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Home My WebLink AboutPermit Electrical 2010-8-17 Electrical Permit Application :..~ -,' ~ ~"':, ~,'-~-L~'OI,;,~_ - _ '~.~4, ;?:CI~ .OF SPRINGFIELD, OREGON . ,':' 1:;;,....,~~.-... ~_.;, . , ...... 1:- ": ~ ~ . . 225 Fifth Street.Springfield, OR 97477.PH(54t)726-3753+FAX(54t)726-3689 DEPARTMENT USE ONLY ID - (/; This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is uot started withiu 180 days ofissuance or ifwork is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION o Residential 0 Government 0 Commercial . JOB SITE INFORMATION AND LOCATION Job site address: J OS 0 AI.5 y 57 City: 5 Pf LO State: 0 R- ZIP: 97 Y 7 Reference: "0'0 Taxlot.te3l:l? DESCRIPTION OF WORK K/f(.I~61V UCNTS OlJiUT S- f:>.fP/L/ ,,"'CO PROPERTY OWNER Name: D ~5 CALc "- '\. IV' Address: 'i 2-0 ':) d t fO g, ,]10 City: Fc. \) State: M- ZIP:CYl Phone: E-mail: This installation is being made on residential or fann property owned by me or a member of my immediate family. This property is not inteoded for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR INSTALLATION Business name: fAsT5/DE ELEnf(IC Address: '?'1i.l5's 80SC(IG.6 IN. City: 5 P f <..D State: 0 fZ ZIP: ~ 7 4 n Phone: - 7LfI-IV'i9 Fax: -731:,' '1960 E-mail: R/(KOS75/i)E(Q: YAHo6. (01)1 CCBlicenseno.: !1'}770 BCD license no.: 20 -YOS'c. lJ7J.7S 06-(;((. I ~it. ~~ Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440-2584-1 (9/08/COM) FEE SCHEDULE Number of inspections per item (J Qty. Cost Total 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 $ 20 I 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 $ 20 I to 400 amps (2) $ 87.00 $ 40 I to 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 ofa service or feeder fee: Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) I $ 55.00 $55 Each additional branch circuit 7 $ 6.00 $'1)" Miscellaneous fees: service or feeder not includ~d 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 subtotal of above fees $ '1'7 ~ (Minimnm Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ i/"0- (e) Techoology Fee (5% of [A]) $ ~~ TOTAL fees and surchnrges (A through C): $ 1/ '$ '-d. .. ,. Sf .R.,.....I..N.G...FIE L~ ~. ",t'" .~ .>";,, } 'OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00069 IVR Number: 811182347364 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: Issued :" ,I ISSUEp: 8/17/10 APPLIED: 8/17/10 . .' ,.,.~ ' . .. EXPIRES: 2/12/2011 VALUE: $0.00 SITE ADDRESS: 4205 DAISY Springfield ASSES OR'S PARCEL NO: 1702323305300 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Circuits for kitchen lights and applainces Phone Number: OWNER: ADDRESS: HODGES CAROLYN A .POBOX390" . '~'I SPRINGFIELD OR 97477 _" : Or~flon I.... . in ," '!"" c;~, !."':..C1CONTRACT:ORtiNFQRMATION . ,1-1:J(;,)'11'\ -. . "uveru .....-or V lilt . OOSJ C?~!ractorlN_a.!'1~II"=' ,...Ues arR on" Y LIe Type CallEASTSIDE ElECTRIC.INC' ~~!Jrl UAR 9 . .6"11 CCB IIln tJ..__ - --'-;.-11,) ("'1'"...... nUmberro; th~n~". (NCBVI~':l!~~rif.iF'ORM Center' "un U1ility N :/;''' ne IS 1-80n.~~~ ~_ ot/flcation 11 <wStar...si). I Height of Structure: Type of,Heat: Wat~r ~TY'P~:--'- """":"-- ..' "' ~.~.t r. ,'. ; RangiiCliype'::rh,n Haz'rhlrtJr ~t'i li~l f Contractor Type # of Units: o # of Bedrooms: ~OTlCE: . .,..",,. H~~RMrr~,. ~r AUTHOR 'r=I""tr~'I!'.!i/!'l~altx..code Edition: COMM fZED Ul1jfJiePlfi~Ifl,/iir.rclialEltitiil.riDRK A ENCED ~~~anic:il sp~c!i,\fM~~.'i Ij.dllion: NY 180 DAY pmrr\cffi~ft,D.rv:~!'!e.'B"J!tf~[/~: I Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Speci~!tx ~~~e E~ition: 1. '....._.:.<:" _. . ~~\.~~.:... Site.'.inf~rffl_~t~on 1., ~ Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: ',"'. '," ~ :IYil:~''',-, ",c, . , ,~.. ' ',i ' ''E{Ir'~lk 10 ~i~~~(): : ....i:t i"J { ^l~"-' Springfield, Building Permit 8/17/2010 11;13:22AM Lie No 117770 Lie Exp 10/04/2011 Phone 541-741-1499 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: Page 1 of 3 . WWW.ci.springfield.or.us CITY OF'SPRINGFIElD .. ,;:rj,:~"~,f!:t';~J'~l BUlldll1g+J~esldentlal Permit PERMIT NO: 811-SPR2010-00069 IVR Number: 811182347364 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perTT'lilce nter@ci.springfield.or,us PROJECT STATUS: Issued ISSUED: 8/17/10 APPLIED: 8/17/10 EXPIRES: 2/12/2011 VALUE: $0.00 SITE ADDRESS: 4205 DAISY Spring"field ASSESOR'S PARCEL NO: 1702323305300 -:.f;:' SCOPE: Electrical Only WORK INVOLVED: Alteration ~~ tl::,:i i,{!; ~:[ , ',TYf;'E OF STRUCTURE: Residential ~,,;. '. PROJECT DESCRIPTION: Circuits for kitchen lightS and applainces DEVELOPMENT INFORMA nON ~ 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 , ... , -..01"( u__ north property Iiri:e: .' "" r .,:,l_'::~, . , ';.,. .-,;,H ,',~1<' Total: Handicapped: . Compact: : '. PUBlic IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: 'I' ~; ';.'},I;:' ,;.:-".n 'i' .T':,"'- \t;UI~' , ( rX,l.~_ .,......' Valuation Description I Oescriotion T vce of Construction Unit Amount Unit Tvee Unit Cost Value r-z-c --u~-:-:u:7~:7---:--,,-~::-:-:u;.i -- -1;1;.E'(e~ii:i";' Descriotion Amount Paid . ~. .' ..~ Branch circuits without service or feeder -1st circuit $5~.Oq'1 Branch circuits without service or feeder - each additional, ,~;..',~ ! : ~',.J $4?:QQ):t".' State of Oregon Surcharge (12% of applicable fees) : !.'7~i?"i-i.U ~ . '$11:64 Technology fee (5% of permit total) ''":'1 ",-. '$4.85 Total Amount Paid $113.49 :ti~:~,"(J;i,i .' '1" -".~:r"':~.~' "-_ -- . -- uJ H, . J -,k._,;......_.~ Date Paid 06/17/2010 06/17/2010 06/17/2010 06/17/2010 Receiot # 299244 299244 299244 299244 ....~ '! .l'~~i'" ,i ,:'i!.~:,J , ; ~.i., .r' '.' " Springfield Building Permit . ;<;-'8~,17/2o'~qrl1:13:22AM ":r'i," .. , ,1-,.:; Page 2 of3 www.ci.springfield.or.us PROJECT STATUS: Issued ;.,;~{"gj~; :"\~,~~,H~ ~" ,~....~ , 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: 81 ~ -SPR201 0-00069 IVR Number: 8\1,1~~,3473~4 permitcenter@cLspringfield.or.us ISSUED: 8/17/1'6:/.\' :. >~.. '. ~ . . ,~ It- APPLIED: 8/17i1b EXPIRES: 2/12/2011 VALUE: $0.00 SITE ADDRESS: 4205 DAISY Springfield ASSESOR'S PARCEL NO: 1702323305300 PROJECT DESCRIPTION: f~}:~!:;~':" -'{:; Deoartment Application Acceptance Initial Review Planning Review Public Works Review Structural Review Permit Issuance SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential ,;10"";:;':' k:. Circuits for kitchen lights and applainces >>'~~;~'t';; . ":X"~t~rr~i~I~~~;;~:+~;>;1:'~'l'i'-''- :."0 ...--"'h.l:~: ?-~~i __'i~~,~-~; :~~~~_ ~'~i: __-~~. . -.' J "-ry--;.,.-:- Received 08/17/2010 08/17/2010 08/1712010 08/17/2010 08/17/2010 08/1712010 Due Date 08/17/2010 08/17/2010 08/1712010 08/17/2010 08/17/2010 08/1712010 Comolete 08/17/2010," 08/17/20)0" 08/17/2010 . 08/17/2010 08/17/2010 08/1712010 Result " Oi.ier'the Counter .Ovetttie.Counter Not Required Not Required - Not Required Issued Reviewer Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Comments Over the counter permit Over the counter permit Over the counter permit Over the counter permit Inspections 4500 Rough Electrical 4999 Final Electrical INSPECTIONS REQUIRED I .Ii, ',\ ,. By signature, I state and agree, that I have carefully exa')1in~d t~~.,co",pl~t~d,application and do hereby certify that all information hereon is true and correct, and I further c~rtjfy:tti~t:any'and ?l.I'work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of th"e:'State or 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. ~[J1 I(~ Owner or Contractor Signature Springfield Building Permit ,~;;,i, .', D - / 7~ I (} .~11t HlC'.:-;\;ll; :,):: 0) i~ r'\'J~;f :rp~te "~-:::~{;m ':";\.'\'-t"t"l ;.. ''OJ[' . ~ '-':., ''In'.-lif<} "':,Hd.\':'; , , r... "1'; , -"..1 ~.,I ..~1 !'if.;:?J . ,:- 'If' 8/1712010 11:13:22AM . }j"\J Page 3 of 3 . S~.:I~~E~ ~.".. . "c.,~ .. > OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us permilce nter@ci.springfield,or.us DATE: 08/17/2010 RECEIPT NO: 2010000069 ~f:}2d'f2i1: RECORD NO: 811-SPR2010-00069 IDESCRlfltlbN~!:i',~'tc';''''... "_ -~. " ,,:~'j:, "' Branch circuits without service or feeder - 1st circuit Branch circuits without service or feeder - each additional State of Oregon Surcharge (12% of applicable fees)' 'i:';' .q....... Tec~~nology fee (5% of permit total)1:i;~,,~~- '~il."-~:";"~CCPI..rN:1Ic.bDEi" -,," . ~MOJI.~JLOJ.)E 224-00000-426102 $55.00 224-00000-426102 $42.00 ,/1. i;;', .821-00000-215004 $11.64 ,l(:'~:.". 100-00000-425605 $4.85 TOTAL DUE: $113.49 .. :r ... ~\ 'c'?:'.: ....:JL~~~tQ_U.N:r-R~IO-"--"~'-"'" j $113.49 ~{j~AYM~tj;t:'r'a1E' l.~ : P~,(QR i~4;cASHiER:cCARP[NLE~C.OMMENTS Credit Card EASTSIDE ELECTRIC INC 00580c .~' Ii . ," ,,~r ~ '.~~~!:~;." :.~~~'-rl:1 ~: .-. f;' . . .r (<~.: !.~ ii;::.. ~.I' fH.', "1"'.' "J,l.'\ ~" . . ~ .."'<Z",:'':" ,~ '! .. ":,~t~f~ . ,. " .1' , '''. .~"