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Home My WebLink AboutPermit Electrical 2007-1-25 ZON INITIALS DATE SOURCE 225 FIFTH STREET. SPRINGFIELD, OR 97477 0 PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (OM LDOb - D, 07)" 1. / g>7 b6{-k ~+- LI7C/iC~q;=( D 2 , O? JOB DESCRIPTION: SlA b .:I 5: (( rC\A.--:~ Permits are l-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address City Phone Supervisor License Number I J ~.,'..~~ / Expiration Date D-/ Constr. Contr. Number ./ t Expiration Date Signature of Supervising Electrician Owners Name 3('Y~t1 ~a./Ic)/"a/1o '789 66';11. s,L City ..s~-/1'k5.p.."t:.-/<::/ Phone 5L//-7Yt-6~~? Address OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. ''W0w~ture: ~ 1_ ,,. /J,~<t"1 ,- ,/ /~~, V' Inspection Request: 726-3769 Date .I - Z ~ - 0'7 3. A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. ~. , .~. 200 Amps or less 201 Amps to 400 Amps 40'l'Amps to 600Amps 6Cn Att\.psito .1'000 Amps Over fooo ArhpsN olts " " :ReconneC't qn1y' $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40;l: b..mps to 600 Amps 'T';10 """0'0 I ! i : , .oVW; (), Amps !\ L n: $ 50.00 $ 69.00 $100.00 C" ,/; New:Alterati9P m' ~~Wmf?~ "trcr~ffR Ori~! Gi17~uitF-1 r, i! i ;'\'1 '. .j ~ · - Each Additio~aiCii6uit or with .c- Service or Feeder Permit .::> $ 43.00 $ 3.00 IS- E. Pump or irrigation $ 50.00 Sign/Outline Lighting \, $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 78 8% State Surcharge b ~ l( 10% Administrative Fee 78- 5% Technology Fee I -::i:" 70 TOTAL t 9 S- 9.J Shared Drive(T:)/Building Fonns/Electrical Permit Application 8-06.doc 4. CITY OF SPRINGFIELD - Status Issued . . Building/Combina.tion Permit PERMIT NO: COM2006-01075 ISSUED: 12/11/2006 APPLIED: 08/21/2006 EXPIRES: 07/2512007 VALUE: $ 4,160,00 ;225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 789 66TH ST ASSESSOR'S PARCEL NO.: 1702341102908 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Detached garage Owner: BRY AN MARTORANO Address: 789 66TH ST SPRINGFIELD OR 97478 . Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type General Electrica,l Contractor A License COVERT ENTERPRISES/I~.lV/ZOII\. 82272 '. 'U lOW "/-o OWNER NQf'if':_ rfJl@~.._'. '~eor._. ~~ . _ -_t:;"-''''".~I ""''1\",.. ~ -. '_11_"', [' B{J.I.uI)I~ t;fl:NF.ORMWTION.1 reqUir. uV;:$U -,,~UO '. If'> ..'c~O eSyO . Yo!.. "- 1~OO '/08.':.4 .,'" 1130, lJ t\-. 08,,#..0.' Stoli;.e.s~h 70 thE< ... r!';les ~ ..::Ion (:n.ot Size: Ilf[..;,..Y", #, I.OU" ~...,. 'Iflr" . nUm.6\!~,i~nt;,o[.~t\~udu'Ij~~,o,., , tN"! (},4.50" Set~:! 'Ft, 1st Floor: Ty-pe''';of/Heat~r. 1f\ln/.JfGS O' fit 19 95"1 sg'F.t 2nd Floor: ?'\ -Jen 1"i''-tlS in <~fI(J" . Wat~.Ii,,:rlype:i~,r'iO'''' : tl;L>. t e rUIF' SglFt Basement: '0 1!;1.. <1;< III)., .... elf'" cS, ~ Range Type;-800~":, !ility IV: '-JJhoIJ ~qJ,Ft Garage/Carport Ene.rgy Path:. . 1.:73<"23 O/ifiCqfi eSq Ft Other: Sprmkled Buddmg: '44)n/a0I10ccupant Load: Expiration Date 02105/2007 Phone 541-729-1649 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: u VN 480 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: . Solar Setbacks: I DEYELOPMENT INFORMATION' if/UrIC!_ . liIS0vC};J'ay Dist: 4Urli{1~f!~~qf..~ee~ Rqd: . COM -Pa~~e~&nW1{qtl:,... 15.60 ANy M[oNI.9[-Lo{J&'6;y.e/iaftPIR[ IF 0.00 780 DAy~~R IS AJ:J~/S P[l)h!litW()h,.. I PUBLIC IlvlpiO~J;MEN!fSi"fD';;S NO:;" F II I d . Si<<ewalk Type: . u y mprove . Yes' 5.00 REQUIRED PARKING Total: 2 Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Downspouts/Drains: Setback 5' Curb and Gutter Notes: Storm Drainage to curb & gutter. Tied to existing system. No additional square footage to driveway, 12X20 pad exists where garage to be placed. Adjusted SDC's accordingly.JLP . . Pal!:e 1 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01075 ISSUED: 12/11/2006 APPLIED: 08/21/2006 EXPIRES: 07/25/2007 VALUE: $ 4,160.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description' Gara!!:e Gara!!:e Gara!!:e Gara!!:e $ Per Sq Ft or multiplier $26.00 $26.00 Square Footage or Bid Amount 480.00 160.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $12,480.00 $4,160.00 $16,640.00 08/21/2006 12/07/2006 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $85.02 8/21/06 1200600000000001306 + 10% Administrative Fee $19.98 10/9/06 1200600000000001500 + 5% Technology Fee $8.79 10/9/06 1200600000000001500 + 8% State Surcharge $14.06 10/9/06 1200600000000001500 Fire SF Fee - Residential $24.00 10/9/06 1200600000000001500 Garage/Carport $130.80 10/9/06 1200600000000001500 Plan Review Minor - Planning $112.00 10/9/06 1200600000000001500 SDC Sanitary/Storm Admin $5.57 10/9/06 1200600000000001500 Storm Drainage Impervious Area $111.42 10/9/06 1200600000000001500 Storm Sewer - 1st 50 Feet $45.00 10/9/06 1200600000000001500 + 10% Administrative Fee $3.12 12/11/06 1200600000000001743 + 5% Technology Fee $1.56 12/11/06 1200600000000001743 + 8% State Surcharge $2.50 12/11/06 1200600000000001743 Building Permit $31.20 12/11/06 1200600000000001743 Plan Review Residential $20.28 12/11/06 1200600000000001743 SDC Sanitary/Storm Admin $2.69 12/11/06 1200600000000001743 Storm Drainage Impervious Area $53.70 12/11/06 1200600000000001743 + 10% Administrative Fee $7.80 1/25/07 1200700000000000077 + 5% Technology Fee $3.90 1/25/07 1200700000000000077 + 8% State Surcharge $6.24 1/25/07 1200700000000000077 Add, Alter, Extend Circ Ea Add $15.00 1/25/07 1200700000000000077 Perm Serv/Fdr 200 amps or less $63.00 1/25/07 1200700000000000077 Total Amount Paid $767.63 I Plan Reviews I Initial Review 08/22/2006 08/23/2006 APP LLH Plannin!!: Review 08/23/2006 09/21/2006 APP TAJ Pa!!:e 2 of 4 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2006-01075 ISSUED: 12/11/2006 APPLIED: 08/21/2006 EXPIRES: 07/25/2007 VALUE: $ 4,160.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 08/23/2006 APP JLP Storm Drainage to curb & gutter. Tied to existing system. No additional square footage to driveway, 12X20 pad exists where garage to be placed. Adjusted SDC's accordingly.JLP 8/2/06Waiting for information from contractor or owner.RE storm & existing impervious area.JLP Quick addition for David. Added 160 sq/ft new for change to new additon. Added $56.39 new SDC's.JLP Revised structure to 32'x20'. Adjust fees and sdc's. Public Works Review 12/08/2006 12/0812006 APP JLP Structural Review 12/11/2006 12/11/2006 APP DJB Structural Review 08/23/2006 09/2012006 APP RJB To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~e(]uiredJnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Pal!e 3 of 4 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2006-01075 ISSUED: 12/11/2006 APPLIED: 08/21/2006 EXPIRES: 07/25/2007 VALUE: $ 4,160.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 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 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. . Owner or Contractors Signature Date Page 4 of 4 Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us ":';;~. ..-- Pennit#: [OIA^ Z.c"l1;)o- 0/07 J b 61-~ 78'1 ~' , s'J- Address: Issued by: Date: I - 2 S - (:) ( . Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed With the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, eleCtrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under " ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: 1r1. }(2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~ 3A. My general contractor is Gvc..-v+- f3NT- ]::Ate (Name) g '2-'2- 7 2- (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR D 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. , . I hereby certify that the above information is correct and that I have. read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side ofthisform.. . '.--7# _/ ~~~/~ tA~~7 . - -..~=- " ~S'lgnitlfre~df=p~Hllit"'applieant~ (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 . . ' __ ActiJ:1gas ~ our Own General.'Contractor? , , ' INFORMATION. NOTICE TO PROPERTY OWNERS ABOUT. CONSTRUCTION RESPONSIBILITIES . . . NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. ''. '.', .', . '1:,' '. . ' .' ,.-,:" If you are acting as your own contractpr to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the, following re'sponsibilitie:s and concerns. :Employer Responsibilities ,~ .. " Youwill,in most instances, be JuleQ to be an "employer"'and the, contr?-ctors you contract with will be "employees" if you use. contractors not licensed with .the Construction Contractors Board to do labor in constructing .or to assist in the construction oril~lP~?v~:n~ntof,~'resid~tial s~cture. As the ~mJ)loyer, you must' comply with the fc:-lIowing: ~-. . . -. .' . _ ~ .t., . . , ,'- Oregon's Withholding Tax Law: As an employer, you must withhold income taxes frortl employee wag~s at the time employees are paid. You will be liable for the, tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-3784988. '. " .' .;' . Unemployment Insurance Tax: As an employer, you,are required to pay'a tax for unemployment insurance purpose~ on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. . - . ~. . ... " The Oregon Business Identification Number (BIN) is a combined number for both .Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsuav.htmll for the appropJjate forms..-' .J . - I I Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain wo~kers' compensation insurance for your employees. If you fail to ohtain workers' compensation insurance, you 'could be subject to penalties and be 'liable for,all claim costs if one' ofyoW" employees IS injured on the job. For more infortnation, call the Workers' Compensation Division at the'Department of Consumer imd Business Services at 503-947-7815. U.S. Internal Rcvcimc Service: As an employer, you must withhold federal.i~come tax from employees' wages.: ' You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 'or' Visittheir web site atwww.irs.l!ov. ..' . Other ResponsibiUties.and'Areas ofConcej4ns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to'meet code requi~emeI?-ts that may be br?ught to your attention through inspections. Liability' and Property' Damag~ Insurance: Coritact YOW" insurance .'agent" to see if you haveadequite' insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe pUnctures, fire or work that must be redone. ,TIme: Make sure you have sufficient time to supervise your employees:; ~. ,.; ., .' ,'. '. . Expertise: Make sure you have the skills to act"as your own general contraCtor,' t6 coordihatethe work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06-01-04 225 Fifth Street Springfieid, Oregon 97477 541-720-3759 Phone C:- Qf Springfield Official Receipt L ..:Iopment Services Department Public Works Department Job/Journal Number COM2006-01075 COM2006-01075 COM2006-0 I 075 COM2006-01075 COM2006-01075 Payments: Type of Payment Check cReceint 1 RECEIPT #: Date: 01125/2007 1200700000000000077 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DENNIS COVERT Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1782 In Person Payment Total: Page I of I 3:01:34PM Amount Due 63.00 15.00 3.90 6.24 7.80 $95.94 Amount Paid $95.94 $95.94 1/25/2007