HomeMy WebLinkAboutPermit Electrical 2006-10-13
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689. ~'-.J
ELECTRICiU- PERMIT APPliCATION
City Job Numberc.:5- 0 1(030 Date 10.- \3. -2<JOSO
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1. . WCATION OF nvSTALIATION ':. "1
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits arltnon-transferable and expire If work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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2. CONTRACTOR INSTAiLAT!ON ONLY:
EIec~::~:~ct~~-' L, 7/ Iii)( (:s Ek rfu c-
Address =:h3 ~h.. t~ bt
City ~I. it5~;.JL Phone 747-0311
Supervisor License Number
:'OOG,. 5
Expiration Date 10 - I ,.. 0 I
Constr. Contr. Number J 8 '3 ce,
/rg-Ol
Expiration Date
Signature of Supervising Electrician
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Owners Naf -xrv/LQ e,L ~0X QQ..xz)
Address Qg1.? -VUltfrY\.()'(\.i- -
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City' ~' 6 :ld Phone 4-1 -7570'
OWNER IN ' iT~
The installation is being made on .._...;/ I own which
is not intended for sale. lease or rent.
Owners Signature:
Inspection Request: 726-3769.
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3. ~.COMPLEfEFEESCHEDUfE}!EfOw:..'~:'.\l-:"',o,. . ',;
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A. "'l'i,ew:,Resi<!entla! -::; Single,or l\1ulti-Fa!DU)( per.'dwemiig unit. ~
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Service Included
1000 sq. fl or less
Each additional SOO sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$19.00
$SO.OO
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B. >'!s~rVic~~r Feed~ri-:~.iiiS~ll~ti~n;.~te~dons' or R~iOcatioD:
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200 Amps or less $ 63.00
201 Amps to 400 Amps $ 7S.OO
401 Amps to 600 Amps $12S.00
601 Aq/JQllH'o60Amps7.r~ If 'H~-9PJRK
Over Iml~~bliS SHAll E^nl\~;."~lSI~NnT
ReconnAlJ~rrR\ZED UNDER I M'" ~~~(6~B'R
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C. ' TemporarySernces 'If lieedus .' ,'-,.'.' . ' . ,
. "'. ANYl80 OAyrEtw. .'--... '.
InstaUatlon, Alteration or Relocation
200 Amps ar less $ SO.oo
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps.$100.00
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New Alteratllinlo,I.Exfe'.fsion.p,errPantt OAR 952-UU~1 . ~
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One Cireuit'l 952-0 - . ('~"i" 01 t$11i3:00
Ea JiIIAddi"': I eire"1 "bt'lhn. te\ephon~
c r,if: t1ona~' W orw, 'Note.tb.e . n.
Servi~~ 8r'E~der\Pcrmitlnter. \ '.Y r.S,)~\Q9atlon--,
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E. . Miscfli~g~cen~~~~.ll.<t)~iii:b'liistaU8tion~
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Pump or irrigation $ SO.OO
Sign/Outline Lighting $ SO.oo
Limited EnergylResidential $ 2S.00
Limited Energy/Commercial $ 4S.00
Minimum Electric Permit Inspection Fee Is 545.00 + Surcharges
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4. ,SUBroTALOFABOVE', '.
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7... l.:> 0
8% State Surcharge
I 0% A~strative Fee
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Shared Orive(T:)I8uilding FonnsIElectrical Pennit Application J-06.doc
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225 Fifth Street
.
Springfield, Oregon 97477
541-726-3759 Phone
. :j7P;-
Ut...
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C.f Springfield Official Receipt
~lopment Services Department
Public Works Department
Job/Journal Number
COM200S-0 1630
COM200S-0 1630
COM200S-0 1630
, COM200S-01630
COM2005-01630
Payments:
Type of Payment
CreditCard
cReceint 1
RECEIPT #:
2200600000000001437
Date: 10/13/2006
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
LH MORRIS
Item Total:
Lheck Number Authorization
Received By Batch Number Number How Received
njm 077044 Fax
Payment Total:
Page 1 of 1
9:43:36AM
Amount Due
43.00
9.00
2.60
4.16
5.20
$63.96
Amount Paid
$63.96
$63.96
10/13/2006
.
.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01630
ISSUED: 10/13/2006
APPLIED: 11/22/2005
EXPIRES: 04/13/2007
VALUE: $ 29,820.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1243 PIEDMONT ST
ASSESSOR'S PARCEL NO.: 1703264114700
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Remodel
Residential
PROJECT DESCRIPTION: Garage Conversion
Owner: HARPER GERALD L & MICHELLE M
Address: 1243 PIEDMONT ST
SPRINGFIELD OR 97477
Phone Number: 541-741-7570
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
OWNER
L H MORRIS ELECTRIC
OWNER
OWNER
License
08699
01838
Expiration Date
12/18/2006
06/08/2007
Phone
541-747-6638
541-747-0811
VB
BUILDING INFORMATION I
# ofStories:TTEN IIUI" Uleyu, lid'^' Lot Size:
.. .. I 'C..L~'IJ_eti \/,OU 10
Heigbt ofISti'uctu~6>> adopted by th~'b'.!t~~ Jllqox.:
Type o~'Heat:~at'IOn CelWaU Heats Sn FnndlFI~~~:Y
--...... Ilt:::a.Tqu er~ffiC'''''' c:.o.tf,...
Water 1iyne:\R 952 001 'iElectnc n Ft'Bfsement,1~
. 1'_, - - '" III 'moue "( '1180""
Range 1\ypej You may lec ric .~, Ft aragel€!i\1-port
v" ~ . oo'al" r.OP1€S ,,' .t' - , b
Energy Path:/lina th Path 1 "'q"Fr0ther:eS ~
Sprinkled B~I'lding: e cente'nA.l\lote: ~Cetp8iittKOlld:
flUB oar lor the OrAnnn I'WitH "'l,...:':__&~_
I DEVELOP!\o,r..'H mrORMATi0N"<rLl-332-2344). "-,"
REQUIRED PARKING
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:'
# of Bedrooms:
R-3
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% otfWtllfevc~age:
THIS PFRMIT Cu", -;C .
I PUBLIC tMMlD>'rEMf11''fI1Sr'ER TH"~';E'~ I Nt WORK
lIutVIWltNCED OR . e I MIT '.S NOT
Fully Improved ANY 180 DAY IS A~~m~M'ElJfuR
No PERIOD. DownspoutslDrains:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Speeiallnstruction:
Setback 5'
Curb and Gutler
Notes: No SDC fee interior remodel only no n~w fixtures 11/23/2005 CAS
Paee 1 of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description Tvpe of Construction
Garaee Conver. Garaee
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Building Permit
Miscellaneous Plumbing
Perm Serv/Fdr 200 amps or less
Refund - Admin Fee
Refund - Electrical
Refund - Surcharge
+ 100/0 Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Cire
Add, Alter, Extend Cire Ea Add
Total Amount Paid
.
.CITY OF .3rKH~\.JrIELD
Building/Combination Permit
PERMIT NO: COM2005-01630
ISSUED: 10/13/2006
APPLIED: 11/22/2005
EXPIRES: 04/13/2007
VALUE: $ 29,820.00
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$71.00
Square Footage
or Bid Amount
420.00
Value
Date Calculated
Total Value of Project
$29,820.00
$29,820.00
11122/2005
F'pp<, P'IiiJ
Amount Paid
Date Paid
Receipt Number
$164.87
$41.97
$29.38
$43.00
$15.00
$253.65
$45.00
$63.00
$-4.00
$-40.00
$-2.80
$5.20
$2.60
$4.16
$43.00
$9.00
11122/05
12/23/05
12/23/05
12123/05
t 2/23/05
12/23/05
12/23/05
12/23/05
12/27/05
12/27/05
12/27/05
10/13/06
10/13/06
10/13/06
10/13/06
10/13/06
2200500000000001608
2200500000000001739
2200500000000001739
2200500000000001739
220050000000000t739
2200500000000001739
2200500000000001739
2200500000000001739
VOUCHER # 98805
VOUCHER # 98805
VOUCHER # 98805
2200600000000001437
2200600000000001437
2200600000000001437
2200600000000001437
2200600000000001437
$673.03
I Plan Reviews I
Initial Review 11/23/2005 11/23/2005 APP LLH
Plannine Review 11/23/2005 12/14/2005 APP TAJ No Planning issues.
Public Works Review 11/23/2005 11/23/2005 APP CAS No SDC fee interior remodel only no
new fixtures 11/23/2005 CAS
Structural Review 11/23/2005 12/21/2005 APP DLM See documents for plan review
comments.
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
UeollirerUnsnections I
Foundation: After forms are erected but prior to concrete placement.
Paee 2 of3
.
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-01630
ISSUED: 10/13/2006
APPLIED: 11/22/2005
EXPIRES: 04/13/2007
VALUE: $ 29,820.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
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.
Final Plumbing: When all plumbing work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, t 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 witb
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.
I'
Owner or Contractors Signature
Date
Paee 3 of 3