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Home My WebLink AboutPermit Electrical 2006-8-11 ~!..:t.'> I" ~, ~... ,- ~ '. '." 'i'~ . ,', \~. . CI=rY OF, SPRTht...)IELD, OREGO~ . iI~ '" 1(,,, ZON ~,~ INITIALS N M DATE 5(-11' l~ SOURCE(Y'v.I (':?.t'~G 225 FIFTH STREET. SPRINGFIELD. OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT A PP11r"" TIOlj City Job )'lumber COWl '2(>06 ::- 0.0 67 7. Date 1. LOCATION OF INSTALLATION: II..{ 5"2 /) tl:-d ~O'^ +- 3. COMPLETE FEE SCHEDULE BELOW LEGAL DESCRIPTION: 1703, ZS-::J Z. 03'700 A. New Residentiai - Single or Multi-Family per dwelling unit. Service Included Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1000 sq. ft, or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 JOB DESCRIPTION: UJ. L{ c(rc<-^--:-'K $ 19.00 $50.00 2. CONTRACTOR INSTALLATION ONLY' B. Services or Feeders - Installation, Alterations or Relocation: City Phone 200 Amps or less l --- 201 Amps to 400:Amps. 0 $ 75.00 I" '... "" re 401 Amps.to~600:AmPad gOn law,,,..,, '. $125.00 l\il.~'~'~"'f:_ ;.... Opted b,-"es Va 601 Aml1s, toJ 00. 01<Xmpsler. Th Y the o,,,,.,~IH.\joo '" ~AH <:)<;" r _'. 0 "On U Over LOO.o.Atrips1Volil\'-OOI0 th Se rUles ".,~1 .~IJY Vvv Y'" ro tr""U"'rth Reconne\OtJOnlyJ may obta' u9h 0.1':' ~ 50:U\1 "<t ling th In Co " v:>2-00 nu e center Pies of the 1- mbef.J~ .. . JNfl'''' th rUles b C. Temporary 1;er\uc~C9rJiec~et'S e teleph Y Center is ;.agon Utility Non one . . lon()~._'1.~ IICatlon 1nstallatoon, AlteratIOn or ReI ''''D44), 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 40 I Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. n. Branch Circuits $ 63,00 Electrical Contractor Address Supervisor License Number _ . ~ l ~ V" V Expiration Date Constr, Contr. Number Expiration Date . Signature of Supervising Electrician OWNER INSTALLATION \ . New Alteration or Extension Per Panel One Circuit I . $ 43.00 , _ L/ J " B\l:8111ll~onal Circuit or with ~ C, 3 c I Sfmsef9EAMffrSiermit -> $ 3,00 I i r~ r.:.<<-1>f'<Y\ AU]:ttG~ HALL EXPIRE IF THI= E. MtJiM 6~,l.W~Re7f<1ffl"r'f't!lMrfl~qflK..ach Installation CEO OR IS ABANDD NOr- 7uI ~ (5q~ ~S/XpW~\{dilER/OO, NED FOR $ 50.00 '., o Sig'fiutline Lighting $ 50.00 Limiteo Energy/Residential , $ 25.00 Limited EnergylCommercial U' $ 45:00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Name ft-;~ / Address ( C-( ~ ---- '--- City S f7 F Phone The installation is being made on property I own which is not intended for sale, lease or rent. 8% State Surcharge 10% Administrative Fee 5% Technology Fee 52 Ll/b <~ ZbO b37b owne~ ) Inspection Request: 726-3769 4. SUBTOTAL OF ABOVE TOTAL Shared Drivc(T:)/Building Fanns/Electrical Pcnnit Application 8-06.doc Status . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1452 PIEDMONT ST ASSESSOR'S PARCEL NO.: 1703253203700 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00679 ISSUED: 08/02/2006 APPLIED: 06/02/2006 EXPIRES: 02/10/2007 VALUE: $ 15,768.00 Springfield TYPE OF WORK: Single Family Residence PRO~ECT DESCRIPTION: Garage conversion TYPE OF USE: Alteration Residential Owner: BREEZE EASTON Address: 1452 PIEDMONT ST SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Contractor OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VB Fronlyard Setback: Side 1 Setback: Side 2 Setbaek: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: \ Phone Number: quireS 'IOU 0 . oregon laW re on U\ili\'{ ^'f,FN110N,. . ,.rl h\l \\W Oreg _.. fnrth ._11.....\'" ru\e~ ou.....r; -n"r"Ic,e rU\e~ u'_- ('52-00~. I TV1HM€:rOR INFORMATiION 'I) les b'l \.. 95Z'Uu ,'V_, 0 ies 0\ ,''v ru in O!>.R obtaIn c ~I.~ '_\eph~"e. . D 090 You ma'l (NO~,c'ense " ,t(1tP.~rahon ate o . . the center. Ut'lit" Notl\lca calling oregon \, ) ber lor the. 00_332-2344 . num Center \5 1-8 BUILDING INFORMATION' 541-514-4055 eel Phone # of Stories: Height of Strueture Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Electric Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: nla Occupant Load: I DEVELOPMENT INFORMATION , REQUIRED PARKING . .~T1CE: Overlay D, ~QERMIT SHALL EXPIRE IF~a,~ORK # Street Tr II. ~'f.jWfed: Paved Drivllli(fa ORIZED UNDER THIS PER 9l).1p.acf: % of Lot c~lAENCED OR IS ABANDONE rUli ANY 180 DAY PERIOD, I PUBLIC IMPROVEMENTS1 Sidewalk Type: Downspouts/Drains: Setback 5' Curb and Gutter Fully Improved Yes Notes: Existing structure no fixture~ 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 -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge Appliance Not Listed Building Permit MinimumlAdjustment Mechanical + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00679 ISSUED: 08/0212006 APPLIED: 06/0212006 EXPIRES: 02110/2007 VALUE: $ 15,768.00 I Valuation Descrintion , $ Per Sq Ft or multiplier $73.00 Square Footage or Bid Amount 216.00 $15,768.00 $15,768.00 06/0212006 Value Date Calculated Total Value of Project F",,<, PIilLI Amount Paid Receipt Number 1200600000000000792 1200600000000001187 1200600000000001187 1200600000000001187 1200600000000001187 1200600000000001187 1200600000000001187 2200600000000001122 2200600000000001122 2200600000000001122 2200600000000001122 2200600000000001122 Date Paid $100.23 $10.00 $19.92 $15.94 $9.00 $154.20 $36.00 $5.20 $2.60 $4.16 $43.00 $9.00 6/2106 8/2106 8/2106 8/2106 8/2106 8/2106 8/2/06 8/10/06 8/10/06 8/10/06 8/10/06 8/10/06 $409.25 I Plan Reviews I Initial Review 06/06/2006 06/06/2006 APP SKG Planning: Review 06/06/2006 06/09/2006 APP TAJ No Planning issues Public Works Review 06/06/2006 06/07/2006 APP CAS Existing structure no fixtures 617/06 CAS Structural Review 06/06/2006 06/27/2006 APP RWC 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. I R"nllir"rll~ 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. Paee 2 of 3 . . CITY OF SPRINtd<lt.LD . Status . Issued Building/Combination Permit PERMIT NO: COM2006-00679 ISSUED: 08/02/2006 APPLIED: 06/02/2006 EXPIRES: 02/10/2007 VALUE: $ 15,768.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line Ceiling Insulation: Prior to COver. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanieal 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 deseribed 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 durif)uct[) y: ~ fer 0 ;; '--->-- '>--- ' Owner or Contractors Signature Date Paee30f3 -'. \ .: ", ," ". ." . - . onstruction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: C.OWl z:_ (;- C> 0 67<7 Address: /LfSZ. H~d.-o.A ~ Issued by: J::::(('" Date, o/~ftb Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the app,vp,;ate blanks and initial boxes I and 2, and either box 3A or 3B: ~1. tt 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above i Notice to. Property Owners out Ii; ( 1:>-(0- 010 ~ignature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) rmation is correct and that I have read and do understand the Information onstruction Responsibilities on the reverse side of this form. P.or...,_owner.doc 06-01-04 A~_~nnn~ ~~ Y'1ll1If((J)Wnn <GlennleJY'~ll C!~JY'~~~@JY'? INFORMATlbN NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contrac10r to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. JEmJlllnl!)yeIr Re!!lJlllI!)IID.!!ln1b1m~fie!!l You will, in most instances, be ruled to be an "employer" and the contractors you contrac1 with will be "employees" if you use contractors not lice,nsed with the Construction Contrac10rs Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the foUowing: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employmen1 Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and'.... Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.slate.or.us/fonnsnav.htmll for the app.. ....1".. ~ate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and mus1 obtain workers' compensation insurance for your employees. If you fail to obtairi workers' compensation insurance, you could be subject to penalties and be liable for all claim cos1s if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you mus1 withhold federal income tax from employees' wages......- You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at www.irs.l!ov. OltJmell" JResjpollJl.sJilbiJillJiltJies ~lllIlI.dl AlI"e2S of COllJl.cems Code Compliance: As the permit holder for this projec1, you are responsible for resolving any failure to meet code requirements thaI may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint ovcr spray, water damage from pipe punctures, fire or work thaI mus1 be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the al'l" VI" ;ate limes so 1hey can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner.doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone · Wii:;;:~~ '. > ~ 'I'. ~ ,......,., ... ,'''''''''' '..x C~f Springfield Official Receipt ~opment Services Department Public Works Department Job/Journal Number COM2006-00679 COM2006-00679 COM2006-00679 COM2006-00679 COM2006-00679 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200600000000001122 Date: 08/10/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee + 5% Technology Fee Paid By BREEZE EASTON Item Total: <.;heck Number Authorization Received By Batch Number Number How Received djb 002691 In Person Payment Total: Page 1 of 1 10:23:09AM Amount Due 43.00 9,00 4.16 5.20 2,60 $63.96 Amount Paid $63,96 $63.96 8/10/2006