HomeMy WebLinkAboutPermit Electrical 2010-4-21
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. Ei~ctrical Permit Application
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.,ClTrOF. SPRINGEIEL])~',QREGON.
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225 Fiftb Street+Springfield, OR 97477+PH(54t)72&-3753+FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.:
Date:
This permit is issued under OAR 918-309-0000. Permits are nont~ansferahle. Permits expire if work is not started within 180
days ofissnance or if work is snspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Ves 0 No
CATEGORY OF CONSTRUCTION
o Residential 0 Government 0 Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 'Ot)l(' D fr
City: State: t9/l.-.
Reference: Taxlot:
PTION OF WORK
PROPERTY OWNER
Name: ~.........(Il,.s 1/1/1/ uc..
Address: '3 :2- 'Z. ~~V..el)
City:C.t~ State:O~ ZIP:" 1.7-
Phone:
E-mail:
This installation is being made on residential or farm property
,owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479:540(1) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION
Business name: e A.ST .5/D e EL (<-TrUe
Address: ~ iJS 3 130SC/lG-E IN,
City: 5 P f (D State: 0 R. ZIP: '1 7 lJ 7/5
Phone: - 7lf/-/Y<19 Fax: -75/,1(960
E-mail: RK/(c",S751i)E (Ql YAHoo. (OM
CCBlicenseno.: )li'7jO BCD license no.: 10 -VOS'c
1./7J.7S
oG-Ef(.
Signing supervisor's license no.:
Print name of signing supervisor:
f( Jlv (j-
(6;
Signature of signing supervisor:
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440-2584-1 (9I08/COM)
FEE SCHEDULE
Number of inspections per item () Qty. Cost Total
ea. cost
Residential, per unit, service included:
1,000 sq, ft. or less (4) I $134.00 $11'-1
Each additional 500 sq. ft. or portion "Z- $ 25.00 $)Z)
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 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see ~ervices or feeders section above
Branch circuits: new, alteration, extension per panel
a Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch cirsuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
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 limited~energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $141(-
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $~~
(C) Technology Fee (5% of [A]) " $ q~
TOTAL rees and snrcharges (A throngh C): $ "2./~'t!.
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00493
ISSUED: 04/22/2010
APPLIED: 04/21/2010
EXPIRES: 10/22/2010
VALUE: $ 147,096.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1004 53RD ST
ASSESSOR'S PARCEL NO.: 1702283402400
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Single family residence
Contractor Type
General
Plumbing'
CUMMINS INVESTMENT~~lf<NTION:..Oregon Jaw requires you to
31221 OSPREY RD follow rulesadopted by the Oregon Ut'l1Iy
LEBANON OR 97355 Notification Center. Those rules are set ;orth
In c;_~. R ::2 BS 1 631 (1 1I11UUYII UJo\" t:fo~.U01.
OO~~ii~~~~~?if!i.~:':.~=~.."
C number for the Oregon Utility N~ilil'...titm
ontractor Center is 1-800-33 _ 1l"CII"'"
DA VIS CONSTRUCTION SERVICES d:~34 60347
JOHNS PRECISION PLUMBING 158279
BUILDING INFORMATION I
Expiration Date
06/1412010
02104/2012
Phone
541-868-6294
Owner:
Address:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I # of Stories:
R-3 Height of Structure ] 8.00
U Type of Heat: orced Air Electric
vIJI'JOTlCE: Water Type: . Ele'ctric
THIS PERrvRlTn9MAtteEXPIRE IF TH~IM!lIllK
:y.,UTHORIZ~~l:HI.S PERMIT IS NOT
COMMENcW'lWletS~~lI!eONED FOr<a
AN~!~~NFORMATlON I
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Lot Size: 4,746
Sq Ft 1st Floor: 1,352
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport 429
Sq Ft Other:
Occnpant Load:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
24.00
5,00
5.00
10.00
17.50
O~erlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
2
Yes
37.30
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Sidewalk Type:
Fullv Improved Curbside 5'
Yes Downspouts/Drains: Drywell- Provide
storm draius from structure will drain to drywell. Impervious driveway will ddlilyt'lllllw:dgineeemg
Storm Sewer Available:
Special Instruction:
Notes:
. '. Page I of4
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Gara2eIMisc
SF/Duplex
U VB Utility
R-3 VB 1&2 Familv
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
2 Baths One or Two Family
Addressing Assignment
Building Permit
Curhcut - 2nd Curbcut
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Heat Pump
Plan Review Major - Plauning
Plan Review Resideutial
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sauitary/Storm Admin
SDC Storm - Improvement
SDC Storm - Reimbursement
SDC Transpo Improvement
SDC Transpo Reimbursement
SDC Transportation Admin
Sidewalk Permit
Vent Fan
Willamalane Single Family
+ 12% State Surcharge
+ 5% Technology Fee
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Total Amount Paid
,I ,.."
'~,'
I V aluation Descri~tion I
$ Per Sq Ft
or multiplier
$37.72
$96.83
Square Footage
or Bid Amount
429.00
1,352.00
Total Value of Project
~
Amount Paid",'""
$166.33 . .
$86.41 '
$79.00
$337.00
$38.00
$904.11
$-45.00
$88.00
$9.00
$13.00
$89.05
$17.00
$211:00
$587.67
$485.02
$637.85
$10.00
$22.63
$1,333.57
$101:97 ",
$101:51..
$56.86 :
$80.54 "
$931:65.
$211:21
$92.05
$88.00
$27.00
$2,858.00
$22.08
$9.20
$134.00
$50.00
$9,833.71
Date Paid
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/1 0
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/22/10
4/23/10
. 4/23/10
4/23/10
4/23/10
Pa2e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00493
ISSUED: 04/22/2010
APPLIED: 0412112010
EXPIRES: 10/22/2010
VALUE: $ 147,096.00
Value
Date Calculated
$16,181:88
$130,914.16
$147,096,04
04/2112010
04/2112010
Receipt Number
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000385
2201000000000000397
2201000000000000397
2201000000000000397
2201000000000000397
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00493
ISSUED: 04/22/2010
APPLIED: 04/21/2010
EXPIRES: 10/22/2010
VALUE: $ 147,096.00
225 Fifth Street, Springfield, OR
541-726'3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plaonine: Review
04/21/20 I 0
Plan Reviews ~
04/21/2010 APP DDK Minimum Setbacks. See letter
attached.
04/21/2010 APP BJG Storm water from structure will
drain to drywell.
04/21/20 I 0 APP CJC As noted on plans
Public Works Review
04/21/2010
Structural Review
04/21/20 I 0
,
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. wilLbe made the following
work day.
l.JtenuiredJnsnections'
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground roq.,M footing and call for inspection in conjunction with footing andlor
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior'to cover.
Drywall: Prior to taping.
Masonry:
Final Building: After all required inspections have been requested and approved and the building is complete.
Undertloor Plnmbing: Prior to insulation or decking.
Undertloor Drain: Prior to cover or placement of concrete.
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Rough Plumbing: Prior to cover and includiI~g:requir~d testing.
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Water Line: Prior to filling trench and inchl!ling required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Paee 3 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO: COM2010-00493
ISSUED: 04/22/2010
APPLIED: 04/21/2010
EXPIRES: 10/22/2010
VALUE: $ 147,096.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Final Plumbing: When all plnmbing work is complete.
Underlloor Mechanical. Prior to insulation or decking and including required testing.
, i ~; . ~ . 'i ,
Rough Mechanical: Prior to Cover ., ,.
,..; ,
Final Mechanical: When all mechanical work'is complete.
r,,:
Temporary Electric: Approval required prib'r to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
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 described herein, and
that NO OCCUPANCYwill be made ofany structure without permission of the Community Services Divisiou, 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.
1rz,/(O
Date
Owner or Contracto s Signature
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. I" ' . Page 4 of 4
225 Fiah Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000397
Date: 04/23/2010
IO:55:49AM
Job/Journal Number
COM20 I 0-00493
COM20 I 0-00493
COM20] 0-00493
COM20 I 0-00493
Payments:
Type of Payment
CreditCard
cReceintl
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
SCOTT DA VIS'
Received By
cjc
Check Number
Batch Number
" It-
\i t.
,.
Page I of I
Item Total:
Authorization
Number How Received
Amount Due
134.00
50.00
22.08
9.20
$215,28
Amount Paid
'05524d In Person
Payment Total:
$215.28
$215.28
4123/20 \ 0