The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2011-1-6 Electrical Permit Application '., ,",-,'-,., ". .,.... ,_" :OEPARTMENt.\JSEONL.Y 225 Fifth Street. Springfield, OR 97477+PH(541)726-375HFAX(541)726-3689 <. ....'1:.;' S!(~ooc'3, Pemit no.: Date: /-b-// 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. ". ;-,'':',1 " :IJfOC';L:-GOVERNMEf\lT:Ap.I"J~0YAlf'iThf,-,,'~!>'j:\i;"i:: ;}:~(:~\1~H:j~1~~0nZ~1i?:~~~~i:-:{ISI:.I;'i?SC_H E_[jJ:Jl!lEWJ~l&1f;~~~~1~\~~~'~~~~~J~tJ .' Zoning approval verified? DYes DNo .. .. :.... ", ',',. _," ',' ,,',' "'C-'_: ',' .,k..." ~,' ......_'... ':~ost' Total !.N u~~er o.t:~~.~p~~iio:~~ ,p~rjtf.in"( l" ;;~ ~ 'Qty., ; '~-:~ ~;!?i~\~/ ;~I:;: ;,CMEGORY~;OF;!CbNS1RLJCTIOI\fl;:?"}';j;' . :(i' _' >" ,. ,fl'" <-_ , ".>,.". '.."..~.,;,...,.... ,I H', '. ,,. ;-'.i "";"~" ..', _'" .') ~~~~~t;", , c_ost;'l'; Residential, per unit, service included: D Residential I D Government I D Commercial ~~~\'3QB];sITE~lINI70RM~TIONi~~ND~L():C'A$ION~~ik';:1: 1.000 sq. ft. or less (4) $134.00 $ Job site address: flCf/S '1/0 IClY\ d CA..... , Each additional 500 sq. ft. or portion $ 25.00 $ thereof City: BA?A. 1 State: or I ZIP: 07<17 '?5 Limited energy (2) $ 32.00 $ Reference: /70Z I 9 s3" I Taxlot.:OcfOe Each manufactured home or modular $ 63.00 $ """.'., ". .'.' -'DESCRIPTION, OFWORK'J;fi ,ii:[,'1i",}.;~~;",r";': dwelling service or feeder (2) ~e\'iJ ",=e ('Ud. ,L) / f? enm. r t/ W--ru<Js Services or feeders: installation, alteration, relocation n.,~ i<> \v'r-,.. " 200 amps or less (2) $ 81.00 $ . PROp,ERTY OWNER. "'. . . ". 20 I to 400 amps (2) / $ 95.00 $ 9 r- ., Name: M'~( s: c..l.~:- J f- I 40] to 600 amps (2) $158.00 $ , Address: 2(1/') Vo~~.A. , 601 to '1,000 amps (2) $205.00 $ " City: $ t::F\::, ( State: 6~ I ZIP: '7"7L(;:?- Over 1.000 amps or volts (2) $469.00 $ I Fax: , Reconnect only (2) $ 63.00 $ Phone: - - - - E-mail: Temporary services or feeders: installation, alteration, relocation i This installation is being made on residential or farm property 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This 20 I to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 40 I to 600 amps (2) 479.540(1) and 479.560(1). $126.00 $ Signature: Over 600 amps or 1,000 volts, see services or feeders section above " ;,;CONTRACTOR INSTAI.:LAHON , Branch circuits: new, alteration, extension per panel " ,j" Business name: Jc:tM Flee /'-v<:, a. Fee for branch circuits with purchase ofa service or feeder fee: Address: :~'?0'-( ....16-'" Qo r tIT '. Each branch circuit ;} $ 6.00 $ zl{ City: ~()~A, State: t"l, I ZIP: QN7'6 b. Fee for branch circuits without purchas~f a service or feeder fee: Phone:6't-1 -7~q-I07(j I Fax: - - First branch circuit (2) $ 55.00 $ E-mail: I Each,additional branch circuit $ 6.00 $ CCB license no.: I/Jo1"'~ I BCD license no.: :JO'S'J.1C Miscellaneous fees: service or feeder :,ot inciuded Signing supervisor's license no.: /70f:? S Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: ~" I 1A - 'U:."\ : Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor: /'\ I 'IT/JJl/1-o . Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) ~:e . Each additional inspection: (1) $58.00 $ ATTENTION: Oregon I~ equires you ,0 [;~i~i:ts~mf!l:f;t~~~:;~tA"Rei2lc-ANTirOSEyj1t~~t:j;ri~'~;i0.;1qI~{i~]('~: ':c~ follow rules adopted by the Ore Ion dlity . N,"""" C,,,,,. Th~ w'", "'m"~: (AI tifi," '"",,' 0' "'.recr $ If f in OAR 952-001-0010 through OAR 952-001- V'l\;, (Minimum Permit Fee $58.00) . ,. 0090. You may obtam caples of the rules by " OTIC (($) Enter 12% surcharge (.I?_xJAU "',,,v self z.~ calling the center. (Note: the telephone "':HIS P:W r'T C'uI~).,!_~t,X~b~~J~I~: ~L. '.'. I~T ---- number for the Oregon Utility Notificalion .' h - 8);recfinology-Fe;,(~},"J, AJ.."T te MI $ S ,r ~AUTHCf" " '\J{i"JJ':1d II lei , ~"~M:il $ 1<.. '1 Center is 1-800-332-2344). !~!~ J!.e~~ ,r1'HfMm,~ '~F.ough C): cuunlul\l..""....-. . 2> ---- COMlV1tl~u ANY 180 DAY PERIOD. 440-2584-J (9/08/COM) CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00037 IVRNumber: 811102709231 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued . 01106/2011 ISSUED: APPLIED: 01/06/2011 01/06/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfieJd,or.us EXPIRES: VALUE: 07/05/2011 $0.00 SITE ADDRESS: 2915 YOLANDA AVE, Springfield, OR 9747!-1784 ASSES OR'S PARCEL NO: 1702193300600 SCOPE: Electrical Only . WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service change and for circuits ~ue to fire Phone Number: OWNER: ADDRESS: SCHMIDT MICHAEL C & DONNA J 2915 YOLANDA AVE SPRINGFIELD OR 97477 Contractor Type Contractor Name JEM ELECTRIC INC CONTRACTOR INFORMATION ~ Lic Type ELECTRICAL BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat:, Water Type: ! Range Type: Hazmat: # of Units: o # of Bedrooms: Sprinkled Building: . Fire Alarms: Energy Path: Electrical Spe,cialtY Code Edition: Springfield Fire Code Edition: Mechanical S'pecialty Code Edition: Municipal I D~velopment Code: Plumbing SpJcialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: , lie No 20~527C Lie Exp 07/01/2011 Phone 541-746-7174 Lot Size: Sq Ft 1 st Floor: Sq Ft2nd 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: ATTENTION: Oregon law requires you to Retaining Wall: . jollow rules adopted by the Oregon Utility SOils Report Requ"'i~btification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9p2-001- 0090, You may obtain copies of the rules by calling the center. (Note: the tele~hone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield BUilding Permit 1/6/2011 2:44:55PM , " . ..' ~,l':";')' ~ . NOTICE: . THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00037 IVR Number: 811102709231 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/06/2011 ISSUED: APPLIED: 01/06/2011 01/06/2011 EXPIRES: VALUE: 07/05/2011 $0.00 SITE ADDRESS: 2915 YOLANDA AVE, Springfield, OR 97477-1784 ASSES OR'S PARCEL NO: 1702193300600 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Service change and for circuits ~ue to fire 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: Valuation Description ~ Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value I FEES PAID ~ Descriotion State of Oregon Surcharge (12% of applicable fees) !echnologJ fee \:i,~,~f permit tot!,I!_ Services 201 to 400 amps Branch circuits with service or feeder each circuit Total Amount Paid Amount Paid $14.28 $5.95 $95.00 $24.00 $139,23 Date Paid 01/06/2011 01/06/2011 -~...._-""-,---- 01/06/2011 01/06/2011 Reciot # 2011000058 2011000058 2011000058 2011000058 Springfield Building Permit 1/6/2011 2:44:55PM Page2of3 . . . S!,~ING F. I.E~ . ~,,lJl~... ~.;! .... ,:"i!:;a -~ . OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00037 IVR Number: 811102709231 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@cLspringfield,or.us PROJECT STATUS: STATUS DATE: Issued 01/06/2011 ISSUED: APPLIED: 01/06/2011 01/06/2011 EXPIRES: VALUE: 07/05/2011 $0.00 SITE ADDRESS: 2915 YOLANDA AVE, Springfield, OR 97477-1784 ASSESOR'S PARCEL NO: 1702193300600 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service change and for circuits due to fire Plan Review ~ DeDartment Application Acceptance Received Due Date ComDlete'd Result 01/06/2011 01/06/2011 01/06/2011 Over the Counter Reviewer David Bowlsby Electrical Review Comments: Over the counter permit !t'niti~I'Review< ~'''.'~''~'jZ,>~~:..~r 01106/2011,~"'Or/06f20f1' .' '01J06/2011",7'~ ~Ove-rt!h-e Counten7;--:':'. :;. Da"'vldrs6WiStl'Y,;'l 1 . .; f '~co~~~"e-~~~;:',60kr~~~~~'flte'"f~~'r~ftl~'~~:"~+':~~~~1~~~~~-'~t-?~~tt~~~ti"_:~~,i~>i;~~'"-" ~ ;~~' ..~. : _~_~: "~':L:~, _sl,.2'if. ;jj'~ ' ,,; ..~~;:], , . ".;'~ "". .' ~ . ',- ", .. ,". ',";, ~l:-" '" _,.: INSPECTIONS REQUIRED ~ Inspections 4220 Electrical - Service 4500 Rough Electrical 4999 Final Electrical Rough Electric: Rrior to Cover Final Electric: Wnen all electrical work is complete. By signature, I state and agree, that 1 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 approve:!:! set of plans will remain on the site at all times during construction. Owner or Contractor Signature_ Date Springfield Building Permit 1/6/2011 2:44:55PM Page 3 of 3 . . . SP.\~,~,.::EL~ ~_.L'~' ".\.~ ~~~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 www.ci.springfieJd.or.us 811-SPR2011-00037 2915 YOLANDA AVE permitcenter@ci.springfield,or.us RECEIPT NO: 2011000058 RECORD NO: 811-SPR2011-00037 [DESCRip.JlorC'ilC',T-,'" ~'''f'''"y,-",'4:'''''' x. h. ,.;;,.;. ;;,~':'::.:..:::J,""';;'';"ACCOUN:f"C,0DE;' Branch circuits with service or feeder each circuit 224-00000-426102 224-00000-426102 -"'-- ., 821-00000-215004 100-00000-425605 TOTAL DUE: t-,RAYM'i::NT,'TYPE,' - ;~PA YOR;r.;r::;-:;'CASHIE,!!:'DBowCSBY' :;;t:::.<;:.Qi~tl','L~~IS:;-'.:'.; ""','- " "'.' '",~ Credit Card JEM ELECTRIC INC ' __~~rvjces 201 to 4~.O amps State?f Oregon Surcharge (12% of applicable fees) -2e,E,hnology fee (5% of permit total) DATE: 01/06/2011 ,~;;;\"/ii".Ii,\M0(jNT:.bUE;lytr ' 24.00 95,00 --.---- 14.28 5,95 139,23 AMOUNTPAID " !":' !"j $139.23 390651 TOTAL PAID: $139.23