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Home My WebLink AboutPermit Electrical 2011-1-24 225 Fifth Street. Springfield, OR 97477. PH(541)726~3753. FAX(541)726~3689 -~,' - -J", , ,,' "'-',.- DEPfl.RTMENT USE ONLY - S7'~z.?H - Permit no.: Date: This permit is issued under OAR918-309-0000. 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? 0 Yes 0 No CATEGORY OF CONSTRUCTION ~esidential I 0 Govelllment I D Commercial JOB SITE INFORMATION AND LOCATION Job site address: C~if5 (,;"",/.;,1 (t%/' City5I'r~/)jrjeL) I State Of. ZIP: fllf?1 Referene Taxlot.L~2?1 DESCRIPTION OF WORK '.. 1/" ,110 / H6YJ.X'.fLuf~ /5eciM'dd , I PROPERTY OWNER . . Name: vu-r V"';;- ~ Address([Zf ;v1u'ce-..;r:e CYt!r:! PI. City:<;'flrfJ.tJ)f.'eLJ I State: OX ZIP: '17'11:: Phonc$4/ Lin- z.. q t ( I Fax: - - E~mail: This installation is being made on residential or farm property owncd by mc 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( I). Signature: CONTRACTOR .INSTALLATION '0' Business name: V Y aA-1- 11-/' Address: "71/ f( f L~.1 faJvWf' TJ 1/;( l City: ~.: .... 8 I State: 0{'( ZIP: q7~(jIJ . Phone.JT/j !;;sif.t2 2 q I Fax: - - E-mail: jO/l c-{lQI/YIf.."p~,C6M CCB license no.: r;51<{'1 I BCD license no.:2.Jp-/fY1clF Signing supervisor's license no.: <";--'11 (E.4- Print name of signing supervisor: G Il.ie- f;n k' / Signature of signing supervisor: H. A/.....:;../J/ ~wt ~6J^-' \'(); 440-2584-J (9/0S/COM) . . FEE SCHEDULE :Ntil~be.. of insp~ctiolls pCI' itcm{). Qty. Cost e~l. To!:.1 cost Residential, per unit, service included: I ,UUU sq. it. or less (4) $134.00 $ Each additional 500 sq. n. or portion $ 25.00 $ thereof Limited energy (2) I $ 32.00 sTL ~actured home or modular $ 63.00 S t 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 $ 40 I to GOO amps (2) $158.00 $ GO I to 1,000 amps (2) $205.00 $ Over \,000 amps or volls (2) $469.00 $ Reconnect only (2) $ 63.00 $ Tempor>>r)' services or feeders: installation. alteration. re/ow/ioll 200 amps or less (2) $ 63.00 $ S 87.00 $ $126.00 $ 20 I to 400 amps (2) 40 I to GOO amps (2) Over 600 amps or 1,OpO volts, see services or feeders section above Branch circuits: lIeJ. alteration. extension per pallel u. Fee for branch circuits with purchase ofa service or fecder fee: , Each branch circuit' 51 6.00 51 b. Fee for branch circuits without purchase of a service or feeder fee: , First branch circuit:(2) S 55.00 S Each additional brapch circuit $ 6.00 S lViiscellaneous fees: s~rvice orfeederllol included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited~energy panel, alteration, or extension (2) S 63.00 $ S 63.00 $ $ 63.00 $ Each additional inspection: (I) . j. <.' ":,' ,0. ,APPLICANT USE. $58.00 $ .' (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) (C) Technology Fee (5% of[AD TOTAL rees and surcharges (A through C): sst $ I.Q6 $ 2.1~ $ bktG www.cLspringfield.or.us TRANSACTION RECEIPT 811-SPR2011-00109 6018 FERN HILL LOOP CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2011000151 1I:lESCRIp..l'10r.CJ:;;"f'tf." "-''''~; Audio I Stereo ."_._~:ate ?f O~egon Surcharge (12%,_?f applicable fees) __ Technolo~x fee (5% of permit total) RECORD NO: 811-SPR2011-00109 DATE: 01/24/2011 ';S,;4',~ 'ii,-, ,",,':';;'-':"'0::;;:;'~~ACCOLJNJj::OtJE',' i;'; ;,;".. IX: _. -AMOUlllttJl.JE-'" "l:'1,;, '1'1 224,00000,426102 63.00 -~'-'--- 821-00000-215004 7.56 100-00000-425605 3.15 TOTAL DUE: 73.71 'c6M~ENn;(";~: ',. . ,J,,',' ::.:.:.,',AMOUNTPAID:' ~~'l_:L,.:iJ 73.71 t::e~ YI\r1~!'!TTYRE~":""lP.A YO~", CASHTER;oKK.'-U"MAN;;~""':'" Credit Card Vyanet Security Group 066888 TOTAL PAID: 73.71 , SPRINGFIELD-~- ~' ,.:"'M.cl 'fII"-' ~_w,.~lI' .;:~ OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00109 IVR Number: 811155847799 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/24/2011 ISSUED: APPLIED: 01/24/2011 01/24/2011 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: 07/23/2011 $0.00 SITE ADDRESS: 6018 FERNHILL LOOP, Springfield, OR 97478- ASSES OR'S PARCEL NO: 1702343406900 Phone Number: lie No 65149 Lie Exp 07/01/2012 Phone 541-389-0015 # of Units: BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o Occupancy Type Construction Type R-3 Type VB # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: )(fFg~~ Spe,cially Code Edition:' 2008 fdl~M~fjel~~teQ;8/!llJEIdlli9.nleq U/r N~"" ..'es adoDtqr! h tl-. '.. es you to , 4"eC1ll(l1l'Ijlt:We",laltY.:C"~e'l:altlq'l;;"'on Ut'/' In I>Al:! '"ler. fho"" r " " J Ity OO;Fni.n{j31"OO<l'Ll;\9P1l'frW~CtfJafolS are set forth c~9H' .x61Ii91SPJ!<Oil:1IJ\~'Wp~diP,oQ(\R 952-001_ '1]9 t~e c.~nt" ' ~s 6'1 the rul b nulWiillleR la~fi'''p Ilredillj(,'SOPY;!jl1Won/' es y "r e n\, ~~<n.'}'" " Ie ephone Slruc!9M!t F,~Th .. =ue~ctfl~~'!otificatio Site Information Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall:' Soils Report Required: Springfield Building Permit 1/24/2011 3:18:19PM Lot Size: Sq Ft 15t Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Page 1 of 3 SPRINGFIElD. . "'0/ -"~r.7"'1~ .i\ '-;.'GON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00109 IVR Number: 811155847799 225 Fifth St Springfield, OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 www.cLspringfield.or.us permitcenter@cLspringfield,or.us PROJECT STATUS: STATUS DATE: Issued 01/24/2011 ISSUED: APPLIED: 01/24/2011 01/24/2011 EXPIRES: VALUE: 07/23/2011 $0.00 SITE ADDRESS: 6018 FERNHILLLOOP, Springfield, OR 97478. ASSESOR'S PARCEL NO: 1702343406900 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Audio and Security only DEVELOPMENT INFORMATION I 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 I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descr;otion Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Description State of Oregon Surcharge (13.!' of:pplicable fees) State of Oregon Surcharge (12% of app.licable fees) Technology fee (5% of permit total) Audio I Stereo Technology fee (5% of permit total) Total Amount Paid Amount Paid $15.12 $-7.56 $.3.15 $63.00 $6.30 $73.71 Date Paid 01/24/2011 01/24/2011 01/24/2011 01/24/2011 01/24/2011 Reciot # 2011000151 2011000151 ..-----.-" 2011000151 2011000151 2011000151 Springfield Building Permit 1f24f2011 3:18:19PM Page 2 of3 S'~~r-.IEL~ ~".~ , ,~ .,. . OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00109 IVR Number: 811155847799 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or-us PROJECT STATUS: STATUS DATE: Issued 01/24/2011 ISSUED: APPLIED: 01/24/2011 01/24/2011 EXPIRES: VALUE: 07/23/2011 $0.00 SITE ADDRESS: 6016 FERNHILL LOOP, Springfield, OR 97476- ASSESOR'S PARCEL NO: . 1702343406900 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Audio and Security only Plan Review ~ Department Application Acceptance Received Due Date Completed 01/24/2011 01/24/2011 01/24/2011 Result Application Accepted Permit Issuance 01/24/2011 01/24/2011 01/24/2011 Issued Reviewer Kip Kaufman Kip Kaufman Electncal Review, ~ 1i~" _ ,Q'1J24[2Q}1',: t:~Ot/24i20~;1', 01g4[~b1A; 'NofReqiiife(j.r" ::'-"!~:rfJKip,!<~uf[l?fl,: ~ ,.t::~..!,........,-<._~""-.,,,,f.~.~i'-.,^,_:,>,<p#._:'_.._._"',, ~.'" "Ot",r' ,.-, . ;0C()~me-rits: '-~Ov~r'Ni~:C:oun!er,permjt. \ -""i.;.'.~\'!;E01r:'<;~:~~' .>".~~""~-~ ,;;;-.~:~;_:":L~' -';~ ",'~;~:: - t-,.; .'~::;,":<:::~- L';:",;;,,;c""',-,', '-;,,'i0.,,~~......~.,.,-,,"_ -''-'-'''-'''-~,A-i/''' ......,.,..':.,..H"-'.."... ",~..".'t:'P ','-, Initial Review 01/24/2011 01/24/2011 01/24/2011 Over the Counter Kip Kaufman Comments: Over the counter permit . ,';--, . " ~. '" ~~. i , I \-,', ~.~.~' ,",,_.:t,- INSPECTIONS REQUIRED ~ Inspections 4550 Limited Energy 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 loc at t front of the property, and the approved set of plans will remain on the site at all times during construction 1/2 ((iii t I Date Springfield Building Permit 1/24/2011 3:1B:19PM Page 3 of3