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Home My WebLink AboutPermit Electrical 2003-09-11Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00888ISSUED: 0911112003APPLIEDz 0911112003 EXPIRESz 0311112004 VALUE:r SITE ADDRESS: 2112 sTH ST ASSESSOR'SPARCELNO.: 1703262106100 PROJECT DESCRIPTION: Feeder panel and circuits Owner: EATON MICHAEL J Address: 2112 N sTH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential License Expiration Date PhoneContractor Type Electrical Contractor OWI\ER CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: #of R-3 Height $ Per Sq Ft or multiplier \t Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: Dist: Trees Overlay # Street REQUIRED PARKING Total: Handicapped: Compact: Rqd: Rqd:DrivePaved Lotofo//o o$l(\ Square Footage or Bid Amount Total Value of Project Pase I of2 Description Type of Construction Value Date Calculated \$ wo\ Valuation Description Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit Fee Description + l0Yo Administrative Fee + lVo State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less + l0o/o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $10.s0 $7.35 $42.00 $63.00 $2.40 $1.68 $24.00 $150.93 Date Paid 9ny03 9nu03 9lru03 9lrU03 t0n7t03 t0n7t03 t0lt7t03 Receipt Number 2200200000000001s10 2200200000000001s10 2200200000000001510 2200200000000001510 r200200000000002340 1200200000000002340 1200200000000002340 Plan Reviews To Request an inspection call the 24'hour recordingat726-3769. AII 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. I Rough Electric: Prior to Cover 2 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 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 during construction. A cr*/ 7-a'3 Owner or Paee 2 of 2 Date PERMIT NO: COM2003-00888ISSUED: 0911112003APPLIED: 09/1112003EXPIRES: 03/1112004 VALUE: Iees rato I Keourreo lnsDectrons I 1tu;LLJ--/ e CA Contractor6ignature 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department coM2003-00888 coM2003-00888 coM2003-00888 + 7o/o State Surcharge + ljoh Administrative Fee Add, Alter, Extend Circ Ea Add Item Total:$28.08 1.68 2.40 24.00 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check MICHAELEATON djb In Person Payment Total: ) $28.08 -$28J-5. Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Safem OR 97309-S0Sz Phone: 503-378-4621 Web Address: www.ccb.state.or.us Statement: lnformation Notice to property owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submtt this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2,and either box 34 or 38: W l. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 4 38. I will be my own general contractor If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify 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. -c tr E of permit applicant)(Date) Permit *: l-orw ?oc oogg 8 Address: 2-l r L SrtL S-lr<-t Issued bv:t,( P prop-own/f/ 3-99 (s (LVhite copy to issuing agency permit file, pink copy to applicant.) Dare: 9-ff-oR_ -4 I v' .v trnlormation-Notice to Property Owners About Canstruction Responsibilities ;k:w!,,perl b1,ii'tr.; t')<;*s*'ttcfir;* tlt;*f r*tlt;rs flr;arri ix {tL't:,.}rd{s!'tL'i: N'il} #fi'S 1{}1 i}55{3}' ll you are aetir:q as -vour cxvrl c${ilrfift*r t{} e{},lst}ir.lct fi r'}cw hcrle r:r rnake a suhstantial inlpr*vetncnr lo an existing srruct{ire, }.ou can prevefit urany problems b1' beir;g aware cf tlre l*lloiving resp*nsibilities and cotrcems' r m Pl*Y*r Resp*nsibilities 11..r,,r-,u hire pelsons fiot register*il rtirit the Cq:xrstructir:n Contract*rs Bi:ard t* rlo lahar ill c*nstrueti:lg cr assisting, in lil* **gstr*cticn *r inipr*verrlent *f a rcsidr:r"ltial s{rnctu{e. -vt}t.} rvill" in m{]str instances. be ruled t* bc ar Oreg*m's rvithhnlding tax l*rw: As an emplo--vflr. ,vou nrust ttithh*ld income xax*s f'rcm empi<ly"ee tinielrnpl:-vees are p*irl. Y*u will be liable f*r the tax ;;avrnents even il)'*tt don't aciuall,v r'vithlrold ,r'.,,*, **rpl,r"*es. I:'or mtre irritlrm*tioll, *all thr: Oreg*tt f}l;partnle*a rri'Itcvetttle at 5{}3-94i-ll{}9-l. rvages at the the tax from Une*rployment ins*r*xe* taxt As a:: etxpir:-t'*r- )'*u :rre r*quircrl ti") pa-Y a t;lx 1'*r tl*empl*-v*le*{ insurllfice purposes cN: th* 1&,rill*s *l iell *nrpk"rvees. l'*r mr:re inl*r*rati*n. call tlre Orcg*rl [:rrpl$,vment Departrnlen: at 5*]* I ?8- 1 i: -1. lVorkers, eom;rensation insur*rrre: As ar empkiyer, i.,ou are subject tr: the Orclgfin Workers' Ccmpersation ' i,arv, ar:cl n:ust r,:irt:li:r rv*rke:"s' **nlpensati*l,r insurance f*r 3.'cur *ntpia3'**s. If 3'*u tiil to obtain l*'orkt;rs' cc,lnp*r:satic,n ilrsut'ance" ).*u nla3' {:* sullj*cl t* peltilllir:s al,d lviii he liahle frlr all tiaitn c*sts ;f one r:1'-vour *n1piu_n**, is ili"iur*il *ll tli* jiitr. i':,"rr nli:r* ittitrrnatiq;*" *all the l\"*rk*rs' Ct:r;1p*ilsaiit}r: Divisi*l; at lhe l)cpar.lnrcnl oi L ('|ni;utncr att.l iltriirtccs Scn ices at j0 ; -q-J r-:8 I {} {.j,S, {n{ern*rl Stev*:rue $ep,iee: As;an empli:},,er, -y*u t*r.rst lvithh*kl i'r;dera} it:come tax lrutt] emplo.vec*'\\'agcs. yr:u l\il! lrc liable for th* tax p3}.]lieilr even if ;-'i-ru rJidfl't aclually withhold tlre iax. F-or rr;*re i*feirtnatir:n, eall the l*ter**i Rcrenue Servi*c at 1-S{}{}-819-l{i4S" Other Responsibilities and Areas of Concerns' Corie ccxrplia*ce: As tl.re permit holcie r iirr this pr"*.ieet. you are respo*sible {br rest''lving an3'fai}ure li: meet crlde r*quir,:m*nts lhat nr*3' b* brouglit t{i }'ol!r altenti*tt thr*itglt iltspecti*lts. Liahili$' and pr*pert"v ri**rage insurance : C*ntact -v.'oitr insurafiee agent to see if .*-.'.*u have adeqitate i*stlra*c* cov*ragr f*r ac*irlents and clnissii:*s s*ch as falling tacls. paint *verspra-v, r.v*ter dantage liom pipe pu*cttlres, flre " i:r rv*rk th;rt rnusx be rs-d,:trc. Time t6 supenise *mSrloye*s: Makc sure vc* itave slrfllcient limc to rupcrr ire vour empk:3'ees fixp*r{ise: h.{al,e sure -v*u havc thc, sxpertis{-: t{} act a}i }{.}irr olvr} Srficrtrl *r:nlracl*r, tc caordittate the rvork *l' rauglr-in anel finish trarle,s. anil r* ni:titr builrting *{fir:ials ,rs the appr*priatc tinr*s $o the}'cit* perfortn the requirei.l in:pcctitrtt r. l{ v*u i"i;*'* *driiti**ai q$esti$115" *,rite r:r call the C*nstrire ti*n Clontracrors B*ard {F{} I}ox l4 1 4.0" Sa l*rn. {}R 973$*-i*5:. 5t)3-3:S-4611). "fi,e E*;rrr! is lo*aled *t 7{}{] Sirmnrer StNf.. Suite 1fiO. in Salenr. prop*orvnifl 3-!)9 225 FIFTH STREET . SPRINGFIELD, OR97477 o E LE CTRI CAL P ERM IT AP P LI CATTON Ciry Job Number Cor{ ZNZ ^ oO 888 pate I. LOCA:{ION O} TATS?H.LIA'I'ION/z ru pH:(541)726-3753 o FAX:l(S"d^Pl@g689ect as submitted has the following zo|irng and does not reguire specific land use approval Zoning Oate -0 I-EESCHEI)/i.tiiLinZeCl LEGAL DESCzuPTION(-1obz/-zl o btO 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. ) Address ,/^* Phone Supervisor License 3. \\' Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Each Additional Circuit or with Service or Feeder Permit Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 7Yo State Surcharge l0% Adminisffative Fee TOTAL $s0.00 $ 63.00 s 75.00 $12s.00 $ 163.00 $375.00 $ 50.00 $ s0.00 $ 69.00 $ 100.00 $ 43.00 $ 3.00 $ s0.00 $ s0.00 $ 25.00 $ 4s.00 COIIIRACTOR INSTALIATION ONL]r' B. Sen,ices or Feeders - Insrallation, Alterations or Relocationr Electrical Contractor City &z,oo wExpiration Constr Expiration S of Electrician Owners Name Address E. l{iscellaneous (Service/feeder not included) -Each Installatiorr City OWNER INSTALLATION The installation is being made on properry I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 126-3169 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTALAFAEOVE Ios.oo ,no"" 4:%2.7 r,35 I D .SO IZZ,Bg J b^?Shared Drive(T:)/Building Fotms/Electrical Pennit Application I -o3.doc CITY OF CIilrcN A. New Residential - Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less $ 106.00 Each additional 500 sq. ft. or portion thereof $ 19.00@8, '- ./C,, ',' see "B" above. Per Panel 63,* \\., Reconnect Only 14- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00888ISSUED: 0911112003 APPLIED z 0911U2003EXPIRES: 03/1U2004 VALUE: SITE ADDRESS: 2112 5TH ST ASSESSOR'S PARCEL NO.: 1703262106100 PROJECT DESCRIPTION: Feeder panel and circuits Owner: EATON MICHAEL J Address: 2112 N sTH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Etectricat Work Onty TYPE OF USE: Alteration Residentiat License Expiration Date PhoneContractor Type Electrical Contractor OWNER BUILDING INF( # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: DownspoutslDrains: REQUIRED PARIilNG Total: Handicapped: Compact: Total Value of Project Page 1 of2 PUBLIC IMPROVEMENTS Description Type of Construction Value Date Calculated uvr\ rML r un rr\r\-rslljlf_l:zlll Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00888ISSUED: 0911112003APPLIED: 09/1112003EXPIRES: 03/1112004 VALUE: Fees Paid Fee Description + l0o/o Administrative Fee + 7oh State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $10.s0 $7.3s $42.00 $63.00 $122.8s Date Paid 9nu03 9flu03 9mt03 9nU03 Receipt Number 2200200000000001510 2200200000000001510 2200200000000001510 2200200000000001510 Plan 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. 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. ired Insnections 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 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 during construction. q-) / -o3 Owner or Contractors Date Pase2 of? iql :, 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Oflicial Receipt Development Services Department Public Works Department 10 ate:l:25:34PM coM2003-00888 coM2003-00888 coM2003-00888 coM2003-00888 Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + lDYo Administrative Fee Item Total:$122.85 63.00 42.00 7.35 10.50 TypeofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check MICHAEL J EATON Jmp 344 In Person Payment Total: $ 122.85 $122.8s