HomeMy WebLinkAboutPermit Electrical 2010-2-10
Electrical Permit Application
I DEPA~TMENTUSE ONLY I
.PhQ~ ~ ., ,
WiL.. Permit no,: (71 rO/Q-'Qj)
Date: '2-/)!J/lo I
" . ,~ c '
CI:rv OF SPRINGFIELD, OREGON
, "..~' ,~ " , . -
225 Fifth Street+Springfield, OR 97477.PH(54t)726~J753.FAX(54I)726-3689
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is Dot started within 180
days of issuance or ~rwork is suspended for 180 days.
[" LOCAL GOVERNMENT APPROVAL I, FEE. SCHEDULE
I Zoning approval verified? D Yes D No IN~m-lJerOf inspections. per item:( ) _ '. -'IQ~.1 ~t
I .,CATEGORY OF CONSTRUCTION I
1 Residential, per unit, service included:
1 Q!fResidential 'J 0 Government I 0 Commercial
I, .' JOB'SITEINFORMATION AND, LOCATION I 1 1,000 sq. II. or less (4) ,
Job site address: /6:J I V ~t\ S; '1' ' I ~~~~oaritional 500 sq. ft. or portion 4
Cily: Sn"'~ ,t.:':"1::( I State:~ I ZIP: 97 '1:77 I Limired energy (2) I
[ Rcreren~e: (:t':I't .2..()O~ - CJ f &-03 1 Taxlot.: / I Each manufactured home or modular
I , DESCRIPTION' OF WORK I dwelling service or feeder (2) .
I/') 1 1 Services or feeders: instal/ation, alteration, relocation
~SW f~ I JVC.-,-Cl,(,.
1 1 1 200 amps or less(2) $ 81,00 $
I, --' PROPERTY OWNER' I 1 201 to 400 amps (2) $ 9S,OO $
1 Name: U2.-l-F- G. rHo\. Ii. IT' 1 I 401 to 600 amps (2) $158.00 $
1 Address: 1 1 601 to 1,000 amps (2) 1 $205,00 $
1 City: I State: I ZIP: 1 I Oyer, 1 ,009 amps. or ~0Its(2).. '1 $469,00 $
1 Phone: S:-"/ftf"'o-JJorl Fax: I I Reconnect only (2)",''',., ' F' 1 $ 63,00'1$
1 I Tem~~ary. '-~~~i(es ~r' ieeder's;:ihit~,'JiiJ/jbii, alleratio~, relo~alion
E-mail: t'~
This installation is being made on residential or farm property 1 200 amps'or,less (2r",;,q~ :"'.: $63;00; $
own.e~by ine ofa:inember o(niy iinrii'ediatefamily. This - __. I 201 to'400 am~s (2); $ 87.00 $
pr.operty is not intendc9-.forsale, exchange; lease, or rent. OAR
479.540(1) and 479,560(1), ' I 40,!10. 600-,II11Ps.<D, ?'" .., '_ $126,00 $
Signature; lOver 600 amps or 1,000 volts, see serVices or feeder~ ~ection above
.. CONTRACTOR INSTALLATION 1 Branch eireuits: new, ai/era/ion, extension per panel
Business name: .:z;ck.r$'~ E le<- -J~f:- I a. Fee for branch circuits with purchase of a service or feeder fee;
Address: I?.!J, noy 7J<-{2. 1 Each branch circuit 1 $ 6,001 $
I City: S4-l/.l..v-t I State: c.:!J/t. I ZIP: -=, 7 :Yo J' I b. Fee for branch circuits without purchase of a service or feeder fee:
I Phone: J2>::!>J7'':>-2.2...2..71 Fax: ~3,;193-97L'1... I First branch circuit (2) I $ 55001 $
I E-mail: I I Each additional branch circuit I S 6,00 I $
I CCB license no.: it? I;L, I BCD license no.;,2 C('-:.J~ I Mist:ellaneous fees: service l!r feeder not included
I Signing supervisor's license no.: V r' / -S I I Each pump or irrigation circle (2) $ 63.00
I Print name of signing supervisor: tl-t ClC (,+>4-t?tt, ill Eac~ sign o! o.H!-'in" lighting (2) , $, 6~.pp
I S.'".,~:, "'f".. "'/'=. ~.:'.I '::,"..'i..-' !r.:.,., r.""." I I-SignalCirCuitoralimited-energypanel
, Igt:ta~E~ 9.,slgn~ng,~,up'eJ:VIsor:;~..:;i?;:::-1:;~I',~ . a.Jteration;'oc'extension (2) , ~ 6~.0~ ~
1 y'. :,. _it?l~:(':.,_~,I""'~' .., '-'li:>;.;t/:l:!I}I..:,:,I'~'.fj.._,. I Each'additio~alinspedion:(l) ':$58:00 $
-;'\',j,
I
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I
$134.00 $/3'1 I
$ 2S,OO $ t.:1::> I
$32,00 $';)J--I
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I ,!,.;,'" ..,; .,.-","...'APPUCANT'uSE '"" ,',;, ,,", : I
I::C $ ic"bj
,"'~-. .
I ,$' /, '1.2..1
I $ (3.30 I
I $j ,1:-2.ij.
$ 63,00
$
$
$
"J~l!'
...., :.\..,...) .
i. '.!r,'
~w.~
tJ.~Q/
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I (A)'.Enter subt~ial:of above fees
.(Minimum, PerR'!it,Fee S58.00)
1 (B) Enter 12% surcharge (.12 x [A])
1 (C) Technology Fee (5%nf[A])
1 TOTAL fees and snrcharge. (A through C):
440,2584,J (9108ICOM)
, \, ~,\~' ,)
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01/27/2010 15:12
5033939722
125 FIIUI StrNi.SprtEllrldd, OR 97"77.PH(S41)716,.J75.hFt\.X(~I)71'..3689
INTERSTATE ELECTRIC
PA ,E 01
. , ,. I DEPARTMENT USE ON L Y
~ I Penn it no.:
I Da~ J "
Tbis permit is issued under OAR 918--309..0000. Pumlb arc nontra1lderable. 1 ~ermitJ upire Irwo",~ls not started wit-bi [( 180
day. of issuance or if ..orkis suspended for 180 days.
,1
1
1
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1 Scrvkes Of C tdr",: JHSlaUalion, ol,eralion. ,.efrx:aJjOtl
I I 200 amp. or~" (2) $ 81.00
PlItOPERTY OWNER I I 201104oo"/'ps (2) $ 85.00
::r-r2PF- G. n,.....li. Tr 1 I 40llO 600 mjIp. (2) $158.00
I Address: I I 601 to 1,000 F'P' (2) UOs.aO
I Cil>: I State: I ZIP: 1 I OVOJ' 1,000. np, or ".Its (2) _.00
I-Phone: ~4, I d'ifo -J-fbl-I FIlX' I I R.e<;onnect 0' Iy (i) ,S 83.00
f E-mail: I I.TcJ;IIporary: tnriu!I or ked,-": ;,,~ta"allon. a/luation. r~Jc. -;:(11;011
This installation is being made,oo resideotial or farm.property I 20U amps or os, (2) I I $ .3.00 I ,
owned by me or a memberofroy immediate family. This I 201104oo~P, s (2) I I $ 87.00 I ,
property is not intended, for sale, exchange, lease, or renl. OAR
479,540(1) and 479.560(1), I 40110600 ps (2) I $126.00 I ,
S igna1ure: I Ov~ 600 am lS or 1,000 volts, see service:5 or feeders section above
I CONTRACTOR INSTALLATION J8",..b ...., I..: new, o/"'",/;on, .."n"jnnp.,_1
I Busincssname: .z.krl'~ E /".<- j.."....;'C-, , )!L Fee fur bn tlch circuits wjth purcha!le of il se1"Yicc or fee~ fe~:
I Ad,""ss: A.tJ, /JO'l<' 73<-12 I I E..hbranteire.j, I I $ 6.00 I '
City: SAllUrt ' ____I-stiilc: <Cr(LI ZIP: <;;'7::70 J I I b, Fee for,br"eh cire.its withoo' purchase ofa servi"" 0' fe, kr ree:
/,hone:_.r-ort'.:>_-:22:L71-p",,: ~""'J"Y}-97L'LI I Firstbran1CirCUi,(2) .. I I $ 55'001'
\' E:[Oail:----- I Each IllIdl nal branch .m:..1 $ 8,00 I
CCB liQ.":J1se no.: I (? (2., I BCD license 00.:.2. c..r-.:J~ I Mb.c:e)bDeol . tees: service o,.feeder""l incJwkd
I Signing .upervisor's Ucense 00.: <i r' / ..5 I EaclI pump 0 . irrigatiou circle (2) S 83.00
Print o"",e of .ignjng supervisor: Ji,r c /'- (,~I? / J I leRChsi"" or '"tline ligl>tiuS (2) $ 63.00
I Signa] ..ircui' or l!Ilimited-encrn p8flcl, (' 83.00 i
SignaturEofsigningsupavi50r: - --- ~ a1teration,or,;xtcoslon(2) ~
I J;a.b DdcU1DII.,pe<liOD: (I) - . $&8.00 I
I : APPLICANT USE
I (A) Enler otu.l of abov~ fus
$~'.bb
(Minimum en.il Fa $53.00)
I (Il) 5..., 12~ surchllIse (.12 X [AD
I (e) TeeboDlcto- Fee (6% of[A])
I TOTAL r.... and ,ureba'll.' (A tllrougb C):
I LOCAL OOVEAdIINT APPROVAL
I Zoniog approval verified? 0 Ves 0 No
I CATEGORY OF-CONSTRUCTION
I ""Residential I 0 C',overnrneot 1 0 Commercial
I JOB SITE L, "0 ",.IIATlON AND LOCATION
Job site address: I" J I V ~A s,. ,
I City: S"...~.. .t.:-....br I State:c:...<l I ZIP: 97<1'17
I Reference: ~.;;. :2,,00'1 - 0 f 6-a::S I Taxlot.:
I DEBCRlPTlON Of WORK
I A/PU ~ rs"c....r:..~)
I
I Name:
HO-Z'''oj...J (~roerc(}M)
,.'
.. ~
I I FEE SCHEDULE
I N..berof+".f perl_ll IQIy.1
IIl~idototial. Per uah, IIervke IDeluded:
11,000 sq. 'n, <Ir less (4)
I Each additjohlSOO sq. fL or portiOn
thl;:.reof
I Limited ener .y (2)
Each manufn ~ home or modutar
dwelling !.Ie.., ice or feeder (2)
J
Cost
...
Total
cosl
5116.00
ifJ'f
f
4
I I
I
$ 26.00
./-:1.:>
S 32.00
:);2..
$ 83.00
I
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I
I
$~ ( 'i'J.,
S IJ.30 I
$_". .2.:4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54J-726_3676 Fax
541-726-3769 Inspection Line,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01805
ISSUED: 01/11/2010
APPLIED: 12/1712009
EXPIRES: 08/0512010
VALUE: $ 219,528.00
SITE ADDRESS: 1631 VERA ST
ASSESSOR'S PARCEL NO,: 1703243103800
Springfield TYPE OF WORK: Single Family Residence
PROJECT DESCRIPTION: Single family residence
Owner: EMMETT JEFF
. Address: 1539 CANAL ST
SPRINGFIELD OR 97477
TYPE OF USE: New
I CONTRACTOR INFORMATION I
Contractor Type
General
Eleclrical
Mechanical
Plumbing
Contractor
ADAIR HOMES INC
INTERSTATE ELECTRIC INC
INTERSTATE ELECTRIC INC
3T PLUMBING INC
License
593
117121
117121
147077
BUILDING INF<?RMA TION I
# of Unils:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construclion Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
I
R-3
U
VB
3
19,00
Wall Heal
Electric
Electric
nla
I DEVELOPM,ENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay riiSl:
# Street Trees Rqd:
_... "
I'aved Drive Rqd:
% of Lot Coverage:
10.00
12.00
28,00
14.00
0,00
, Floodplain
3
Yes
37.57
Residential
Pbone Number: 54J-840-8508
Expiration Date
03/J9/2010
09/05/2010
09/05/20JO
03/04/20 II
Phone
503-645-1156
503,393-2223
503-393-2223
503-932-2719
I! Lot Size:
Sq Fl 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Fl GaragelCarport
Sq Ft Other:
Occupant Load:
7,405
1,952
809
REQUIRED PARKING
Tolal:
Handicapped:
Compact:
2
I PUBLIC IMPROV~~1l:1 '~~ E IF THE WORK
Street Improv~ION: Orego'1!f\W ~!L<t!Jires'you to THIS P[KMIT %~~I yUl S NOT
follQw rules adopted'b'y''hIJ'O'?il'd'BII Utility AUTHORIZED I,lNDER I::> t'ERMIT I Curbside 7'
Storm Sewerl'M:f1fli!~lOn Center, Those rule~ aIee~etfo.rth COMMENCED l1trfS''A'8~wro FOR Curb and Gutter
Speclallnstr'll'i'6>JlR 952-o\ltp..m.l~o\l'gwO'A'fI:g~~~fje AY PERIOD.
0090. You may obtain copies of the rules by ANY 180 D
Nores: calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332'2344).
Paee J of 4
'..i;i;",\'~
_S~R!N~I!lII!J,._qi'_
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Status
Issued
225 Fifth Streer, Springfield, OR
541,726-3753 Phone
541,726-3676 Fax
541-726-3769 Inspeclion Line
Description
Tvpe of Construction
Gara2e/Misc
SFlDuplex
U VB Utilitv
R-3 VB 1&2 Familv
Fee Description
Plan Review Residential
+ 12% State Surcharge
+ 5% Technology Fee
Temp Power 200 amps or less
+ 12% Slate Surcharge
+ 5% Technology Fee
] st Appliance
2 Baths One or Two Family
Addressing Assignment
Building Permit
Curbcut Permil
Exhaust Hoods
Fire SF Fee - Residential
Plan Review Major - Planning
Plan Review Residenlial
PW Disc - 2nd Permit
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvemenl
SDC MWMC Reimbursement
SDC Sanilary/Storm Admin
SDC Tran Reimburs-Residenlial
SDC Tralls Improvement-Resident
SDC Transportation Admin
Sidewalk Permit
Storm DrainagC'!mpervious Area
Vent Fan
WiIlamalane Single Family
+ 12% Slate Surcharge
+ 5% Technology Fee
Low Vorlage - Residential
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
1'\'
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT.NO: COM2009-01805
ISSUED: 01/11/2010
APPLIED: 12/17/2009
EXPIRES: 08/0512010
VALUE: $ 219,528.00
I Valuation, Descriotion I
$ Per Sq Ft
or multiplier
$37,72
$96.83
Square Footage
or Bid Amount
809.00
1,952.00
Value
Date Calcnlated
$30,515.48
$189,012,16
$219,527,64
12/2812009 '
12/28/2009
Total Value of' Project
J;'pr<'~,
~~':
Amount Paid
$J,037.41 '
$7.56
$3.15
$63.00
$J99.46
$J 00.96
$79,00
$337,00
$38.00
$1,197.15
$88,00,.
$13,00
$138.05
$2J 1.00
$-259,26
$-30,00
$617,30
$8J 1.8J
$10,00
$1,044.54',,.; , .. ".
$101.97 ";
$176,86'
$2II.2J'
$931.65
$74,24
$88,00
$1,293,59
$36,00
$2,858,00
$31.92
$13.30
$32.00
$134.00
$100.00'
Date Paid
Receipt Number
12/17/09
12/28/09
12/28/09
12/28/09
VII/IO
VIllI 0
VI VI 0
VII/IO
VII/IO
VII/IO
VIlIIO
VIlIIO
VIllI 0
VI VI 0
VII/IO
Vll/IO
VJ VIO
1/11/10
III VIO
VIllI 0
VII/IO
VII/IO
VIllI 0
V] VI O'
VII/JO
VII/J 0
VIllI 0
VII/JO
VI VI 0
2/J01I0
2/10/10
2/10/10
2/10/10 '
2/10110
3200900000000000814
220090000000000J430
220090000000000J430
2200900000000001430
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
120J000000000000027
120J000000000000027
120J000000000000027
J20J000000000000027
J20J000000000000027
J20J000000000000027
120J000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
1201000000000000027
]201000000000000027
120J000000000000027
J201000000000000027
120J000000000000027
2201000000000000132
2201000000000000132
2201000000000000132
2201000000000000132
2201000000000000132
Pa2e 2 of4
Status
;.;;,-"
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01805
ISSUED: 01111/2010
APPLIED: 12/17/2009
EXPIRES: 08/05/2010
VALUE: $ 219,528.00
Issued
, :-..'
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
:~': :
Total Amount Paid
$]],789.87
Plan Reviews I,
Initial Review
, 12/22/2009
12/22/2009
OK
DJB
Structural Review
J 2/2 9/2 009
. J 2/29/2009
WE KLK
Completed Jst slructural plan
review, Adair to provide enginering
for /loor/ledger system.
PlanniD!! Review
J 2/22/2009
12/30/2009
APP DDK
Submitted delaHed LOMA
document shows that the proposed
structure is not within a Special
Flood Hazard Area. See attached
documents. 3 Street trees required:
I - 16th Slreet, 2 - Vera.
l.:ttt;,' "';,
Structural Review
12/3 J/2009
12/3J/2009
WI KLK
Public Works
Public Works Review
12/30/2009
01l05/20JO
APP LKW
Storm water to curb via weephole
Structural Review
12/22/2009
01107/20JO
APP CJC
As noted on plans- review by Kip
Kaufman
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 I Rf>nilirlflol~prtillfnli', I
Temporary Electric: Approval required prior to Utility Company energizing pole.
Ufer Electrical Ground: Install ground rod al footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms arc erecled but priol;loconcrete placement.
Post and Beam: Prior tonoor insulation or decking.
\;-, ,
floorlnsulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials,
framing Inspection: Prior 10 cover and after all rough in inspections have been approved.
Walllllsulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Roof Sheathing/Nailing: Before covering sheathing with finish material.
Paee 3 of 4
CITY OF SPRll~tjl<u.LD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01805
ISSUED: 01/11/2010
APPLIED: 12/17/2009
EXPIRES: 08/05/2010
VALUE: $ 219,528.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541"726-3676 Fax
541-726-3769 Inspeclion Line
Final Building: After all required inspections have been requested and approved and lhe building is complete,
. ' .j~; " . ' ;. '
Underground Plumbing: Prior to filling the 1I'5nch and including required tesling.
Perimeler Foundation Drains: After graverind filter c101h is installed but prior to backfill.,
UnderOoor Plumbing: Prior to insulation or decking.
UnderOoor Drain: Prior to covel' or placemenl of concrete,
Rough Plumbing: Prior 10 covel' and including required testing,
Water Line: Prior 10 filling trench and including required lesting,
Sanilary Sewer Line: Prior 10 filling trench and including required lesting,
Storm Sewer Line: Prior 10 filling trench,
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Covel'
Final Mechanical: When all mechanical work is complele.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Ufor Eleclrical Ground: Install ground rod at footing and call for inspeclion in conjuction wilh footing and/or
foundation inspection.
Rough Electric: Prior to Covel'
Electric Service: Approval required prior t~ ~tility'c~mpan; energizing service.
'('.:!. ';!. .
, "
Low Voltage: Prior to covel',
<; i
Final Electric: When all electrical work is complele.
Curbcut" Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed,
By signature, I state and agree, that I have carefully examined'the conipleted application and do hereby certify lhal all
information hereon is true and co....ect, and I furlher certify tbat any and all work performed shall be done in accordance wilh
lhe Ordinances of lhe City of Springfield and the Laws of the State of Oregon perlaining 10 the work described herein, and
lhat NO OCCUPANCY will be made of any structnre wilhout permission of the Community Services Division, Building Safety.
I further certify thaI only contractors and employees who are in compliance with ORS 701.005 will be used on lhis project.
I further agree to ensure lhat all required inspections are requested at the propel' time, that each address is readable from the
street, that the permit card is located al the front ,of the property, and lhe approved set of plans will remain on the site at all
times during construction.
Owner or: Contractors Signature
Dale
. ~:" '
t: ,; .'1 ~t ,
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Pa2e 4 of4
225 Fifth Street
Springfield, Oregon 97477
'541-726-3759 Phone
Job/Journal Number
COM2009-0 1805
COM2009-0 1805
COM2009,Ol805
COM2009-0 1805
COM2009-0 1805
Payments:
Type of Payment
Check
cReceintJ
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
2201000000000000132
Date: 02/10/2010
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Low Voltage - Residential
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
INTERSTATE ELECTRIC, INC
Item Total:
" Check Number Authorization,
Received By I Batch Number Number How Received
njm
. 17837
By Mail
Paymenl Total:
"
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Page I of I
I :26:00PM
Amount Due
134,00
100,00
32,00
31.92
13,30
$311.22
Amount Paid
$311.22
$311.22
2/1 0/20 I 0