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Home My WebLink AboutPermit Electrical 2003-10-2 ; as submitted has the tollowin~ ~t require specific land use LDR fiRQrova 225 FIFTH STREET . SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 Laning ELECTRICAL PERMIT APPLICATION City Job Number CofH c.c,c"] - DC":';' j 7 ( Date c.:T~~P~;~{6~~r~1~~~~i;~~~'~!~r~ . H'';) 'i~ \':~;:~.i ..e~~It~~~'ntion or Relocation \.o:-l'l' k.).~e9v. s,t 0 .r 00' \\'~~ ~~~~ eec \ $ 50.00 Constr.Contr.Number ILf4l.t?'i<;-S .~\.O\~ge6\;)'l ,46>>}~S't0' ~.ps $69.00 - "\;..\,\\"< ',<>-009' .\\,oSI::'~(fi~s.~6~~p~ $100.00 Expiration Date -.ie../;) '=<- Lil.'.t.\ (J1e'D" c->",,:2I';,,\ () ~\\ 41.@S ~e"Q ..r?l."'-Ooo V It "B" b _ " \\O"~ \ '..1 ()V. cVIVt:r w-lD 0 s see a ove. "0\\ \\0' ,,0" -0.\'0- . N.. . Signature of Supervising Electrician' i ~\\\c?;. c,'..~~,\.J ,',' 0'0\ " ~!i&llSi\t,lts ...\0 ....0.J ~3-j \e'" .~\\ 0,1'[0 " ~ \ 0 "i0\) e Ce0 O,eC:J.~~~(>>1reration or Extension Per Panel ( . 1""\2;'\:1' r\ ~\".,e 9.l'v.. '" r:; ..s.~r \)v _\:\\"\'0 ,/'{ \\, . c- \'vne CIrcUIt , ./" CP~,'Oe\ \J('0\~~ I Each Additional Circuit or with C", ,L/'~.l 00 r Service or Feeder Permit Owners Name -::c. ell ~ ,t.' ."Lq,fv{,(. , C~ IA-(~ f2d E. 1. Lg9ATIONOFINSf4M1i01'f ' . ."-7 l.t' '.j... ".......... . .., _">:> OJLt-,/vl h/t-,--"';'- ....1:"- LEGAL DESCRIPTION i 701_ I '7~ II JOB DESCRIPTIONw O~~ fc-:;O CO L~ Jc-, 1-/-;7 (-'C:-- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor D~v<2A~\~ ,;d C{ech-Ct1I~ Address p. 0, AO'f.. LfDScfr City G:"~~ 9 7YMPhone !:ffr.;~ 9078'- Supervisor License Number ~'i( (0 ~ LC-14 I 0 I, J as Expiration Date Address '/vz'?,- C-D .:>) City el,,\..C--c--~ve Phone OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 IQ=,Q3- 02, ~ ._..::> a-cDate - I/O / /0 ~L ,- , .J r--..W I-\uthonzec' Signature .__n__ 3. . CCl-/l''IPLETEFEESCIIEDULE BELOW A. pcr d'rycllingunit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. 200 Amps or less 201 Amps to 400 Amps 40 1 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 43.00 $ 3.00 Installation P~mp or i~gatiJ'!\0,t- \~.:':l\~ \S \~\ $ 50.00 ", S~g~~~~Hlt.~:lli~~t~8?t~,\~.\,,\ \~C)\\ $ 50.00 ) " \Ll1ni,te\d,~e~f~~~~,S;\~t~y,al:S) / $ 25.00 -;;<' "Umlted EA.er~yYC'cimmercial $ 45.00 ,'" " v,\) Mi)lJml1~\~\el;trf.\pierinit Inspection Fee is~ + Surcharges . .. \D\A:'~'...'. ........-............. '.< .................-.\........... ... ............ ....... 4:'STJBTOTAL,OFABOVE L( r' 7% State Surcharge '7d 10% Administrative Fee L( ) "-- TOTAL S? (, J Shared Dlive(T:)/Building Fonns/Electrical Pennit Application 1-03.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541~726-3769 Inspection Line SITE ADDRESS: 3376 Ambleside Drive ASSESSOR'S PARCEL NO.: 1702193406800 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-00177 ISSUED: 04/24/2003 APPLIED: 03/17/2003 EXPIRES: 02/14/2004 VALUE: $ 138,103.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: SFR - same as 3342 Ambleside COM2003-00071 New Residential Owner: SCOTT JORDAN Address: 28235 CLEAR LAKE RD EUGENE OR 97402 Contractor JORDAN CONSTRUCTION DEANS ELECTRIC 99579 GREGORY HAFFNER LAWN SERVICE 7192 COMFORT FLOW 460 FRANKROMERO . 40892 N' . I BUILDING INFORMATI011~O~~~\\~ (I. '(eo..v ~o~ ~.'O. # of Stories: ~ \'().~ 0 O~e e.~e fOe ~.J:P l-ot Size: Heig~~~~~~ ~\)\e;;~i~\-e~ ~q Ft 1st Floor: J,.~o ~I{\Os'F~\flft"'~i{<!J~O~~'LFt 2nd Floor: A~~ \V&~&.'1~:. '<<'~o ~e'b 0 \~. C'tJ.~}?t Basement: ~\ · ~ ~ng~}ry.prP\~~ Co9 . ~e ~~~~ Sq Ft Garage/Carport 4 ,o\~o. c~~<1i~tto'O\~ ~o\e. ~\\~~%r~'" Sq Ft Other: '\O\\'\~t...~ ~~ ~~i~\e'(' t\O~ \) ~?:7- Impervious Surface Area: f'\r" 1^~ . (",0 O~e"s r'}~ I Dk~~{(iq~~~TION I v ~ (\"\-c;l REQUIRED PARKING ~~y (;e ~verlay Dist: Total: 2 # Street Trees Rqd: 1 Handicapped: Paved Drive Rqd: Yes ~~~~t: % of Lot Coverage: 20.~ \r ,\'\'t. \'2> ~Q' c.. \.. t.'fS> \ c.~~\' \ _r,Q1'\Cl;.',:\ c.\\~\.: . ,u\S, ~\.. ,..C"'\ ~()\\ PUBLIC IMPR" . R ':~ \)~\)t.t\ ~~f>..~\)\.)\'4\.o'" , 0\\ \<2> l\'U~~~t.~Ct.~ ~~~Jk Type: C~~'{ "\ CO\) \)t\ Downspouts/Drains: Contractor Type General Electrical Landscape Mechanical Plumbing # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 6.00 13.00 49.00 65.00 Street Improvements: Storm Sewer Available: Special Instruction: Phone Number: 541-688-3998 I CONTRACTOR INFORMATION' License Expiration Date Phone 06/2012004 06/30/2004 06/27/2005 12120/2003 541-935-5303 541-935-5361 541-726-0100 541-935-3263 1 R-3 U-l VN 850 898 393 FullV Improved Yes Curbside 5' To Storm Sewer Notes: Pal!e 1 of 4 Status . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction V Wood Frame Gara2e Dwellin2s Gara2e Fee Description . Plan Review Same As + 10% Administrative Fee + 7% State Surcharge -Mechanical Issuance Fee- 2 Baths One or Two Family Addressing Assignment Annexed 1997 Appliance Vent Building Permit Copies - Ea Addtl @ 50 Cnts Ea Copy 1st @ 75 cents Curbcut Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Plan Review - Planning PW Mult Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family I Valuation ~escriDtion I $ Per Sq Ft or multiplier $74.60 $19~60 Square Footage or Bid Amount 1,748.00 393.00 Total Value of Project ~. Amount Paid $100.00 $4.50 $3.15 $10.00 $254.00 $8.00 $-18.94 $6.00 $692.40 $12.50 $0.75 $75.00 $6.00 $9.00 $12.00 $15.00 $4.00 $59.00 $-30.00 $106.00 $57.00 $335.80 $441.80 . $10.00 $34.83 $332.86 $75.71 $50.73 . $709.81 $160.87 $75.00 $521.70 $50.00 $18.00 $1,000.00 Pa2e 2 of 4 Date Paid 3/17/03 4/14/03 4/14/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 4/24/03 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00177 ISSUED: 04/24/2003 APPLIED: 03/17/2003 EXPIRES: 02/14/2004 VALUE: $ 138,103.00 Value Date Calculated $130,400.80 $7,702.80 $138,103.60 03/17/2003 03/17/2003 Receipt Number 1200200000000000838 1963 1963 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 2200200000000000773 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 10% Administrative Fee + 7% State Surcharge + 10% Administrative Fee + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge + 7% State Surcharge Backflow Device Backflow Device Low Voltage - Residential Minimum/Adjustment Electrical Minimum/Adjustment Plumbing Minimum/Adjustment Plumbing Refund - Admin Fee Refund - Admin Fee Refund - Electrical Refund - Electrical Refund - Plumbing Refund - Plumbing Refund - Surcharge Refund - Surcharge + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00177 ISSUED: 04/24/2003 APPLIED: 03/17/2003 EXPIRES: 02/14/2004 VALUE: $ 138,103.00 $122.94 $86.08 $4.50 $4.50 $4.50 $3.15 $3.15 $3.15 $14.00 $14.00 $25.00 $20.00 $31.00 $31.00 $-4.50 $-4.50 $-25.00 $-20.00 $-31.00 $-14.00 $-3.15 $-3.15 $4.50 $3.15 $25.00 $20.00 6/13/03 6/13/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 8/14/03 10/2/03 10/2/03 1012/03 1012/03 1962 1200200000000002254 1200200000000002254 1200200000000002254 1200200000000002254 1200200000000001530 1200200000000001530 1200200000000001963 1961 1963 1200200000000001963 1961 1963 1200200000000001961 1200200000000001963 1961 1961 1200200000000001963 1963 1962 1962 1962 $5,516.79 , Plan Reviews I Initial Review 03/1812003 03/18/2003 APP LLH Planninl! Review 03/18/2003 03/21/2003 APP EMM Public Works Review 03/18/2003 04/02/2003 APP DJW Structural Review 03/18/2003 04/2312003 APP DLM To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. 1 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 2 Curbcut - Standard: After forms are erected but prior to placement of concrete. 3 Site Inspection: To be made after excavation but prior to setting forms. 4 Vfer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 5 Footing: After trenches are excavated. 6 Foundation: After forms are erected but prior to concrete placement. Pal!e 3 of 4 CITY OF SPRINGFIELD. Building/Combination Permit Status Issued' PERMIT NO: COM2003-00177 ISSUED: 04/24/2003 APPLIED: 03/17/2003 EXPIRES: 02/14/2004 VALUE: $ 138,103.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 7 Post and Beam: Prior to floor insulation or decking. 8 Floor Insulation: Prior to decking. 9 Shear Wall Nailing: Before covering sheathing with finish materials. 10 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 11 Wall Insulation: Prior to cover. 12 Ceiling Insulation: Prior to cover. 13 Drywall: Prior to taping. 14 Hold Downs Installed: Special Inspection performed prior to placement of concrete.. Provide report to City Building Inspector. 15 Final Building: After all required inspections have been requested and approved and the bui.Jding is complete. 16 Underfloor Plumbing: Prior to insulation or decking. 17 Underfloor Drain: Prior to cover or placement of concrete. . 18 Rough Plumbing: Prior to cover and including required testing. 19 Water Line: Prior to filling trench and including required testing. 20 Sanitary Sewer Line: Prior to filling trench and including required testing. 21 Storm Sewer Line: Prior to filling trench. 22 Final Plumbing: When all plumbing work is complete. 23 Underfloor Mechanical. Prior to insulation or decking and including required testing. 24 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 25 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. 26 Rough Mechanical: Prior to Cover 27 Final Gas: When all gas work is complete. 28 Final Mechanical: When all mechanical work is complete. 29 Temporary Electric: Approval required prior to Utility Company energizing pole. 30 Rough Electric: Prior to Cover 31 Electric Service: Approval required prior to utility company energizing service. 32 Final Electric: When all electrical work is complete. 33 Low Voltage: Prior to cover. 34 Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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 OCCUPANCY will be made of any structure without perinission of the Community Service~ 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. Owner or Contractors Signature Date Pal!e 4 of 4 225 Fifth Street " Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00 177 COM2003-00177 COM2003-00177 COM2003-00177 Payments: Type of Payment Check Paid By JC CONSTR Receipt #: 1200200000000002254 Description Low Voltage - Residential Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department. Date: 10/0212003 12:03:01PM Amount Paid Item Total: 25.00 20.00 3.15 4.50 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65