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Home My WebLink AboutPermit Electrical 2006-02-03Status: Issued 225 Fiftr Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541.:7 26-37 69 I ns pe ction Line F PRINGF'IELD Buildin g/Co mbination Permit PERMITNO: COM2006-00136ISSUED: 0210312006APPLIEDz 0210312006E)?IRES: 08/0312006 VALUE: SITE ADDRESS: 1108 4TH ST ASSESSOR'S PARCEL NO. : 1703263403899 PROJECT DESCRIPTION: Replace service entrance Springfield TYPE OF TYPE OF USE: Electrical Work Only Repair Residential Owner: Address: ROBIN BREWER 1108 4TH ST SPRINGFIELD OR 97477 Phone Number: 541-747-1128 Contractor Type Electrical Contractor OWNER of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled 1$\s .o\\( Square Footage orBfoI Amount Expiration Date Phone Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING $e 1 . # of Unib: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: R-3 VN Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: nla .st $ Per Sq Ft or multiplier DEVELOPMENT INFORMATION Description Type of Construction loI 2 Value Date Calculated Overlay Dist: # Street Trees Paved Drive Rqd: %o ofLot Coverage: \o $'.1 rr'.l $e Valuation treseription Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 54l-726-3676Fax 541:7 26-37 69 I ns pe ction Lin e Buildin g/Co mbinatio n Permit PERMITNO: COM2006-00136ISSUED: 0210312006APPLIEDz 0210312006E)PIRES: 08/0312006 VALUE: ; Fee Description + l0Yo Administrative Fee + BVo State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $6.30 $5.04 $63.00 $74.34 Total Value of Project Date Paid 2t3t06 2t3t06 213t06 Receipt Number r200600000000000105 1200600000000000105 1200600000000000105 Fees Paid Plan Reviews To Request an inspection call the24 hour recording at 7263769. All inspection requested before 7:00 a.m. \ryill be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. By signaturer l 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 OCCUPANCYwiII be made of any structure without permission of the Community ServicesDivision, Building Safety. I further certiff 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 stree{ 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 Owner or Contractors Signature 2of2 Date l t(eourreo tnsDecuons I timesylrinS construction. * /(drt" r" ."/ 7 ht t u-<---Je satoc Construction Contractors Board Perrrit *: Co tPt ?Q-: - O O I 3 Address:o6 L 5 I Issued by:b(Z 7 CDate: 2 3A. My general contractor is (Narne) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. V rr I wilt o" -r:: 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 IIE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 \treb Address: www.ccb.stete.or.us Statement: lnformation Notice to Property Owners About Gonstruction 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, and either box 3A or 38: \ .$ f . 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.k ffir_x r//t\ (Signature of permit applicant) (White copy to issuing agency permitfile, pink copy to applicant.) ) Property_owner.doc 06-0 I -04 225 Fifth Street Spri4gfield, Oregon 97 477 541-726-3759 Phone Cify of Springfield Official Receipt i,elopm ent Services Department Public Works Department RECEIPT #: 1200600000000000105 Date: 0210312006 9:45:41AM Job/Journal Number coM2006-00136 coM2006-00136 coM2006-00136 Description Perm Serv/Fdr 200 amps or less + 8% State Surcharge + l0% Adminishative Fee Amount Due 63.00 5.04 6.30 ltem Total:$74.34 Payments: Type of Payment Paid By Check Number Received By Batch Nunber Authorization Number How Received Amount Paid Cash ROBIN BREWER djb In Person Payment Total: s74.34 -sug. tl 't ri '1 21312006 lofl a&Iffiis 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)726-3689 E LECTRICAL P ERMIT AP P LI CAruON City Job Number Cow<zt>O6 - oO ljb Date '7 3. CAMPLE'rE FEEILO CA'T I ON A F' T N S'LET IA:TI ON | 0z q+!S. LEGAL DESCRIPTION JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2 Supervisor License Number Expiration Date r/ Constr. Contr. Number Expiration Date Si gnature of Supervising Electrician lfo 3z63Ll o3 977 A. \cx Residcntial* Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder C. Over 600 Amps or I Branch Circuits ? $106.00 $ 19.00 $50.00 I'f'?e outo C$}y'I]ft-ACTOR INSTALI-ATTON O&TI' B. Services or Feeders - Installation, Alterations or Relocation: Electrical Contractor 200 Amps or less I sur.oo L3 I Arnps to 400 woRK__ $ 75.00 Address IS $ 125.00 toR $163.00 Phone $375.00 $ 50.00 Cify AITY te0 ,l'Services or Feetlers Installation, Alteration or Relocation 200 Amps or less $ 50'00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 D. 000 Volts see "B" above. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with \.\Y torth owners "^ " Rubir. l^ Service or Feeder Permit 8% State Surcharge 10% Administrative Fee TOTAL (fi\)C 11 E. Phr"" t-lq? -l I X&Pump or irrigation Address City 50.00 63 5 0Y 670 7q )a OWNERINST The installation is being made on property I own which is not intended for sale, lease or rent. Sign/Outline Lighting $ Limited Energy/Residential Limited EnergyiCommercial $ 4s.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 0tALLATION Owners SigpErure:#u^/6r".*1- 4. SL\BTOT:ALOFABOVE Inspection Request: 726-3769 Shared Drive(T:)/Building Forrns/Electrical Pennit Application I -06.doc ;ffi$,HiffiF ]iiffi The \r-- C.r-,.,*C-{rC -o Zon\ng unrt. \av'l a(e the CITY OF SPRINGFIELD, OREGON 6FHIntGTIELl, 225 FIFTH STREET . SPRINGFIELD, OR 97477 o PH:(541)72G3753 o FAX: (S4r)72C3689 E LE CTfr'I CAL PERM IT APPLI CATI ON City Job Number Date Z1O =O 6, 1. LOCATTON 3. COMPLETE FEE SCHEDULE BELAW l(Og LEGAL DESCRIPTION A. New Residential -t703263 c( 03g 77 servicerncruded';'''and OF INSTALIATIONtftU st ha5 r{rI119?.1 1000 sq. ft. orlessr r;'9rl 6\ Zo$\ng b'0 JOB DESCRIPTION >L if ls not started within I days of issuance or if work is Suspended for 180 days. 2. O0NTRACTOR INSTN,LATION ONLY Electrical Contractor Address Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Sigrature of Owners Name Address City =?Ynone 7?7 -ilz g OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Each Manufact'd Home or Modular Dwelling Service or Feeder B. Scrvices or Feeders - Instrllatiot, Alterations or Rclocation: +--,tkrr.{o Each additional portion thereof 500 sq. ft.or 19.00Date City 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olts Reconnect Only $ 63,00 $ 75.00 $125.00 $163.00 s37s.00 $ s0.00 Electrician Circuits s+fi{tntfiF af; ffitdd E WORK S PEBW rs ${&Ioo iZ#'- €{a-*ANY 1BO DAY o%1 ,*3O //oK v#- sr E. Miscellaneous (Service/feeder not included) -Each [nstallation C. Temporarl' Seryices or Feedcrs Installatlon, Alteratlon or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. DER THI 4, SUBTOTALOFABOVE 8% State Surcharge l0% Administrative Fee TOTAL OwnersAisnature: 4/L,,f.4-.,, - Pump or inigation $ 50.00 Limited Energy/Residential $ 25,00 Limited Energy/Commercial $ 45.00 Mlnlmum Electrlc Permlt Inspectlon Fee ls $45.00 + Surcharges 3c2 zqo =3t9Inspectlon Request: 726-3769 Shared Drive(T:/Building Forms/Electrical Permit Application l -06.doc 3 A $s0.00 D. OF Buildin g/Co mbination Permit PERMIT NO: COM2006-00136ISSUED: 0210312006APPLIEDz 0210312006E)GIRES: 08/1012006 VALUE: D Status: Issued 225 Ftfth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 264769 Inspection Line SITE ADDRESS: 1108 4TH ST ASSESSOR'S PARCEL NO.: 1703263403899 PROJECT DESCRIPTION: Replace service entrance Springfield TYPE OF TYPE OF USE: Electrical Work Only Repair Residential Owner: Address: ROBIN BREWER 1108 4TH ST SPRINGFIELD OR 97477 Phone Number: 541-747-1128 License Expiration Date PhoneContractor Type Electrical Contractor OWNER , # of Unib: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ,St""ut Storm Sewer Available: Special Instruction: Notes: R-3 VN # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Overlay Dist: # Street Trees Paved Drive Rqd: Coverage: TH o/o of Lot NOTICE EXPIRE IF E WORK COMME ANDONED FOR REQUIRED PARKING Total: Handicapped: Compact: ANY 180 DAY PERIOD Sidewalk Type: Downspouts/Drains $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION Description Tvpe of Construction lof2 Value Date Calculated \-(ri\ I I(AL I (rI( il\ t'(Jl(ll'lA I t(Jt\ I Valuation Description ] CITY OF SPRINGFIELD Buildin g/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7263676Fax 541:7 26-37 69 Inspection Line PERMITNO: COM2006-00136ISSUED: 0210312006APPLIEDz 0210312006E)GIRESz 0811012006 VALUE: Fee Description + l0o/o Administrative Fee + 87o State Surcharge Perm Serv/Fdr 200 amps or less + l0oh Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Total Amount Amount Paid $6.30 $s.04 $63.00 $3.00 $2.40 $30.00 $109.74 Total Value of Project Date Paid 2t3t06 2t3t06 2t3106 2n0t06 2n0t06 2n0t06 Receipt Number 1200600000000000105 120060000000000010s 1200600000000000105 1200600000000000143 1200600000000000143 r200600000000000143 Fees Pa PIan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCT PANCY will be made of any sfructure without permission of the Community Services Division, Building Safety. I further certi$ that only contractors and employees who are in compliance wittt ORS 701.005 will be used on this froject. 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 will remain on the site at all times *.L to, a&u Reouired fnsnections Owner or Contractors Signature 2of2 Date 225 Fifth Street Springfield, Ore gon 97 47 7 541-726-3759 Phone city of Springfield Official Receipt .:velopm ent Services D epartment Public Works Department RECEIPT#: 1200600000000000143 Date: 0211012006 10:42:28AM Job/Journal Number coM2006-00136 coM2006-00136 coM2006-00136 Description Add, Alter, Extend Circ Ea Add + 8% State Surcharge + l0%o Administrative Fee Amount Due 30.00 2.40 3.00 Item Total:$3s.40 Payments: Type of Payment Paid By Received By ChEFNumEr Batch Number ffi Number How Received Amount Paid Cash ,lt 4 ROBIN BREWER djb In Person Payment Total: $35.40 -$ffid- ,tI -l 2n0t2006 lofl SFTIII{GFIELr}