HomeMy WebLinkAboutPermit Electrical 2005-7-20
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54])726-3753 . FA'!l.~q)~26-3(j89
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ELECTRI914L PERMIT APPLICATION
City Job Nu~L/ - O~I Date '7- d, 0 - ~ tJ"l;J.
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LEGAL DESCRIPTION
!7()3 3.5 :;;3 dO 700
JOB {)ESCRIPTION
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not started within ]80 days of issuance or if work is
Suspended for ]80 days.
2.
Electrical Contractor
tle/I'>
;; 5-10 7
Address
.It)
&L 'l~1.L Phone &\{t ~2S-4J
(j
Supervisor License Number & 1 Y'- S
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City
Expiration Date
Constr. Contr, Number
Expiration Date
Signature of Supervising Electrician
iJj)~ ~
ownersNameJn);1) fOji-PJcL
Address(acSl /. $T .s+I2,o +--
C~//Z? ~JrX Phone ?5D .~ / 679
OWN~R I~LLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106,00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or "It:> u\reS V~(}~O
Feeder N: Oregon law. '\ on Utility
t) . t '.., reQ'; .' " '.'"d\'\
B'~19~!.~~j;1~(:atiol1:
, ' . O/i.R952.001...," .' , oQ
200 ~ri?~~;_001-001? th~~;f of the tOBI~ bY{d :;:;--
10 u -.1IWOl. ~ obtain C ...Jr.m::\e
201 ~~ '\!}W"-II'flJ> 'Not~: the te~v:!w:
401 Amp~iIll:I.>(){U~psenter. \ "tHin' N($titi~~O"
",crnITl'd' ~ Oregon - ~
601 Am~mWBOfj2fri ~\S 1_80Q::332-234'in-63.00
Over 1000 AmpsN e $375.00'
Reconnect Only $ 50.00
C.
Installation, Alteration or Relocation
200 AmpS 'or less,:' $ 50.00
. '.-'1
201 Amp~'~!~O~tP:J?-s;T SHALL ~;~P:~!: I~ q~.~WO~!f.
40 1 Amp~, to .60.Q ~mp!? 0 U r Ii U- r: R 1" U I (' 0 r: [$ .J001rtlO, 1\ I n T
,.,L . ! 'U' ~ILL I~ L "....... I .:..nfVII Iv.......
Over 600 Arp s d,OQO N' 6lts1 see "
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43,00
$ 3.00
/6 cJTJ
-6'
E.
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50,00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
K, OV
.s . Cf f:'
. -7' kG
Jfic; I. ;;){r/
4.
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application I-03,doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00951
COM2004-00951
COM2004-00951
COM2004-00951
J>ayments:
Type of Payment
GreditCard
"
;t
"
~,
7/20/2005
RECEIPT #:
3200500000000000442
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
BARBARA COFFMAN
Received By
nJm
Check Number
Batch Number
Page 1 of 1
015503
City of Springfield Official Receipt
velopment Services Department
Public Works Department
Date: 07/20/2005
Item Total:
Authorization
Number How Received
015503 In Person
Payment Total:
1:49:44PM
Amount Due
63.00
15.00
5.46
7.80 ,
$91.26
Amount Paid
$91.26
$91.26
, ~~~\~~~~~~'~'~~"'"'*'-'"-"-
. ' \',
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00951
ISSUED: 07/20/2005
APPLIED: 08/02/2004
EXPIRES: 0112012006
VALUE: $ 17,496.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6511ST ST
ASSESSOR'S PARCEL NO.: 1703352300700
Springfield TYPE OF WORK: Garage
Contractor Type
General
Electrical
Plumbing
Contractor
OWNER
DELLS ELECTRIC
OWNER
TYPE OF USE: New Residential
on law requires you. ~O
: -:--:-,:~.rTlnN', Oreg d 'v €~':'3nn IItI\lW
t~\lOW rules adoPte~h%\~@~et9~~47-1579
l'...\otitication ce~t~~1 0 through OAR 952~OO~y.
in OAR 952-00 ,-~ht~in copies 01 the rul~~_
009U. wU \I...., ' (N te: tne 1t:J1l;;ti"J~I-
I CONTRACTOR INFQ&N1Ag-I()NV,nte~'e o~ Utility Noti1icatlon
number IVI \' e. 0 _~OO-332-2344). '
Lic~er IS Expiration Date Phone
PROJECT DESCRIPTION: garage
.~' Owner: FAIRFIELD JOHN A
.' Address: 651 W 1ST
SPRINGFIELD OR 97477
,-
,
109864
01114/2007
541-935-2154
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
, Secondary Construction Type:
# of Bedrooms:
VN
# of Stories: 1 Lot Size:
Height of Structure 15.00 Sq Ft Ist Floor:
Type ofHeat:~JT~C\E: Sq Ft 2nd Floor:
Water Type: ~HIS PERMIT SHALL E)~q!~t~~s~w~Ii,t;'ORK
Range Type: l'HORIZED UNDER 1 ~,.,F~R~fv~~,e/fSap;pJrt
Energy Path: AU Sg~t O\~her:F~R
. .ro,f.\F,f,MENCED nn IS AEh\,\llJOI~tU
Sprmkled BUlldmgl n/a' Occu}Tanf Loa :
^ ~IV ~ on n^V pl=Rlnn
720
U-l
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
6.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
10.00
0.00
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Yes
Storm to weep hole in curb
Downspouts/Drains:
Curb and Gutter
, Notes:
Pal!e 1 of 3
Status
Issued
CITY OF SPRI1~(jFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00951
ISSUED: 07/20/2005
APPLIED: 08/02/2004
EXPIRES: 0112012006
VALUE: $ 17,496.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion 1
Description
Garal!e
Tvpe of Construction
Garal!e
$ Per Sq Ft
or multiplier
$24.30
Square Footage
or Bid Amount
720.00
Value
Date Calculated
Total Value of Project
$17,496.00
$17,496.00
08/0212004
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $110.37 8/2/04 2200400000000000999
+ 10% Administrative Fee $21.48 8/20/04 1200400000000001246
+ 7% State Surcharge $15.04 8/20/04 1200400000000001246
Garage/Carport $169.80 8/20/04 1200400000000001246
Plan Review Minor - Planning $59.00 8/20/04 1200400000000001246
SDC Sanitary/Storm Admin $12.90 8/20/04 1200400000000001246
Storm Drainage Impervious Area $257.92 8/20/04 1200400000000001246
Storm Sewer - Ist 50 Feet $45.00 8/20/04 1200400000000001246
+ 10% Administrative Fee $7.80 7/20/05 3200500000000000442
+ 7% State Surcharge $5.46 7/20/05 3200500000000000442
Add, Alter, Extend Circ Ea Add $15.00 7/20/05 3200500000000000442
Perm Serv/Fdr 200 amps or less $63.00 7/20/05 3200500000000000442
Total Amount Paid $782.77
I Plan Reviews I
Initial Review 08/03/2004 08/04/2004 APP LLH
Planninl! Review 08/04/2004 08/06/2004 WE TAJ The owner needs to record a deed
restriction to tie both tax lot 600 and
700 together as a single development
site or he can shift the garage 2'
toward 1st Street to maintain a
minimum rear setback of 10'.
Contact Liz Miller 726-2301
regarding this. The property is
zoned and designated HDR. No Site
Plan Review is required per
exception in Article 31. Called John
Fairfield and left message on 8/6/04.
LM Site plan revised to reflect 10'
rear setback for garage. tara
8/19/04
Plannine Review 08/13/2004 08/13/2004 APP EMM Owner has decided to move garage
forward 2 feet.
Public Works Review 08/04/2004 08/04/2004 APP MS
Structural Review 08/04/2004 08/19/2004 APP DLM
Pal!e 2 of 3
Status
Issued
, CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00951
ISSUED: 07/20/2005
APPLIED: 08/02/2004
EXPIRES: 01/2012006
VALUE: $ 17,496.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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.
I Reouired Insoections I
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Foundation: After forms are erected but prior to concrete placement.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Building: After all required inspections have been requested and approved and the building is complete.
Storm Sewer Line: Prior to filling trench.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspect~r.
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
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 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. ,
~\~C&- ~ ~~~cSL-
Owner ~ontractors Signature
I ~~O--O ~
r{::J~
Date
Pal!e 3 of 3