HomeMy WebLinkAboutPermit Electrical 2009-3-10
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Electrical Permit Application >PR'"~""O ."._~:I
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22::; Fifth Slrrt'tt Sprin!.:fi,e1d, ~R :7.~77. PH(S4 ~ )726.3753. F:\:\:(S41)726-3689 i\',; ->< ~, _.. ~. . _ . _ n . . _.. ~ .,
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: ';This:jll'rmit is issued'under OAI{.91S':309-0000: Permits' :lrc l,ontl~lc'-'Peh6~ts'cxpirc It 'hiii(ii.~~f;"liil:~'iill-mIW
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'. "days oUssllallce.ol:iLwork.is;,s,!J~I~~IHlcd for,18.o,~la)'s. . _.__~'_____ _ ___._.~__tl~~__:_'_:_."__.'.'
,( lJr ; ,\.J', .' ,,;.i,~ "., .:f'l;l'-!(II."'!f?':-,~ I c:'.;i'ct, ,
I-.'.~::. ;-'l:OCAL- GOVERNMENT- APPROVAL--'. ...:::.,.-';::-FEE~SCHEDUCn-'-,::- -;~-'i- ..
I-Z~ning approval verified" .--- --eJycs ' 'n_ 0 No' - I II\Uljlbiroi,insPc<:'ionspei~iicniiT'I'QG".j'-:~~:~]~ I-"I:~,\';]'
I CA TEGORY OF CONSTRUCTION I I Residential. per unit, scn ice Illcludcd.
I M Residential I 0 Govemment I 0 Commercial I 1
1''\ JOB SITE INFORMATION AND LOCATION. I I.UOUsq It orbs(4)
1 Li, ' ({l~ I/~ I I Each addullll1.11 500 sq n, ur portiol1
' Job site :tddress: ,TlfJ7' (~.X. thereof
I City: Six! f'O.-I-u J.!d.. I State: I ZIP:<f7Lf7j I I Limited energy (2)
! SubJj~s~n': -. UJ/70 ~ ZZ'-t'l... ) Lot no.: OZ~~O I I Each manufactured home or modular
I DESCRIPTION OF WORK , dwelling service or ]ceder (2)
I k~ t r Avr-Vt...l t- I I Scn'iccs or feeders: illSrallmion, aflermioll. relocalioll
I I I 200 limps or kss (2) S 81.00 S
I PROPERTY OWNER I 1 20] to 400 amp' (2) I 5 95.00 5
1 "ame: gIve/\:. J).l(ey--'T~;A~'ldiM"',.- 1 l.ltJ].io('oo;o~pst2).,."._:. ":. 1""[ 5158.00 I,
i. :\dejrl'ss: '? u" a ()Jx-~--:B~'3'-Z:- ;.. ~.:- \:,~-~ --~._-- -- I 1-(lUl-ln-LOOO amps en ~.,,::-:.-':~'~~r.I::r;Jr';:: - -$205.00 !. S
I Titv.s"~"lr' t+..'~' ':: 1 Staic:--CiL -I' Zi;': 97 J B4 1 O\'erI.OUO'aii'rsc,; 0OliS'(2') - ---. - 5469.00 ! S
I .. . ,,"u I ,LA ....'8tD.( 1 '''', ..-- ".-- I II{cconnect on]l ('I . S 6300 ,'S. .
Phon~::;t;'7f ..7t:)V,,-." c:;iI' ~irF3.\::.-. :'(l,~\"..._ "'.H."'{';": "'.", .....,. -;.,;. ....'ll".:;.l1....t'.,'r,~i;o~ ~=:'.I...'..' .,J~'l.'
. ". 11.. ,.1. .!. . . '1'. .' . .. ...... .~ .' < '1 -.. ..- -. . ~
I. I' '1 I Tl>n;pi;l:arv St'l"\'kl'.~'li':h'ctlC'I~.~: 'il1slt."i/II;'()~-';lil'i';,7dlli~~,,'l'I'(lfi(ill
::'-11131 : . ; > '" .'.' . ,
. b '200 ,ll1lpS or less'11,) '. . ' .':i 6foo 'I ,
I hIS IllsE31lallon IS emg made on .resldenllal or f~rmyr?perty If .. ~:~",..t:l.C ~/n' 'TO
0\\ m:d b~ me or a member of my lInmedlute famIly nilS. 01 egOI 201 t~40\411lTIr!Jt!MY S 8700 I s
propeny IS nOE mtended for sale, exchange, lease. <;lr.rent t0~Rted b\ II ,[) l l..... C:PT flll
,7~ 5,O( II and ,79 560( I) , ':, .. ation Cenlar. T 101;C4()lJtS~0~\1~rr').,(~I\L \12600 I \
Ilotl.]C 010 th 0<"'11 v,{;,,' ~"'~ - - "
Slgn.11l11 e in OAR 952-001-?,_,"-, ":'~~~~ 6'!'!h,p~WhqresOBOj\ oh~. see Sel\ Ices ur teedl.'lS Sel.'!l(lll .11111\1.
. .. YOU 11 lay v~.~'-I] Cll.-. h
CONTRACTOR INSTAL.LA'P.ION.. _ ~-,y (N ),lr~~:~I!J<1i[Cil!ts:Ql'\\!.a/leralio". ex/e"sh", per p""el
/ - CO r r ( f(; ~~t]tll;J "'v v.v...","); dJ .,.. Mnlll'''i-l\'VIL
Business Ilfame: L4 (~r r-:, It! r rcr.~~~" fnr the ore~91' r,,~!~~) en reuns with pUlchase of, scrvice or Iccder ]ce: ,.,;.."
I.\ddrcss .n. L'U\ \.laR . Cenleris1"TU ''''[ii;r,);"nchcireuit .",1/15 6.001 S(~.(/I!..I
IClY: A/n'Jlinu I St~tc:OC. 'I 'Z-JP:~L-I !... _b..Ec.c,lor..branch.circlliEwitholltPllrdwse ~)r:J servil:e!li" ]l:edn kL': J
! I'honc:t:::;LIl qI.R7 ''i?1o)..-'! 1 r,,:t::)(,(/ qh7 7m5"1 1 Filst branch circuit (2j I I $ 5;.tlol 5
! ['Il1,jjl: ~..f"~f)(aJ risWe0vu.J..1. CO'Y'l I Each additional brall<..:h cin:uil I S 6.00 1 s
J cen lic('r~t' no.: I R;::) 4?;8 r BCD license'no.: cL/-20 I I .\list'c/laUl'IIU.'I Ice.s: sen'icc' orji'edl'I'lInt il/eI/lded
I Signing supervisor's license no.: dq X1) 5 I Each pump or irrig:ltioll circle (2) S 6300 I '\ I
I Print nallle of signing supervisor: ED Q(~h.e(c;h,. I EachsignoroUlliIl1.'lighlillg(2J --~;oo-i-~--~
I S. I'" , J (-') ,- ~ ) Qj Signal.circuit ur a lil.niled.el1t'l"!.!.."~'~' ~ .'''. 63.00 I ," I
. 19nawre 0 slgnlllg SUpcr\lI<:~ '- ----f-'" ~ Ii ... ,
-r" . _ '_ _ .I _ :tIEeratJOn. or e,\lenSlun (& <1'):.\\=-_ Cl \ ._______1
C~: I Each ad~i\iOPA~lfl>'[;.1~li\1V \S 1'1' 55800 I s I
, ~O\\ c~i~\i '511~~r. 1\-\\'5 i.~~~~~~'q\ USE I
~ IS? ?-' Lei>> ~~W~~pW[l.~~ov~~" J -- /p I
\)"(\,\0 . \~\1\!JiQli\n '""",it Fee $;S.]III) 'lV
WlC':tO. -~ ,1'
COWl 1'l;ltW~1t'rr\:LYoS;lIchargC(.I2\[A/I 5 .11f
I\~'/"\ '(ClTechlllllog)' Fce (5%of[A[J 5 . i)J
VI nrh-
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DEPARTMENT USE ONLY I
[
Permit llo.:Ccvv1 0 B - (J/-,zS
I
$134.00
5
S 25.00
s
$ 32.00
s
$ 63.00
5
~~Q~
y.-~
~
\A fb .
QJ$"
TOTAL fees and surcharges (A through C):
~.~t)-2~x.:-J 19/0SICO,\1)
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
. PERMIT NO: COM2008-0I735
ISSUED: 12/12/2008
APPLIED: 12!()412008
EXPIRES: 06/3012009
VALUE: $ 5,000.00.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54]-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 467 OAKDALE AVE
ASSESSOR'S PARCEL NO.: 1703224202500
SPRINGFIETYPE OF WORK: Foundation
TYPE OF USE: Addition Residential
PROJECT DESCRIPTION: Foundation for relocated single family residence. Previous address 1071 Harlow Rd
Owner: RIVER VALLEY BUILDERS INC
Address: 1071 HARLOW RD
SPRINGFIELD OR 97477
Contractor Type
General
Electrical
Mechanical
Plumbing
I CONTRACTOR INFORMATION I
Contractor ATTENTION: Oregon law requireLlceh'se
follnw rttl". ~rlnr.t"rl by the Oregnn ] IfTt
RIVER VALLEY BUICDERS INC 13'4566 Y
l'OUUIICctUUII \..J~111~1. I nose rules are ~At1orth
G & E ELE~;r~I,~ ~f-001-0010 through OAR5,1~~!b01.
MIDWAY M".!'?J:L"'~!G~lJ,lli<;:ain copies of thJ~MJifby
ADH PLUMBh"lG'I~!Qe center. (Note: the teldi3~Q,7i73
f1urnoc" T....... .......... '''......--- . .O_'-.l-..~' -,-,. "
I~BUlLDINmNJ;:O~~A TION',J~..
. . - -J
Expiration Date
04/1512011
09/15/2009
01/30/201 ]
04/0312009
Phone
54]-760-7881
541-967-8627
541-928-2423
541-967-7686
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
No
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
]5.00
19.00
5.00
38.00
0.00
I DEVELOPM~NT INFORMATION I
Overlal Dist: \f ir\C 'NO\'l~
~{r.et'rrees ~~\. fi-?\\'Ic EI'-~:\3.S ~Oi
~"Se'l>~R . EI'- :\\'11'5 ? '\101'-
{>.U~~'eM\q;'D.~j;);O PolS {>.\3{>.~\)O .ob .
t"'nMN\:~C~,.;: rCQ\('\\).
I PUBLI~'IMPR'tVE'MENTS I
REQUIRED PARKING
Total:
Handicapped:
Compact:
2
Street Improvements:
Storm Sewer Available:
Special Instruction:
FullV Improved
Yes
Sidewalk Type:
Downspouts/Drains:
Curb and Gutter
Notes: Storm water to curb
!
Paee ] or 4
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
541-726-3676 Fax
54]-726-3769 Inspection Line
Description
, Tvpe of Construction
. Fonndation Onlv Use Bid Amonnt
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$1.00
Sqnare Footage
or Bid Amonnt
5,000.00
CITY OF SPRINGFIELD.
Building/Com bination Permit
PERMIT NO: COM2008-01735
ISSUED: 12112/2008
APPLIED: 12/04/2008
EXPIRES: 06/30/2009
VALUE: $ 5,000.00
Valne
Date Calcnlated
Total Value of Project
L.~r~~ P'1irlJ
$5,000.00
$5,000.00
12/0412008
Fee Description Amount Paid Date Paid Receipt Number
+ ]0% Administrative Fcc $30.36 12/12/08 ]200800000000001222
+ ]2% State Surcharge $36.43 12/]2/08 ]200800000000001222
+ 5% Technology Fcc $21.13 12/12/08 ]20080000000000]222
Addressing Assignment $37.00 12/12/08 1200800000000001222
Fonndation Permit $78.58 12/12/08 1200800000000001222
Moved Structure Plumbing Conn $52.00 ]2/12/08 1200800000000001222
Plan Review Minor - Planning $119.00 ]2/12/08 1200800000000001222
Plan Review.Residential $51.08 12/12/08 120080000000000]222
Sanitary Sewer - ]st 50 Feet $52.00 12/12/08 ]20080000000000]222
Sanitary Sewer - Improvement $273.48 12/12/08 ]200800000000001222
Sanitary Sewer. Reimbursement $359.65 ]2/12/08 ]200800000000001222
SDC MWMC Administration $10.00 ]2/]2108 1200800000000001222
SDC MWMC Improvement $1,009.17 ]2112/08 1200800000000001222
SDC MWMC Reimbursement $97.90 12/12/08 1200800000000001222
SDC Sanitary/Storm Admin $109.74 12/12/08 120080000000000]222
SDC Transpo Improvement $888.98 121]2/08 1200800000000001222
SDC Transpo Reimbursement $201.54 ]2/]2/08 120080000000000]222
SDC Transpnrtatinn Admin $77.67 12/12/08 ]200800000000001222
Storm Drainage Impervious Area $907.57 ]2/12/08 1200800000000001222
Storm Sewer - ]st 50 Feet $52.00 12/ 12/08 1200800000000001222
Storm Sewer Each Addtl ]00' $]7.00 12/12/08 120080000000000]222
Water Line - 1st 50 Feet $52.00 ]2/12/08 ]200800000000001222
+ ]2% State Surcharge $9.72 1/22/09 3200900000000000037
+ 5% Technology Fee $4.05 1/22/09 3200900000000000037
Perm Serv/Fdr 200 amps or less $81.00 1/22/09 3200900000000000037
***+ 100/0 Administrative Fee*** $5.80 2/25/09 1200900000000000131
-Mechanical Issuance Fee- $21.00 2/25/09 1200900000000000131
+ ]2% State Surcharge $6.96 2/25/09 1200900000000000]31
+ 5% Technology Fee $2.90 2125/09 1200900000000000]31
Heat Pump $]5.00 2/25/09 1200900000000000131
Minimum/Adjustment Mechanical $43.00 2/25/09 ]200900000000000]3]
+ ]2% State Surcharge $0.72 3/9/09 ]200900000000000167
+ 5% Technology Fee $0.30 3/9/09 1200900000000000167
Add, Alter, Extend Circ Ea Add $6.00 3/9/09 ]200900000000000167
Total Amount Paid $4,730.73
Paee 2 of 4
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2008-0I735
ISSUED: 12/12/2008
- APPLIED: 12/04/2008
EXPIRES: 06/30/2009
VALUE: $ 5,000.00
~l\ti:SrRI\II':J~IlA-J;! . .
i'.....'.tii'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plan Reviews I
Initial Review
12/04/2008
12/0412008
WE LLH
Structural Review
] 2/0412008
]2/04/2008
APP DLM
Initial Review
1211212008
1211212008
APP LLH
Plan nine Review
12/0412008
12/1212008
APP DDK
Public Works Review
12/12/2008
12/1212008
APP LKW
Cannot issue until moving permit
has been received and approved.
See docnments for Plan review
comments.
House moving permit is ready to be
picked up. Called Chris Schoap, bul
his message box was full. Gave
permit to Don Moore to issue with
foundation permit. This is a
springfield to springfield move- no
willamala~e sdc.
2 Street trees required unless
already in.
Storm water to curb/Fixture count
given by Greg Larkin
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.
I Rpnlli~prtionli,;J
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Final Building: After all required inspections have been reqnested and approved and the bu'ilding is complete.
Underfloor Drain: Prior to cover or placement of concrete.
UnderOoor Plumbing: Prior to insulation or decking.
Sanitary Sewer Line: Prior to tilling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing wnrk is complete.
Electric Service: Approval required prior to utility company energizing service.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Paee 3 of 4
Status
Issued
225 Fifth Street, Springticld, OR
54]-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2008-01735
ISSUED: 12/12/2008
APPLIED: 12/0412008
EXPIRES: 06/3012009
VALUE: $ 5,000.00
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 Stale 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 Safely.
I further certify that nnly 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 prnper time, that each address is readable from the
I . 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 Signatnre
Page 4 01'4
Date
2ZS Fifth Street
Spril)gfield, Oregon 97477
541-726-3759 Phone
it~.
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM200S-0 173 5
COM200s-0 1735
COM200S-01735
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
1200900000000000167
Date: 03/09/2009
Description
Add, Alter. Extend Circ Ea Add
+ 5% Technology Fee
+' 12% State Surcharge
Paid By
G & E ELECTRIC INC
Item Total:
Check Number Authorization
Recei~'ed By Batch Number Number How Received
djb 2074 In Person
Payment Total:
\
Page] of 1
8:54:27 AM
Amount Due
6.00
0.30
0.72
$7.02
Amount Paid
$7.02
$7.02
3/9/2009