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Home My WebLink AboutPermit Electrical 2010-1-8 225 Fifth Streett Springfield, OR 97477tPH(541)726-3753tFAX(S41)726-3689 I"'''.. ,-",..,'" '." '. .,." '., ".1 <:t'~tiE-RAiHMEN:t "USE ONLY' ,'"..",,:', -",",. ':Y:,~;', ",,<', "~' " '".,,-!,. - . . . I C1:'W'oz.oro - DOC:> SLfI Permll no.: I Date: I - ~ ~ 2. 0 I D 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. I Tr", ';';P'llbCALi':GOYERNMENT~Jl;RR.B.o.vAI1!!B',i\;17t(J\fv'):iil::1 lii;z~S!!l!~~i~~l!'f,ff,~~f;EEi!SGH E[jl;J[jE:l%1jlS..;\!~t~l!i~~~JF 1 Zoning approvalverifled? 0 Yes ... 0 No 11':~uni~er:Of;~;p~~iio:ri~'pe'rit~~:()!:,~.iIQtrl. '~fo~n\-I',rotal'" . I,."......."'.......".'.... '.. ,...'....C.A. "'.EGORv'."OF. '.".C.ONSTRUCT .JON.". ,,,,..;,,..,,.,...,,, ","',,,,::, ...."..,,:..,. ":.":',,,,,,;,'i'''.f',."~',,, '..'.'. " ,,,,',ea.,. ," cost.,:,. ,~,,:,^,~~:,~;:;,:'::'fi~ "1: 'I,::~' .il" " ~ , " ," '!e'?;>';" .'';:~{"'''".,;",r.,. l~'~es;dential" . 1 D 'Go~'emment" I D C;~mer~;:1 . 1 I Residential, per unit, service included: I . i~7:~~~:~~~TEb~'1MA~k!~~ION~~f~1~\H;: i ~~;;;~i~~~:II~~O(:~ft or portion :1::.::: 1 I City: S j> I::"~ 1 State:oIL.. 1 ZIP: '77'1.77 1 Limited energy (2) $ 32.00 $ 1 Reference,..\;~~I;~\~.w~;~~~~~:\':i:;,0~~\~ I ~~~~I~~nS~~~~~r~~~e~~:r(~)odular $ 63.00 $ J # ~ 4 L\,r~..... :- t--e: I Services or feeders: installation, alteration, relocation I I 200 amps or less (2) I $ 81.00 ] :PRO!"cERTY.QwNER' ..::', 1 201 to 400 amps (2) $ 95.00 '1 Name:., )oV\V\VUv fVlC.UMn !40Ito'600amps(2) $158.00 I Address: II U \ f\!\tUI ~,Jd A::'-Iv 60] to ],000 amps (2) $205.00 I City: SpV1'Yl~h.{;ld I State: 0 (2..,1 ZIP: CJiLf17 1 PhoneSdQ-(P7fl 3110 1 Fax 1 f' ~p~'awrequf;eslyou 0$ 63.00 1 - I 1 N If . 1111 U,tlULI . I E-mail: tft~s.mstt1.lfll.a.tion.re oeation . This installation is being made on residential or farm property In ~~10through OAR 152-0 ~ 63.00 $ owned by me or a member of my immediate family, This DC ll:!trllJ'.\Il~YmIn caples Ofl~e rules bv 87.00 $ property is not iptended for sale, exchange, lease, or rent. OAR :aJIUl9-tII8 center. (Nate: Ill.. \,... "VII 479,540(1) and 479.560(1), ^ / ,I _ '1Illlbllr1fill''l9I&'O'ieqon Utii' . $126.00 $ Signature: ~ I VU(;(~ I Over ~~ l& 1,~o,aa~4).:es orfeederssection above I. ; :'.' '. )cCO,!j4TRACtORi: INSTJl;l!.l:.A'f10N' , 1 Branch circuits: new, alteration, extension per ponel I Business name:- I a. Fee for branch circuits with purchase of a service or feeder fee: 1 Address:::;:;i\. 1 1 Each branch circuit I $ 6.00 I $ City: . i ,.J v . r State: J ZIP: b. Fee for branch circuits without purchase of a service or feeder fee: Phone: _ V 1 Fax: First branch circuit (2) I I I $ 55.00 I $5'<; I E-mail: Each additional branch circuit I ~ I $ 6.00 $ 1 ,a I I CCB license no.: I BCD license no.: I Miscellaneous fees: service or feeder n~luded I Signing supervisor's license no.: I Each pump or irrigation circle (2) $ 63.00 I Print name of signing,supervisor: I Each sign or outline lighting (2) $ 63.00 I Signature of signing supervisor: I Signal circuit or a limited-energypa~el, $ 63.00 $ , alteration, or extension (2) " NOTICE:.. .,;".-.I..Each additional inspection: (I) $58.00 $ XHIS PERMIT SHAll EXPIRE IF; N1l,;J;i.!i!m;;01ik~~;(f~~)i;8efr[c')i;NiJ'*usE~~til~i.-ifiii;;;'~~~7i~it:;'i UTHORIZED UNDER THIS PERMI ~subtotal ofabovelees ' , .-:;:::r--7..5 ;~~MENCED OR IS ABANDONED ~~i.wQ~m Permit Fee $58.00) $ -OJ I , 180 DAY PERIOD. . '(Illlnter 12% surcharge (.12 x [AD $ 'C57. = 1 (C) Technology Fee (5% of [AD $ ~- I TOTAL fees and surcharges (A through C): $ B 5'1 C( ( Over 1,000 amps or volts (2) $469.00 $ $ $ $ $ $ 1 I $ $ ~~\\) \: \"~ ~ 440.2584.J (9/08/COM) '!'.;\\; ;0\ Status Issued CITY OF ~rKll.jGFIELD Building/Combination Permit PERMIT NO: COM2010-00034 ISSUED: 01/0812010 APPLIED: 01/08/2010 EXPIRES: 07/08/2010 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 661 MALLARD AVE ASSESSOR'S PARCEL NO.: 1703221315000, Springfield TYPE OF WORK: Electrical Work Only TVPE OF USE: Addition Residential PROJECT DESCRIPTION: Add 4 circuits Owner: YOUNG JOHNNA M Address: 661 MALLARD AVE SPRINGFIELD OR 97477 Phone Number: 509-670-3770 ,; , I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: # of Stories: Primary Occupancy Group: R-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VB' ~llIr~pe: Secondary, Construction Type: ~'" ~U\t g)\.\~e: # of Bedrooms: O~'. 01e9011 b'/\"e Ole ll-~: ~~~ sado9'e~oSeCU\ell rJ6lUQ\'kJilding: nla l~..e )"" ,.. -1"9 ._~o'ci ;lo\\"ca\~;$,.oo\~~~{i@v~L~ 'NFORMATlON 1 \II O~" u tlIe.'I ob" I~O\r;. .\' ~O\\~U.\l ';.nan. ,0 ce!\\el, ~ I.I\W\\'# 4\.. Front yard Setback:UU~\\1I9 ",e "'It 0Ie90~.a3'2.-~~l[ay Dist: Side I Setback, ~ \OCo\ef \I \.&0 # Street Trees Rqd: Side 2 Setback: ce Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: .. Lot Size': Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: , Compact: );_l; I PUBLlCIMPROVEMENTS, Description Type of Construction . ;:.- . .~ . DownspoutslDnlins:';":"""""'"Q" ~v.. :. ': i\\C '}l'~ " rr(.?\~C W \1 \'2> ~Q\)C ,",O't\C;O\'J\\\ '2>\-\f>-\.\ \\-\\S ?C~~" rQ~ iS~.:\ ';' ..\.lIS ?l:.D _~D 'I\o\DCD . n ^ ,,\\\Q~"'\J .,..,;, ,cO' ,. . I Valuation Descrioti~~~J~~~ci~ ~~~~QD~'''''' -^l--!" '\'00 Dfl' $ Per Sq Ft . Square Footage V I . or multiplier . or Bid Amount a ue Sidewalk Type: Street Improvements: Storm Sewer Available: Special Instruction: Notes: . Date Calculated Page 1 of 2 Status Issued . "1' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid 1 Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add . . ~. Amount Paid Date Paid $8.76. $3.65 $55.00 $18.00 Total Amount Paid $85.41 Plan Reviews I 1/8/10 1/8/tO 1/8/1 0 1/8/10 CITY.OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2010-00034 ISSUED: 01/08/2010 APPLIED: 01/08/2010 EXPIRES: 07/0812010 VALUE: Receipt Number 2201000000000000016 2201000000000000016 2201000000000000016 2201000000000000016 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 Reollired Insneetions 1 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. I By signature, Istate and agree, that I hav~ 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 !lUd 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 wiV 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. c'~ Mc(~' Owner" #Contnlctors Signature Page 2 of 2 01' D'6'ID Date 225 Fifth Str.cct Springfi~ld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00034 COM20 I 0-00034 COM20 I 0-00034 COM20 1 0-00034 Payments: Type of Payment Check. cRcceintl RECEIPT #: .. ,p.~ ':;UN.~.FJ"L"':iii.'..' bk'!A . :"'r .' - ~ . "":""",~,,"~",,,.".w',- _.f City of Springfield Official Receipt Development Services Department Public Works Department 2201000000000000016 Date: 01108/2010 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By . BRADY MCCLAIN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1014 In Person Paym~nt Total: . J,.~ Pa?,e I of I 2:39:54PM Amount Due 55,00 18,00 8,76 3,65 $85.4 I Amount Paid $85.41 $85.41 1/8/2010