HomeMy WebLinkAboutPermit Electrical 2004-1-20
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, f CITY OF S~~ .JNGFIELD, OREGON i ", .
225 FIFTH STREET . SPRINGFIELD OR 97477 . PH:(54I)726-3753 . FAX: '~41~*,I~,"il;~lI'jeCI as submitted has the toll owing
, ,-'BOIng~~'fiO"~'6€s not require specific land use
ELECTRICAL PERMIT APPLICATION a 0 l( approval. +
City Job Number COI'VI zo03 -olobl Date /0: -{ -. . Zoning ~rr ~O. .
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LEGAL DESCRIPTION
1702..1 ?3l..{
Db l{OO
JOB DESCRIPTION
I\..VA/ A ~
Permits are non-transferable and expire if work is
not started wilbin 180 days of issuance or if work is
Suspended for 180 days.
~toNTRA€td;':;1.J~';~ .' . \ ',' rt6FloNt}'i';.!J,
2. t::...--,:!:~',.ijf..J::""'''''' '.. _.; '.' <t'. ~,...-,,~-..- ~-" <....;.'-<.........,.~
Electrical Contractor () ~ E c \ e (. T( \'c , TV\ c
.
. f:~. ,;7.::'fti'9;;....~E.':~..'.:7:151~'V.~.__.;v-.'~~.'~~'f.;1ty;;i~.. ~~i77.~CFT.'?-~l "':;~~~._ ~":..;;i.~ "-.'
A. .~Nel"~R,~s,!ge~~,:;;,l?ii1gl~.~!;M1#otj:.f~i.Jy~pe.i'li~vel~.'\I\it.:..;:~-,J
Service Included
1000 sq. ft, or less
Each additional 500 sq, ft. or
portion thereof
Eacb Manufact'd Home or
Modular Dwelling Serviceor
Feeder
I
3
/0& ,00
57,00
$106.00
$ 19.00
$50.00
B. f~~~!~C~@r~_t~3il1:S~~~;!~n~!!~It~~~~:t~9~~~l~t~io~~~.6.h;1~;;~
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00.
$ 50.00
Address PO \)OX I GB ~
City A \ b.J ill V Phone 5'fI. Cffo 7.8(,2. 7
" )
Qi32..1
Supervisor License Number :;):10 () 5.
loll/()S
I {
tI Sl(Cf0fJ
0//5/0$
Expiration Date
Conslr. Conlr. Number
Expiration Date
Signature of Supervising Electrician
X~-G?~O Ly.
Owners Name 12.:"e'-fL vp..l~ gjd"s,
Address ::PO ~ ~ 20 l.( (
City ,L0tl.-v11-11:-" Pbone
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726~3769
c. J.i~Tenip'''o~jrY;Setvic~~or~F.'' ~edet~~~~f~1i~1t~::~:.;":,, !:~''::.:.\;!;:l;. ~.:<. :~~ './:-i
l'i-_.. ., ,-> .M;e~o~:la;~eq-U;resybO:-'." . ."~,~~,
InA1iIJii~~~~~0~El'lI BvIM@.l@regon UtIlity
2o!il\.l.W61.~r ?:e:nt:r Those rules are ~&~~'
2lHtiti\i~t~~.._ '~0'hrq4!1hO~H.l1~~fll6'
40~~ to IWlai'n copies Of me ~'Mob
0090. 'YOU CfOll@ JMg!?:. e lele-phone
O~f&!!~~18.a> Ii>. ~ t ... ...~. AA~U;9~-;;7,"'-:-""'~<'"
D. ~..!H'\!l~~,.,"..:;.-;;.~;~;~M', - ~e~l:t"c.;f;;:.oI"i'.... \'.~;'':!"'Xcl
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Permit $ 3.00
~~~~ffli~~~ff~~~)'~~~Cl~,rn.s.fu,~~h~~)
A\.l1\-1l'1lWE@.!}~t.RANDONED ~OR $ 50,00
COMffle\ll'9I!\!itGIi~rgrg $ 50,00
AN'i \~tef'lin~~.Rldential $ 25.00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
r-' ',--~ ~~-.r~ ',. "fr.~~t;VJ.-.';;;I~f"""'-': :_,;.~c....~,., .t-~<.'.f>:...v'-':;" l;.' j
4. I SUBTOTAL~OFABOVE;'~,?v~.<,1'/
~~t;'.l~~~ittJ.t::~'€t~',".~;.\.;~l" -." :'''''~~~-Y''tj_
7% State Sureharge
10% Administrative Fee
/(03, {)Q
Iliff
/ (9, ~O
-L9(),7./
TOTAL
Shared Drive(T:)IBuilding FonnslElectrical Permit Application 1-03.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF ~nuNGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01061
ISSUED: 11/12/2003
APPLIED: 10/17/2003
EXPIRES: 05/13/2004
VALUE: $ 194,004.60
SITE ADDRESS: 3391 Falcon Dr
ASSESSOR'S PARCEL NO.: 1702193406400
PROJECT DESCRIPTION: SFR
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
New
Residential
Owner: RIVER VALLEY BUILDERS INC
Address: PO BOX 2041 CORVALLIS OR 97339
Contractor Type
General
Electrical
Mechanical
Plumbing
Phone Number: 541-760-7881
I CONTRACTOR INFORMATION I
Contractor
RIVER VALLEY BUILDERS INC
G & E ELECTRIC INC
MIDWAY MECHANICAL INC
MIDWAY PLUMBING INC
Phone
541-367-1618
541-967-7045
541-928-2423
541-928-7927
,_... _^,,,lIres VOU to
'PUBLIC IMPRQVEMENTi:u",yvd' by-the Oregon Utility
, U /.J. adopte e set tori
lOIlUW ,- ~8lliI?rw.~~s ar
Fully Improved \!otitication Ceol 10 throiua'fiOAR 952..()() Curbside 5'
Yes n OAR 9S2-001-<'I9ownsR~ .... relnt:e rulf)sTo Storm Sewer
Storm sewer to private l2-inch Iined~~.I'j!Woll)il'l\pe"'11~~8 ...~ t'!Tb~f.ltap location.
calling the cents. on Utility Notification
number tor the.O~~~(\n_332_2344).
f"'.......~l"'lr Ie::: .
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Seeondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Street Impr.ovements:
Storm Sewer Available:
Special Instruction:
Notes:
License
134566
54468
154166
4687
Expiration Date
04/15/2005
09/15/2007
01/30/2005
07/25/2004
BUILDING INFORMATION I
I
R-3
U-1
VN
# of Stories: 2 Lot Size:
Height of Structure 28.00 Sq Ft 1st Floor:
Type of Heat: Forced Air Gas Sq Ft 2nd Floor:
Water Typei l\CE' Gas Sq Ft Basm'RK
Range TyptlO . tiM-'\! EX!WillFllG1..QlOrl
Energy Patlftl\S PERMIi ~fID~~ 1H~~~t\llr S \II
A.U1HORIZEO If' ^B~fSlRfaceArea:
",rll"cn np. <;1"
, DEVELOPMENT iNF0RMAA1lilN'T100.
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
1,071
960
420
3
19.00
10.00
6.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
2
Yes
26.30
31.60
0.00
% of Lot Coverage:
Pa2e I of 4
Status
Issued
225 Fifth Street. Springfield. OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetion Line
Description
DweUinl!s
Garal!e
Tvpe of Construction
V Wood Frame
Garal!e
Fee Deseription
+ 10% Administrative Fee
+ 7% State Surcharge
Plan Review Residential
Temp Power 200 amps or less
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
3 Baths One & Two Family
Annexed 1997
Building Permit
Curbcut Permit
Dryer Vent
Exhaust Hoods .
Furnace - up to 100,000 btu
Gas Fireplace
Gas Outlets 1-4
Heat Pump
Plan Review - Planning
PW Mult Disc - 2nd Permit
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
WillamaIaue Single Family
+ 10% Administrative Fee
+ 7% State Sureharge
Residence Wiring 1000 Sq Ft
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01061
ISSUED: 11/12/2003
APPLIED: 10/1712003
EXPIRES: 05/13/2004
VALUE: $ 194,004.60
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$90.60
$23.80
Square Footage
or Bid Amount
2,031.00
420.00
Value
Date Calculated
Total Value ofProjeet
$184,008.60
$9,996.00
$194,004.60
10/17/2003
10/17/2003
Fpp< PiWIJ
Amount Paid
Date Paid
Receipt Number
$5.00
$3.50
$568.36
$50.00
$10.00
$126.24
$88.37
$306.00
$-19.30
$874.40
$75.00
$6.00
$9.00
$12.00
$15.00
$4.00
$12.00
$59.00
$-30.00
$464.67
$611.28
$10.00
$214.23
$314.63
$103.65
$53.45
$727.42
$164.89
$75.00
$654.24
$24.00
$1,000.00
$16.30
$11.41
$106.00
10117/03
10/17/03
10117/03
10/17/03
11/12103
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12103
11/12/03
11/12103
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12/03
11/12103
11/12/03
. 11/12/03
11/12/03
1/16/04
1/16/04
1/16/04
1200200000000002336
1200200000000002336
1200200000000002336
1200200000000002336
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
2200200000000001752
1200400000000000066
1200400000000000066
1200400000000000066
Pal!e 2 of 4
.
. CITY OF SPRIj'~lJt<U,LJJ
Building/Combination Permit
PERMIT NO: COM2003-01061
ISSUED: 11/12/2003
APPLIED: 10/17/2003
EXPIRES: 05/13/2004
VALUE: $ 194,004.60
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetion Line
Residence Wiring Ea Addtl 500
$57.00
1/16/04
1200400000000000066
Total Amount Paid
$6,782.74
Plan Reviews ,
Initial Review 10/1712003 10120/2003 APP LLH
Plan nine Review 10/20/2003 10/30/2003 APP TAJ
Public Works Review 10/20/2003 10/2212003 APP VRJ Storm drainage to private \2-inch
line in the rear of property, see
attaehed as-built for tap location.
Struetural Review 10/20/2003 '11/05/2003 APP RJB No plan review comments.
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Reollired Tnsnectinns I
I Curbcut - Standard: After forms are erected but prior to placement of concrete.
2 Sidewalk - Curbside: After forms are erected but prior to placement of eonerete.
3 Erosion/Grading Inspection: After all erosion measures are in plaee.
4 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor
foundation inspection.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete plaeement.
7 Post and Beam: Prior to Ooor insulation or decking.
8 Floor Insulation: Prior to decking.
9 Shear Wall Nailing: Before covering sheathing with finish materials.
10 Framing Inspeetion: Prior to cover and after all rough in inspections have been approved.
II Wall Insulation: Prior to cover.
\2 Ceiling Insulation: Prior to cover.
13 Drywall: Prior to taping.
14 Hold Downs Installed: Special Inspection performed prior to placement of conerete. Provide report to City
Building Inspector.
15 Final Building: After all required inspections have been requested and approved and the building is complete.
16 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
17 UnderOoor Plumbing: Prior to insulation or decking.
18 Rough Plumbing: Prior to cover and including required testing.
19 Water Line: Prior to filling trench and including required testing.
20 Sanitary Sewer Line: Prior to filling trench and including required testing.
21 Storm Sewer Line: Prior to filling trench.
22 Final Plumbing: When all plumbing work is complete.
23 UnderOoor Mechanieal. Prior to insulation or decking and including required testing.
24 UnderOoor Gas: After line is installed and required testing and capped if not attached to an appliance.
25 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
26 Gas Service: After line is installed and line has heen connected to a minimum of one applianee including required
testing. Presure test done at this point.
27 Rough Mechanical: Prior to Cover
28 Final Gas: When all gas work is complete.
Paee30f4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01061
ISSUED: 11/12/2003
APPLIED: 10/17/2003
EXPIRES: 05/13/2004
VALUE: $ 194,004.60
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspection Line
29 Final Meehanical: When all mechanical work Is complete.
30 Temporary Electric: Approval required prior to Utility Company energizing pole.
31 Rough Electric: Prior to Cover
32 Electric Service: Approval required prior to utility eompany energizing service.
33 Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefully examined the completed applieation and do hereby certify tbat all
information bereon is true and correct, and I further certify that any and all work performed sball be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of 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 complianee 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 eaeh 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 Contractors Signature
Date
Pa2e40f4
225 Fifth Sireet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1061
COM2003-0 1 061
C0M2003-0 1061
COM2003-0 1061
Payments:
Type of Payment
Cheek
:
~1ti\\I...._.=,
1E..:....................".~i
f: ";
"":;',c-'-'" "!i_ -!
._<~, _ _ _ ^."h.,,~! '. ._J
Receipt #: 1200400000000000066
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
G & E ELECTRIC
Received By
djb
(;heck Number
Batch Number Authorization Number
.'
City of Springfield Official Ro;ceipt
Development Services Department
Public Works Department
Date: 01116/2004 9:35:03AM
Amount Paid'
Item Total:
106.00
57.00
11.41
16.30
$190.71
How Received
In Person
Payment Total:
Amount Paid
$190.71
$190.71 .
.
.