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Home My WebLink AboutPermit Electrical 2010-7-12 Electrical Permit Application '. j'. .. . .CITY.oFBPRINGFIELD~ OREGON . ~ '.', ~_. - . . . . -. -' ~ ., ", 225 Fiftb Street. Springfield, OR 97477. PH(S4I)726-3753. FAX(541)726-3689 DEP,ARTMENT USE ONLY' permitno.:G 0 -oor;"'> Date: - /1--/ () This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 'LOCAL: GOVERNMENT APPROVAG...< Zoning approval verified? DYes D No /1." : ,,:. ': CATEGORY;;C5F 'CONSTRI:JCTION';." , f "'., )., DESCRIPTION, OF WORK".., ,~ reo :';\ "",,-.' ,. PROPERTY OWNER Name: Address: City: ZIP: -~ 8'633 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: Address: City: Phone: E-mail: CCB license no.: ZIP: BCD license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: '~AD ,f\....\~J ~~~ ~ 440-2584-J (9/08/COM) ~.~ '; '; ~hi.' ;;,:~-';~'r~lr~f;~~;':!~f.E-E-~~:SeHE_DOUE{~:. :~W,?;tl::;itW~~i;~:f~~~\W;f,W:ff . -., . . .. Cost Total ,Num~~r' ?.finsp~ctio'~~ p~r,it~.~,' (). Qiy. )"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) 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 services or feeders section above Branch circuits: new, al.teration. extension per pane! a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.0Q $ .- b. Fee for branch circuits 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 ~ot included Each pump or irrigation circle (2) $ 63.00 $ Each sigo 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 $ ;;J~t;S:.~~,~I.i!i~,;~')fJ~t~5API~(ICANT~XU'S,E\}~~t': ,:,:.{;~~:~:{~1:~~f,;~: ~,'.~;t;:,;: .' (A) Enter subtotal of above fees $6~< (Minimum Permit Fee $58.00) (B) Eater 12% surcharge (.12 x [A]) $ O.l-\I .P (C) Technology Fee (5% of[A]) $ .~I ) TOTAL fees and surcharges (A through C): $ldi, ,-- " ~ ...-- 00 & Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00775 ISSUED: 06/16/2010 APPLIED: 06/16/2010 EXPIRES: 12/22/2010 VALUE: SITE ADDRESS: 710 McKenzie Crest Dr ASSESSOR'S PARCEL NO.: 1703234200700 Springtield TYPE OF WORK: Plumhing Only I CONTRACTOR INFORMATION I Contractor 'License OWNER RIGHT WAY PLUMBING~~ ~". ."'. 49561 BUILDING INFORMATION I PROJECT DESCRIPTION: 2 fixtures to include a french drain Owner: CHASE KATHRYN S Address: 710 MCKENZIE CREST DR SPRINGFIELD OR 97477 ", Contractor Type Electrical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Cunstruction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: R-3 VB TYPE OF USE: New Residential Expiration Date Phone 12116/2010 541-484-3787 n/a Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carporl Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Front yard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Slorm Sewer Available: Special Instruction: i~:-"~ .;:"_.:..'.....,, ':1); 'l1~"", . ..__.~- Noles: ~diliiion of garage sink - SDCs applied ':~ PERMIT SHALL EXPIRE IF THE WORK r'Tr,ORIZED UNDER THIS PERMIT IS NOT .JMMENCED OR IS ABANDONED FOR ,iN 180 DAY PERIOD. " , ,"J . ~ . ~, I t~ ;\:'t. " Paee I of 3 ,.~t..t. :,. REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: ATTJj)'tl~')~i)tl1sfI)'A/JJf:W requires you.t.o follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number lor the Oregon Utility Notification Center is 1-800-332-2344). Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description + 12% State Surcharge + 5% Technology Fee Fixture Sanitary Sewer - 1st 100 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin + 12% State Surcharge + 5% Technology Fee Fixture Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid Public Works Review 06/16/20 I 0 . '. ." j' . :; t!ct '.i~"': (', ,',;:~ ",,~.,;:,... .1. './'"..' .... ,':". ~~.... '".' ~.\ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00775 ISSUED: 06/16/2010 APPLIED: 06/16/2010 EXPIRES: 12/22/2010 VALUE: I Valuation Description ~ $ Per Sq Ft or multiplier Square Footage or Bid Amount' Value Date Calculated Total Value of Project Date Paid Receipt Number ~ ,_' I. ""'. .. Amount Paid: $13.68 $5.70 $38.00 $76.00 $96.00 :-' j $161.52"".." ,..._,.. $12.91 $4.5~:'~:'. ," .. $1.911;:,,;," $38.00;' $132.15 $220.96 $17.66 $6.96 $2.90 $55.00 $3.00 $886.90 ,:: ,> ::.. . I"(_~ I, Plan Reviews i 06/16/2010 :.:;,u . ."," .' 6/16/10 6/16/1 0 6/16/10 6/16/10 6/16/10 6/16/10 6/16/10 7/9/10 7/9/10 7/9/10 7/9/10 7/9/10 7/9/10 7/12110 7/12/10 7/12/10 ,7/12/10 2201000000000000704 2201000000000000704 2201000000000000704 2201000000000000704 2201000000000000704 2201000000000000704 2201000000000000704 1201000000000000807 1201000000000000807 1201000000000000807 1201000000000000807 1201000000000000807 1201000000000000807 3201000000000000421 3201000000000000421 3201000000000000421 3201000000000000421 "'''.,. APP TSS Over the counter review for the addition of a utility sink in garage. SDC applied. Provided additional SDC estimate for the addition of two more fixtu res. 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, i\l~pectioris 'requested after 7:00 a.m. will be made the following . _I.. or work day_ .. Paee 2 of 3 a~l.:j "!I:~"'_..no~.. _ .,.... ~" ' <., . ' ..... ' ~.__. "-.. . .. .. . City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Qregon 97477 541-726-3759 Phone RECEIPT #: Date: 07/12/2010 .:53:31PM 3201000000000000421 Job/Journal Number COM20 I 0-00775 COM20 I 0-00775 COM20 I 0-00775 COM20 I 0-00775 Payments: Type of Payment Check cReceintl Description Add, Alter, Extend Circ Minimum/Adjustment Electrical. + 12% State Surcharge + 5% Technology Fee Amount Due 55.00 3.00 6.96 2.90 $67.86 Paid By STEPHEN D. ALISON Item Total: Check Number Authorization Received By Batch Number Number How Received NJM 1114 In Person Payment Total: $67.86 $67.86 Amount Paid . .,~. ., .1 . ;. .01'" .~ !:"'". . ......1 . 'J' ~ i..~ ., .J Page I of I 7/12/2010 CITY OF SPRINGFIELD Building/Combinatio'n Permit Status Issued ,~ ~ , .. ',;S. PERMIT NO: COM2010-00775 ISSUED: 06/16/2010 APPLIED: 06/16/2010 EXPIRES: 12/22/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line i' - , , I Reouired InsDections ~ Sanitary Sewer Line: Prior to filling trench' a1ia-ii(~J~iirn-g 'reqtii~ed testing. :('(;{irnn.,; ..t; ,', Rough Plumbing: Prior to cover and including requii:ed testing. '~'-'~~'J.,: . 'Ii.' " ' Final Plumbing: When all plumbing work i{fo;"pJete. Storm Sewer Line: Prior to filling trench. ; Rough Electric: Prior to Cover Final Electric: When all electrical wo!k 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:Sta'te of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any strncturs~without p~rmission of the Community Services Division, Building Safety. I further certify that only contractors and employee~ who are incompliance with ORS 701.005 will be used on this project. I further a eefileUsure that all required inspectionsare requested at the proper time, that each address is readahle from the street, t t the perrhit card is located at the front of the property, and the approved set of plans . re ain on the site at all time (luring consttuction. J..... ., '-'.' 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