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Home My WebLink AboutPermit Electrical 2010-4-21 Electrical Permit Application CITY OF SPRINGFIELD, OREGON 22S Fifth Slree.tSpringfield, OR 97477tPH(S41)726-37S3tFAX(S41)726-3689 DEPARTMENT USE ONLY i2~:D~ . *" Date; t:!9 - /1))..2- ~U-(O Penn it no.;'- - 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 I so days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? ISZr Yes 0 No CATEGORY OF CONSTRUCTION (;!{Residential I 0 Government I D.Commercial JOB SITE INFORMATION AND LOCATION Job site address; ~?\1 1 Ut , ~-r City;......... - "",...,. -r-... I State; hr7_ I ZIP; "'l71..J,17 Reference; (7D 33 57 '3 I Taxlot.; OS? 0,-> DESCRIPTION OF WORK ~PLhTfr1 r-. ,. A. ... -~. /11 Fort.. ~/DeNq- ~/N~'-~ ~,..;, PROPERTY OWNER Name;J6HtJ AMI)en.:sov / CA(l.I1../~ .1,.,.. ~ Address; 513, It./. srf'Z..GG<r City; <~.... ....-. n I State; O~. I ZIP; C17LR"] Phone;sW 13-" ~~7 I Fax; - '- E-mail; FEE SCHEDULE . Number of inspections per item () Qty. Cost Total ea. cost Residential, per unit, service included: 1,000 sq. ft. or less (4) yo' $134.00 $ I 3CJ Each additional 500 sq. ft. or portion V' $ 25.00 $ &5' 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) feJ $ 81.00 $ 20) to 400 amps (2) . $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over) ,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alleration. relocation Th" II' . b . d .d. I < 200 amps or less (2) $ 6300 $ I~ msta atlOn IS emg ma e on resl entia or lartn property . owned b~ me or a member of my immedi_te family. This 201 to 400 amps m'ft $ 87.00 $ property IS not Intended for sale, exchan~e, lease, or rent.,OA ~ 479.540(1) J'ld 479.~~ (I). I _ tLN.. ~ ~ /~ . te 0.\\WI '!.' (UtIlItY $126.00 $ Signaturd l,fthl J tJ..p ~... 7 . !1dOP e~ ~ I; ~~ts, see services or feeders section above CONTRAI trOR INST ALLA ' . . ,_,,' ceote 1 ~g" . stlfation. extension per panel Business name; _. . ~w;:"A.R 952.-00\'U ... tl'dO'llift;t~ _~~ith purchase. of a service or feeder fee: Address; /''"'It.J.I ,..1 C-'" _ ' Q090.. '{O~:~"~eo er . ~ . $ 6.00 $ City; ~ - I State; I *9\"~';f 10f the ~I e ircuits wilhout purchase of a service or feeder fee: Phone; _ _ .; I Fax; _ _ cef\\'" First branch circuil (2) $ 55.00 $ E-mail: ' Each additional branch circuit $ 6.00 $ CCB license no.; I BCD .Iicense no.; Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervis.or: ,~<Y D \Y {\~.~ k:t,.~r ~. ~ 440.2584-J (9I08/COM) Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal. circuit or a li~ited-energy panel, . '" _or; ,to $ 63.00 $ alteratIOn, or extension (2) ,-..-'1v:."'i; n:'.tfl> '"'. Each additional inspection: th" . ~..qo $ -=:;; };' t~~~,\)i ER~~~~lt) fO~.i '5: $ J 5 ~ /tM~X[A])' $ /.,0 ~~.\~~Q~e~ (5% of[A]) $ 7 'I TOTAL fees and surcharges (A through C): $ I 'il L ~ I V\..o' -. . . . . . . '. ." . . Construction Contractors Board 700 Summer St NE Suite 300 PO BOI 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: t!1-i7):2- ~~; :)7 Date: l1!&(! a / Address: Issued by: 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 appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ~1. ~. 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 1T2..4c:... 't S t-4 rr H (Name) Ic').J.:J(p I (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. 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 information is correct and that I have read and do understand the Information Notice to Prope 0 ~ers about OlD tru tion Responsibilities on the reverse side of this form. " 1)'.'" , x 1ni ~, /i) , (Date) Property_owner. doc 06-01-04 '7 .,.' f ,\ ". ,\ Actnng 2l~ Y omrOwltll GeHM~r21R COltlltractOlr? - ...... ' INFORMATION NOTICE TO PROPERTY OWNERS ABOUT,..CONSTRUCTION RESPONSIBILITIES ~. - \ (. - ~ \ ' .J , , . , - 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 contractor 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. Em]lJlnoyer Res]lJlonsibillities , ' You will, in most instances, be ruled to be an "employer",and the contractors you contract.wit,h wi.1l be "employees" if you use contractors nqt licensed wi,th ,t,he Const!:uc!ion Contractor~ 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 followi.ng: '.. . ' . .' 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 y.rithholdthe 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 Employment Department at 503-947-1488. '. The Oregon Business Identification Number (BIN) is a combined number for b()th Oregon' Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formspav.htrnll for the appropriate forms. "': ..:.: . . Workers' Compensation Insurance: As an employer: yo~ a~e subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties 'and be liable for ail claim costs ifone of your employees is injured on the job. For more information, call the Workers'Compensation Division at the Departrnent"of Consumer and Business Services at 503-947-7815. ...... ." U.S. Internal Revenue Service: As an employer, you must 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 theinveb site at www.irs.M_", ,- , Otlb1er Re~lPonJ1Sibmties :.mdl Areas oj[ COInlcer)ms . Code Compliance: As the p~t holder for this project, you are responsible for resolvilig'any failure to'meet code requirements that Il)llY 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 over spray, water damage from pipe punctures, fire or work that must be redone. ' ' . Time: Make sure you have sufficient time to supervise your employe.es, ".. " '. Expertise: Make sure you have the skiils to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions cail the Construction Contractors Board (503-378-4621) or write the agency at PO Box ]4140, Salem, OR 97309-5052., " t Property_owner .doc 06-01-04 ../., ,.,:. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01752 ISSUED: 04/0112010 APPLIED: 12/08/2009 EXPIRES: 10/09/2010 VALUE: $ 69,330.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 587 7th ST ASSESSOR'S PARCEL NO.: 1703351305700 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration PROJECT DESCRIPTION: Moved house- utility hookups and interior modifications- Historic District Residential Owner: ANDERSON JOHN/JACKSON CARRIE Address: 5877TH SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION . Contractor Type General Electrical Contractor '", TRACY ROBERT SMITH ' OWNER ~', , BUILDING INFORMATION, License Expiration Date Phone 541-606-2442 3 # of Stories: _ Lot Size: Height of Structure Sq Ft 1st Floor: 1,152 Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type:' .Sq Ft Garage/Carport EJI!f~~.al:\Veg'on law requires ~iiiiq Ft Other: ~~~tL~~!f%~=fpY the ~etiOrfl\"cupant Load: I DE./~tov~W~6 :~'::"~ 0090. You may ~~;rr (Note: theteleptlone REQUIRED PARKINC cal)ffil\RS6i~r~~90n Utility Not\ficatlOft Total: nU~e~\>Tw'~fs"flllDO-332-2344). Handicapped: Pave~9WJ Jrqd:, Compact: % of Lot Coverage: # of Vnits: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VB Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ".i ,,"_ Street Improvements: Storm Sewer Available: Special Instruction: I PVBLlC IMPROVEMENTS ~ i '.:'~ . Fully Improved". Yes' Sidewalk Type: Downspouts/Drains: Curb and Cutter Storm water to curb Notes: NOTICE: ' IF THE WORl< THIS PERMIT S~~i~ ~~~ERMIT 'S NOT AUTHORIZED U~R IS ABANDONED fOR' COMMENCED . . ,,'co ANY :\80 DAY PERIOD. ' .' . :;':~'>..."'~~;<}\'~L~~~~;ff.:~?V ~ Page I of 4 .-~~I.tIN~l;lf!l,,~, 1Ik~~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line DescriPtion Tvpe of Construction Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fcc Building Permit Fire SF Fcc - Residential Fixture Moved Structure Plumbing Conn + 12% State Surcharge + 5% Technology Fcc Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Total Amount Paid I nitial Review Plaonine: Review CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01752 ISSUED: 04/01/2010 APPLIED: 12/0812009 EXPIRES: 10/09/2010 VALUE: $ 69,330.00 I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project ~ Amount Paid Date Paid $365.72' $88.16 $36.73 $562.65 $57.60 $114.00 $58.00 $19.08 $7.9;C,:;:' $134.00,;"., $25.00" - ,!~t. ~ :'!" 12/8/09 4/1/10 4/1/10 4/1/10 4/1/10 4/1/10 4/1/10 4/21/10 4/21/10 4/21/10 4/21/10 , .~ $1,468.89 I Plan Reviews , 12/09/2009 12/09/2009 APP LLH 12109/2009 12/09/2009 WI TAJ Structural Review 12109/2009 12/10/2009 APP CJC Public Works Review 12109/2009 lU.1612009 . APP LKW :..r' - ,: It'" ". ., r" .;> "', Paee 2 of 4 Value Date Calculated Receipt Number 2200900000000001359 2201000000000000300 2201000000000000300 2201000000000000300 . 2201000000000000300 2201000000000000300 2201000000000000300 1201000000000000371 1201000000000000371 1201000000000000371 1201000000000000371 "Hard Hold" placed on parcel. Unable to enter structural review. I will speak with Molly and Tara about hold, 11m reviewing the Historic approval on this and then will meet with Tracy to discuss it. In the meantime, 1 gave the BP tile to Matt for PWE review, with the request to' return to me when they are done with their review. Tara Pending other depertment reviews Storm water to tie into existing system ~~~'N'~"-D ~ w.:., ' 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: COM2009-0I752 ISSUED: 04/01/2010 APPLIED: 12/08/2009 EXPIRES: 10/0912010 VALUE: $ 69,330.00 Status Issued Plannine: Review 01/05/2010 01/05/2010 APP TAJ This house move and conversion of l1 duplex to a SFR was approved through a Type II Historic Review DRC2006-00043. The work as proposed under this building permit is covered by that approval. Any other exterior changes (e.g. expansion of the front porch, addition of wheel chair ramp, etc) will need to go through another historic approval. Please contact Tara Jones (736-1003) if you have any questions. ,>.t.:,~ "' ~.~ ,'- 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. l....PeCluirerUnsnections ~ Foundation: After forms arc erected but prior to concrete placement. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Shear Wall Nailing: Before covering sheathing with finish materials. Post and Beam: Prior to noor insulation or decking., . . '.-~ . Final Building: After all required inspections have been requested and approved and the building is complete. Undernoor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. ./ '. ; ;1. ,j, f ;'paee), of 4 "If -(~. :\ ) CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01752 ISSUED: 04/01/2010 APPLIED: 12/08/2009 EXPIRES: 10/09/2010 VALUE: $ 69,330.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 dnne 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 structnre without permission of the Cominunity 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 reqnired 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 Date Paee 4 of4 City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone RECEIPT #: ;r '. 12010Q~9000Q1000371 9:17:58AM Date: 04/21/2010 Job/Journal Number COM2009-0 1752 COM2009-0 1 752 COM2009-0 1 752 COM2009-0 1752 Payments: Type of Payment Check cReceintl Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 12% State Surcharge + 5% Technology Fee Amount Due 134.00 25.00 19.08 7.95 $186.03 Paid By TRACY SMITH CONSTRUCTION Item Total: Check Number Authorization Received By Batch ~umber Number How Received djb 2602 In Person $186.03 Amount Paid Payment Total: $186.03 ;)':)iH '~tri1 :;i;-7!' ',r." . v.' !"1.~.1 . ~ ''''"', l......h '-l.tH, ,N.:'J., . :1;.)" , . Page 1 of I 4/2 1/2010