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Home My WebLink AboutPermit Electrical 2011-4-1 Electrical Permit Application 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753' FAX(541)726-3689 bEP~RTMENT USE ONLY ~ 1/- 1)2 0 Pennit no.: Date: ~ JI 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. . EbcAL;. GOVERIIIM ENT . ApPROvAL';;.': Zoning approval verified? 0 Yes 0 No . .i~CATEGORY):Of'CONSTRUCTION: '," .';". Residential 0 Government 0 Commercial ~,jJ~I~;;\JOB1SI1'J::iINFORMAinoNr'AIIID~'GOCA'tION,;:;~i;i:'; z.. C sf- 6 v..... PROPERTY OWNER Name: c',\. Address: ",- & 1'2- City: '7 I? F<.--"" Phone: E-mail: This installation is being made on residential or fann 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: 9.7 l (, Signing supervisor's license no.: Print name of signing supervisor: "t Signature of signing supervisor: ----r,:; ...-:5 ~~OJ k~# ~~ 440-2584-J (9/08/COM) ~~"?:;;;>!',~ifi;','~?~S1~~;;;i1.~~!Jl~t?::- :'fE:~-;k.Sc.H E[)JJCEif:~-:jil~~'~'~f01'~.0~t~}#0:I~~~1~tSt~;~- .. - . - ,'," Cost Total . -, . ,',. Qty. ,Nurriber' oOnspectio'Iis per itein' (.) '.. "', ,_ _,r_', '" ~.'- . cost Residential, per unit, service included: ],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 ] ,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 40 I to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per pane! a Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit 7{ $ 6.00 I $.fJfi p b, Fee for branch circuits without purchase of a service or fe"eder'fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit $ 6.00 $ 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 a'dditional inspection: (I) $58.00 $ ;'i~~~;:~;~:i~~i,~~~~~~~:\f~~~ht\fAR,eGlcANTI~:US'E\:~;~t.:;:~;-t-:;::~;:~i:il!:;:::~~,'~.,'h;f~.:";:,~.~_ (A) Enter subtotal of above fees $ H- (Minimum Permit Fee $58.00) (8) Enter ]2% surcharge (.12 x [AD $~ (C) Technology Fee (5% of [AD $ dJ TOTAL fees and surcharges (A through C): $ -" ~. ~ .." \l t\j \}- i{ '" ~ ~ ~ ~ / Jt 1, tJ l~ "g' 78~ CITY OF SPRING,FIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00526 IVR Number: 811167163776 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 03/31/2011 03/31/2011 03/31/2011 ISSUED: APPLIED: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitcenter@ci.springfield,or,us EXPIRES: VALUE: 09/27/2011 $1,700.00 SITE ADDRESS: 6823 CST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353203500 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Residentia,1 PROJECT DESCRIPTION: Kitchen remodel Phone Number: OWNER: " ADDRESS: MUSGROVE DAVID W & ROBIN L 6823 C ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION I Contractor Type Electrical Contractor Contractor Name POLARIS ELECTRICAL INC # of Units: o Lic Type ELECTRICAL BUILDING INFORMA TION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No C670 Lic Exp 07/01/2011 Phone 541-343-0824 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Fl Carport: Sq Ft Other: 0 Occupancy Load: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Editio/'rTENTION: Oregon law requires you to Municipal I Development Code: follow rules adopted by the Oregon Utility PI b' S 'Ity C d Ed't' "otification Center. Those rules are set forth um 109 pecla 0 e I lon, 2-001 '" ,in OAR 952-001-0010 through OAR 95 . Residential Specialty Code EdlWtio. You may obtain copies of the rules by Structural Specialty Code Edition'calling the center. (Note:.the t~lep'ho.ne , # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Site Information Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Center is 1-800-332-2344). 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 4/1/2011 11 :02:29AM Page 1 of 4 www.ci.springfield.or.us CITY OF SPRINGFiELD Building I Residential Permit PERMIT NO: 811-SPR2011-00526 IVR Number: 811167163776 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 03/31/2011 03/31/2011 EXPIRES: VALUE: 09/27/2011 $1,700.00 03/31/2011 SITE ADDRESS: 6823 CST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353203500 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Kitchen remodel Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handic~pped; Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspouUDrains: Valuation Description ~ Descriotion Tvee of Construction Unit Amount Unit Tvee Unit Cost Value Springfield Building Permit 4/1/2011 11 :02:29AM Page 2 of4 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00526 IVR Number: 811167163776 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 03/31/2011 03/31/2011 Issued 03/31/2011 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: 09/27/2011 $1,700.00 SITE ADDRESS: 6823 CST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353203500 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Kitchen remodel FEES PAID ~ Description Amount Paid Date Paid Branch circuits without service or feeder - 1st circuit $55.00 03/31/2011 Branch circuits without service or feeder w each additional ~-~-~oo~ 03/31/2011 Technology fee (5% of permit total) $3.05 03/31/2011 State of Oregon Surcharge (12% of applicable fees) $7.32 03/31/2011 Technology fee (5% of permit total) $0.30 04/01/2011 Stat~f Oregon Surcharge (12% of applicable fees) $0.72 04/01/2011 Branch circuits without service or feeder - each additional $6.00 04/01/2011 Technol~gy fee (5% of permit total) $0.90 04/01/2011 ~tat"-.,:!_O.-'_egon ~~rcharge (12% of aPl'~~b~_~~_______~~~~___o.~IIJ.1/~?.1~_ Branch circuits without service or feeder - each additional $18.00 04/01/2011 -~-_..,-~._~~ --~-~-,.- Total Amount Paid $99.45 Plan Review Reciot # 2011000590 2011000590 2011000590 2011 000590 2011000599 2011000599 2011000599 2011000599 2011000599 2011000599 ~ Deoartment Application Acceptance Received Due Date Comoleted Result 03/31/2011 03/31/2011 03/31/2011 Over the Counter Reviewer David Bowlsby Application Acceptance 03/31/2011 03/31/2011 03/31/2011 App Submitted Work Au; admin admin Comments: Updated by ACA Script ""': Electrical Review 03/31/2011 03/31/2011 03/31/2011 Not Required David Bowlsby Comments: I!')spection' c-"~.,,' 1. f~' r_'.,.', c",Comments;'- Over the counter permit I '. ~:~"\z<;; . ';, ,,:'03/31/20f1 :03/31/2011i4c: 04/01/2011 :iI~ In P.rocess ~""Jfi~ <^:i'~ ;;:'~8fyan Richardson ~ ,", -~.~~. ,":.~~ .', ~._,:_~,:~":.,:;,:,;,~,,,,~, ~"";i"-::-*JgJ~+S~~ff~:~i:&.-t"';~~.~-""'-'~~~:}':J,.a:;.",-$--"~~fbi41$ ~ ," .\i.' ,,~:'"'. ~ --"\ ';:. tnspecttO!l:ll),prg_ce~~\>';'~l ." . ,- Uf l' . :"'. ~ ',: .. ""tr,:-~-4i"'" '1>'4 1:""^~" -" '~ -' ,_ . ",' .,'.' .%' :",,;;;~---" _'f."~. &! ( _ -::\~ =::b:;.: ~ _ _ INSPECTIONS REQUIRED ~ Inspections 4999 Final Electrical Final Electric: When all electrical work is complete. Springfield Building Permit 4/1/2011 11:02:29AM Page 3 of 4 SP:11H..G.~ElD ~_.~ '!'fi'. \~... <",.' OREGON www.ci.springfleld.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00526 IVR Number: 811167163776 225 Fifth 51 5pringfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 03/31/2011 03/31/2011 EXPIRES: VALUE: 09/27/2011 $1,700.00 03/31/2011 SITE ADDRESS: 6823 CST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353203500 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Kitchen remodel 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. 1 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. , tf-{--QC-/( Date .. Springfield Building Permit 4f1/2011 11 :02:29AM Page 4 of 4 SP!~N~~L~ 1Iif~~ .:~ .'OREGON www.ci.springfield.or.U5 TRANSACTION RECEIPT 811-SPR2011-00526 6823 C ST CITY OF SPRINGFIELD 225 Fifth St Sprlngfield,OR 97477 541-726-3753 permitcenter@ci,springfield.or.us RECEIPT NO: 2011000599 RECORD NO: 811-SPR2011-00526 tDESC.RI~tl(jN=~~__,~~~"'l'j'",;" : ""~~~:'~' .)/::Acto.LiNt~COi5E;~:';::"" Branch circuits without service or feeder - each additional 224-00000-426102 821-00000-215004 100-00000-425605 TOTAL DUE: ___~~te of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) DATE: 04/01/2011 :"i":::Jl.iVfo.lJNt.D.lJ E. :',\q ,':;;.'::l 24.00 2.88 ..-.------- 1.20 28.08 :~~\~>~t~;;:AIY.IOUNT'"P,AID,,~ ,:~ ,.;~~;;-(;''",},J 28.08 UAYMENT f'(PErz;,,,;;CPAvoR:f '.CASHIER~NMACHADb:::;~:.ci,:;;..::COMMEN'Ts;',,:~~ ", Credit Card POLARIS ELECTRICAL INC 012998 TOTAL PAID: 28.08