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Home My WebLink AboutPermit Electrical 2011-4-22 Electrical Permit Application I @1l'W@W~~@~~ 225 Fifth Street. Springfield, OR 97477. PH(54t)726-375Jo FAX(541)726-3689 I~ DEPARTMENT USE ONLY 8//_S 2-o11~ Permit no.: 7 Date: L-.j>-;) ':L ----I ( Tbis permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? DYes D No CATEGORY OF CONSTRUCTION gj Residential D Government D Commercial JOB SITE INFORMATION AND LOCATION Job site address: 3'0 "!> \.>.)....+ 1>. s:..-. City: S ~-. ~ C:e.\.\. State: t>~ ZIP: c\1-n'1 Reference: DESCRIPTION OF WORK (: , -')('<.....,... V\, O,^", e.led~\'- c.~ n::"U:;'\- PROPERTY OWNER Name: :I \ <;'-0" Address: 383 ~~ City: S r, ~..\..i Phone:~~1 ~~z.,.'Z..'l'l~ "1) S-\-. State: Dr(.. Fax: ZIP: !1,'Ill E-mail: ""'-,I).....\..... ~ e.,..<..\:;e:.'f"""L.U:>W\ 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: ~c,~ CONTRACTOR INSTAL ON Business name: (\ ~ Address: City: ZIP: ~ CCB license no.: Signing supervisor' Print name ofs"gning supervisor: Signature of signing supervisor: 'I1QlICE: \RE IF THE WORK THIS PERMIT SHAll E)(~S PERMIT \S NOT AUTHORIZED UND~; :BANDONED FOR \ ~~ ~:-J COMMENCED OR \y ('\ ty ANY 180 DAY PERIOD. t><.~~ ~~ 440-2,R4-.1 IQIOR/r.OM1 \ 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 $ 20 I to 400 amps (2) $ 95.00 $ 40 I 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: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 20] to 400 amps (2) $ 87.00 $ 40] 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 panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder 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) - ,"'11\ '~\1II n.J4U11"'''' ,- ~,\,~,\,~#i~~C?plillinspe~tion:J!) nt' An 0 1 Util .ty $58.00 $ ;,";';'J r'J;'.c ar.:ij~(".'AF:>pLiCAtfti'[USEto~m I ((A)lE~\e'r"s~iit~j11ii\~b~~~:fe~"10AR ":>~~~\~y $C;J. IJo {i . Iii nl',?-llj.' I-V . - 01 the ru Mi :\'1'~u!"n.MJ'1li!t!l~ $SS;oOt_ .olonhone Wk~p.i;*.%~ilffli'.trg~t~P\~i~h No\ihcation $ (p, 9 6f\\)IT.trlirl(\RfgjP(~~'%:eU6]}2.-2.344 . $ j'? . ~C TOTAL lees and surcharges (A through C): $ CdI' 6 <..,) ~ www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00667 IVR Number: 811124687534 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perrnitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/22/2011 ISSUED: APPLIED: 04/22/2011 04/22/2011 EXPIRES: VALUE: 10/19/2011 $0.00 SITE ADDRESS: 383 W D ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703341411401 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Extension of one electrical circuit. OWNER: ADDRESS: MCKROLA MARY 383 W D ST SPRINGFIELD OR 97477 MCNEELEY SCOTT 383 W D ST SPRINGFIELD OR 97477 Phone Number: OWNER: ADDRESS: Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION I Lic Type . Lic No Lic Exp Phone BUILDING INFORMATION I # of Units: o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lot Size: Sq Ft 151 Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Engineered Fill: Fill Volume: . Flood Hazard Area: Land Hazard Area; Retaining w~MnICE: XPIRE IF THE WORK Soils Reporti~eifuif'ed~MIT SHALL E IS PERMIT IS NOT AUTHORIZED UNDER TH R COMMENCED OR IS ABANDONED Fa ANY 180 DAY PERIOD. Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: . 0 egon laW requires YOUUII\OIY TTC,.'T,()N. r h Oregon II Residential Specialty COde'Edition:ac\opted by I e sellorlh l""lll")V' I'lHe~' h e ru\es are Structural Specialty Code.Edition:~enter. T os hOAR 952-001- hln1itlCaUUll v . :"'~ 1"\ +hrnllO \ 6" I Site InforincitlBri"t 'd:J~.vv L -Jt'a:lo copies ot tne I U t:O" , ., ~~" n . h lelephone uu~v. " ler (Nole. Ie.. I' n calling Ihe cen. Utilily Nollllca 10 Ihe Oregon number lor ., _800-332-2344). Cenler IS I # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Springfield Building Permit 4/22/2011 10:53:1 QAM Page 1 of 3 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00667 IVR Number: 811124687534 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/22/2011 ISSUED: APPLIED: 04/22/2011 04/22/2011 EXPIRES: VALUE: 10/19/2011 $0.00 SITE ADDRESS: 383 W 0 ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703341411401 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Extension of one electrical circuit. DEVELOPMENT INFORMATION ~ 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 Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion State of Oregon Surc"~arge (12% of applicable fees) !".0n?~,:@y fe~J.5% of permit total) Branch circuits without service or feeder -1st circuit Balance of Minimum Electrical Permit Fees Total Amount Paid Amount Paid $6.96 $2.90 $55.00 $3.00 $67.86 Date Paid 04/22/2011 04/22/2011 -_..,-",~_.._._-,,- 04/22/2011 04/22/2011 Reciot # 2011000783 2011000783 2011000783 2011000783 Springfield Building Permit 4/22/2011 10:53:10AM Page 2 of 3 .. SP~'.;:.G.."~~E~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00667 IVR Number: 811124687534 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@ci,springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 04f22f2011 04f22/2011 155 ued 04/22/2011 EXPIRES: VALUE: 10f19f2011 $0.00 SITE ADDRESS: 383 W D ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703341411401 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Extension of one electrical circuit. Plan Review I Deoartment Application Acceptance Received Due Date 04/22/2011 04/22/2011 Comoleted 04/22/2011 Result Over the Counter Electrical Review 04/22/2011 Not Required 04/22/2011 04/22/2011 Reviewe r Nancy Machado Nancy Machado Comments: Over the counter permit rn'it'ial:,~eVie~~' ~ ~: ,~;',' ~~' ~ ~':;,"r0.::~4~~?~,~9.T:1~,'~~9~~~s~~::Oi;1~~:'E:j~~J~-~-\l~~'l :3Yc~~fl~,e? ~i~A~'n~r~,?~:~'(..~ancy ~~Ch~9,~; ~ t' ~~nts:",=~~:r:~~~\2r:pe.rmlt,2 f"-';.~!;' ;<~"~d;'r:'~::~: f,~~-'-'::P~;-_;:r' ,~~.,"~],1~. ,,;'i ,,' _ (~_~~'P-S~d~:" INSPECTIONS REQUIRED ~ Inspections 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. !~tz3;'*T .. :-?:71 ."'1 ,.,~ . _ ~,'::s,.;,_;;,* <<. _.~ .') - ... - -,{' ,..--..., r..:?'" 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. . J~ fj; <1IL~ Owner or Contractor Signature q/?-:z/r I I Date Springfield Buitding Permit 4/22/2011 10:53:10AM Page 3 of 3 .~l~~~~ -~ ^;'^'~ OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00667 383 W D ST CITY OF SPRINGFIELD 225 Fifth Sf Springfield,OR 97477 541-726-3753 pe rmitcenter@ci.springfield,or.us RECEIPT NO: 2011000763 RECORD NO: 811-SPR2011-00667 [OESCRIF':i:loN" ;;>-""'~' '.. .__ > "'TYT';"~ 4";:~:;;~ ~4 '51;ACCO).JNf3:;'()OE> "n, , ,,,. Balance of Minimum Electrical Permit Fees 224-00000-426102 Branch circuits without service or feeder. 1st circuit 224.00000-426102 621.00000-215004 1 00-00000-425605 TOTAL DUE: ,,:: .;i-~~* C9~1V!1=~tS':" .\}; ~ ~ ,': .~\":;;~,'A+:: - ;z-'~JJ::' State of Ore~on Surcharge (12% of applicable fees) Technol09Y ree (5% of permit total) DATE: 04/22/2011 .t';~_:~v--Al\ilCj,l.iNJJD.UE~-~0 --- 3.00 55.00 6.96 2.90 --~'--~-'--"- ---- ---~,-,.,~. 67.66 'AMOUNT.,PAID I t RAYMENT:lTY:f'.EJ-']: ,F'.i\'(Qfl ,0 CAsi"ER:CC~~JLE.'iTER)-' Credit Card Scott McNeely .-. '.. -.! ~---- " 67.86 04569C TOTAL PAID: 67.86