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Home My WebLink AboutPermit Electrical 2011-5-2 Ele€frical Permit Application 1:.'-,._ .""" _""..:~} :r~"';;.."" '_-_~~R:",',- :..~ ..:;.;g2~"\.f~1'I::r;:;.c#1",tii.i.~!:;v,.." , CITY OFSPRINGFIELD:':ORE'GONi;-"~- ',,~ ~~ - -:="""'...~~- ~ 0' - --="_ ~..;--:~.";>( - ',,;- ~ -- ~t'" ' - 225 Fifth StreeltSpringfield, OR 97477+PH(541)726-3753tFAX(541)726-3689 '. ;:' DEPARTMENT USE ONLY .": . . , SPe2D 1/- 007;< r Pennit no.: ~.., Date S -d-'- 20/( 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. . '120CAL:GOVERNM ENT' AP,PROVAlO":/""; ':)',:<C; Zoning approval verified? DYes D No ,,":", :"CATEGOR't!iOF.'.CONSTRUCTION'." .,<, Residential 0 Government 0 Commercial t~'i,,!,:JOB'{SITE~INF.ORI\IIATIONt;'AN[jI,;[;oCAliION:,~J;#.:~iii' 7 City: 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: Business name: Address: CI : Phone: E-mail: CCB license Sign; Print name of signing supervisor: Signature of signing supervisor: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- {\ J 0090. You may obtain copies of the rules by \j)'t' ~ . calling the center. (Note: the telephone ~0 number for the Oregon Utility Notification ~ Center is 1-800-332-2344). ~ 440-2584-J (9108/COM) ~. \. '!;~r~;_K~:~:\~~~i}~5f;j;;';' FEE~SC H ED.UiJ1E;:~:i~;;~;;~{;,::ii~i:~~~~41?'~ . . . Cost Total .' . . ~ ,Number of.inspeciion, per item () 'c, Qty. I " '.', _ ',_ ':' ~ . ""'.: . '-;:" ". :.,;/..; : r,~ ;,;l '-:',!".- : \: .,.i...._ "'_'_' . ;:,~ea"'i , . 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 V 200 amps or less (2) !X.. $ 81.00 $~l.(; 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 60 I 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 I 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 panel a. Fee for branch circuits with purchase ofa 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) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder ':lot 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 $ ""'~:'ff"~"ifi"H~""I'ARPi::ICAN1;';-USE"', ';""''';<. ";:r .-,; .' ....~'1:i.,..,'':''i..'''. ...,..~,,_T'.;.~.:::/~...>;; .. ..;.. '. .:.'-.. 1';.:.,:". ./l;::~'",,;:,:~,;....:.....2:-':" c'. : (A) Enter subtotal of above fees $ 8/-i --0 (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ 7'--7 l/ (C) Technology Fee (5% of [A]) $ .?J-.O K TOTAL fees and surcharges (A through C): $00'. t7- 7 ....... " SP~IN.G.FIE~ ..~ ..,,="~ i'f~" ~ :;.), OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00722 IVR Number: 811149506931 www.ci.springfield.or.us 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 " Fax: 541-726-3676 permitcenter@cJ.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/02/2011 ISSUED: APPLIED: 05/02/2011 05/02/2011 EXPIRES: VALUE: 10/29/2011 $0.00 SITE ADDRESS: 1275 LORNE LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703272207648 SCOPE: Electrical Only WORK INVOL VED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service change-out Phone Number: OWNER: ADDRESS: KuHNHENN "KYLE 1275 LORNE LOOP SPRINGFIELD OR 97477 Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type lic No Lic Exp Phone # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire AJarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal J Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lot Size: Sq Ft 1st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: . Sq Ft Other: Occupancy Load: o Site Information ~ Engineered Fill: Fill Vorume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 5/2/2011 9:04:14AM Page 1 of 3 .:::. . SP~.~N~.FIELD lii:,~ , fr~, OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00722 IVR Number: 811149506931 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: Iss ued 05/02/2011 ISSUED: APPLIED: 05/02/2011 05/02/2011 EXPIRES: VALUE: 10/29/2011 $0.00 SITE ADDRESS: 1275 LORNE LOOP, Springfield, OR 97477 ASsESOR's PARCEL NO: 1703272207648 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: sideyard Setback: Rearyard Setback: Solar Setback: Service change-out 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 ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Description Type of Construction Unit Amount Unit Type Unit Cost Value FEES PAID I DescriDtion State of Oregon Surcharge (12% of applicable feesL ~~.~ices 20~_,amps or less Technology ree (5% of permit total) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94.77 Date Paid 05/02/2011 05/02/2011 ..-.-"-----..--- 05/02/2011 Reciot # 2011000844 2011000844 ..-----..--- 2011000844 Springfield Building Permit 5/2/2011 9:04:14AM Page 2 of 3 r-o .) . SP~ING.FI.E~ - :~ " . -"0 'OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00722 IVR Number: 811149506931 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 Issued permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 05/02/2011 05/02/2011 05/02/2011 SITE ADDRESS: 1275 LORNE LOOP, Springfield, OR 97417 ASSESOR'S PARCEL NO: 1703272207648 EXPIRES: VALUE: 10/29/2011 $0.00 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service change-out Plan Review ~ Deoartment Application Acceptance Result Over the Counter Received Due Date 05/02/2011 05/02/2011 ComDleted 05/02/2011 Reviewer Nancy Machado Electrical Review 05/02/2011 05/02/2011 05/02/2011 No! Required Nancy Machado Comments: Over the counter permit InitialR~vJev/ ~i#,+~. ~0, :,:'-0 _'c,}.;Q~J02~201 f, ',O_5/o.f/~qi~i'~91i/02J~01.~~ ,~!, fi~e~-J~~:Q,q~nt~;<'~~>JiT,fN?0~y,'Mach:{~q'5.':~' ',',c,o.nments2ie~:lt~~~~ttnt~r' per[riR :: ~ ~'; <% " '",~;;'~::";;T;'f~.:.' - ' {;'''; -::',t. ":7<";'>"'?:!::~~~~(k~'_ ~:"4 - - '~<r~_:;-~ INSPECTIONS REQUIRED , Inspections 4220 Electrical - Service ''{ .1 'i 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. ~;W~ o ner or Contractor Signature :;-2-1~ Date Springfield Building Permit 5/2/2011 9:04:14AM Page 3 of3 ;./.. " i.~L~ ~.~ ( ~...,.. ,"-." OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541.726.3753 WWN.ci.springfield.or.us 811-SPR2011-00722 1275 LORNE LOOP permitcenter@ci.springfield.or.us RECEIPT NO: 2011000844 [OESCRIP..TION"" . '" Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811-SPR2011-00722 DATE: 05/02/2011 "<l~',.:" -~""r.~ 'i' ~,.., ' '. '. ~'" . 'AC.CO,UNJ_C.ODE": . i - f, ;,AMo.UNI.:D.UE 224-00000-426102 81.00 821-00000-215004 9.72 100-00000-425605 4.05 TOTAL DUE: 94.77 ._ . ,. AMOUNT PAID 94.77 PAYMENTTYPE Credit Card 112008 PAYOR CASHlER:NMACHA[)() KYLE KUHNHENN "COMMENTS' ., . "')". TOTAL PAID: 94.77