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Home My WebLink AboutPermit Electrical 2011-1-18 Permit no.: s;, II - eLl Date: I ) I J ) ) / I 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 ifwork is suspended for 180 days. . Electrical Permit Application ;~-l'fu4 OE spRtNi1EmDD7oREGO~... ., . _r . _ "--4 .' ~ .........., M ., :.~..."~' > ;.... ......, ~. . . <- . . ~ 225 Hfth Street. Springfield, OR 97471+ PH(541 )126-37530 FAX(54 1 )726-3689 !I lOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION o Residential 0 Government 0 Commercial JOB SITE INFORMATION AND lOCATION 3~O. PMI.iflJOG6 I.tdY State: oR 97 Y77 Job site address: City: SP'<'LO Reference: Taxlot. DESCRIPTION OF WORK Dv<..TLfSS HO\I SiH€fYJ "'ODIT/ON PROPERTY OWNER Name: uVi LA , \4/'1o..!" 'it N i"\ Address: . ,.:J City: ZIP:L.!'7 'i ?? Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR INSTALLATION Business name: fAsTS/Dc ElEtT((lC Address: ~~Ll5'3 BoS,CM-E LN. City: 5 P f CD State: 0 f( ZIP: 9 7 1./ n Phone: - 7lfl-N'1'1 Fax: -73/:'" "1960 E-mail: RlClc.c..S75/ilE(f2YAHoO.CoM CCBlicenseno.: }1}'7iO BCD license no.: )0 -VO!;'C \}7175 M.Ue Signing ~upervisor's license no.: Print name of signing supervisor: J( ndj- Signature of signing supervisor: ~ }0w~ 440-2584-1 (9/08/COM) DEPARTMENT USE ONLY 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 manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 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 fceders 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 I $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) I $ 55.00 $W Each additional branch circuit "/ $ 6.00 $ )2..- Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ APPLICANT USE (A) Enter subtotal of above fees $ Lv7 .- (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A)) $ y~ (C) Technology Fee (5% of[A)) $ --; :r.5~ TOTAL rees and surcharges (A through C): $ 7 -O?:!. . CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00084 IVR Number: 811196899567 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/18/2011 ISSUED: APPLIED: 01118/2011 01/18/2011 225 Fifth Sf Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield,or,us EXPIRES: VALUE: 07/17/2011 $0.00 SITE ADDRESS: 3262 PARTRIDGE WAY, Springfield, OR 97477-7536 ASSESO~'S PARCEL NO: 1703221309200 SCOPE: Electrical Only WORK INVOLVED: Addition. TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Electrical for heat pump and addition Phone Number: OWNER: ADDRESS: WilLIAMS TINA R 3262 PARTRIDGE WAY SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ~ Contractor Type. Contractor Name EASTSIDE ELECTRIC INC lie Type CGB BUILDING INFORMATION ~ # of Units: o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No 117770 Lie Exp 10104/2011 Phone 541-741-1499 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy lqad: requires you to - ~N' Oregon laW on Utility Electrical Specialty Code Edition: ATTE~2008 'd t d by the Oreg t 1 rth les a op e \ are se 0 Springfield Fire Code Edition: 10iloW ru enter ThOse ru es AR 952.-001- 'f atlon e. gh 0 Mechanical Specialty Code Edition:NotllCR 952-001-001 0 throU 01 the rules by , OA ' COpies Municipal I Development Code: In090 You may obtal~N te' the telephone O. ter \ 0 '. 'f atlOO Plumbing Specialty Code Edition: calling the cen 0 'egon Uti\l\y Notl Ie Residential Specialty Code Edition: number6~~~~:IS ;_800-332.-2344). . Structural Specialty Code Edition: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Site Information ~ Engineered Fill: Fill Volurne: Flo'od 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. Springfield Building Permit 1f18f2011 11:24:27AM Page 1 of 3 . WWW.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00084 IVR Number: 811196899567 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenler@ci.sprlngfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/18/2011 ISSUED: APPLIED: 01/18/2011 01/18/2011 EXPIRES: VALUE: 07/17/2011 $0.00 SITE ADDRESS: 3262 PARTRIDGE WAY, Springfield, OR 97477-7536 ASSESOR'S PARCEL NO: 1703221309200 SCOPE: Electrical Only WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Electrical for heat pump and addition 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: Handicapp_ed: Compact: PUBLIC IMPROVEMENTS ~ 'Street Improvements: Storm Se'wer: Storm S~'wer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspoutfDrains: Valuation Description ~ Descriotion TVDe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ Description Amount Paid Date Paid State ~f Oreg?~"~urcharg~J.1..2% of aIT!!c~~Jees) ._____.~~::_ 01/18/2011 Technology feej5% of pe:mit total) ___._ ...""..~}!'_____....__----9.1/18/2011 Branch circuits without service or feeder - 1st circuit $55.00 01/18/2011 Branch circuits without service or feeder ~ each additional $12.00 01/18/2011 Total Amount Paid $78.39 Recipt # 2011000114 2011000114 2011000114 2011000114 Springfield Building Permit 1f18(2011 11:24:27AM Page 2 of3 , > .- SPRING... FIE~ .f 00~,'\ 1~ '.. "3W .%~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00084 IVR Number: 811196899567 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.OLUS PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 01/18/2011 01/18/2011 EXPIRES: VALUE: 07/17/2011 $0.00 01/18/2011 SITE ADDRESS: 3262 PARTRIDGE WAY, Springfield, OR 97477-7536 ASSESOR'S PARCEL NO: 1703221309200 SCOPE: Electrical Only WORK INVOLVED: Addition TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Electrical for heat pump and addition Plan Review I DeDartment Application Acceptance Received Due Date Completed Result 01/18/2011 01/18/2011 01/18/2011 Over the Counter Reviewer Chris Carpenter Over the counter permit 111r;i!t<1Re00vl~Yl,~ ,~.~tfr~~~~"!'~~_"">LQ,1!1~12~1,f <.;61!1,8/22j~11~-:211)W~~:t~", .. ,.~."".. __,:'::,',;',,"> ''C'., ~""'.,+ ."_,'" '00"'~T ',' ..., ':". 'i~ "_'0 -, ,..~,""...,..~ ",.0':Y~':~':."; \' "'"_"$"/! r:Jc,om)nehts:&r~Qy~rithecounler,permlt:Ii"..~J" j..:~,'", '-''''',&''J!'!;''~lY'~' u~, ,1,;.., ':i~~;; i;Jt:"Z.:;;:;/"" ",. ,.. /"'''iiE~ ,.'"'"1'7' ......,., '. f'W'.' ,'.,,'. - '. ,I\' '''.'\-",-'%d7>. . <ii',., -'.'.,. ..' I"""'" INSPECTIONS REQUIREO I :?d-0itit;;' '""'k~.' Inspections 4500 Rough Electrical 4999 Final Electrical Rough 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 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. ~IA I~ Owner or Contractor Signature Date Springfield Building Permit 1/18f2Q11 11:24:27AM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 WWW.ci.springfield.or.us 811-SPR2011-00084 3262 PARTRIDGE WAY permitcenter@ci.springfield,or,us RECEIPT NO: 2011000114 RECORD NO: 811-SPR2011-00084 DATE: 01/18/2011 (DESCRIPJION;:":,_,,_~:__..X _ .':.::-::';;"'",-_ _'::.,:L;:;;~~~_:;f:d[;::ACc0U'NT:CbbE ':;:ii] .Jr .:i. AMOUNT DUE.... _ .:~.::.:.j Branch circuits without service or feeder - 1 circuit 224-00000-426102 55.00 Branch circuits without service or feeder - each additional 224-00000-426102 12.00 .~__._w,.__ _....state of Oregon Surcharge (12% of applicable fees) 821-00000-215004 8.04 Tech_~ology fee (5% of permit total) 100-00000-425605 3.35 TOTAL DUE: 78.39 ;iI"AYME~J.2:1WI1.E;;i:;:-::PAY6Rt~Ji"CA~i-lIER;;CCARP~N.illd:!C.QMMENT$"'';'':''...:F"j,;: .:;T-:;:;::~IiAM(tUNtJ?AID;-- '6;;'.;':';",;;}{ Credit Card Rodger King $78.39 02506c TOTAL PAID: $78.39