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Home My WebLink AboutPermit Electrical 2011-7-14 Electdcal Permit Application t 225 Fifth Street. Springfield, OR 97477+ PH(541)726-3753+ FAX(541)726-3689 . DEPARTMENT USE ONLY Pennit no.:.5: ~ 0 (II.{ ~ Date: ,- f'-(- 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. Name: Address: City: 5 Phone: E-mail: Temporary services or feeders: installation, alteration, relocation "LOCAL' GOVERNMENT ApPR.OVAl',' '(c, ',', Zoning approval verified? 0 Yes 0 No ,CATEGORY\:OFCONSTRUCl'ION'.,'} .' City: Reference: 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: 'CONTRACT,OR INSTALLATION Business name: EJ\s 7S wE f:i..(jC:f!?JC Address: 3'6JS3 80$CAGE L/J, City: 5r~(D State: oR ZIP: q1V7~ Phone:S'lI-1H- IVCzq Fax:S~/-H6 "1-<1(,0 E-mail: R{~{Cf....<:;-rSf{)€~.rfl./{OO.COM CCB license no.: tilt 70 BCD license no.: :lO -'{ (J 5' c. . l17:;n s R06.GR. 1::1",(;. Signing supervisor's license no.: . print name of signing supervisor: Signature of signing supervisor: ATTENTION: Oregon law requires youto ow rules adopted by the Oregon Utility f~iification Center. Those rules are set lort~ ~ OAR 952-001-0010 through OAR 9521:00~ ~ y ma obtain copies 01 the ru es y OO~~liin o~he :enter. (Note: the telepllone ~' numb~r for the Oregon Utility NotllicaliOn rfI ~~~ Center is 1_800-332-2344). ~,,": . ~ ~~ 440-2584-J (9108/COM) t{'".,: :':-\,':Y;:'%::;';~~f~,:t;~r?";F:E:~'hSCR E.[jJjl:1Et.\;.1t;~.':\f!~~'4:~::~;~;\;~~'~~;~~~ Num~er ofi~speciio'ns perit'lIl ()'~ Q!y. Cost. Total . ,,' . . . .,,>., .' _ ',' .\ '"'' .. . '." ;'" ea.';, ," cpst, Residential, per unit, service included: 1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) I $ 81.00 $ x./ 201 to 400 amps (2) $ 95.00 $ 40 I 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 $ 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 panel a. Fee for branch circ~its with purchase of a service or feeder fee: Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) Each additional branch circuit $ 55.00 / $ 6.00 $ ${.:, Miscellaneous fees: service or feeder '!ot included $ 63.00 $ 63.00 $ $ Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, . lj; 63. a!!mtj,\n~l\"r:extension (2) r . :~. :'~~Jrf~R $ i;ch addili"~AlTn~fuk t .~\'- "" IS$l<a:op $ 1 \ .h' l o:.;~, \1 r,K:.: "(fiA~fif&~~re'f4~~~'"c'.. i~A'IiJiJ{r!;l.$'l:r}'-"< "'.,,;,, iCi.;;..> ,~~ "r~l,..cr\ HtiJ;:J .t'l.CiF\f'/. (A?; lEntensuot<J!al-tn::a.p9vf ~es . M....'"(p,,^\/Qt:PJln . $""7 ( I HI.I~~rg er,mltl~'ee $58. v) b (B) Enter 12% surcharge (.12 x [A]) $ /() I(I-f (C) Technology Fee (5% of [AD $ I{)S- TOTAL fees and surcbarges (A through C): $ In / 7 ~ /'-.' CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01745 IVR Number: 811132861897 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/14/2011 ISSUED: APPLIED: 07/14/2011 07/14/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmilce nter@ci.springfield.or.us EXPIRES: VALUE: 01/09/2012 $0.00 SITE ADDRESS: 115 WOODLANE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703262202100 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Change panel and add 1 circuit Phone Number: OWNER: ADDRESS: SHORT KRISTIN & RICHARD 115 WOODLAND DR SPRINGFIELD OR 97477 CONTRACTOR INFORMA TION ~ Contractor Type Electrical Contractor Contractor Name EASTSIDE ELECTRIC INC Lic Type CCB BUILDING INFORMATION ~ # of Units: o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: SpringfjeJd Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: lic No 117770 lic Exp 10/04/2011 Phone 541-741-1499 lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Fl Garage: Sq Fl Carport: Sq Fl Other: 0 Occupancy Load: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report~llililN;li!ON: 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-oM- 0090. You may obtain copies of the rules by . calling the center. (Note: the telephone. : number for the Oregon Utility Hotification. Center is 1-800-332-2344). :....:.'-- . NOTICE: RE If THE WORK THIS PERMIT ~~~~~ ~~~ PERMIT IS NOT , ~~~~~~~~~D OR IS ABANDONED FOR . ANY 180 DAY PERIOD. Springfield Building Permit 7/14/2011 1:27:31PM Page 1 of 3 SPRIN. G. Fln~ ~i~-. 0111' \.fJfb ~~" OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01745 IVR Number: 811132861897 225 Fi~h SI 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 07/14/2011 ISSUED: APPLIED: 07/14/2011 07/14/2011 EXPIRES: VALUE: 01/09/2012 $0.00 SITE ADDRESS: 115 WOODLANE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703262202100 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: FrontYard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Change panel and add 1 circuit DEVELOPMENT INFORMATION ~ Overlay Oist: # 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 ~ Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion Amount Paid Date Paid ReciDt # Branch circuits with service or feeder each circuit $6.00 07/14/2011 2011002024 Technology f;;;;{50i,~ p;r,;;itt;;;;ij-----. ----- -----$4.35 "--"-------07""ii4i2OiT----z0i1002024 ~"'~OO-;;;;;P~~~;- ------- ------ -.- --- -$8i:OO---.---ii77i4i201-1 . -- - 2.911-002624 State of Oregon Surcharge (12% of applicable fees) $10.44 07/14/2011 2011002024 Total Amount Paid $101.79 Springfield Building Permit 7/14/2011 1:27:31PM Page 2 of3 S.PRING..FIE~~.D- .~.. ," ('!Jf; .".~ OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01745 IVR Number: 811132861897 www.ci.springfield.or.us 225 Fi~h St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitce nter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/14/2011 ISSUED: APPLIED: 07/14/2011 07/14/2011 EXPIRES: VALUE: 01/09/2012 $0.00 SITE ADDRESS: 115 WOODLANE DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703262202100 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Change panel and add 1 circuit Plan Review I DeDartment Application Acceptance Received Due Date 07/14/2011 07/14/2011 ComDleted 07/14/2011 Result Over the Counter Reviewer David Bowlsby Electrical Review Comments: Over the counter permit fiiiitlaf'Re'viev./~-~, ,. ~'~,,< -07114/2011' ,. -.~ . _. .',. ':,. ','._.'*~. . ," J ',. . ..,' .' _-..'-' ~ 6~m'ments:'~ ov~rth'e' couhtei\permit ; \.._ _" ..::,....0M.,_~,:<. "._~ .., " .. ""^f..T." '. . o711412'O:1J .~_o7i14/2b1iJ, _ j Over. the Counter' ;tr;~P~VJ9-B_ow!~~~:lf' ~_';;;J '""' - f' ,r -- -"'-k^ii'f<: "*:</0>-\11, _ " ' - - ;;,:_-~-j" , - -fs.:,i^; -:;;;:;~~~;;,::;~ ~;:'?;:;i,'. . - ,.' "" ,., .......,'=" "-' '_ ,;:";'\,.;2::. ::.'"~~< '",,-- -,'1 --',,-- ----'i;~i;-.--- INSPECTIONS REQUIRED ~ Inspections 4220 Electrical - Service 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that J have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 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. 1 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 Contractor Signature Date Springfield Building Permit. 7/14/2011 1 :27:31 PM Page 3 of 3 . SP~r=~ lti~~,~ ,,~{~ OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfiefd,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01745 115 WOOOLANE OR permitcenter@ci,springfield.or.us ~jpAYrilENnYPE:)i2;%~PAybR ',~: .::;.SAs}i!<R~I)B_o,!"lSBY\., ,'C;tOMMENTSti." Credit Card EASTSIDE ELECTRIC INC 030160 RECEIPT NO: 2011002024 RECORD NO: 811-SPR2011-01745 DATE: 07/14/2011 tbESCRI&TI0N!€'~;&;'~'.i;.';:;; "'C;~:~~'~~.'-j;'~:.tig,;~,;;. .:.' '~" ;".t;AC.COUNJ~c.bbt.2:':~':';-!0'i:O;iii-~AMOUNTJiuEi.'/i&2~,;) : I Branch circuits with service or feeder each circuit 224-00000-426102 6.00 Services 200 amps or le~~. 224-00000-426102 81.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 ._________.10.44 ---.Iechnolo~y fee (5% of permit total) 100-00000-425605. . no .n_ n_ ...<1;35 TOTAL DUE: 101.79 ,:....,,). .i '';)t'AMOUNJ::pAIO';/;;';>".:',:..! $101.79 TOTAL PAID: $101.79