESSIONAL INFORMATION
PhoneBusiness Name
OWNER - Primary
License
ccB
License Number
000000
PENDING INSPECTIONS
Inspection
4999 Final Electrical
Inspection Group
Elec Res
Inspection Status
Pending
SCH EDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Sched ule or track inspections at www.bui ld i ng permits'oregon. gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811057513788
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
PERMTT FEES
QuantityFee Descriptaon
Balance of minimum permit fees - electrical
Branch circuits without service or feeder
Technology Fee
State of Oregon Surcharge - Elec (12olo of applicable fees)
Total Fees:
permits expire if work is not started within 18O Days of issuance or if work is suspended for 18O Days or longer depending on
the issuing agency's policy,
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to glve authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-OO1O through OAR 952-OOr-OO9O. You may obtain copies of the rules by calling the Center at (503)
232-t987.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structuraultechanical), ORS 479.54O (Electrical), and ORS 693.010-O2O (Plumbing)
Printed on: 10/21119 Page 1 of 1
2
Fee Amount
$s.00
$97.00
$s. 10
$L2.24
$ 119.34
C :\myReports/repofts/ / prcduct:ion/ OL STAN DARD
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SPRINGFIELD
b
OREGON
www. sp ri n g fi eld -or. g ov
Woksite address: 1858 G ST, Springfield, OR97477
Parcel: '17033621 1 1900
Transaction Receipt
81 1 -{ 9-002386-ELEC-01
Receipt Number: 472751
Receipt Date: l0/2{/19
City of Springfield
Development and Public Works
225 Fifth Street
Springfield. OR97477
54r-726-3753
perm itcenter@springfield-or. gov
Fees Paid
Transaction date
10t21t19
10t21t19
10t21t19
10t21t19
Units
2.00 Qty
1.00 Automatic
1.00 Ea
1.00 Automatic
Account code
224 -00000 -426 1 02- 1 033
224-00000-426 1 02-1 033
82 1 -00000-2 1 5004-0000
20 4-00000-425605-0000
Fee amount
$97.00
$s.00
$12.24
$5.1 0
Description
Branch circuits without serviee or feeder
Balance of minimum permit fees - electrical
State of Oregon Surcharge - Elec (12o/o of
applicable fees)
Technology Fee
Paid amount
$97.00
$s.00
$12.24
$5.1 0
Payment Method:Credit card authorization:
044545
Payer: LAWSON EDNA C & KENNETH E Payment Amount:$119.34
Cashier: Katrina Anderson Receipt Tota!:$r r 9.34
Ptinled: 10121 I 19 2:50 pm Page 1 of 1 Fl N_Transaction Receipt_pr
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/
CITY OF SPRINGFIELD, OREGON
Electrical Permit A Iication
LOCAL GOVERNMENT APPROVAL
Zorungapproval verified? E Yes E No
CATEGORY OF CONSTRUCTION
! Residential n Government E Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: / 85 g C, *t
city:J py iv,,aNt e1 l-s,rc: oK ztP: Q?'{?7
Reference: "/Taxlot.:
DESGRIPTION OF WORK
( ,'c.4,rl "a{ it{
L,( "F hr l-4
PROPERW OWNER
Name:ra so
Address: t{i
City:State: B tQ ZIP:Q7t/7/
(Fax:
E-mail:4
This installation is being made on residential
owned by me or a member of my immediate
or farm property
family This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(r) and 479 1).
INSTALLATION
Business name: !r/.t: 6e--
Address:
City:State:ZIP:
Phone:Fax:
E-mail:
CCB license no.BCD license no.
Signing supervisor's license no.
Print name of signing supervisor:
Signature of signing supervisor:
FEE SCHEDULE
Number of inspections per item ( )Qty.Cost
ea.
Total
cost
Residential, per unit, service included:
I,000 sq. ft. or less (4)$186.00 $
Each additional 500 sq. ft. orportion
thereof $36.00 $
Limited energy (2)$44.00 $
Each manufactured home or modular
dwelling service or feeder (2)$89.00 $
Services or feeders: installation, alteration, relocation
200 amps or less (2)$
201 to 400 amps (2)$r3r.00 $
401 to 600 amps (2)$221.00 $
601 to 1,000 amps (2)$28s.00
Over 1,000 amps or volts (2)$6s4.00 $
Reconnect only (2)$89.00 $
Temporary services or feeders: instal lation, alteration, re location
200 amps or less (2)$89.00 $
201 to 400 amps (2)$r22.00 $
401 to 600 amps (2)$177.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new alteration, efiension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit $8.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)I $89.00 $Bq
Each additional branch circuit I $8.00 $B
Miscellaneous fees: service orfeeder not included
Each pump or irrigation circle (2)$8e.00 $
Each sign or outline lighting (2)$r02.oo $
Signal circuit or a limited-energy panel,
alteration, or extension (2)$102.00 $
Each additional inspection: (l)$102.00 $
DEPARTMENT USE
(A) Enter subtotal ofabovefees
(Minimum Permit Fee $102.00)
t lov
(B) Enter I 27o surcharge (. I 2 x [A])$ \2.'u(
(C) Technology Fee (5% of[A])$ E1o
TOTAL fees and surcharges (A through D):s ttq i'(
€c
225 Fifth Street o Springfi eld, OR 97 47 7 . PH(541) 726-3753 4 FAX(54 I )726-36E9
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuance or ifwork is suspended for 180 days.
DEPARTMENT USE ONLY
Permitro., h OO23?t-e
\1Date: lO@
Last edited 7lll20l9 BJones
n
^nf\-
\-
ffi
$112.00
$
SPRINGFIELD
0rt
City of Springfietd
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54t-726_3753OREGON
Web Address: www.springfield-or.gov
Building Permit
Residential Mechanical
Permit Number: 811-19-OO2386-MECH
IVR Number: 81 1063294503
Email Address : permitcenter@springfield-or.9ov
Permit fssued: October 2t, 20t9
Category of Construction: Single Family Dwelling Type of Work: Alteration
Submitted Job Value: 90.00
Description of work: Relocate dry vent and kitchen hood, install new HVAC system
JOB SITE INFORMATION
Worksite Address
1858 G ST
Springfield, OR 97477
Parcel
L7033621t1900
Owner:
Address:
LAWSON EDNA C &
KENNETH E
1858 G ST
SPRINGFIELD , OR 97477
LICENSED PROFESSIONAL INFORMATION
Business Name
OWNER - Primary
License
ccB
License Number
000000
Phone
PENDING INSPECTIONS
Inspection
2999 Final Mechanical
2300 Rough Mechanical
2100 AC/Furnace/Heat Pump/HVAC
2110 Venting
Inspection Group
Mech Res
Mech Res
Mech Res
Mech Res
Inspection Status
Pending
Pending
Pending
Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811063294503
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permits expire if work is not started within 180 Days of issuance or ifwork is suspended for 18O oays or longer depending on
the issuing agency's policy,
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulatlng construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-0O1-OO1O through OAR 952-O01-OO9O. You may obtain copies of the rules by calling the Center at (503)
232-1947.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/l,lechanical), ORS 479.54O (Electrical), and ORS 693'010-O20 (Plumbing).
Printed on: tO/2I179 Page 1 of 2 C:\myReports/reports/lprcdudionl0l STANDARD
ll^/
?
TYPE OF WORK
-
Page 2 of 2Permit Number: 811-19-002386-MECH
Fee Description
Technology Fee
Balance of minimum permit fees - mechanical
Furnace/burner including d uct work/venVliner
Range hood/other kitchen equipment
Ventilation fan connected to single duct
State of Oregon Surcharge - Mech (L2o/o of applicable fees)
Printed on: 7Ol2l/19
Quantity
Total Fees:
Fee Amount
$5.10
$48.00
$22.00
$19.00
$13.00
$L2.24
$ 119.34
1
1
1
Page 2 of 2 C;\myReports/reports//prcduction/01 STANDARD
PERMIT FEES
SPRINGFIELD
'b
Transaction Receipt
811-19-002386-rilECH
Receipt Number: 472750
Receipt Date: l0/21119
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR97477
54t-726-3753
permitcenter@springfield-or. gov
OREGON
www. sp ri n g field-or. gov
Worksite address: 1858 G ST, Springfield , OR 97477
Parcel: 1703362'l 1 1900
Transaction date
10t21t19
10t21119
10t21t19
10t21t19
10t21119
10t21119
Units
'r.00 Ea
1.00 Ea
't.00 Ea
1.00 Automatic
1.00 Ea
1.00 Automatic
Account code
224-00000-425604-1 03 1
224-00000-425604- 1 03 'l
224-00000425604-1 031
224-00000425604- t 031
82 1 -00000-2 1 5004-0000
204-00000425605-0000
Fee amount
$22.00
$19.00
$13.00
$48.00
$12.24
$5.1 0
Fees Paid
Description
Fu mace/burner including duct work/venUliner
Range hood/other kitchen equipment
Ventilation fan connected to single duct
Balance of minimum permit fees - mechanical
State of Oregon Surcharge - Mech (12% ot
applicable fees)
Technology Fee
Paid amount
$22.00
$19.00
$13.00
$48.00
$12.24
$5.1 0
Payment Method: Credit card authorization:
044545
Payer: LAWSON EDNA C & KENNETH E Payment Amount:$119.34
Cashier: Katrina Anderson Receipt Total:$1 19.34
Prinled: 1ol2'l l'ls 2:47 pm Page 1 of 1 Fl N_Transaction Receipt_pr
I ["r
Ctrv or SpnrNGFIELo, ORtrcow
Mechanical Permit Application
225 Fifth Strcct 0 Springfield,OR97477 . PH(541\726-3753 o FAX(541)726-3689
CATEGORY OF CONSTRUCTION
E Residential E Govemment E Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: /8t8 G S+
State:1Q f,nP.q.7(77
Referente: /Taxlot.
DESCRIPTION OF WORK
llonl ,L'r,on Vt-rr.f * V Uqc ur7'7'.-&.tJ -tl.t \ I tr,i,
PROPERW OWNER
Name:E e
Address: l85A <r st
State:ZIP:7
Phone '@ Fax
E-maif:a I
This installation is being
member of mv immediate
made me or a
licensing
requirements 70
CONTRACTOR INSTALLATION
Business name:f'l on-'
ZIP
Phone: -V Fax:
E-mail:
CCB license no
Print name
Signature
gPRtxcFtlLo
FEE SCHEDULE
Residential 4ry.Cost
eA.
Total
cost
First Aooliance il02^00 s
Furnace/burner including ducts and vents
'Up to 100k BTU,4rr I $23.00 $
Over l00k BTU/hr $26.00 S
Heefers/stoves/vents
Unit heater $23.00 $
Woo&pellet/gas stove/fl ue $54.00 $
Evaporated cooler $19.00 $
Vent fan with one ducVappliance I $13.00 $
Hood with exhaust and duct I $19.00 $rQ
One to four outlets $9.00 $
Additional outlets (each)$s.00 s
Up to 10,000 CFM s15.00 $
Over 10,000 CFM $26.00 $
Comnressor/absorntion svstem/heat nu mn
Up to 3 hp/100k BTU t23.00 $
Up to 15 hp/500k BTU i4t.00 $
Up to 30 hp/I,000 BTU x61.00 s
Up to 50 hp/1,750 BTU $78.00 s
Over 50 hp/l,750 BTU $132.00 $
Incinerators
Domestic incinerator $26.00 $
Commercial
Enter total valuation ofmechanical system
and installation costs $
Enter fee based on valuation ofmechanical system, etc.$
Miscellaneous fees Cost
ea.
Total
cost
Reinspection u02.00 $
Specially requested inspections (per 1r02.00 $
Rcgulated cquipment (unclassed)il9.00 s
Each additional inspection: (l)1102.00 $
DEPARTMENT USE
(A) Enter subtotal ofabove fees (or enter set
minimum fee of $ '102.00)S \CflZ
(B) Investigative fee $
(C) Enter l2%o surcharge (.12 x [A+B])slz.zd
(D) Seismic fee, lo/o (.01 x [Al)$
(E) Technology Fee (5% of [A])f,r'(u
TOTAL fees and surcharges (A through E)$(\n 3l
DEPARTMENT USE ONLY
Perrritno.: \1 lo 23qb-ll
Date, lo ltx Itq
PIJ+
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
Lasl edircd 711l2019 BJoncs
t)aol, trc^{
Address:
State:
r I
h,
-1
Air-handline units. includins duc s
Propefi Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construclion Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2ll
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.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is
Name CCB#Expiration Date
I will inform my general contractor that all subcontractors who work on the struclure must be
licensed with the Construction Contractors Board'
or
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. lf I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the lnformation N
and I hereby certify that the information on th
otice to Homeowners About Construction Responsibilities'
is homeowner statement is true and accurate.
Ed,no-Ctral n
Print Name of Permit APPlicanl
Signature of Permit APP|icant
Permit #:
Address:
lssued by:
-
Date:
Date
This Copy for Permit Offices
lnformation Notice to Owners About
Conaainction Res ponsi bi I ities
(oRS 701.325 (3))
CONSTRUCTION CONTRACTORS BOARD
PO Box 14140, Salem, OR 97309-5052
Telephone: 503-378-4621 - Fax: 503-373-2007
Website Address: www. oreoon. oov/ccb
cti as their own gene ral contractorc to construct a new home
Homeowners ng
existing structu re can prevent many probl ems
or ma ke a su bstantial tm provement to an
by being aware of the following responsi bilities
a Homeowners who use labor provided by workers not licensed by the construction contractors
Board, may be considered an employer, and the workers who piovide the labor may be considered
employees. As an employer, you must comply with the following:
oregon,s withholding Tax Law: Emp_loyers musl 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 tro, vout employees. For more information' call the Department of Revenue at
503-378-4988.
Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance
purposes on the wages of all employ"".. Fo. more information, callthe Oregon Employment
Department at 503-947 -1 488.
oregon,s Business ldentification Number (BlN): is a combined number for both oregon
\Nithholding and unemployment lnsurance Tax. To file for a BlN, go online to the oregon Business
Registry. For questions, call 503-945-8091'
Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain workers Compensation lnsurance for their employees. lf you fail to obtain
Workers Compensation lnsurance, you could be subject to penalties and be liable for all claim costs
if one of your workers is injured on the job. For more information, call the Workers Compensation
Division it tne Department of Consumer and Business Services at 800-452-0288.
Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from
employee wageJ. you.may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, go online to www'irs.gov.
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Other Responsibilities of Homeowners:
Code Comptiance: As the permit holderfor a construction project, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
propefi Damage and Liability lnsurance: Homeowners acting as their own contractors should
coniact {heir insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liabiiity lnsurance must be sufficient to cover rnjuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation lnsurance.
Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough-in and finish trades.
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