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Home My WebLink AboutPermit Electrical 2010-1-14 . Electrical Permit Application 'f 225 Fifth Street+Spdngfield, OR 97477+PH(54t)726.3753+FAX(54t)726.3689 I",\.",."e,'~', ',',',"'-, "e.e,' ,". "...,...,''". . ~.,',.,"," :p.f';DEf!ARTNlE:NJU$E, ONLY;, ,".. ~.. . ._ ,. _1..;,_. _' .... . ,.... . ~ '.' .' - I permitno~2DJ() -(}O{i<-/-;/ I Date: /- / 7~ ;;2DjtJ This permit is issued under OAR 9]8-309-0000. Permits are nontransferable. Permits expire if work is not started within ]80 days of issuance or if work is suspended for ]80 days. 'ij':L1bCAli:GOVE_RNMENT~~F?PR().vAEf~':'N~'iV.;l:J~\;!;1 I Zoning approval verified? 0 Yes 0 No I IJ\';":'f~;",,,~,!;'t,:f"'AT",E G'O', R",;'O' ""i"O'N' S"R"'C' '1" ,10' Nl,'%'h"-1',;,,.,..i:,;'e1j,,I ,., .,~;lJ>""'''R....".,,',,\J., _' .,.' :.H-,.._ _If_,...,.""..... ... ,'I: ..,U.. "'." _.,,,...~ .... ';.~P' " I 0 Residential 1 0 Government 1 0 Commercial' I r~::~:~:~:sl~E~~~Nl,~~~IK(jCJ\1!I(jN~lffl~~i1: 1 City ~Y\Q?e..,\d. 1 State: C)(2... I ZIP Q,1.f77 I 11.~~~~~~~ce: :"ESCRIPT'ION"'O' F"Wol RTKa~,I.~,:',:",~,,,;..,,,,,,,,.,,...~1 '. ". " , "', "'IJ .' ,", ; .' 'n"'.". '., . ';:~';1~'-.~~:~"v~.l{:,<:,;5~'I;~':'~'_-""',;~" I ::Cl^~k \ \ (\) \~)\J :nAM() Ovr~()L-\- fOr I I SoVv'\ DJV\'O I 'PROf'ERTY.,OWNER'. . I Name:::5.v(t.( V\\c..~ I Address: ;;;lS~ ~Ue.. I City: ~vv:fe.Lcl 1 State:0<2- 1 Phone: - - I Fax: 1 E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, This property is not intended for sale, exchange, lease, or rent. OAR 479,540(1) and 479,560(1), Signature: ~ I: ..' <:CONTRACTOR" INSTAt,"MION.: '. I Business name: R0.r!l~ bl~'C I Address: ;:).\"1\ I~'~~ ,~ue... I City: ~Sf-V\.e . 1 State: c:lR. I ZIP: ql LIO\ I Phone5-l1-% 86$/ I Fax5/1 ,~ BLj'S'-j I E-mail: avo\0-hoY\e\u.-\-(\.cf[J(.O\fV\CU-;.+....et I CCB license no,: Ii-CiOb6 I BCD license no,,: C "S'SL\ 1 Signing supervisor's license no,: ';'5d-\.+S I Print name of signing supervisor: t~.\\- S::.k... l t-Z- I Signature of signing supervisor: I\,{~~ I ZIP C{7477 I I ~~~ p. ~tfj5 ~0~ ~~<lt ~~ 440.2584-J (9/08/COM) '.,' 1:{~~~~t4~~~1:~~:~!~~~~:~~~-~~;~2;~,:~~~~~,~Zf~~~~J~~~:~r~l} 1'\~~mg,~f~"?$~TJ.pe,.~~~~;~~R~td.~~,m\f ;~~~#.i~':lg.t~ ~;I.!;,.{~~1:'~::i'.-;:I'-8;~9Sf(:,',: I Residential, per unit, service included: 11,000 sq, ft, or less (4) I Each additional 500 sq. ft. or portion thereof , I Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) I Services or feeders: installation, alteration, relocation I 200 amps or less (2) $ 81,00 $ I 201 to 400 amps (2) $ 95,00 $ I 401 to 600 amps (2) $158,00 $ I 601 to 1,000 amps (2) $205,00 $ lOver 1,000 amps or volts (2) $469,00 $ I Reconnect only (2) , $ 63,00 $ I Temporary services or feeders: installation, alteration, relocation 1 200 amps or less (2) $ 63,00 $ 201 to 400 amps (2) $ 87,00 $ 401 to 600 amps (2) $126,00' $ lOver 600 amps or 1,000 volts, see services or,feeders section above .' $134,00 $ $ 25,00 I I I 1 I 1 I I I I $ $ 32,00 $ $ 63,00 $ "I' I I I I I I b. Fee for branch circuits without purchase of a service or feeder fee: I $ 55,00 $ 51),''''1 $ I 1 I Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: I 1 Each branch circuit. 1 $ 6,00 I $ 1\ Each additional branch circuit I $ .6.00 'I Miscellaneous fees: service or feeder ':lot included I Each pump' or irrigation circle (2) $ 63.00 I Each sign or outline lighting (2) $ 63.00 I Sig'nal circuit or a limited-energy panel, $ 63.00' $ alteration, or extension (2) I Each additional inspection: (I) I $5~.OO $ [ 1ii"jf'GJ'<'Hlllill'cSl,,';".:l?i7!$'"A''ririi;'I'''A'N''",B'i''-S''' 'E"U,,'li:it"'",iW':";>';\!i:~;:;<"-""1 )1!~j?:k.\;.'\'~;0;:,,-~;,,~g;"'tf:t-,,~;'\ "1';:,'1:;1,,,;; '"':, , . ".:e.,::;,U - - ~?f,\'i>f'l-.ft.jJ'l,;;:,:,'lt~~J''*;:''io~!>.'?,il.~"'J (A) Enter subtotal of above fees 50< C. (Minimum Permit Fee $58,00) $ I (B) Enter 12% surcharge (.12 x [A]) $ &. <10 I (C) Technology Fee (5% of [A]) $ Z-- 'fa I TOTAL fees and surcharges (A through C): $ /~-J.. Kt(~ -' , First branch circuit (2) $ $ Status Issued 225 Fifth Str~et, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 25 SEWARD AVE ASSESSOR'S PARCEL NO.: 1703224400700 PROJECT DESCRIPTION: Sump for kitchen sink Owner:, NICKELSON JERRY D & JOYCE H Address: 25 SEWARD AVE SPRINGFIELD OR 97477 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00044 ISSUED: 01/12/2010 APPLIED: 01112/2010 EXPIRES: 07112/2010 VALUE: Springfield TYPE OF WORK: Kitchen TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION' Expiration Date 10/30/2011 06/II/20 10 Phone 541-505-8351 541-689-1711 Contractor Type Electrical Plumhing Contractor License REVOLUTION ELECTRIC, INC 179066 JENCOURT ENVIRONMENTAL SERVICES 1182531 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Sccondary Construction Type: # of Bedrooms: R-3 VB # of Stories: Height of Structnre Type of Hcat: Water Type: Range Type: Energy Path: Sprinkled Building: nla Lot Size: , Sq Ft J'st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragclCarport Sq Ft Other: Occnpant Load: I,DEVELOPMENT INFORMATION I I PUBLIC IMPROVEMm'lfIfSllvN: Oregon law requIres you.to . ,lmv\. ,Illes ~re(!.b~ the Oregon Utility , Notification C ~'fWOOl\IltiIes are set forth . , in OAR 952-00ir.ll.Q~lJ#Ir!W.B~(MR 952.001. 0090. You may obtain copies Ollhe rulee by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: - ,'~ Storm Sewer Available: Spechll InstJ,'uction: jl!(.;t:: NoteJ,'IS PERMIT SHALL EXPIRE IF THE WORK .uTHORIZEDUNDER THIS PERMIT IS NOT ~OMMENCED OR IS ABANDONED FOR flNY 180 DAY PERIOD. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: ' % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: - ' 1 I'\it ,I .-, r I Paee I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 I nspeetion Line ~ I', V ~Iuation Description .1 Description $ Per Sq Ft or multiplier Sqnare Footage or Bid Amonnt Tvpe of Construction .1'[ Total Value of Project J;'pp<.~ Fee Description + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid $6.96 $2.90 $19.00 $39.00 $6.96 $2.90 $55.00 $3.00 1/12/10 1/12/10 1112/10 1112110 1114/10 1114/10 1114/10 1/14/10 Total Amount Paid $135.72 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00044 ISSUED: 01/12/2010 APPLIED: 01/12/2010 EXPIRES: 07/12/2010 VALUE: Value Date Calculated Receipt Number 1201000000000000034 1201000000000000034 1201000000000000034 1201000000000000034 1201000000000000045 1201000000000000045 1201000000000000045 1201000000000000045 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, Rrfllvrprl In~np('tio~ Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. '.,,::~ . Paee 2 of 3 ':f~ Status Issued 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: COM2010-00044 ISSUED: 01112/2010 APPLIED: 01/12/2010 EXPIRES: 07/12/2010 VALUE: By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all 'information hereon is true and correct, and I further certify that any and all work performed sball 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, 1 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. .~" !, Owner or Contractors Signature Page 3 of 3 , Date " , 225 Fifth Str~et Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM20 I 0-00044 COM20 I 0-00044 COM20 I 0-00044 COM20 I 0-00044 Payments: Type of Payment Cred itCard cReceiotl RECEIPT #: 1201000000000000045 Date: 0111412010 Description Add, Alter, Extend Clrc Minimum/Adjustment Electrical + 12% State Surcharge + 5% Technology Fee r.id By MATTHEW SCHULZ Item Tot.l: Check Number Authorization Received By Batch Number Number' How Received NJM 035327 In Person Payment Total: , .. ~, "- . "'.1' ,'" Page 1 of 1 12:56:I2PM Amount Due 55,00 3,00 6.96 2,90 $67.86 Amount Paid $67,86 $67.86 1114/2010