HomeMy WebLinkAboutPermit Electrical 2009-3-5
Elec(rical Permit Application
225 Fifth Slreett Springfield, OR 97477. PH(541)726-3753. FAX(54t)726-3689
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1-~io6?:-oo77 3""""1.. .
PermIt no.:
I Date: 3> - '5 - 0 <7 I
This permit is issued under OAR 918-309cOOOO. Permits are nontransferable. Permits expire if Work is not started within 180
days of issuance or if work is snspended for 180 days.
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"",'" UJDer#o ,mspec lons'.per01tem'v ;11l;iS:<,' y; ';Y!jm><"-""~ t. "'"""~t-""
~Ki".~$'i!1't:~iliit$'%$,1':1&>0;1ihii~4J::@p7il;~J:i:5;,"{;~; i.t~,,-,,l!,; ~'"!~~!?#:.'fffiii Ji ,jj.f;,Qs~'ifb.l\\
I Residential, per unit, service includt:d: I
11,000 sq. ft. or less (4) $134.00 $ I
I Each additional 500 sq. ft. or portion $ I
thereof. $ 25.00
I Limited energy (2) $ 32.00 $ I
I Each manufactured home Dr modular $ I
dwelling service or feeder (2) $ 63.00
I 11 Pt rJ 6 L- C' I-Li\.N b g + 5 C JL.j .s pf)Q.. I Services or feeders: installation, alteration, relocation I
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Name: WI II IA'"'"'- 5r-h:--fy>lta-~ I 1401 to 600 amps (2) $158.00 $
I Address:. g- 17 :> "3 7+1..:.' I I 601 to 1,000 amps (2) $205.00 $
City: S?F-):) I State: o(L I ZIP:97~771 I Over 1,000 amps or volts (2) $469.00 $
Phone:~\;nb. (eO ( I Fax: _ I I Reconnect only (2) .. I $ 63,00 $
I I tr,... ,,,nyjrA~ \(QU lU f d . II.
E-mail: ATTENTION: Ore 10~ \ (e~por.!. _y. ~e,=~I~~~;p.r\ ee ers: msta atlOn, alteration, relocation
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ThIS mstallatlOn IS bemg made onresldentJaI o!.'!~m"prep.el(/iJnt;r T ~nM ""pS a" '"~t or $ 63.00 $
owned b~ me or a member of my ImmedJatefam~Y/;'.!'l),t~~ 0G~-OC 1 oltilPJlt'YllDQ)IDnpSiPil-O~!... $ 87.00 $
property IS not mtended D.or sale, exchange, lease,.oMen\. OWR C .~ -""n'AO 01111<: ,'~l~".~l
479.540(1) and 479.560(1). 0090. You. may 0 .all(:t~\J1."-~'O\~.g, 'WH'J...IhhnA $126.00 $.
II. the cen\f r J'ww. ..~. ,
Signature: . .. . . .. ca,~I~~. !('[ .t"', ( r~ ,Rneu~P.R~Ii>iidalOOAolts, see services or feeders section above
~~Jt~9~NiI1~G:1i0BliINSmJ,l;\J!l!'J,I;ml~~~~A~t1j'r:fs; l-~lBr~Il..;w-a1\l;~ new, alterotion, extension per panel
I Business name:])A-V\': 0 w&8ftJ g/~ ~ I a, Fee foibranch circuits with purchase ofaservice or feeder fee:
I Address: ~ y.~q '<'. SO: l..L vJ It '4 1Z0.. I Each branch circuil I I $ 6.00 I $
I City:C.O~rlo Qo..r,~ I State: all.. 1 ZIP: 't7Y ~I.-j I b. Fee for branch circuits without purchase ofa service or feeder fee:
I Phone: - 9if)"-~7 ['ll I Fax: I I First branch circuit (2) $ 55.00 $
I E-mail: lJAvbvJWI!CJ;:JN (1j>_GMINL~6.:JrI\ I I Each additional branch circuit $ 6.00 $
I CCB license. no.: / to I ), to I I BCD license no.:;l.c, - <; iR <:-1 '1 Miscelianeous fees: service or feeder notincluded
I Signing supervisor's liZense no.: '-II ':\ o.~ I I Each pump or irrigation circle (2) I $ 63.00 I $
I Print name of signing supervisor: 1>:A v : () \Iv ~ flJ I I Each Sign or ouflme lighting (2): \M"~ $ 63.00 1 $
I Signature of signing supervisor: <;U.-:) 'w.NA-- ,1.~'T\t~: ~'\R=~~~~~~~~~9i $ 63.00 $ I
irllS ?C ,,~~ TM\!i~~I'1F~~r.~i.l.} rUn I $58.00 $ I
^'\lirlO\ ~1t\;.~':ltn"l\'5'lIt-~ERem€'A'N:ril"T'.S"-E-~;!fA~'li:f~1~1
COMM'~;~W~;o;ab;v:fees ~.u l;~~"t_~~"
f>.~'{ 1 ~q~i~imum Permit Fee $58.00) . $ 71
I (B) Enler 12% surcharge (.12 x [A]) $ ,~e:
I (C) Technology Fee (5% of [A]) $ 3':5-
I TOTAL fees and surcharges (A through C): $ c; Z- ~
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I Zoning approval verified? DYes D No. I
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I Job site address: ~q.7 :'5 ,~7~ s '(, I
I City: <. P P-1-0 ~ I State: c> R...I ZIP:971..f7J:? I
Subdivision: I BoZ Db I z. I Lot no.: 01ooc:::.
440-2584-) (9/08/COM)
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00173
ISSUED: 02/05/2009
APPLIED: 02/05/2009
EXPIRES: 08/24/2009
VALUE: $ 16,500.00
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 897 S 37TH ST
ASSESSOR'S PARCEL NO.: 1802061203000
Springfield TYPE OF WORK: Bathroom
TYPE OF USE: Addition
Resid.ential
PROJECT DESCRIPTION: Bath addition
Owner: SHEPPARD WILLIAM C & J A
Address: 897 S 37TH
SPRINGFIELD OR 97477
.Phone Number: 541-726-1801
....) CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Contractor License
GARY WAYNE STEFANEK & ANTHONY D0178017
DAVID WILLIAM WEBB 161361
fATfl1 ::buh~~\. ~G"W}ii}iiX%'Qfti'U~i1'ity
o ," I If il 1.1:
NOtificati~9!JJ]te(. Tho.se rules are set forth.
in OAR 95 _~tOO.~~ through OAR 952-001-
R-3 0090. Yo nW?b!'iia\lt~.'olJ1i!'3 of the rules by
calling ti\;'~PSe~~<!f~~~ote: the telephone
VA numberiW~!j 1)j1!~on Utility Notification
c\!f\Iij\eiIweuO-332-2344)..
Energy Path:
Sprinkled Building:
Expiration Date
08/22/2011
09/07/2010
Phone
541-744-2999
541-942-2718
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
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:
. 80
n/a
I.DEVELOPMENT INFORMATIO.N I
Fronlyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
24.00
14.00
5.00
37.00
0.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Yes
26.50
REQUIRED PARKING
Total:
Handicapp.ed:
Compact: .
Street Improvements:
Storm Sewer Available:
Special Instruction:
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I PUBLI~I~P.IMb~~~tiN1iS1 EXP\R~~~M7T IS NOT
RilED UNJt~ 1\-11.$. ~a
Partiallv Improved AU1\-10 CEO OR IS ABAT-!e'OW~
Yes COMMEN v PERIOD Downspouts/Drains:
ANY 180 OP\I .
Notes: New tixtures were added but on septic; therefore, no new sanitary SDC's charged.
Pa2e I of 3
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Building Permit
Fire.SF Fee - Residential
Fixture
Minimum/Adjustment Plumbing
Plan Review Residential
Storm Drainage Impervious Area
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
Plannine: Review
Structural Review
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00I73
ISSUED: 02/05/2009
APPLIED: 02/05/2009
EXPIRES: 08/24/2009
VALUE: $ 16,500.00
I Valuation nescri~tion I
$ Per Sq Ft
or inultiplier
$1.00
Square Footage
or Bid Amount
16,500.00
02/05/2009
Value
Date Calculated
Total Value of Project
$16,500.00
$16,500,00
L.Fpp<, P~W
Amount Paid
Date Paid
Receipt.Number
$40.95
$17.06
$79.00
$204.25
$4.00
$38.00
$20.00
$132.76
$44.95
$9.48
$3.95
$55.00
$24,00
2/5/09
2/5/09
2/5/09
2/5/09
2/5/09
2/5/09
2/5/09
2/5/09
2/5/09
3/5/09
3/5/09
3/5/09
3/5/09
1200900000000000081
1200900000000000081
1200900000000000081
.1200900000000000081
1200900000000000081
1200900000000000081
1200900000000000081
1200900000000000081
1200900000000000081
2200900000000000226
2200900000000000226
2200900000000000226
2200900000000000226
$673.40
, Plan Reviews .~
02/05/2009
02/05/2009
02/05/2009
02/05/2009
No planning. issues.
as noted on plans
APP DDK
APP CJC
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.
~prtiori< ,
Footing: After. trenches are excavated.
Fouridation: After forms are erected but prior to concrete.placement.
Post and Beam:. Prior to Iloor insulation or decking.
Floor Insulation: Prior to decking.
Framing Inspection: Prior to cover a'l~ after all rough in inspections have been approved.
Pae:e 2 of3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-00173
ISSUED:. 02/05/2009
APPLIED: 02/05/2009
EXPIRES: 08/24/2009
VALUE: $ 16,500.00
225 Fifth Street, Springtield;OR
541_726-3753 Phone
541- 726-3676 Fax
541-726_3769 Inspection Line
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and the building is complete.
Undertloor Plumbing: Prior to insulation or decking.
Under-tloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Final Mechauical: When all mechanical work is complete.
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 ofthe 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
str.eet, 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
tirries during construction.
Owner or Contractors Signature
Date
Paee 3 of 3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00 173
COM2009-00173
COM2009-00 173
COM2009-00 173
Payments:
Type of Payment
CreditCard
cRcccintl
RECEIPT #:
.~~
ilk
City of Springfield Official Receipt
Developmcnt Serviccs Department
Public Works Department
2200900000000000226
Date: 03/05/2009
Description
Add, Alter, Extend Circ
Add, Altcr, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
DAVID WEBB
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
b2432 I In Person
Payment Total:
Page I of I
8:51 :08AM
Amount Due
.55.00
24.00
3.95
9.48
$92.43
Amount Paid
$92.43
$92.43
3/5/2009