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Home My WebLink AboutPermit Electrical 2010-5-3 Electrical Permit Application )." . c!'~' "';C"', "C' "_H,' 'C i.GJTY OF SPRINGFI:BVD, OREGON.-. ... ,':;. . ~. \..- ~, ",~~"l'""", * t' .., I -"...\, . . ,._" 225 Fifth Street. Springfield, OR. 97477+PH(541)726-3753+FAX(54t)726-3689 ~~ DEPARTMENT USE ONLY COUA.ZOIC- 00 ss-t Permit no.: Date: 5 -3 -/ 0 Tbis permit is issued uuder OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180 days of issuance or if work is suspended for 180 days. Each pump or irrigation circle (2) J( ) N (j- Each sign or outline lighting (2) : Signal.circuit,9I.~.llmited-energy panel, v E ~on, or extension (2) , AUTHORIZED UNDER T"~Kion: (I) COMMENCED OR IS A n;nlVll/ IllI'IUAp,PLlCANT USE ANY 180 DAY PERIOD (ATEAr.~'1~ ,t ," 9{a~i>-e fees . (Minimum\ Permit Fee $58.00) ~ \\) (B) Enter 12% surcharge (.12 x [A]) ~A' ~ (C) Technology Fee (5% of[A]) ~? I( TOTAL fees and surcbarges (A through C): 0:' lOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION "esidential 0 Government 0 Commercial JOB SITE INFORMATION AND lOCATION Job site address: '1 Z. ~ m A-N' S Fr{,,"'Z- ~ City: s:;:>,-=-b State:oiL. ZIP:'=Pt<?7 Reference: (70'SZs 3l( Taxlot.:c>Si6o DESCRIPTION OF WORK Ad tEll 7 Cth..,; r Name: Address: City: $: p ,=- Phone: E-mail: Center This installation is being made on'residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent OAR 479540(1) and 479.560(1), Signature: CONTRACTOR INSTALLATION Business name: e ASr SIDE ELEn/( IG Address: ~'ii).S:5 BO$C/l~E l.N. City: S P ~ CD State: oR. ZIP: '1 7 4 7'6 Phone: -7LfI-IV'19 Fax: -731:,-'1960 E-mail: RIC K{ "ST5/ilE C2 Y AHo6, Co /VI CCBlicenseno.: }lj'7'O BCD license no,: 16 -VOS-C Signing supervisor's 'license no,: LJ 7), 7 S O&E I~ Print name of signing supervisor: Signature of signing supervisor: ~~ ~~~ ~. 440-2584-J (9108/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) $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) Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit , I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee: First branoh circuit (2) Each additional branch circuit I h $ 55,00 $ 6.00 $.55' $J{" Miscellaneous fees: service or feeder not included $ 63,00 $ 63.00 $ $ $ $ $ 63,00 $58.00 $ 91 $ ID 12 $ 'f S ':l $ 106 '17 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00558 ISSUED: 05/03/2010 APPLIED: 05/03/2010 EXPIRES: 11103/2010 VALUE: $ 2,000.00 .';.r" r., 1':' , Status Issued 225 Fifth Street, Springfield, OR 541-726.3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 428 MANSFIELD ST ASSESSOR'S PARCEL NO,: 1703233405900 Springfield TYPE OF WORK: Bathroom PROJECT DESCRIPTION: Bath remodel TYPE OF USE: Remodel Residential Owner: WILLIAMS FAMILY REVOCABLE TRUST Address: 2870 RIVIERA CRT ' SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Plumbing I CONTRACTOR INFORMA TlON ~ Contractor License DUKES AND DUKES CONST 65060 EASTSIDE ELECTRIC INC ",T 117770 SUNSET HEATING & AIRINC 171706 DENNIS SCOTT EGGERS 142776 I BUILDING INFORMATION I # of Units: # of Stories: Primary Occupancy GroAl'TENTIOM/.Oregon law lIt~irl!&MW,JQure Secondary Occnpancy <fllIlmN rules adopted by th~eYt!lltyh Primary Constrnction liIotIIicatlon CMIler. Those IlMl,fort Secondary Constructio(rjIl)AR 952.()()1.()()10throum(;l& ;OO~-, # of Bedrooms: 0090. You may obtain COPi~pf~'t> ~s y calling the center. (Note~ il.P ~~~:ng: n/a IIUlIlb...fntoth.. o~catl!llt . Center is T INFORMA TlO~ Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLI,C',IMPROVEMENTS ~ ..{, ; Expiration Date 03/16/2011 10/04/2011 08/18/2010 05/0512010 Phone 541-747-3130 541-915-9828 541-988-3181 541-459-0110 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I:',.. Sidewalk Type: ..' NOTICE: ,.:.Do~~~I~~I!~,s!P'[,j'lg,~;" TH IS PERMIT SHAll EXPIRE IF THEWO~K ; AUTHORIZED UNDER THIS PERMIT IS NOrc COMMENCED OR IS ABANDONED FOR ' ANY 180 DAY PERIOD. """,,' Notes: Page 1 of 3 \';"" ':~ r '.'.! . " ,'\ 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ii"., . ~~~:: CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00558 ISSUED: 05103/2010 APPLIED: 05/03/2010 EXPIRES: 11/03/2010 VALUE: $ 2,000.00 Status Issued I Valuation Description I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Sq uare Footage or Bid Amount 2,000.00 Value Date Calculated Description Total Value of Project $2,000.00 $2,000.00 05/03120 I 0 ~ $42.96 $17.90 $79.00 $55.00 $36.00 $58.00....., "..~,., ,~ $9.00 ..", $20.00 $76.00c, $7.00, $18.00 5/3/10 5/3/10 5/3/10 5/3/10 5/3/10 5/3/10 5/3/10 5/3/1 0 5/3/10 5/3/10 5/3/10 Receipt Number 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 1201000000000000403 Fee Description + 12% State Surcharge + 5% Technology Fee 1 st Appliance Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Dryer Vent Fireplace (Listed) Fixture Gas Outlets 1-4 Vent Fan Amount Paid Date Paid Total Amount Paid $418.86 I Plan Reviews ~ 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.PeClllirecUnsnections ~ Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspection,s ,have be~n reqnested and approved and the building is complete. " . ,,", ~. ,,' Rough Plumbing: Prior to cover and including'required testing. " Shower Pan. Prior to covering and includingrequired testing. Final Plumbing: When all plumbing work is complete. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Paee 2 of3 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00558 ISSUED: 05/03/2010 APPLIED: 05/03/2010 EXPIRES: 11103/2010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rongh Mechanical: Prior to Cover i:~"" ..',,~ .. Final Mechanical: When all mechanical wo'rk.;s complete. . '(.!. :' Rongh Gas: After line is installed and reqnired testing and capped if not attached to an appliance. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signa lure, I state and agree, that I have carefully examined the completed application and do herehy certify that all information hereon is true and correct, and 1 further certify that any and all work performed shall he 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. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will he used on this project. I further agree to ensnre that all required inspections are requested at the proper time, that each address is readahle 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 ';m"'"""~~~_ ~~ Owner o(Contractors Signature Oat: ;' :. ,- '-\". 'nl! ~)I. , r;-'f!;. 0,'1 .,,::' " Page 3 of 3 225 Fifth StFeet Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000403 Date: 05/03/2010 2:38:08PM Job/Journal Number COM20 I 0-00558 COM20 I 0-00558 COM2010-00558 COM20 I 0-00558 COM20 I 0-00558 COM20 I 0-00558 COM20 I 0-00558 COM20 1 0-00558 COM20 1 0-00558 COM20 1 0-00558 COM20 1 0-00558 Payments: Type of Payment CreditCard cReceintl Description Building Permit Fixture I st Appliance Vent Fan Dryer Vent Gas Outlets 1-4 Fireplace (Listed) Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Amount Due 58.00 76.00 79.00 18.00 9.00 7.00 20.00 55.00 36.00 42.96 17.90 $418.86 Paid By DA VID DUKES Item Total: Check Number Authorization Rec~iycd By Batch Number Number How Received Amount Paid ;djb J;"."'~~~l .,:~itf ,", ;"~f.j; ~rrY" "jl 02069b In Person Payment Total: $418.86 $418.86 " ~.,., I)JV '. ',<,.. ';~','.: :1"". '.;':;' ~f,~?l:. I'e, Page 1 of 1 5/3/2010