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Home My WebLink AboutPermit Electrical 2011-8-17 Electrical Permit A lication ;c'i:!E'y OE,SP,Ri~G1FiEThD';i~RE1i:ID:N' :~; .~ ",."",'" (, {" '. j' ~"7" ~' jJ."" '~'-",+' _Z,"'. :'" jt ~ .'.& _" ..... 225 Firth Street. Springfield, OR 97477. PH(541)726~375]. FAX(541)726-3689 ,DEPARTMENT USE ONLY ~PAINC"U!LO . ^; }, "! A,fij ~--:,,_...hJ't::j,! . ''''~,;--'~i.:', Pennit no,: .s II - /'1S'-( ,~~ " Date: 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 t 80 days. LOCAL ,GOVERNMENT APPROVAL Zoning approval verified? DYes D No CATEGORY OF CONSTRUCTION D Residential D Government D Commercial JOB SITE INFORMATION' AND LOCATION S-q 6 ,PROPERTY OWNER" ,<4. tJS ~-<'-' s;-r E-mail; This installation is being made on residential or farm property owned by me or a member afmy immediate family. This property is not intended for sale, exchange. lease, or rent. OAR 479.540(1) and 479.560(1). E-mail: cD license no.: ..:(10--33 Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~flA~ ~~ W 440.2584.) (9/0B/COM) 4f) .' ---' . / FEE.SCHEDULE. .. . - - Numb~~, of ins pccti OilS per ~tem () Qty, Cost 'I 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 $5('1 20 I to 400 amps (2) $ 95.00 $ 40] 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, alfermion, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alleration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit .;)" I $ 6.00 $/2 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 nol 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: (I) $58.00 $ ."1'<:. ' :r"}'" .APP~ICANfuSE" . ." (A) Enter subtotal of above fees '7J (Minimum Permit Fee $58.00) $ (13) Enter 12%surcharge (.12.'{ [AD $ 1/ i}!. (C) Technology Fcc (5% offAl) $ ,/0' TOTAL fees and surcharges (A through C): $ /0'1 !.! . SPRINGfIEL~D' .. . .,~ .' """OREGOt-l CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01954 IVR Number: 811180999407 www.cLspringfleld.OLUS 225 Fifth 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: APPLIED: 08/17/2011 08/17/2011 Iss ued 08/17/2011 EXPIRES: VALUE: 02/12/2012 $0.00 SITE ADDRESS: 5964 G ST. Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702342200404 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service and two circuits Phone Number: OWNER: ADDRESS: SCROGGINS MARION V 5964 G ST SPRINGFIELD OR 97478 Contractor Type Electrical Contractor CONTRACTOR INFORMATION I Lie Type CCB BUilDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: . Range Type: Hazmat: Contractor Name MY ELECTRICIAN INC # of Units: o # of Bedrooms: ' Spr'inkled Building: Fire Alarms: Energy Palh: Electrical Specialty Code Edition: Springfield 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 87506 Lic Exp 11/20/2011 Phone 541.729.1454 lot Size: Sq FI 151 Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq FI Garage: Sq Ft Carport: Sq FIOther: 0 Occupancy Load: AT12,~WnON: Oregon law requires youto follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number 10r the Oregon Utility Notification Center is 1-800-332-2344). Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT \S NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 8/17/2011 1:18:09PM Page 1 of 3 SP~.IH..G..FIE~.D. . ti[ ""~ :<;"'::;d OREGON www.ci.springfield.OLUS CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01954 IVR Number: 811180999407 225 Fifth Sl Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 08/17/2011 ISSUED: APPLIED: 08/17/2011 08/17/2011 EXPIRES: VALUE: 02/12/2012 $0.00 SITE ADDRESS: 5964 G ST, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702342200404 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Selback: Rearyard Setback: Solar Selback: Service and two circuits 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 ~ Description Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion Branch circuits with service or feeder each circuit Technology fee (5% of permit total) Services 200 amps or less Slale of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount Paid $12.00 $4.65 $81.00 $11.16 $108.81 Date Paid 08/17/2011 08/17/2011 08/17/2011 08/17/2011 ReciDt # 2011002259 2011002259 2011002259 2011002259 Springfield Building Permit 6/17/2011 1:16:09PM Page 2 of 3 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01954 IVR Number: 811180999407 WWN .cl.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 08/17/2011 08/17/2011 Issued 08/17/2011 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: 02/12/2012 $0.00 SITE ADDRESS: 5964 G ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702342200404 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service and two circuits Plan Review ~ Deoartment Application Acceptance Received Due Date 08/17/2011 08/17/2011 Result Over the Counter Completed 08/1712011 Electrical Review 08/17/2011 08/17/2011 08/17/2011 Comments: Over the counter permit Initial Review - '; -; "'_,<f ,. 08/171201'1",08117/2011; .08/17/20U .~, '; .>,j1i".""~~.'ii;{L'i0"'L .c'''' "_-,,,~"\2"t;"'~,"; ~,~,j"~~+:i.0;";',: ,.,.v . 'Com'fnents:;,~,40ver the;count{~'r per"mib!::f,' "'-E' Yr,'", " >~ <':&_~':X: ','V,~;' ",,', , ' , ','," 'c' ,',." " . ...'"!: "'-,";'''i{ L. " '.. ..' ", ' - ,,, /- ~ ,~..; i.'0]i, \'t:~;jJ Not Required Reviewer Chris Carpenter Chris Carpenter '~~,v~~t~;~?:~~~~i"':, cr.~~pr~~,;t~..:"~~j'~~1;;'~~: ~A<l "k~'.,,~' .:,.~,<",j:;- <::')~&'f;"i:<- -'!~;.hY~:;I';tr. ,'t.'. ., t! INSPECTIONS REQUIRED ~ Inspections 4225 Service or Feeder 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 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 ~f 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 Date Springfield Building Permit Bf17/2011 1:1B:09PM Page3of3 S~A:~~~E~ ~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01954 5964 G ST perrnitcenter@ci.sprJngfield.or.us RECEIPT NO: 201,1002259 RECORD NO: 811-SPR2011-01954 DATE: 08/1712011 ldesCRIp..TIONC:::'=l ,-,' "';-.~"Y 'c -';'~,:::..'.;,2"":ACCOi))NT&b[)E~:.;1;; "'P,.MOUNT,DUE'" ,iJ Branch circuits'wlth service or feeder each circuit 224-00000-426102 12.00 -~.~- ,... Services 200 a,[':'ps or less 224-00000-426102 81,00 Slate of Oregon S~rcharge (12% of applicable fees) 821-00000-215004 11,16 Technology fee (5% of permit total) 100-00000-425605 4,65 TOTAL DUE: 108.81 ,''",' . cJ)iVlI\iE~Ii1~:g.1:,:' " AMOUNT;pAIQi~'fi;i~";-:;;;1 108,81 y'~~ ',LP.~YQ8~~HIER:~'CCAR'PENiiR;~ MY ELECTRICIAN INC l;Elr,:~ENi':T:Y!:,EY Check 3655 TOTAL PAID: 108.81