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Home My WebLink AboutPermit Electrical 2007-05-11Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00680ISSUED: 0511112007APPLIED: 05/1112007 EXPIRES: 11/1112007 VALUE: SITE ADDRESS: 5790 MONTCLAIRE wAY ASSESSOR'S PARCEL NO.: r802030001500 PROJECT DESCRIPTION: Install circuit for hot tub TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential PhoneNumber: 541-301-3400 License Expiration Date Phone Springfield Owner: Address: Contractor Type Electrical MICHAEL MCDONALD 5790 MONTCLAIRE WAY SPRINGFIELD OR 97478 Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: tta Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure: Type of Heat: Water Type: A nge Type: ttta tg Pa o/o oILot Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VB nlaV $ Per Sq Ft or multiplier r Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact:th 2j44 rHE Description Tvpe of Construction Page I of2 Value Date Calculated LUI\ I l(AL I ut( rNI (,/ry!ljs:lf_.] IF varuation Pescri#tful Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00680ISSUED: 0511112007 APPLIED: 05/1112007EXPIRES: l1l1112007 VALUE: Fee Description + lDoh Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Minimum/Adj ustment Electrical Total Amount Paid Amount Paid $4.s0 $2.25 $3.60 $43.00 $2.00 $5s.3s Total Value of Project Date Paid 5nu07 5nu07 5nu07 5ltu07 5fiu07 Receipt Number 1200700000000000563 1200700000000000563 1200700000000000s63 1200700000000000563 1200700000000000563 Fees Pa Plan Reviews To Request an inspection call the24 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. 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 alt 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 Page 2 of 2 Date .f -tt-o-? l(eoulreo lnsoecuons I tJ>L SPFI!NGFI€LD *1i':r;: :r,{ : :l!r: !. _l ir:i,,;i:- $,"" ' ' zoN INITIALS DATE il- SOURCE 5225 FIF[H STREET r SPRINGFIELD,OR97477 . PH:(5.11)725-3753 . FAX: (s4t)726-3689 E LE CTRI CAL P ERM IT APP LI CATI O N City JobNumber (Ovtzt ZO <>-7-e o 6 ro 1. LOCATION OFIi"STAIIII.TIO.IV: Date o 3 LEGAL DESCzuPTION /go2-c>3<> c o/reo, JOB DESCRIPTION A. Nerv Rcsidcntial - Single or i\{ulti-Fanrily pcr dwelling unit' Service Included 1000 sq. ft. or less $106.00 Each additional 500 sq. ft. or portion thereof S 19.00 Each Manufact'd Home or Modular Dwelling Service or $50.00 Feeder 1":.B. SCrvices,gr Feedels = fnqtallalion, Alterations or Relocationi -, Ct( Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. C ONT RACT O R IN STALLATI ON O N LY _L I Address 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPS uttboo Amps $ 63.00 $ 75.00 $12s.00 $ r 63.00 $375.00 $ s0.00City\aw r by the those AR 95 OU maY ca\\ing the o(egon or less tor or FeedersSupervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Address C I(L Phone h tion or Relocation Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits ' , 201 Amps to 400 AmPs 401 Amps to 600 AmPs Pump or irrigation SigniOutline Lighting Limited EnergY/Residential Limited EnergY/Commercial 8% State Surcharge l0% Administrative Fee 5% TechnologY Fee $ 50.00 $ 69.00 $100.00 Panel qJ$ 43.00 $ 3.00 not included) -Each Itrstallation $ s0.00 $ s0.00 s 25.00 $ 45.00 f \ZL 0 ciry l_f3t)af1gtp- prrone Stl I ' 3o 1"3 ?O0 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Minimum Electric Permit Inspection F;GGF*Surcharges 4. SUBTOTAL OF ABOI''E SS 3' Inspection Request: 726-37 69 TOTAL Shared Drive(T:/Building Forms/Electrical Permit Application 8{6'doc COMPLETEFEE 7+ Electrical Contractor ?'0'itcE: i\ :6o___zeg_ ---?zT Construction Contractors Board Permit #:Zouu^L-7_ oo 6?o Address: S" 7 (> Issued by:>-r Date:o 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 thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom 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, md either box 3A or 38: $ t. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3,A.. 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. OR E 38. 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 immediately notiff 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 Construction Responsibilities on the reverse side of this form. 700 Summer St I\fE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us c f.lt^o-1 (Signature of permit applicant) (White copy to issuing agency permitfile, pink copy to applicant.) Lts g (Date) Property_owner. doc 06-0 I -04 ,&c**xxm ffi$ x*xxr *wxx ffiexx*raX {Sntracf*r? 225 fiftt Street Springfield, Oregon 97 477 541-726-3759 Phone Citu of Springfield Official Receipt I elopment Services Department Public Works Department RECEIPT #: 1200700000000000s63 Date: 0511112007 2:06:32PNl Job/Journal Number coM2007-00680 coM2007-00680 coM2007-00680 coM2007-00680 coM2007-00680 Description + 5% Technology Fee + 8% State Surcharge + l0% Administrative Fee Add, Alter, Extend Circ Minimum/Adj ustment Electrical Amount Due 2.25 3.60 4.50 43.00 2.00 Item Total:u55.J5 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard MICHAEL MCDONALD djb 041035 In Person Payment Total: $55.3 5 -ffi cReceint I Page I of I snU2007