The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2010-3-29 Electrjcal Permit Application e 225 Fifth Street. Springfield, OR 97477 tPH(541)726-3753t FAX(541)726-3689 '. DEP~RTMENt USE ONl V . C:O,.c-1 20(0 . 002'02 Permit no.: . Date: '3 .z 1-/0 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. . '. ....l!.bCJl.l:G0VERNMENTA~p~OVAL\.:i;c'!. 'c,. Zoning approval verified? DYes D No <<.'; .',C,/\TEGORVVOFCQNSTRUCIION');",:., .' o Residential I 0 Government I 0 Commercial ~\),"3!1:\?,~tOBW.SITE;(INFQRMAtl()r\j?;ANp~,r:;O~C'A;tiOr\j~i...tif:~'j;; Job site address: t?071 Po~y-rtJ/1I Ill? 017 City: ">1>2.1 N i. F' ,6i-D I State: 0 e I ZIP: q"1 '-11 \3 Reference: /862. ol{z-z- I Taxlot.:CZ~ . .. DESCRIPTlONQFWORKi.,....." '0"" 'J1'\-c!cl jf'Cftvt. 8' c\,rUA'-~ ( r-' ~" :,;i~N,r~!'~A'i;,\~W~;~~r.:f.~:T1'l7:E:Ei,iSC.R E.PXtUEW't;;'?~~z!-i_i~:i~;j;,~t;i~~~t~~~Ii , . '. .' ..... '. Cost N~m~~r ~fi~spectio~.!p~rit~'r P. Qty. ,.'ea. Residential, per unit, service included: Total c.Qst ,_. 1,000 sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation .. 200 amps or less (2) $ 81.00 $ 'PROPERTYOWNER . '. 201 to 400 amps (2) $ 95.00 $ Name: ~A~Or-l tHiJ/2'r zJ ILL- 401 to 600 amps (2) $158.00 $ . - Address: 50T7 r~;2fE,Y-nj{A PZ. 601 to 1,000 amps (2) $205.00 $ City: ~Pf!IN{,.'(leLO I State: 07Z- TZIP: '"t7'1f1;~,. N ~~ r,vpltsq) $469.00 $ Phone:5/!3 -110- /!J0 -z.- I Fax: _ _ NOtific~~i ~~~SltB1d)i:(jl)the OrAt'I';.t,'::..~1 $ 63.00 $ E-mail: kg uti .3 ) fJ.. II H/V1ftlt... LLiNl ~~~:t 9 2=t:7!l~~ ~I\lk6<ll1l86&tt6~ IOn, alteratIOn, relacatlOn ThIS mstallatlOn is being made on residential or farm propertycalii 0 mQl"lli!H!lineCil~I';e oJ,;-' ...2-oot $ 63.00 $ owned by me or a member of my immfjdiate fal liY' This numb~ ,;ro;r,'tg'~~ JtWte) Ihe te,~,:,:::.."a uJ $ 87.00 $ property IS no~mt ded for s~le, ?l:an ,Ie , or rent OAK C ~C''' \.WIIIV /Il' 1m 479.540(1) an 560(l)./] IlIl9MSi~ _ ..0 cation $126.00 $ Signature: . ~\ / ~ .. Over 600 amps or 1,000 vo1!s, see s~rvices or feeders section above :C!(lNTRACtOR INSTAllATION. Branch circuits: new, alreration. extension per panei Business name: 0 W' Ale,^- a."FeeJor branch circuits with purchase of a service or feeder fee: .. . . .. ~::-:.: '~":' '~SignalCircu. it oralirriited;el1f"..~.p~ .e.I' I HIS op.t(~nslOn 2 ". AUTHORIZ (] . . ".; ti. I COMMENC - . 7 ANY 180 0 YJRERlOO:,btotal of above ees:>ii'. . (Minimum Permit Fee$S8.00) . '. (B) Enter 12% surcharge (.12 x [AD (C) Technology Fee (5% of [AD TOTAL rees and surcharges (A through C): Address: City: Phone: E-mail: CCB license no.: I State: I Fax: I ZIP: I BCD license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~,\ ~?;Ot.{<.Q/ ~ . ~ 440-2584-J (9/08/COM) Each branch circuit $ 6.00 $ b. Fee for branch circuits witho}lt ~urchase of a service or feeder fee: First branch, circuit (2) Each additional branch circuit I $ 55.00 $ S S I $ 6.00 $I.(l Miscellaneous fees: servic,e or feeder ':lot included Each pump or irrigation circle (2) Each sign or outline lighting (2) $ 63.00 $ 63.00 $ $ $ $ $ 63.00 $58.00 ~.;,):.: "',. $'t17 $/fbl $ l( 81 $ 113. 4 If Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00202 ISSUED: 02/23/2010 APPLIED: 02/12/2010 EXPIRES: 09/12/2010 VALUE: $ 10,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726.3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5077 FORSYTHIA DR ASSESSOR'S PARCEL NO.: 1802042202000 Springfield TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration PROJECT DESCRIPTION: Garage conversion- Family room to two sleeping rooms Residential Owner: Address: CHURCHILL JASON M 5077 FORSYTHIA DR SPRINGFIELD OR 97478 Phone Number: 503-710-1862 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ou\O o;U\leS ~ \)\i\\~ '>Nl~01\\' _ :\\O~I,~_uiI:;~;9' ~ -, \",\'\ , ,," \ " "'e .. fl.' tU\e~ (\W1, <hl0U", 0\\\' 'ir\~'" \O~,O~ \0(\ Ce .rjblff ~'fa~S \eva'f" \,\01fl,\'3~~o'2.-0~~ ~ig~~i.81~q\1l\\\'l i(\ O~ '10U ~ ce~e ~~~Z-'2..y.4). O()lB~\\1\g \\'1 \\'I~~ ~t1\'Oel \01 x~au~Type: (lU Ce(\ Energy Path: Sprinkled Building: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMA T10N . REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 9verlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: d~~ PUBLIC IMPR Street Improvements: Storm Sewer Available: Special Instruction: '" Notes: Three plumbing fixtures added, no new impervious area. Page I of 3 T ~. ,., "t.U" .il:' I',' ,. '":,;;1._ .~,"~ .,'C." ,. :~lji' ''f: "~;/:I , .,~, .... !-' i", 11.. . ,.J' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00202 ISSUED: 02/23/2010 APPLIED: 02/12/2010 EXPIRES: 09/12/2010 VALUE: $ 10,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 10,000.00 Value Date Calculated Description Total Value of Project $10,000.00 $10,000.00 02/12/2010 ~ "., Fee Description Amount Paid ~'\~t ' ~'{:'-$<:' " Date Paid Receipt Number ~ ~~'. ., " Plan Review Residential $88.40 2/12/10 1201000000000000131 + 12% State Surcharge $40.56, 2123/10 2201000000000000162 + 5% Technology Fee $16.90 ' 2/23/10 2201000000000000162 1st Appliance $79.00 2/23/10 2201000000000000162 Building Permit $136.00 2/23/10 2201000000000000162 Fixture $114.00 2/23/10 2201000000000000162 Sanitary Sewer - Improvement $154.32 2/23/10 2201000000000000162 Sanitary Sewer - Reimbursement $202.95 2/23/10 2201000000000000162 SDC Sanitary/Storm Admin $17.86 2/23/10 2201000000000000162 Vent Fan $9.00, 2/23/10 2201000000000000162 + 12% State Surcharge $11.64 3/29/10 1201000000000000269 + 5% Technology Fee $4.85 ,. 'r't" 3/29/10 1201000000000000269 Add, Alter, Extend Circ $55.00 3/29/10 1201000000000000269 Add, Alter, Extend Circ Ea Add $42:00 3/29/10 1201000000000000269 Total Amount Paid $972.48 I Plan Reviews , Initial Review 02/16/2010 02/16/2010 APP LLH Planninll Review 02/16/2010 ,02/22/2010 APP DDK No planning issues. Public Works Review 02/16/2010 02/22/2010.' APP TSS Three plumbing fixtures added, no " new impervious area. Structural Review 02/16/2010 0~/22/2010 APP CJC As noted on plans To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be rnade the same working day, inspections requested after 7:00 a.m. will be made the following work day. l....ReCluiredJnsnections , Foundation: After forms are erected but prior to concrete,placement. , Post and Beam: Prior to floor insulation or decking. Pa2e 2 on CITY OF SPRINGFIELD Building/Combination Permit 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 't)./,~( " r~ ",' '\:, PERMIT NO: COM2010-00202 ISSUED: 02/23/2010 APPLIED: 02/12/2010 EXPIRES: 09/12/2010 VALUE: $ 10,000.00 Status Issued Floor Insnlation: Prior to decking. Framing Inspection: Prior to cover and after all rongh 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. Underfioor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing: Final Plumbing: When all plumbing work is,complete. Underfioor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. . f'.t~ .' ,or '" By signature, I state and agree, that I have carefully.el<],mi'ned the completed application and do hereby certify that all information hereon is true and correct, and I further'ce'rtify !hat 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 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 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. . 29 /1./j'z, 20/0 Date Owner 0 " .L~~ :;;( i l \'1' ( :1 Page 3 of 3 225 Fifth Street Springfielcl, Oregon 97477 541-726-3759 Phone ~j~-~;"'~.' .. ..r fIk:. .'. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000269 Date: 03/29/2010 I :37:39PM Job/Journal Number COM20 I 0-00202 COM20 I 0-00202 COM20 1 0-00202 COM20 1 0-00202 Payments: Type of Payment Check cReceil1tl Description Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By JASON CHURCHILL Check Number Rec.eived By.~ Batch Number . d'b 1. " ", " 1.: ',r (; ~ \' .: 1~, '. . . .'.i' , "'.,.dl' . h ,,.,.,. " Page 1 of 1 Item Total: Authorization Number How Received Amount Due 55.00 42.00 11.64 4.85 $113.49 Amount Paid 1079 $113.49 $113.49 In Person Payment Total: 3/29/2010