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Home My WebLink AboutPermit Electrical 2010-10-1 EleCtrical Permit Application . 225 Fifth Street. Springfield, OR 97477t PH(541)726-3753+ FAX(54 1)726-3689 ,." .',' ......... ';'. DERARTMENTUSE ONLY . '. "'~,':" .. . ., . . . . SIO - 00 L.t1L( Permit no.: Date: /0 -/-(0 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. :'! \. ""EOCAVGO\lERNMEN"'~MRBOVAI1l<:.,'\1;"~~;;1'~", Zoning approval verified? 0 Yes 0 No ',::;I.\.,;,;\;,CMEGORy~OI7'L:<::ONSTRU.CTION2R;-;";;,. ';:^< bA/t!f-( Name: Address: City: Phone:']'1' 7V7-0VtJ Fax:...-- E-mail: hfft, vr-e-II7 elJ CD qff'T'. I'J~ This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not' d for sale, exchan e, lease, or rent. OAR 479.540(1 d 479.5 (1). Signature: 'V") . ;:CQNTRACTOR INSTA~LATION Business name: D M ....Il Address: City: Phone: E-mail: CCB license no.: ZIP: Fax: BCD license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ATTENTION: Oregon law requires you.t.o follow rules adopted by the Oregon ~~h%, N tIfI atlon Centet Those rules are se 0 I oO~ 952-001.0010 through OAR 952-001- ~ You may obtain copies of the rules by liln the center, (Note: the tel~~hone :mb~r for the Oregon Utility Notification Canter Ia 1.800-332-234_4). ~.~ ,W"\' 440-2584-J (9108/COM) ~ f\;1?~t;js~~~~~\f]r~1:;;\~~~~R~f:~"'}FEE'~~S'CH E_[j_UlEEl[a\{*~~\~~~%~~~~~~t$~B "" " .,' .. ,;":"-'-"-,' ;_ 'r' :-"-"-'-,,"-,__Jii-','.::'. <>.'. ," cost;J 'Total ,Num'berofin;peciio'ns~peritein().: .,;, 'Qty: ,~l.'l:;'eil~~t -" ,,~::"'C9st: " '-"', _ ,',j ,>,"/c",j e._,.... "1-: .,;.';i.'.;,....'~:, .::/f;:; "'\-!-,"';...:\..",.~":" '.,-, :." 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] to 400 amps (2) $ 95.00 $ 40] to 600 amps (2) $158.00 $ 60] to 1,000 amps (2) $205.00 $ Over] ,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temp~rary servic'es or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 20] 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, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) I $ 55.00 $ s-s Each additional branch circuit $ .,6.00 $ .. "'~~. , Miscellaneous rees: service or feeder not inCtu~ \NO?'\( . Each l\~"\~tion crol. to., EJ(?\P-'t '11 ~ Ol," Each Si~WI~{a'CR iH\ ,~:, . . {l)~"~:!,, Signal ~1t 1.'OW\S>,j\,\:I!". $ 6300" $ alteratlcil't'1\\~wro - - . Each ad;jjilN"ijlMl~hi"ni; $58.00 $ ""'l1-\,L"",j-*:>''l}.~'''''--l"'F~''\:'''''''""''''':^'~'''''".---''''''''"'.'~'' .....,'..,,--.......,,-.. ..- .e__~'.'.A.,> . .--.. - ~ ,~!-'::, 1{,;~\~1,~.:'i,~,~i3r(~'A~jf7&'S1AEPllIGAN1Vf.USE ?$.'k":--<~;l.'*)j\;'{;'t:,;>';lK).ti_,;;;~"..'~:,'., ,l\,__,,,;j ,.,.._"", d':i> ,if':,.;",.,?L".". ~".m:'; .. __... ..... 'G'._ _ /:iC,-~.:c;,,1\;',,<i~~;,)'i).,:~.J,~2.';J-,i<,.:,,~ :,,~ (A) Enter subtotal ~f~ ~ $ 58 (Minimum Permit e $58.00>- ~ (B) Enter 12% surcharge (.12 x [A]) $ b:;E:;o (C) Technology Fee (5% or [A]) $ 'ZfO TOTAL rees and surcharges (A through C): $b7~ ~ ..SPRINGfiELD. ~~~''t!Ii' ,ifi" ~ $ /c, OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00414 IVR Number: 811174114031 225 fifth 5t Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726.3769 Fax: 541.726.3676 www.ci.springfield.or.us perm itcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 10/1/10 APPLIED: 10/1/10 EXPIRES: 3/30/2011 VALUE: $0.00 SITE ADDRESS: 301 69TH ASSES OR'S PARCEL NO: Springfield 1702353201700 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Add 1 circuit OWNER: ADDRESS: FARREll RICHARD M & D l 301 69TH Pl SPRINGFIELD OR 97478 Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type lie No lie Exp Phone BUilDING INFORMATION ~ # of Units: o # of Stories: I Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq FI Garage: Sq FI Carport: Sq FI Other: Occupancy Load: # of Bedrooms: Sprinkled Building: Fire Alarms: Electrical Specialty Code Edition: Springfield Fire Code Edition:' Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Energy Path: Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wail: Soils Report RAA1l1~TION: Oregon law requires you to 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 for the Oregon Utility Notification Center is 1-800-332-2344), . . . " -:1:.-~-'if'~\';:'~;'\~;:"::':>.',~i"":'-"-'" NOTICE: .... ....". . THIS PERMIT SHAll EXPIRE IF THE WORK ~:. AUTHORIZED UNDER THIS PERMIT IS NO~\ COMMENCED DR IS ABANDONED FOR \. " ANY 180 DAY PERIOD. '. ..,.:.,. Springfield Building Permit 10/1/2010 8:13:24AM Page 1 of3 .5.~R.IH...G...FIE~.D.. . ~t 'ii~- r;A->. 'C_,.~ >";:.. OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00414 IVR Number: 811174114031 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 10/1/10 APPLIED: 10/1/10 EXPIRES: 3/30/2011 VALUE: $0.00 SITE ADDRESS: 301 69TH ASSESOR'S PARCEL NO: Springfield 1702353201700 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Add 1 circuit DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # StreetTrees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Total: Handicapped: Compact: PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description' I Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value Description Branch circuits without service or feeder ~ 1 st circuit Balance of Minimum Electrical Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid Amount Paid $55.00 $3.00 $6.96 $2.90 $67.86 Date Paid 10/01/2010 10/01/2010 10/01/2010 10/01/2010 Receiot # 374459 374459 374459 374459 Springfield Building Permit 10/1/2010 8:13:24AM Page 2 of 3 . SPRIN.G.FIEL.~.D.. .~~ li f;tJ ""OREGON www.ci.springfiefd.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00414 IVR Number: 811174114031 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 ISSUED: 10/1/10 APPLIED: 10/1/10 EXPIRES: 3/30/2011 VALUE: $0.00 SITE ADDRESS: 301 69TH ASSES OR'S PARCEL NO: Springfield 1702353201700 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Add 1 circuit r;,"'::~-;~t>~ :;-'\ .~'::7;:L'~Hf; ,~~,:;!-;,t:~"^lJ ~"~,"tlJ;:t'~r~?^~r::~~~~~3.~'V~~7J1;~~~:::l~~ ~~,?l0::T,"'::::~':~t:;:: ;u:~,~. _.": -: r' '"'~ -'" '" -1 DeDartment Permit Issuance Application Acceptance Initial Review Planning Review Public Works Review Structural Review Received 10/01/2010 10/01/2010 10/01/2010 10/01/2010 10/01/2010 10/01/2010 Due Date 10/01/2010 10/01/2010 10/01/2010 10/01/2010 10/01/2010 10/01/2010 ComDlete 10/01/2010 10/01/2010 10101/2010 10/01/2010 10/01/2010 10/01/2010 Result Issued Over the Counter Over the Counter Not Required Not Required Not Required Reviewer David Bowlsby David Bowlsby David Bowlsby David Bowlsby David Bowlsby David Bowlsby Comments Over the counter permit Over the counter permit Over the counter permit Over the counter permit INSPECTIONS REQUIRED I Inspections 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 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 constr ~ ~ ,f} 1", /, (J , ,- Owner or Contractor Signature Date Springfield Building Permit 10/1/2010 8:13:24AM Page 3 of 3 www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2Q10-00414 301 69TH PL CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitcenler@ci.springfield.or.us RECEIPT NO: 2010000451 RECORD NO: 8II-SPR20 I 0-00414 DATE: 10/01/2010 t@SCRIPTi9NfT=~:1:~~!1,~!,'~~ :"\'"'-;'~~ij;:'~:'~<=:.,,':'~ 'Jk;:1:j:~\~!r~.2WitAGG.P~O'NT~C~QE~",~:yftft0:-E:;~~~~QQ}"ltitUE't:r'" >~r:~~ ~;~7 :I Branch circuits without service or leeder - 1st circuit 224-00000-426102 $55.00 Balance of Minimum Electrical Permit Fees 224-00000-426102 $3.00 State 01 Oregon Surcharge (12% 01 applicable lees) 821-000~0-215004 $6.96 Techr1.ologx lee (5% o.!permit total) 100-00000-425605 $2.90 TOTAL DUE: $67.86 LJ~A YlV!l;,lIlt;TYgg~7'PA't'<;)R1;;;' ciisHIE:R9tfQvVi,sBY.F",;.;C9MMglllI.S'JS;:4;,,,.i;"~ ii11if.i~":::'~;':AM()UNT:pAID. .:",..J;", I Check 10210 FARRELL RICHARD M & D L $67.86 $67.86