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Home My WebLink AboutPermit Electrical 2010-8-13 (3) "Electrical Permit Application I ~CIDI1~~CID~ 225 Fifth Stret't tSpringfield. OR 97477. PH(541 )726-3753. Io"AX(54I )726--3689 I~ DEpARTMENT USE ONLY .fSll-~/o- Permit no.. Date: '/..- I 3.- 10 57 This permit is issued uuder 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 APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION e.s.s. PROPERTY OWNER ZIP. 7 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: City: Phone: E-mail: CCBlic 7c'; Print name of signing supervisor: Signature of signing supervisor: . c;;., ~'Y\5. ~ ~~ ~~;\ \5)~ ~'J ~~O lb' " ~ 440.2584.J (9I08/COM) FEE SCHEDULE Numb~r of inspections per item f:) Qty. Cost Total " ea. cost Residential, per unit, service included: 1,000 sq. fl. 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) I $ 81.00 $'i'I.- 201 to 400 amps (2) $ 95.00 $ 40 I to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or vnlts (2) $469.00 $ Reennneet 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 tn 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit i).. $ 6.00 $,".00 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 not included Each pump or irrigation circle (2) $ 63.00 $ Each sign 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 $ APPLICANT USE (A) Enter su~total of above fees $ 't ,.tlt) (Minimum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) $ J/.fb" (C) Technnlngy Fee (5% of [A]) $ '+.165 TOTAL fees and surcharges (A through C): $JOr;..tt . S"P""~,,IN,G~ IE,L,"~'- ~El~" "'",~, -ii..'"-, " '7 ":4;cr'~'~" ...':\.3t)lJ!.J<..............- ,~'/&. J\... '~OREGON 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541.726.3676 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00057 IVR Number: 811109578099 W#\N. ci. spri ngfield.or. us permitcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/13110 EXPIRES: 2/8/2011 VALUE: $0.00 SITE ADDRESS: 1367 N ASSESOR'S PARCEL NO: Springfield 1703253300400 PROJECT DESCRIPTION: SCOPE: Heating System WORK INVOLVED: New TYPE OF STRUCTURE: Residential Service upgrade f ductless Phone Number: OWNER: ADDRESS: ROSE KAREN L 1367 N ST SPRINGFIELD OR 97477 Contractor Type Contractor Name GMD ELECTRIC INC CONTRACTOR'INFORMATION ~ ".." ",". " ',,' . Lie Type CCB Phone 541-741-7369 Lie No 162191 , Lie Exp 11/19/2010 .; .11['-, 'J' # of Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: ASaUs Report Required: 11~111..t:. THIS PER' AU MIT SHALL CO~~~~~~g UNDER ~~~i~~~f;rE WORK QNY 180 DAY OR IS ABAi.JOO^IED T IS NOT PERIOf} FOR Springfield Building Permit .. BUILDING INFORMATION ~ ' # of Stories: I Height of Structure: Type of Heat: Water Tv'pe: 1 " '1 " . ,~~. v vi ..... Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: RangeiTy:pe: /1 :~-r~! (' Hazmat: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residen!ial SpeciallY.,CodeEdition: Structural Special,ty'Code Edition: ,It,'.,....:..; . ,-",;,,,,,.(.,,-l-'.' ,'" " .,';., . ..... .." ;.~,..~ , ~ ATIENTION: Oregon law requires you to foHow rules adopted by the Oregon Utility Notification Center, Those rules are set forth m OAR 952-001'001,0 through OAR 952-001- 0090., You may obtain copi s of the rules b caHmg the Genter, (I\!UI9: the t~I';p~one y number for th& OreC'''n ';'1'" r', "" '" . ";' '- I.. '.. ~ ",l/.,C.;.n,cn Center is 1-b0.1,,< " ,', ^,)' OJ ............. '-......"1 t . Site Information t:. . '," LV:;'f. ~ ~11 'lU". ,., ,,'. . ','i:!~'~P;~ ;.; :51':"[ ~It: 8/13/2010 1:37:10PM Page 1 of 3 1Iffl\N. ci. spri ngfield. or. us CITY OF SPRINGFIELD Building I Residenti~IPermit . ~ ... . . 1 .'. ~.:\ . ,~' PERMIT NO: 81..1~SPR2010"00057 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenler@ci.springfield.or.us ,.,rl IVR'j>,,i'umher: 811 f09578099 PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/13/10 EXPIRES: 2/8/2011 VALUE: $0.00 SITE ADDRESS: 1367 N ASSESOR'S PARCEL NO: Springfield 1703253300400 SCOPE: Heating System " WORK INVOLVED: New . iY;RE"\.",TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: '''';'1J\~ ,. j." ".... Service upgrade I ductle~~:,::" ,,', ,,_ , DEVELOPMENT INFORMA TION ~ REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: i ,: __01;: Total: Handicapped: Compact: PUBl;iC,IPiiPROVEl>'I,ENTS ' ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: , - .... Tt~;\"l--;": 1 \ ~" ,",;;", Sidewalk Type: Downspout/Drains: r.. i:;~(:;.Jfi . 1l'y:r-'-:-" , '~ .. .tn"3Jr "1;..1' I .....; " . -,~.. ',':',Valuation Description ~ Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value f&"l,",",'.,,' ,~ .--v ~'$<!,,'~" 00"-~;;-" ~ ;""4~"~',,jt* ;,,;,,~ +2.:..(~j,"",- i'i'-' "/'_ Descriotion Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid . ."c ~, . .~: ~ IFEES' P:~_I.Q~:i~~:'~~:';?:{l~~=~~::~:c; 2~~ ....J:,l~:~~:-:...~.~; -3 .~.' " ~~~~'j'"-~:^~J , Amount Paid '" - . Date Paid Receipt # $8L09.,:-" .. ~., 08/13/2010 224437 Ui ,,' " ',$12'OG\.;' ,', 081131201'0'" 224437 ~, '." ''.,,IN',J $1 1.16 0811312010 224437 $465 0811312010 224437 $108.81 . ;\ "~. . !J'~p{-:. " '~J F'~'~r'T _;:j,'~~;;! .I:. .~.' ;' Springfield Building Permit ~:8!~~/201 0'::"1' ::37: 1 OPM :t:,:'" Page 2 of 3 Si,P~,IN,G",F,IE.L~" " 111:' !It ~. :. rfdg ".'~~::, ~;EGON :":':, '~,\ ',.: 't l,.'f.... 225 Fifth st springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us CITY OFv,;SPRINGFIELD Building llR~s'id~htial Permit PERMIT NO: 811-SPR2010-00057 permitcenter@ci.springfield.or.us IVR Number: 811109578099 PROJECT STATUS: Issued ISSUED: 8/13/10 APPLIED: 8/13/10 EXPIRES: 2/8/2011 :. VALUE: $0.00 SITE ADDRESS: 1367 N AssEsOR's PARCEL NO: Springfield 1703253300400 .~ " ,)'; ~ SCOPE: Heating System ,,/'i,.~;\':C.:WORK INVOLVED: New :, .\ . TYPE OF STRUCTURE: Residential ." ",'0 PROJECT DESCRIPTION: Service upgrade I ductless ~1: _r'J~ ~o ':;';jf'~~,~<(> ,&~ ~ 'M .;'," ,ci";:~/t, :;Planj:~e"Vi;w-';; : , '~, ';:~':'-~~: ,;7:,~-.:4,~~J~-:;_:~:,-~:', :l~~'~l ::,~~(-'-- {::.~ ,;~. '::~-:~~'~D Department Received Due Date Complete Result Permit Issuance 08/13/2010 08/13/2010 08/13/2010 Issued Application Acceptance 08/13/2010 08/13/2010 08/13/2010 Over the Counter Initiai Review 08/13/2010 08/13/2010 08/13/2010' Over the Counter Planning Review 08/13/2010 08/13/2010 08113/20'10"'- 'Not'Require~ . Public Works Review 08/13/2010 08/13/2010 08/13/20,'0;3 '-NJi\RJqijir~d\:: Structural Review 08/13/2010 08/13/2010 08/13/291,2., N?t.R,equired Reviewer Nancy Machado Nancy Machado Nancy Machado Nancy Machado Nancy Machado Nancy Machado Comments Over the counter permit Over the counter permit Over the counter permit Over the counter permit INSPECTiONS REQUIRED . ~ Inspections 4220 Electrical - Service 4500 Rough Electrical 4999 Final Electrical 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 6F Oreg,M pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permissfon of the"Coh,munity 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. Owner or Contractor Signature 'r" " .I,luC "j. Nf):'l~:~R~,t~t ,~';'o-~B 'NJ~J3~{-ti .~:,~.:", :?:A~Cf~ ,'..1.)( Ret.... ), ,~. iI~:~;;fd: :! " . \ ,:~:l ~(';"t"; I (',11 Springfield Building Permit 8/13/2010 1:37:10PM Page 3 of 3 TRANSAQJI9N RECEIPT ;'i.!~r~~: . ~'~'~F:J::;~~~' , CITY OF SPRINGFIELD 225 Fifth SI Springfield,OR 97477 541-726-3753 www.ci.springfield.or.lJS perm\tcen1er@ci.springfleld.or.us DATE: 08/13/2010 RECEIPT NO: 20 10000056 RECORD NO: 811-SPR20 10-00057 LDESCRIPTI0N*~il-i"" ': '1':-"; ':_--_;0JF.'\i'"'"' ~:-~-;;'\:-;-,'1i--'-- -~l::.cJ):uNr::c_OQEt:;-: ",-.-- -4~1VI9.U.Nr:O_uE- .'- -:...J Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge (12% of applicable fees) Iechnology fee (5% of permit total) 224-00000-426102 $81.00 224-00000-426102 $12.00 821-00000-215004 $11.16 100-00000-425605 $4.65 TOTAL DUE: $108.81 ..,-,';"i"--:--.'+--A'M"O'U' NOT'PAID-'>''''':', _2' I ;;l.;.......~~.;1..,._._~..b.,,~!ti.~~._._~___~~_J $108.81 h... ',j.""__.......__.._.n~ "",-,-,~",:.:.;,-- "~;'--"',-'-'--'::"',',":~''':. - " '.i,....'.,.......''':',...,.'' ',. ','-. .... " ...., ",..,"':' ....... .. _\": i - :PAY..Mj;NT TYPE;:;. PAYj)Rk_-.'"CASHIE~:N~.ACHAg.'2.:~;';C.C>MMENtS.:--:bf ,: Check G,M.D. ELECTRIC . . . '. ,', 4326 }~~~ .; ;!~;~. ~ .' .(, ,~ (;i8ir\'J.::.,1",' >,' ,- , ro' .'; 'lor., ;'. . !7(;~-' '''-;''~d'~'' J'" , .,-..,'.-...... "'.. .' .1,",' ;:('Y '~'-, . "