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Home My WebLink AboutPermit Electrical 2009-1-9 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 1:~~~"'-'?J<"""';"~ldit\l'!-$lI'~.:;:;;t:;;=i:-I"*'J7~"~'l$1:.~'t'$6;it:1 .%p~ ,iDERARliMENiPUSE10NU,Y/"""': 'it"'. =~'"""C.":'I'""0~" ,~___-,<."',_",",,o.~ ~'~"'r.=4,... '''''''(''''''''~'~';';~ "".""u;.,.,....~..'~ .'_ 't'-"'"~_"-.,_",.~,.c,~,'"'".={#""b_''''.,.:;l'~'f;. I . CbW\~007- I. Pennit no.: 000 3 b I Date: /,/~ 1 I Ele"~trical Permit Application This permit is issued under OAR 918-309-0000. Permits are nontransferable, Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 1~1E0:0e;I!I.G~.MERNMENif"JSgeR0V~~~~1 I Zoning approval verified? 0 Yes 0 No I 1.~~0~illEG(!~RYIiIol:I~QNSJTIRQQm[OJ'J~~~~1 .. ... 1::~~~:~~'j[EIDfi~~Ra,;~~7~~~Nb})~~c~;r:~;~~11 ~:~;::tl;I,:,el:S:n(:; servIce meluded: $134.00 ,$ I I b. ddr --,,, " :/ v7 . D ^,' I I Each additional 500 sq, ft. or portion $ 25.00 $ I Jo SIte a ess:.F7 --, --f V I V_<"", 1',,) Il t/-C.. , thereof ' I City: <;PF(<:!' lState:(:A1'L... IZIpii~:t8 I Limited energy (2). $32.00 $ I [~;;~~~~~~~f;~~l0F;I\WJ~~;~~~~f I J~~~I~~s~~~~~r~~ ~~~;r (~)odUlar $ 63.00 $ I I f4e[f'() J.....e. l +- r2..L:p.() \' tL - ~ - - - . - - - - I I Se~vices or feeders: installation, alteration, relocation I I I I 200 amps orless (2) I $ 81.00 $[;1 I I 20 I to 400 amps (2) $ 95.00 $ I I Name: ~\ r".-r..\-- R.u~ C\--11" r"---'-I I I 401 to 600 amps (2) $158.00 $ I I Address: 3"Y1?- VI VLZJ.)'J"~ fJe.--z.. I I 601 to !,OOO amps (2) $205.00 $ I t City: -sPF(<;:!., ~ I State: Df'L-1 ZIP: Q'.j-rJ8, IOverl,000ampsorvotts(2) $469.00 $ I I Phone:~)cJt(,ob (.-,7l/-6 I Fax: ,_" .onllin~~,'iI'm'OtonlY(2) $ 63.00 $ I I E-mail: . . r-.-\i:'~~'f\1jN: ureBU\\ ,......1-.. n.re)'!)nn.p'o~aY;y servic,es or feeders: installation, alteration, relocation I /.\1 1.:. .,_.-.torlhvtlle\..f- Th" II' 'b' d ." 'd" "'I"~ \;~~,- - ' rulE S I r2(1Q(l/n\Hl\\! less (2) $ 6300 $ I IS msta atlOn IS _ emg ma e on~reSl entia "''or~larm\propel1t)8 j -_ nrrl nni.. . owned b~ me 0: a member ofmY\4mrie~iat~~a'mii~DThi~ thrOUgh 0 :~B(ffi~91b~ps (2) . $ 87.00 $ I property IS not mtended for sale, ~l',change'):lease! or rentil9t\.l}1les 01, ' ~ ""'" 479.540(1) an~479 ~O(l . 0090, You may OPt" (Note: tl,e :elQPlO'-o~",..amps (2) $126.00 $ I ,. . the center. . " Nf.lTlII""l;".. J~~gn.a~re: 7-'-'-T~ _.' _' _ "T" _, _ _ ~~\\:C? ~~~r,~hH, c?'f:9?n" ~~~ i..J -1 ~f~bon .amp.s or 1,000 volt~, see services or feeders section above J 1~JL.~.B.c.oNm~cm:OR~INsi19,\:'1lJr;'P,:it;IQNllfr'&\tlli!:~.p~gl 1 Branch CIrCUIts: new. alteration. extensIOn per panel I I Business name: ~~t:Y1 I I a. Fee for branch circuits with purchase of a service or feeder fee: I I Address: I I Each branch circuit I I $ 6.00 I $ I City: I State: I ZIP: I I b. Fee for branch circuits without purchase ofa service or feeder fee: I Phone: I Fax: I First branch circuit (2) $ 55.00 I $ I E-mail: I Each additinnal branch circuit l( $ 6.00 I $ Z4 I I CCB license no.: I BCD license no.: I Miscellaneous fees: service or feeder npt included I I Signing supervisor's license no.: I Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signing supervisor: e' :. I I Each sign or outline lighting (2) $ 63.00 $ I I Signature of signing supervisor: , . I Signal CirC$!~.~jenergy panel, $ 63.00 $ I fi\?\CJ;.- I-Ir..\.\. D13\l\'!l~3 \~~~ 11-11S PERIMI~; ~NOER ~~!O\!~~;~~1\~, c,~~o_n,.-'~~,l~,) .'..._.ffl.~Iii~:~~, $~Hj,""', "11 f>,\.}1I--IOR" OR IS \.Il.,t\,'f.l"" .~~~"'lit~}XP.RJ.jtc;ANm"l!I!>Ew~_~j,'iTli1\"" COMMENCEO ERIO )(A) Enter subtotal of above fees D) I ANY '\ 80 Of>,Y P (Minimum Permit Fee $58.00) $ I I (B)EnteiI2%surcharge(,12x[A]) $ IZ bY I (e) Technology Fee (5% of[A]) $ S- 'Z r I TOTAL fees and surcharges (A through C): $ I Z 7 ~ ~,O\. y\~~CV ~. '~ 440-2584-) (9/08/COM) \ Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00036 ISSUED: 01/09/2009. APPLIED: 01/0912009 EXPIRES: 07/0912009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3997 VIRGINIA AVE ASSESSOR'S PARCEL NO,: 1702314402100 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Repair / replace plumbing and electrical Owner: CHENEY KIM S Address: 3165 N A TLANTIC AVE APT A401 COCOA,BEACH FL 32931 Contractor Type Electrical Plumbing Contractor OWNER OWNER I CONTRACl'OR'INFORM11TIQN':IY ,'" -I'l'. - '" - ;, by tne v,o,,- . th r . I" acJOp,eo \ ~~ set ,01 , I ,,'I !"";,c,,,, ter ThOse lU e"J.;Oi eJI"""01. Expiration Date , .' 1 ren. \'101'. :!"Z"1J ",otii\ctl'\O\ _~01-00i 0 t\'110U9 tth81ules by , in O~i'\~~~m"v obiain CO~_le;h~ 1f'lephOne . vU~i:;IBUIILDING:~F6~JiWA\IlIDN-~llca\\UI' .-no", ~,!. 80' o' _~~.HJ.'. nU,,' tell? 1- ~f1f'Slones: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Phone # of Units: . Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB . Secondary Construction Type: # of Bedrooms: . Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: 'Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I D~VELOPMENT INFORMATION,' REQUIRED PARKJNG Overlay Dist: " ?'/.. Total: # Street Trees Rqd: X. \r i\\t. \N~\01 Handicapped: pa~ve Rqt~\..\.. ~?\?; t.?WI\1 \S 1'0 Compact: 't\O S ?~11F.i~Ut.?1\\\S ? O~t.Q fO? 1\\~~,jl\?\2t.Q \l~,.., ,C, f>,~f>,~Q I PUBLi(;:'i~~~~. f>,~'/ ,~V!' \ Sidewalk Type: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: DownspoutslDrains: Notes: Page I 01'3 ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726.37691nspection Line I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project FPP5 P~;r1 I Fee Description + 12% Sta~e Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Fixture Minimum/Adjustment Plumbing Perm ServlFdr 200 amps or less Amount Paid Date Paid $22.08 $9,20 $24,00 $57,00 $22,00 $81.00 1/9/09 1/9/09 1/9/09 1/9/09 1/9/09 1/9/09 Total Amount Paid $215,28 I Plan Reviews I , CITY VI' ~nuNGFIELD Building/Combination Permit PERMIT NO: COM2009-00036 ISSUED: . 01109/2009 APPLIED: 01109/2009 EXPIRES: 07/09/2009 . VALUE: Value Date Calculated ) . Receipt Number 1200900000000000008 1200900000000000008, 1200900000000000008 1200900000000000008 1200900000000000008 1200900000000000008 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. l..jeCluirerunsnections I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Pace 2 of3 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-00036 ISSUED: 01/09/2009 APPLIED: 01/09/2009 EXPIRES: 07/09/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line By signature, I state and agree, that I have carefully examined the completed application aud do hereby certify that all informatiou 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 iuspections are reqnested 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 time~1iln, / _ ~_ O~ Owner or Contractors Signature , Date Pa!!e 3 of3 '. e. . . . . . . '. . '. .' '. .' .. , . . . Con'structionContractors Board. . 700 Summer St NESuite 300 ,PO Box'14140 Salem OR ,97309-5052 . Phone: 503-3784621 Web Addres~: 'www:ccb.state.or ~iIs' ~ermit#: COW/ZOO 9- OOq3,b , Addn,ss: 3777 ).;:j~' V,/rLf,v-.,1l- . All Date: 1 / f/6 C; / Issued by: ..", ,". .- State~ent: Il1for,matio'n 'Notice t'o: Property Owners AboutConstruction Responsibilities _ Note: Oregon Law, ORS 701.055(4) requires residential constru~tion permitapplican'ts whoare not . licensed with the Construction Contractors Board to. sign the following statement before a building permit can .be'issued. . This statement is requiret;lfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), neednot submit .this. statement. This/statement will be filed with the per,mit. . , ", ;..' .' .' ','. . . , . . Fill In the appropriate blariks' and initiai boxes 1 and 2, and ~itherbox 3Aor 3B: Kr 1.' ~2. I own, reside in, orwili reside in.the completed structure. I understand that I must become licensed as. a construction contractor ,ifthe structure is sold or offered for sale before or on completion. " o . 3A My general contract~r is' (Name) , (CC~ #) ., J .will instruct my generaJ. contractor that all subcontractors who work on th~ structure miIstbe licensed with the Construction Contractors Board. . OR' ~~R I will be my own general ~ontractor. _ If! hire subcontractors, I will hire only subcontractors licensed with, the Construction Contractors Board. If! change my mind and hire a,general contractor, I will contract with a contractor who is- licensed with the CCB and will immediately notify the office issuing this building permit of the naine of the' contractor. - - . I hereby certify that the above information is correct and that I have read ~nd do und~rstand thelnf~rmaii~n' Notice toPi'opei'ty Owners about COl}struction Responsibilities "n the reVerse side of this form. ',~ ----~ ;/ " \ -~ - O~ - (Signature<r[ l'~m-';; applicant) (Date) . -. ' .' (White copjrto issuing agency permit file, pink copy tf? applicant.)' Property_owner.doc 06-01-04 City of Springfield Official Receipt Development Services p~partment Public Works Department 225 Fifth Street Springfielil, 'Oregon 97477 541-726-3759 Phone Job/Journal Number C0M2009-00036 COM2009-00036 C0M2009-00036 COM2009-00036 COM2009-00036 COM2009-00036 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200900000000000008 Date: 01109/2009 11 :07:44AM Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Amount Due 81.00 24,00 57.00 22.00 9.20 22.08 $215,28 Paid By KIM CHENEY Item Total: Check Number Authorization Received By Batch Number Number How Received djb 160662 In Person Payment Total: $2 I 5.28 $215.28 Amount Paid ,Page I of I 1/9/2009