HomeMy WebLinkAboutPermit Electrical 2010-12-7
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www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-5PR2010-00839
IVR Number: 811144364350
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilce nter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/07/2010
ISSUED:
APPLIED:
12/07/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$0.00
SITE ADDRESS: 91.1 ISLAND ST, Springfield, OR 97477-3523
ASSESOR'S PARCEL NO: 1703342100700
SCOPE: Electrical Only
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Two circuits for heat pump
OWNER:
ADDRESS:
TILLER JOEL
911 ISLAND ST
SPRINGFIELD OR 97477
Phone Number:
Contractor Type
Contractor Name
CONTRACTOR INFORMATION ~
Lic Type
Lie No
Lic Exp
Phone
BUILDING INFORMA nON ~
# of Units:
o
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
Sq Ft Basement:
Sq Ft Garage:
o n law re~'!JPel$~Jlto
ATTENTION: d rereod by theS,qIF.t"Qther:tility
follow rules a op _ _. 1M'>'
. t' Center Those rLOccupancy.[oad:
Notlflca Ion . hOAR 952-001-
Electrical Spec!'altr, "ode'Edition:001 0 throug f h I by
II /..... . -.... - .' 0 t e ru es
S ' f' Id F' ~ -d Ed' 'ti -ay obtain copies
pring Ie "e.,<o e Ion: (N t ,the telephone
. .r-IIi..." thq ['enter. 0 e. ,. .. .
Mechamcal Specialty Code EdlllonOregoll Utility Notification
number tor 1118 4)
Municipal! Development Code:'r 'IS 1-800-332-234 ,
Vtllll......
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
o
Site Information
~
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
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r. \'f -n-\r. ~01
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1\-11S ?r.I'\\IJ\~~ \l~Dr.1'\ 1\-1I~DO~r.D 1'01'\
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Springfield Building Permit
12f7f2010 12:37:41PM
Page 1 of 3
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00839
IVR Number: 811144364350
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
pennitcenler@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/07/2010
ISSUED: .
APPLIED:
12/07/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$0.00
SITE ADDRESS: 911 ISLAND ST, Springfield, OR 97477-3523
ASSESOR'S PARCEL NO: 1703342100700
SCOPE: Electrical Only
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Two circuits for heat pump
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
'% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
PROJECT DESCRIPTION:
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
DownspoutJDrains:
Valuation Description
~
DescriDtion
Tvee of Construction
Unit Amount Unit Tvee
Unit Cost
Value
I
FEES PAID
~
Descriotion
Branch circuits without service or feeder - 1st circuit
~._--
Branch circuits without service or feeder - each additional
- ~ ---
Stat=-~Oreg~n Surcharge (12o/~_-,,-~ appli~~I=-fees) _._
Technology fee (5% of permit t~al)
Total Amount Paid
Amount Paid
$55.00
$6.00
$7.32
$3.05
$71.37
Date Paid
12/07/2010
12/07/2010
12/07/2010
12/07/2010
Receiot #
375064
375064
375064
375064
Springfield Building Permit
12n12010 12:37:41PM
Page 2 of 3
ST1N....:-fIE.~~ .
~,~~
iA~'\.~ '
. ...~\ OREGON
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541.726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
Building I Residential Permit
PERMIT NO: 811-SPR2010-00839
IVR Number: 811144364350
permilce nter@ci.springfield , or. U S
PROJECT STATUS:
STATUS DATE:
Issued
12/07/2010
ISSUED:
APPLIED:
12/07/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$0.00
SITE ADDRESS: 911 ISLAND ST, Springfield, OR 97477-3523
ASSESOR'S PARCEL NO: 1703342100700
SCOPE: Electrical Only
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Two circuits for heat pump
Plan Review
~
DeDartment
Application Acceptance
Received Due Date ComDleted
12/0.7/20.10. 12/0.7/20.10. 12/0.7/20.10.
Result
Over the Counter
Reviewer
Nancy Machado
Permit Issuance
Structural Review
12/0.7/20.10. 12/0.7/20.10. 12/0.7/20.10.
Not Required
Nancy Machado
Comments: Over the counter permit
[Plabning'Rey;e't!." :;~l.-:, >;, -1?/07/2D1D'" 12/Q7/2D1D\'i.12/D1I20jO>.i/, N"jReguired:""""":'''':''Nancy:f!'1achadoj C'
f :"~E~fu~:~t~":~": ov~~tb~'~9~h~rp:~~i',o:;:;,&~7%;~~:~~~ ';.'~'~~4f~~~:~~~~~:~i-~:~:;~~:~~~~t~~~> "~ ::, ~~j~'- r,..', ,~~~~' '" 1;~ ~' -~;'
\~: jJ
'-:':1
INSPECTIONS REQUIRED ~
Inspections
450.0. Rough Electrical
4999 Final Electrical
~ough Electric: Prior to Cover
Final Electric: When all electrical work 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 1 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.
/2-- 7-10
Date,
Springfield Building Permit
12/712010 12:37:41PM
Page 3 of 3
Electrical Permit Application
SPRINGFIELD t:";,"\i\'^,'\fi:;'-
~~~~,:p,"",'n'i'-:;.ic ~",;~.i';~'-.,...:> ,..~'.,.~-':::,<i:_;a;r""'-;'':1<,,".-M'''l;V'~~~'Y. <,~:~
:';\7~';DEPARTMENT,USE;ONI::Y!;',*",
';'t.!::J;....\"+~-,,;:~.,<;'., .:<' -";;'>"':.'''''1;''';'';', ";<;:Sq, -;'C;; f ;<'\~:<,"'.':r;"A0'J.:}j,iS
225 F;fth StreettSpdngfi,ld, OR 97477tPH(541)726-3753+ FAX(541)726-3689
J;;~~j)fr:;af:~:/ Penn it no.:
30
Date: :2.:-- 1 - 1 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,
I~-' '~--lf()CAEX!fGOVERNMENT".ll:EF1R0VAlrr~~'-"---' SiAf~l~t:4W;\$~\1"S~~}t:ilii'~'tEEEJS'CREBl:.JIJIE~~~';'\<""'lig>>;X,~':":'~~t~AV1t;
'l:~:~:7 i$~'.~~4&;t& ", ___'_ ..~"+.l_ . ',. : __.J_; ,._ "J \~'L'__" ~ __ -'.. __ ,_.,,~~.,.. Wt'i~\i~!f.il.f~9ft '11~" :i',""'c:,?:$l~1};fj?J~*,-k1' _9 _..::"-" _.,',. ; , ,_ , '
,.' . ~__ 1kJ,{Y;"X::':r(',,:;-iiJ;.l'#+t:;;'j.'xtla. :'!-'iii;ii
Zoning approval verified? DYes DNo i"~1Ii,~Q,~~~"J;~!1i.",,?Z'i!"""\'f1~ "''''f'_S\~'Tot:ilf!'1!
ctNumber,,;of,lOs ectlons> er,dtemr,;; ,tf;~~_ ' t ! , ,i/'" 0" ';'
!';;~'ljj(,4''l1r''~'7CA'T;EG()RY,'~()F'(C0 NS;tRlJCTI0N)!i';1'\~"IW"'!!i'-, h:p~lm;';~1l-~",';tih,,;'!~<c:JJ:;,\il,i~{';'&l~;R!:f{';~Jr1-'~D:,iJ~'~~ ~:~~~'~'L~Q~J\@t
dt-;,..'-:"-, ,,~,1;(;t,,~.,;l.~,,\t.. .', :_.1_ ',,, : .:.,." '~":S' _ ., .,1,' . _, i.' _... ,1,9l"th ~.." ".:.",..~'ii, Residential, per unit, service included:
~Residential I D Government I D Commercial
1,000 sq. ft. or less (4) $134.00 $
~\W~~~'ti1'J()B):simE~1 Nf;'ORNi;tl.TION .':iAN[),!L()CA'l'I()Nir~);~'l.J.1:)
Job site address: ~ II IC(u'\.J "',t- Each additional 500 sq. ft. or portion $ 25.00 $
thereof
City: SP{'iw. r'..!d_ State: () K I ZIP: "179'< '( Limited energy (2) $ 32.00 $
Reference:' Vl (')?.,~, .\ I TaxlotOCJ1Cl:) Each manufactured home or modular $ 63.00 $
'v""i"~"iJ1@-'F"'-DESCRIP;rIOI i-&~~i~,WdRK{~{EJ,:}~~!{%~~~~r~ dwelling service or feeder (2)
iti;$};\,::;, -?'.,~~irt!;}~';;'ft};j!}, '_' " ;;j;,,_
*<I'Y/ (It "h(l i \.,. ~ , -=-l Services or feeders: installation, alteration, relocation
~n' tvU) U . 200 amps or less (2) $ 81.00 $
. . '; ~ - ", "~~f1;:~qi-&J11'r~-~"" ,jli1~~ 201 to 400 amps (2) $ 95.00 $
, . RT:'Ii,,,o'WNER.'M'~'.,_,,,,~'@i;~~,.,,w,
Name: 'Soul 1/11'(,( 401 to 600 amps (2) $158.00 $
Address: i:1/1 !<,/c,,^d 'II- 601 to 1,000 amps (2) $205.00 $
City: SPf,'wJ,'<.ld I State: DR. I ZIP: Cj 7V11 Over 1,000 amps or volts (2) $469.00 $
Phone: <'!;-:q .fI 5'lo-8!;i 31 Fax: Reconnect only (2) $ 63.00 $
- -
E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or fann property 200 amps or less (2) $ 63.00 $
owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 87.00 $
property is not intW~ sale, exchange, lease, or rent. OAR 401 to 600 amps (2)
479.540(1) and 47 6 "" / $126.00 $
. -I. Over 600 amps or I ,000 volts, see services or feeders section above
SIgnature: .d"t~ -
~bI!i"RACT0RlIiN$:rA'l!IE'A'I1I()N""ii:1\:'{,'W,%~~:'r'4" Branch circuits: new, alteration, extension per panel
, __ '" '" _ , , ' ~"A',_" _ ,L:_,_ --:, ~._..'< '___)l:&;;J'..;.'j'~!]r<:'&t;L,;,l'A\~~~
Busine s name: a. Fee for branch circuits with purchase of a service or feeder fee:
--- /'
Address: Each branch circuit $ 6.00 $
I State: J.-.ro>:' . b. Fee -for branch circuits without purchase of a service or feeder fee:
City:
p~ - - ~ - - First branch circuit (2) / $ 55.00 $ 5_
E-mail: ...---- -- Each additional branch circuit I $ 6.00 $ &,
CCB licen~ BCD lice~ Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: ~ Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: -.""" Each sign or outline lighting (2) $ 63.00 $
>-
~~ circuitJ>!-tl,li~iH;:9-~f[gl'~parieliN reql Ire~_~v"" . -
Signature of signing supervisor: 1e 0 e$c63.00il t,$
alte 10n,l~r extensI9n(~L,.,Y\tPrl bv ~ " ,In
- --I- ~I
d-'lf'\\~' . un..'" -- . rUl8;1~ air. ....... .
Each ad itianal ins~ectian:,(,I) ThOSE _~ '\h~~8jIl.O( 0$-
.' L,,,;,,n,,,,_",,,,,,,,,,,, .
;rOnCE: '~-.'."'.-r--""-"'~---'~i~l1'J~~
'.,.".,J;,,:;';.', jll\eEJ.!IGANJ....USE.: .' . ;~-:_ :iL~~<.\.
THIS PERMIT SHALL EXPIRE IF THE WORK ,.. 'f! :"(I~\I fJUl.:l" , ~-. t l:lpnollt:: ~
(A) Enter's)lbfutal of above feesr I\~c\e: the 61 J. . & (
AUTHORIZED PERMIT IS NOT ,'" . - 4!1P. f"P.ll~t;. \ .' N titICr$IOr.
UNDER THIS (M' . (P""'~'t F '$5800) U"III'V ,( ,
IDlmUm ,er?1~~ .f;~ef ([l~ ,-,..eg~n _t_ ~~"''' I \ I
COMMENCED OR IS ABANDONED FOR (B) Enter 121J!'''~~~h:.rg,,;('l'2 "'[A]PUU-""~ ~- $
ANY 180 DAY PERIOD. (C) Technology Fee (5% of [AD $
TOTAL fees and surcharges (A through C): $7/.5 /
440-2584-J (9108/COM)
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00839
911 ISLAND ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenler@cLspringfleld.or.us
RECEIPT NO: 20]0000985
RECORD NO: 811-SPR20]0-00839
DATE: 12/07/2010
'i";.c'j'~c_CPUNJ[c.QDE':~';~:'.z~~.MQUI':lLI:l.UJ:;.. . ~ ; J
224,00000-426102 $55.00
224-00000-426102 $6.00
821-00000-215004 $7.32
100-00000-425605 $3.05
TOTAL DUE: $71.37
1"'fFiAvMENJ.:rVPE, ..,'j,RAYOR:: T. CAfHIER'Nf1ACJfADO'"C'(CO.ll.'lMENTS': .,". ... . . "AMOUNt:RAID:...;j:4T~:';,rQ;J
I 'DE'S'C'R""P'T"O N..5 .""'.' if')""" -i'i: ",' .. ;wv. ">",
l!_._,.,~_...__.~:J ,,~, "" ~? ;" ,;' \"'~,o.: ':~4 ':'4'; ,~,"~ .-74'~ ~~f;"",'" _:';."'.
Branch circuits without service or feeder -1st circuit
Branch circuits without service or feeder. each additional
State of Oregon Surchar51e (12% of applicable fees)
Technology fee (5% of ~~mit totali..
Credit Card
701160
TILLER JOEL
$71.37
$71.37