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Home My WebLink AboutPermit Electrical 2010-11-5 Electrical Permit Application . . 225 Fifth S'reet.Springfield, OR 97477tPH(54t)726-3753+FAX(54t)726-3689 ~ DEPARTMENT USE ONLY Sf?rZ.z..o<O-CO bb.3 Penmt no.: Date: //-<:;-( Q 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 APPROVAL Zoning approval verified? DYes, D No CATEGORY OF CONSTRUCTION "lSlResidential I D Government I D Commercial ,JOB SITE INFORMATION AND LOCATION Job site address:/35 lc,-k,<:.LlYv l\ tCO."l CityNl\' '\",,\111 I StateC42- ZIM/4-IS:1) Referen~e: /7e: Z- '3 s z.. -S I Taxlot.:6/Cf (sO DESCRIPTION OF WORK ;::... ,. \r Ir ,?' ~0 '/\ P ~ (In", >r\' ,.0 (j PROPERTY OWNER Name: thr Ir.\ ,1,(1r y-y .\. Cd7'-f..'JJ.... ') Address: ,i:::::::. t r\ ~ <G'h }, X:...-n ( 'Ili'1 City?J\)\{ \ yy~ \ p(),1 Stat('k ZIFYJ L\--P Phone;jJ\ =JZ1n 'X~ I I Fax: - - '-' E-mail: f" \J \~ V"~( \r\C.w-r\N )'(")((V \ICI.1rv n, Co ,v, This installation is being made on residential or f.Jm 'property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.54~ IJ .'" Signatu....-;- (be.:-. ~ . "2.> ~ ...0NTt<A..., OR illiSTAL '",uN Business name: I'J V I .~ Address: City: I State: ZIP: Phone: - - I Fax: - - E-mail: CCB license no.: I BCD license no.: Signing supervisor's license no,: Print name of signing supervisor: Signature of signing supervisor: FEE SCHEDULE Number of inspections per item () 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 manufacrured home or modular $ 63,00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) , $ 81.00 $ 8; I 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: instal/ation, 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, alteration, extension per panel a. Fec for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for bran~h circuits without purchase ofa service or feeder fee; First branch circuit (2) Each additional branch circuit $ 55.00 $ $ 6,00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or extension (2) $ 63.00 $ $ 63.00 $ $ 63.00 $ $58.00 $ $ <61 $ 97Z $ LjD" $ 9 'i 7.1 Each additional inspection: (1) ATTENTION: dOretdn ~~~hr:6~~~~X~iii~y \c--..~ 0 APPLICANT USE follow rules a op e les are set forth ~\\.9 ~ (A) Enter subtotal of above fees Notification Center, Th~se rUh OAR 952.-001- ~.~. ~ (Minimum Permit Fee $58.00) in OAR ;52..001-~gt~~~ ;~~i~S of the rules by r\f ~ (B) Enter 12% surcharge (.12 x [A]) 0090. ou may t (Note' the telephone \J'- calling the cen er. 'N t'f' ation (C) ,Tcchnology Fee (5% of[A])<. number for the, oregon_Util~t2.Y3440 I,IC NOTICE Center IS 1-800332.) THIS PE TOTAh.1 S~lJ\!>f\'!P'Wi~.wIW>\{gh C): AUTHORliE'6 UNDER THIS PERMIT IS NU I COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. 440-2584-J (9/08/COM) SPRINGFIELD ~.'!'i~,,;~tf; .. :>'.lY>".:~ ~ ,. ... . OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00663 IVR Number: 811135596080 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 11/05/2010 ISSUED: APPLIED: 11/05/2010 11/05/2010 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield,or.us EXPIRES: VALUE: 05/04/2011 $0.00 SITE ADDRESS: 735 LAKSONEN lOOP, Springfield, OR 97478-7268 ASSESOR'S PARCEL NO: 1702352301400 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service panel change Phone Number: OWNER: ADDRESS: RICHARDSON ELVIA l YNN 735 lAKSONEN lOOP SPRINGFIELD OR 97478 Contractor Type Electrical Contractor Contractor Name OWNER CONTRACTOR INFORMATION ~ Lic Type OWNER BUILDING INFORMATION ~ # of Stories: Height of Stru~ture: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal' Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Spe,cialty Code Edition: lic No 0000000 lic Exp 08/12/2025 Phone lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy load: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: .. .. . NOTICE:'..'.>'" . THIS PERMIT SHALL EXPIRE IF THE WORK. . AUTHORIZED UNDER THIS PERMIT IS NOT. COMMENCED OR IS ABANDONED FOR .,... ANY 180 DAY PERIOD. ATTENTION: oreflo; ~~~hr:6~~~~X~~i~i~Y follow rules adop e ules are set forth Notification Center. Th~se r hOAR 952-001- in OAR 952-001-0~t~~~ ;~~i~S of the rules by 0090.. You may 0 Note: the telephone call1n9 the cen~r. (on Utility Notification number for the 11e8900_332-2344). Center IS - Springfield Building Permit 11/5/2010 10:01:32AM Page 1 of 3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00663 IVR Number: 811135596080 225 Fifth 51 Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued . 11/05/2010 ISSUED: APPLIED: 11/05/2010 11/05/2010 EXPIRES: VALUE: 05/04/2011 $0.00 SITE ADDRESS: 735 LAKSONEN LOOP, Springfield, OR 97478-7268 ASSESOR'S PARCEL NO: 1702352301400 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Service panel change DEVELOPMENT INFORMA TION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuati.on Description ~ Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ DescriDtion Services 200 amps or less Technology fee (5% of permil tolal) State of Oregon Surchar~e (12% of applicable fees) Total Amount Paid Amount Paid $81.00 $4.05 $9.72 $94.77 Date Paid 11/05/2010 11/05/2010 11/05/2010 ReceiDt # 374812 374812 374812 Springfield Building Permit 11/5/2010 10:01:32AM Page 2 of 3 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00663 IVR Number: 811135596080 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 11/05/2010 11/05/2010 Issued 11/05/2010 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 05/04/2011 $0.00 SITE ADDRESS: 735 LAKSONEN LOOP, Springfield, OR 97478-7268 ASSESOR'S PARCEL NO: 1702352301400 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service panel change Plan Review I Department Application Acceptance Received 11/05/2010 Comoleted 11/05/2010 Result Over the Counter Due Date 11/05/2010 Reviewer David Bowlsby Electrical Review 11/05/2010 11/05/2010 11/05/2010 Comments: Over the counter permit VnitialReview,"', :"It.,~ ',''.' ~,:.:-111D5/261 ri~-',11i05L2D1 D,_ ')1/051201 0 ,~_ ('~~~~~m~~ts:.~:?~~+i~,h~e\~8~~qie~I~4r~i(~'"'~::Zr:[;( ~;_::7';'. -:;':>,.: .~~.~ 4 ~-~;'h;. I Not Required Ov~r-t~e~,Couh!et": .' "'_ :"-; >0ilf~''''';_7:';~. f""':'""; I INSPECTIONS REQUIRED Inspections 4220 Electrical - Service David Bowlsby -David\.Bowlsby;' .il'.. --.~~,,;_-;',- : :~ = ~~;jf;~: .~ " By signature, 1 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 construction. ~ //- 'J-~ / 0 Date Springfield Building Permit 11/5/2010 10:01:32AM Page 3 of 3 .' . www.ci.springfield.OLUS TRANSACTION RECEIPT 811-SPR2010-00663 735 LAKSONEN LOOP CITY OF SPRINGFIELD 225 Fifth 5t Springfleld,OR 97477 541-726-3753 permitcenter@ci,springfield,or,us RECEIPT NO: 2010000767 RECORD NO: 81 I-SPR20 I 0-00663 DATE, 11/05/2010 :"' '".~".f~;,.;^'CC()U'-NT:'CO'D. E- ':>~~;&'~:;~"J"" ,~A.MO- UNT-DUE'- ~.,--._.. , . -- ,._. ~. , ~- ,_..--._~.~-_.._- -".-,-_.,._.- 224-00000-426102 $81.00 100-00000-425605 $4,05 821-00000-215004 $9.72 TOTAL DUE: $94.77 , F?AYMENT,;TYPE;;:40'0P.AYOR~~~~CASHf{RbBQWuSBy,~"(.i:G.()MME~[s\k~.-i: .~.'" "'''':','~''~';*'AM0UNT.PA!D;i;:i' '0 :1 !OESCRIPilor'l?0 _ ' _.-,~:;,;:- , -.0';." ': " Services 200 amps or less TeChnology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) ''''-A] Cash RICHARDSON ELVIA LYNN $94.77 $94.77