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Home My WebLink AboutPermit Electrical 2009-9-22 225 Fifth SlreeltSpringfield, OR 97477tPH(541)726-3753+ FAX(541)726-3689 li'G"'\DERARTMENT"us'it ONi:'1:~ -(I ,\.....~:, .:. ",' --:.~ .~.>,,:,-~,'. . ~...- "~- : ~...' .. .;;:,- ~-'- .:> ' .., .' :,," ". - I pe~z.oO" - C>1t(OLfI I Dale ?- 22-0 i I Electrical 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. ~ ., . .. ", ,.{~OeAL, GOVERNMENT -.APPR0VAli:- "A ~~~'ln"' ",,] If~~1~~~4'1}1~~~~FJ:I;~S'CA~Pl1irnE};:]~}~jJt~~~1W." I ";on'I~;~ ':;~;oval' ve:ified? .. O:e,' > , ~'~,;j"~:r'i"';'~;:1 I :Nu:~~e/~'6~';p.~iji~';s\p';[i!~~;(n~,r QW.',i',,9o~~;?i: ',,:rot:i~" ;" I",,,,~,,,,T' """,,.'A"'E GO' R"'rO<="'C'ON' S"'R'U"TION"""""""" "-"'1 ,'w>,.',."\",'",,, ~""",,,,,,,,,,',,,,,,, """1..,, ",I ,,,,,ea.,,J,,,cost,,,, tt.~I_j<i.:'\'N1i~:(j:\;,~ "'.: ._,".. ',Ird:" JrJ,t.','.. .. .,:1: -'' _~,Ii, '- ",~;,~~-f'~H;i~':"}V,,':rr 1 Residential, per unit, service included: I 0 Residential I 0 Government I 0 Commercial I I' I 1~'t~~!J,bl3iii$IJ1Ei'!JNr;;bRI\IIAmloNlfJXND!llJ:()~CAmION~iN'iill 1,000 sq ft, or less (4) $134,00 $ I I' ') 71.>/\ I J 5 f. ' I I Each additional 500 sq, ft, or portion $ 25,00 $ I Job sIte address: "'- 7)1/ lVDv tl. thereof,' i ~:::r~ti~1~:~~~E:F:1;~~:~~:ii~~1 'i ~~~~:;~~~;;~~;~7e~~:r(~)odular : :::::: ,I, l e I"l ~)r I k /'1 ",le",' <I- hal' ,.#e>~ ~ ..' , ,',~..' '.. ,,,I I Services odeeders: installation, alteration, relocation ~b}Q( e" ..~:r:~b;E T.y,io~NER' ': ',e&:;oi~)':~ ~~;~~ ~:~oo:::: ::; / : ::::: I Name: C)"JrJ~ S ..;.. S.Hh,Ule A~~(:'~d~.,'P",i11~e;I~~01 to 600 amps (2) $158,00 I Address: ~ 711 ^ , NA., ..ri!I!":."f:> v' ",'0 \" ~ 1,)';','(\<;\ '1,,\[ :6%to 1,000 amps (2) $205,00 C (J ~ vI') J"''t'O'"7.~{')~ -<nO ,$).,' ^\ ''\0, . n' 1~. , City: 5 ~'eIJ~-<.~~St,~t,:'" ;1~\,kzyrc117t;.'7t~I~,II~Over f,ooo amps or volts (2) $469,00 $ Phone:.JW _ 55"<<1- ~1'~I~F~~$\)\':'~,.?>-\\\';\o\.;\"\\,!;~~I".1 Reconnect only (2) $ 63,00 $ I E-mail: -, . .:..\O\W-~ g',)"' ,\<,,0.'1 :(\\e" e~?" f~b'" I I Temporary services or feeders: mstallatlOn, alteratIOn, relocatIOn \' 0~ ..,,\) _ ,,'0 n, ^,,\) I .' ..' .\\- .. It'~'''''.\f\'r:: ,,~.... _ 200 amps or Jess (2) ThIS mstalIatlOn IS bemg made ~nft'!.~i~~}1tl'tl.or'~a~!Jl property $ 63,00 $ owned by me or a member offrly Lmn;,edjateJ~tilily, This I 201 to 400 amps (2) $ 87,00 $ property is not intended for sale, e~cJiHlige,qease, or rent. OAR I, I 479,540(1) and 479,569}1), 401 to 600 amps (2) $126,00 $ ,) ~Signature: /")~ $?.... ~ lOver 600 amps or 1,000 volts, see services or feeders section above 1 ," :::'CONTRACl;QR"JNSTAl!.l!.AJION',.' , .:"~'..I' I Branch circuits: new, alteration, extension per panel I Business name: Ot.J .Ale-<l........ 1 I a. Fee for branc-h circuits with purchase of a service or feeder fee: I Address: I I Each branch circuit I I $ 6,00 I $ 1 City: 1 State:. I ZIP: I _I b Fee for branch CIrcuits Without purchase of a s;lvlce or feeder fee I Phone: [ Fax: I I First branch CIrCUit (2) ,~~~"\'i5 00 $ I E-mail: I I Each addllIonal branch CIrCUIt " \~ '\' ~:$ 6,00 $ 3c:J> I CCB license no,: I BCD license no.: I I Miscellaneous fees: serviC~.f(!f"jte~"I<-'iIo"?)~f{dJd , I Signing supervisor's license no,: I I Each pump or irrig-"{i~it,?ir;""'t2\i;),\~\)~'v I $ 63,00 $ I ~".. ~CJ'.oY,.O,\"" ! Print name of signing supervisor: I Ea~h~sign'?[,~H,tIine,}~~lll.1~J~:1V $ 63.00 $ I Signature of signing supervisor: I I SI;tg~~tj:Si7c~i~<!-t(a\~!"b-,it~(2~5~panel. $ 63,00 $ a era IQn.,\OJ e'i.~p,s] "n, ';"'J;"..\" I E' iV"d'd' ,'Y',', --",: (I) I $ 'I $ , ac a n!~!on!!.\tn~pectlOn: . 58.00, 1"_l€'i'Ytb"".-,~1't''''~T:':\\vA\''''*{~'''.'' ,4,.'....."........,._~."."..__+,.. -'----- "1'dj"-d<-,"'''''''':;.if'.''n..<;o:;-,;.'.'--vc'''' ',.., i'f:tWt'~~l;;,,;ffi~~'S!l\~;~i7]~~'~R_~~IC-ANffigJ.:J_S_Ef,~;Jji:~!~?;~~I~1tb~t~i::tti~ ". (A) Enter subtota' ,Of above fees $ r I (Minimum Permit Fee $58.00) 11 I (B) Enter 12% surcharge (,12 x [AJ) $ /312 I (C) Technology Fee (5%of[AJ) $ c:;~ 1 TOTAL fees and surcharges (A through C): $ I 2 9 a 7 , ,- $ ?S} $ I $ I $ I I I I I I I I 1 I I ~,' ~~O^- V\ S 'Q... <J;/ ~~' 440-2584,J (9/08/COM) Status Issued CITY OF ~rK11~GFIELD Building/Combination Permit PERMIT NO: COM2009-01404 ISSUED: 09/22/2009 APPLIED: 09/22/2009 EXPIRES: 03/22/2010 VALUE: 225 Fifth Street, Springfield, OR' , 541-726-3753 Phone' , 541-726-3676 Fax ' 541-726-3769 Inspection Line , t .. . SITE ADDRESS: 2780 NOVA ST ASSESSOR'S PARCEL NO.: 1703224403700 Springfield TYPE OF WORK: Bathroom " TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Remodel bathrooms Owner: Address: , ECKERSON CHARLES 2780 NOVA ST SPRINGFIELD OR 97477 OU \0 eo,\llles'l \)\I\M ~,," \8:.N1_ ()le90j'\_~, 101\\'1 ..,~,(J~'. v'-_~onO'.l ~"~,M~S'O.\~;':,,?~OU\- f>-\l~~, hCON'fRA€\f0R INFORMAl1I.0N'lt \0\\0~ \IOj'\V~":GGW "..-" leS 0'" ;eO\'lO\~V .:_ ContractOl;~o\\\lC~ 9S?..GG\ o'O\i'j'\ ~~~e', \\'Ie ~!t,\I:erl~t OWNER' Ij'\ 06 '{O\ll1'la.~ej'\\el. ~ 0" \)\I\\\l..,AA). OWNER GG:.~i\\"g \~~, ,\'Ie OI~~(\G'',)',)?.' "U"I:-B~iH\DfN'G iNFORMATION, Phone Number: 541-554-3803 Contractor Type Electrical Plumbing Expiration Date Phone " # 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 I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: _.f 'VB nla Frontyard Setback: Side 1 Setback: Side 2 Setback: ' Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION' \: W "i\"\\: ~~;~~ , Ce.. \' \:'f..?I\'\ CQ~J{.QflIRtD PARKING O"'i\\;.' S\"\fX\..\.. '0 ?"-",, a\'- Overlay DisM. ?\:\,-W\I"i ~a\:\'- "i\"\\ oa~.li: # Street Tree~Rlt~~a\'-ll\:D \) \'- IS ~'Pf>-~ Handicapped: Paved Drive ~qd:, .,\:~c,\:D a \,-laD. Compact: % of Lot Covec,agef,'" Cl D~'/ ?t. ~~'/ \~ I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: ;1 Page 1 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01404 ISSUED: 09/22/2009 APPLIED: 09/22/2009 EXPIRES: 03/22/2010 VALUE: , 225 Fifth Street; Springfield, OR ,541-726-3753 Phone, 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Hescriotion I I ~ I I I I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Rpp<. P'\\IU Fee Description : + 12% State Surcharge + 5% Technology Fee .. Add, Alter, Extend Circ Ea Add Fixture Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $27.00 $11.25 $30.00 $114.00 $81.00 9/22/09 9/22/09 9122109 9/22/09 9/22/09 1200900000000001086 1200900000000001086 1200900000000001086 1200900000000001086 1200900000000001086 Total Amount Paid $263.25 I Plan Reviews I i: 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. ~eoHire<Unsnection~ I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. I. Page 2 of 3 ' Status -.Jssued~..-----_.._.. 225 Fifth Street; Springfield, OR 541-726-3753 Phone" " 541-726-3676 Fax' " 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01404 ISSUED: 09/22/2009 APPLIED: 09/22/2009 EXPIRES: 03/22/2010 ' VALUE: By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is trne 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. r'" ~~.. 12 _ f)A~~ , Owner or Contractors Signature tj \' '. Page 3 of3 q-,),..2"'-/J q Date 225 Fifth S.tr~et Springfleld,-Oregon-97477 541-726-3759 Phone, .' :. ~ ~..::'::: ~. Job/Journal Number COM2009-0 1404 COM2009-0 1404 COM2009-0 1404 COM2009-0 1404 , COM2009-01404 Payments: Type of Payment Check cReceintl RECEIPT #: 1200900000000001086 , .,. " Description Fixture . '1 Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add :+ 5% Technology Fee ~ ". .'! , ,~\+12% State:Sur~harge '::1: , ,," ' ..' ~ :Paid" By;' , SUZANNE ECKERSON .;.r" :, " Received By djb Page I of I City of Springfield Official Receipt - , ,." -,--- Development Services Department Public Works Department Date: 09/22/2009 Item Total: <":heck Number Authorization Batch Number Number How Received I 03 In Person Payment Total: 12:15:19PM Amount Due 114,00 81.00 30,00 11.25 27,00 $263.25 Amount Paid $263,25 $263.25 9/22/2009