The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2004-10-13 f . ~ :I, 0' ;0,.., 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~4541)726-369& % ~LECTRICAL PERMIT APPLICATION {, / '. -s'v00Q. ~"/".9 \\' "0/....& ~6 CIty Job Number c..o~ v:;oC{ -O{/~ '6 Date 0 Is / d1aV/ ~O' 90;, '?J/i.--6>' , / <5>.' 6>\\,0' 1. 3. LEGAL DESCRIPTION 170 Z. I c; '3 ( 00201 JOB DESCRIPTION SHLuI-Lt: I' t./ G<~I+-s;. Permits are non-tr:fnsfera~le and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor BURRtLL IjliUS. ~i.~(Jl;K P.O. Box 697 W",,:L~"V;I:0, OR 9748? 541-747-2724 Phone Address City Supervisor License Number L1'17 ,1"S Expiration Date }O Itfl Constr. Contr. Number ZO"{jLlZQ, Expiration Date 7 / 0 c, Signature of Supervising Electrician OlDlwu b\l\M1~^, ~ Owners Name \)'^- "1' /. - ":-, l2c..c Address S '3 '3 "3 J ~~ {S'r- 9Fb City Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $ 19.00 $50.00 "" follow ru es a op NogRgc1'fm~ @E1~~s;r. Those rules are s t fO$1&3.oo in G~J,)Kn1~,(o:4l00)~.1mpshrough OAR 952-0@'1Js.oo 009m ~prno190,Gb\fri.fJscopies of the rUles $1~5.00 t6fl~iA.wps(fuqfOO~Anftdote: the telephonE$163.00 nomr.)l;~d@)Ic\\Hffi's~fSon Utility NOtillCaLlO!'-375.00 Reconn~otR:lyiS 1-80Q-332-23'W). $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over ~QO~Xm'sill' 1 000 Volts see "B" above. D. ,.. i ITHnRI/ t;; . ':1 New A'lteratwn or ExtensJOn,PeB~anelONED FOR One c~dJNIMEi'~CtlJ UK I~ f\ I'W $ 43.00 Each MitubloUlQ:;QAYt ~~i\RD. Service or Feeder Permit L.-( 11- $ 3.00 E. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. "75: 5v~ 750 <g7'~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03,doc :S,i'~~\h":rlgI,.D 1E;'tf" .~ . , Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01168 ISSUED: 10/13/2004 APPLIED: 09/21/2004 EXPIRES: 04/13/2005 VALUE: $ 50,000.00 r :2 -:: ", '1 Street, Springfield, OR 5.' -,' ::-3753 Phone 5.: 1-':. ~-3676 Fax 5) 1 -'; '1-3769 Inspection Line . : DRESS: 3333 HAYDEN BRIDGE RD ":'m's PARCEL NO.: 1702193100201 Springfield TYPE OF WORK: Single Family Residence ,)".'" TYPE OF USE: :~T DESCRIPTION: Add master suite with bath, kitchen, and family room. Addition Residential RICE PHYLlS :\'d' ',0;: 3333 HAYDEN BRIDGE RD SPRINGFIELD OR 9747fi-TTCi-:-"':" ,~..,...:., -.. :'-~' ,. , f~~~ :"'.4< I (I " Contractor 13 URRELL & SONS INC BURRELL BROS ENTERPRISES INC DOUGLAS LEE JONES I CONTRACTOR I~FORM*iiciN,i~~ I (~ ~\~. ~ 'j ;, - -Iv" 1" 8. .. . - ,..,..... !, . bY ma obtain COpiES 0, lllv I U,I,,;;::> 0090. ~P~twef~ente~,pj5i!~iP.PJ Uai~hoiVJlOne call~~~ the orego9~(9~~9Q6otificatUil-746-4702 nUmP.f6'1..YIt r is 1-80B1t~Qt~4J' 541-747-2724 104wt:1 e 02/17/2005 541-747-1254 CnI'L"'-.:tor Type ~.--: f.nt . L" ',) BUILDING INFORMATION' VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 462 t' .," . , !~: 1';-;"; :' Occupanc~' Croup: ~"':~: ".\' OCCII fl;' '~I_'Y Group: I r'p . r" Constrllcl:/:11 Type ~":". i'Y Construction T"pe: t' ," ,"OOIllS: R-3 n/a {'.: ",.....~ ';""l~"",,,'d Setback: ~;: 1.'\!Jack: ~; /,', ; harlc : S(,tIJ:Jck: 7...D.,EV,EL'OPMENT INFORMATION AUTHUR'i2ED UI~I~~~ ){PIRE IF THE WORK 28.50 COiVjiViEI'.pverlaY~lst: THIS PERMIT IS NOT 24.00 ANY 1 80 f;sHe~tllJ~e~\iiqdl:[)ONED FOR 12.00 pMRDf.Lta~qd: % of Lot Coverage: 26.00 REQUIRED PARKING Total: Handicapped: Compact: j',. . bad,s: 0.00 I PUBLIC IMPROVEMENTS I ~:~n'''' "!lpro\'ements: Sidewalk Type: ti~~!:"~' ':ewcr AV:Jj"l~;le: Downspouts/Drains: ..,,,,, ':lstrllctiO': Additional storm water drainage shall flow into existing system. CS :'\:"" '.:: Pae:e 1 of3 ~'" ",i.\JI"'l~""IELD ,c=:<"-' ~ 1"-- . .' , :>,ltus Iss 1I cd CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2004-01168 ISSUED: 10/13/2004 APPLIED: 09/21/2004 EXPIRES: 04/13/2005 VALUE: $ 50,000.00 .&'/'1. '1 ~ {f:'"> C' 2"'5 Fifth Street, Springlicld, OR 5-1 ~ - 726-3753 Phone 54! - 726-3676 Fax ~ ,. -7: 1-3769 fnsprrtion Line Valuation Descriotion , "::1 ,\ mOllnt : 'se Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 50,000.00 Value Date Calculated :\':scrillt ion TYDe of Construction Total Value of Project $50,000.00 $50,000.00 10/0412004 ~ !;'.'e '~f.'scrilltion Amount Paid Date Paid Receipt Number .. ~c,jew Rcsiden!ial $240.92 9/21/04 2200400000000001181 . . - ':, '~tr'iral lssllan '", Fee- $10,00 10/13/04 3200400000000000286 -1- I ')'Y., :\dlllinistrat' c Fce $66.67 10/13/04 3200400000000000286 -1- ~ '/~, :)Lllc SlIrrhar"c $46.67 10/13/04 3200400000000000286 .' . ,!, Altcr, Extend Ore Ea Add $12.00 10/13/04 3200400000000000286 ':'. -randling llnit 1': 'O~I~,OOO $8.00 10/13/04 3200400000000000286 "1, ; '1" Perlll i ( $370.65 10/13/04 3200400000000000286 ,., '\''' . \' ent $6.00 10/13/04 3200400000000000286 ",' 'stlloods $9.00 10/13/04 3200400000000000286 . .j . 'C $168.00 10/13/04 3200400000000000286 'I"!> p $12.00 10/13/04 3200400000000000286 ';; ";':'\'/f'dr 200 amps or less $63.00 1 0/13/04 3200400000000000286 ,. In ' (" "cw ;\1 inn!' - :anlling $59.00 10/13/04 3200400000000000286 . ,:f :, :;cwer -! ' "l'o\'el1\ent $109.68 1 0/13/04 3200400000000000286 .. I ::'lry Sewer - ltc' ; 'll'rSement $144.24 10/13/04 3200400000000000286 " ~an:fal')'/Sf(\,... .~ '~:""'1; n $22.26 10/13/04 3200400000000000286 nr:tinag' : .. " \'i~lUS Area $191.27 10/13/04 3200400000000000286 '" $18.00 10/13/04 3200400000000000286 Total Amollnt Paid $1,557.36 I Plan Reviews I ! .- : - i .,' ~ l f'" i (.,,, '''I ':I~ Rcdew . .. , \Yorks ('cvi/'w ,.. I nc\'i~' 09/2312004 09/23/2004 09/27/2004 09/23/2004 09/22/2004 10/08/2004 09/28/2004 10/04/2004 APP SKG APP TAJ APP CS APP DLM See documents for plan review comments. q !'cst a!l i.:. . '~ct=an call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. , : 'ade ~he ~".:c working day, inspections requested after 7:00 a.m. will be made the following work Pae:e 2 of3 ~_,D~I" r\~c[-"'n 21--D :r--------.--~ \,....- . I' CITY OF SPRINGFIELD' / ~. '0.. ~', Building/Combination Permit ~,. (~ ~ t . I,' Issue PERMIT NO: COM2004-01168 ISSUED: 10/13/2004 APPLIED: 09/21/2004 EXPIRES: 04/13/2005 VALUE: $ 50,000.00 225 F:'" h Street, SFr:",~field, OR :=:.' 1-7:;:)-3753 Phone 5.H-72()-3()76 Fax 5.1! -7::1-37"<) Inspccti'1I1 Line Reouired Insoections . I.'ool ing: f\ p,,,. 'rellchcs are excavated. :Olllldalio:" ,h'r forms are erected but prior to concrete placement. ')o~t and P. .: Prior to floor insulation or decking. ., ,. Inslll' ~ ': Prior to decking. :,.1(,( . Insllla~i: ': Prior to decking. Fr:1 . ing] 1I,'~ec'ion: Prior to cover and after all rough in inspections have been approved. ',\,,: 11lSII::" "" ~Jrior to cover. Ce: ',Ig Ills' ":: Priur to cover. Dr~\\l\ll: l ' ":l taping. I,'i, 'II Build' .. :'~lT all required inspections have been requested and approved and the building is complete. " 'I' '....floo ,. : I' (J: Prior to insulation or decking. ','11 ,'rl1oor : T' rioI' to cover or placement of concrete. \) 0 "h Ph: . I: P"ior to cover and including required testing. "il' Phlll I Y'cn all plumbing work is complete. '..Il rl1oor" "~~alli':al. Prior to insulation or decking and including required testing. Ho' hi\lec','."'al: PriortoCover ~.it, ,\Icc',; '..,': When all mechanical work is complete. l{o' h Fie""', .'rior 10 Cover Fil' I Elect I'. .,',',cn all electrical work is complete. J':k '~rie Se"" . '.\I''1roval required prior to utility company energizing service. ", I st,ll " ag"ce, that I have carefully examined the completed application and do hereby certify that all here;. . '''C ,'lit! correct, and I further certify that any and all work performed shall be done in accordance with :es of 'y or ~~;)ringfield and the Laws of the State of Oregon pertaining to the work described herein, and =: U 1',' ~ . ' ',vil: hc made of any structure without permission of the Community Services Division, Building Safety. r \ i i 1\ t:-. :'~' co II 1 ractors and employees who are in compliance with ORS 701.005 will be used on this project. r, cc (0 (" '" that all required inspections are requested at the proper time, that each address is readable from the street. ,", Ie IHT'''' ",'rd is located at the front of the PJJperty, and the approved set of plans will remain on the site at all times,,:r ,~COlls'r "I. I; f)aU/' r;~ ~ 0"'""(' '''tn' ", j '~n"t"'" By si~"- '1: info I'! , 'i, the C" II: that 1': I furt! I furtl 10- (3,-6 'f Date Pa2e 3 of3 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO. OF FIXTURES' ORAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 0 0 3 = 0 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRYTUB 0 0 2 = 0 I CLOTIIESW ASHER / MOP SINK 0 0 3 = 0 I CLOTIIESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER 1'RAIT-ER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK I DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 1 0 2 = 2 SHOWER GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 1 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 6 .1 *EDU (Equivalent DwelIin~ Unit) is a discharge equivalent to a single family dwelIing unit (20 DFD's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE :'\:::",:, $5:29';:"" : n'$5.29 n,::$5,19 $5.12."":",,... $4.98" $4~80' $4.63 $4.40 ,"" $4.07 $3.67 $3.22: $2.73, $2.25': $1.80 $1.59 $1.45 $1.2~ $1.09 $0.92 $0.72 $0.48 ' $0.28 ' $0.09 ' $0.09 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGffiLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR o o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5.29 = , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $O~O x $5~9 o TOTAL MWMC CREDIT $0.00 = , 225 Fifth Street " " " Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number C01\12004-01168 , C01\12004-01168 CO/v12004-0 1168 COIv12004-01168 COM20Q~-01 168 Co.fvl2004-01168 COi\12004-01168 C01\12004-01168 Co.l\112004-0 1168 COM2004-0 1168 Co.i\l12004-01168 COH 2004-01168 COiV12004-0 I 168 Co.l\1!2004-01168 Co.V! 2004-0 1168 COM2004-01168 COM2004-0 I 168 Payments: Type of Payml'nt Check 10/13/2004 RECEIPT #: 3200400000000000286 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Air Handling Unit Up to 10,000 Exhaust Hoods Dryer Vent Heat Pump Vent Fan Fixture Plan Review Minor - Planning ~Mechanical Issuance Fee- Perm Serv/FdrpOO amps or less Add, Alter, Extend Circ Ea Add , + 7% State Surcharge + ] 0% Administrative Fee Paid By TERR Y BURRELL Check Number Batch Number Received By nJm Page 1 of 1 , r'ity of Springfield Official Receipt ,velopment Services Department Public Works Department Date: 10/1312004 Item Total: ' Authorization Number How Received 2149 In Person Payment Total: 8:41:40AM Amount Due 191.27 144.24 109.68 22.26 ' 370.65 8.00 9.00 6.00 12.00 18.00 168.00 59.00 10.00 63.00 12.00 46.67 66.67 $1,316.44 Amount Paid $1,316.44 $1,316.44