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Home My WebLink AboutPermit Electrical 2011-9-6 Electrical Permit Application cii;Y(oF~spiuN'GFIEiJj~;.oREGON: :-.. - ...~-,~..t,-..~l~~"~....r? "+:;'~:'~'F...!."r"~;;r,";~':' ~'\j"\~u.~.J:::i'~r ;,'" -.'-+~. !>~,_~:~" -." 225 Fifth Slr..USpringfield, OR 97477+ PH(541)726-3753. FAX(541)726-3689 ":'~';;<;;$:'~'''~';''':1i'>:,":",.:~;"...._r;*,!.~~~~~~-..,. . "&i-{o.!:PAEP:.M_~-m~SEQ!:l,",y,;. ~, ;i-.:'; ,1:"0-' . ....,;".~;~'"-;.m:",~~ ~.- ;- I ...5f12..2@ H Permit no.: Date: Cf - t, - J.1- I I 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. 1,000 sq. It or less (4) $134.00 Each additional 500 sq. It 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 $ Phone: Reconnect only (2) $ 63.00 $ E-mail: Temporary services or feeders: installah'on. alteration, relocation 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: ""'"., ~~t:0NjftB$GiJ[g~,-fj~i[~~W~ffR~IiJ~,,!~,,;' Business name: J[ L<< . Address: City: Phone: E-mail: CCB license no.: 44O-2584-J (9/08/COM) ~~t~ ~~\Y~ ~ 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, alteration. extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 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 not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limitedwenergy panel, alteration, or extension (2) Each additinnal inspection: (1) '. . :laB"llW,t(tiitf;;1l.~[~' (A) Enter subtotal of above fees (Minimnm Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) (C) Technology Fee (5"10 of [A]) TOTAL fees and surcharges (A through C): $ 63.00 $ $ 63.00 $ $ 63.00 $ $ $58.00 .o '.. SPRINGFIEL~ -~ ., .""'- ,,~ ,-of, OREGON CITY OF SPRINGFIELD I Building I ResidEintial Permit PERMIT NO: 811-SPR2011-02068 IVR Number: 811163252238 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: 09/06/2011 09/06/2011 09/06/2011 SITE ADDRESS: 4245 CAMELLIA ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702323300700 EXPIRES: VALUE: 03/03/2012 $0.00 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Fire Damage Repair Phone Number: 541-747-5340 OWNER: ADDRESS: GOODY ARD THOMAS H & VIOLA M 4245 CAMELLIA ST SPRINGFIELD OR 97478 Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lie No Lie Exp Phone # of Units: BUilDING INFORMA TION ~ # of Stories: Height of Structu~e: Type of Heat: Water Type: Range Type: Hazmat: o Occupancy Type Construction Type R-3 Type VB # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: I Electrical Specialty Code Edition: Springfield Fire C,ode Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Special,ty Code Edition: Residential Specialty Code Editio!l: Structural Specialty Code Edition: lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy load: 2011 Site Infonnation ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: ATTENTION: Oregon law requires you to Retaining Wall: follow rules adopted by the Oregon Utility Soils Report Requi',e.5'iification Center. Those rules are set forth in OAR 952-001-001 0 through OAR 952-001- omio. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). . ' Springfield Building Permit 9/6{2011 1:14:38PM " 'OT1CE: . :HIS PERMIT SHALL EXPIRE IF THE WORK \UTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of 3 ~ L' SP::~...~:EL~ ~'1'-' c. \t;U :L. OREGON WWN.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit I PERMIT NO: 811-SPR2011-02068 IVR Number: 811163252238 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 09/06/2011 ISSUED: APPLIED: 09/06/2011 09/06/2011 EXPIRES: VALUE: 03/03/2012 $0.00 SITE ADDRESS: 4245 CAMELLIA ST, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702323300700 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Fire Damage Repair 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 ~ Descriotion Tvpe of Construction , Unit Amount Unit Tvee I Unit Cost Value FEES PAID I DescriDtion Technology fee (5% of permit total) .Residen~~ w;r~n~_~ ~OO_O s~f!. ~r_I:.~~_. _ __.,.,_,____ St~te ~f+S'~o_n_~urcha!jLeJ1.~~ of applicable fees) Total Amount Paid , Amount Paid Date Paid $6.70 09/06/2011 $134.00 09/06/2011 _.".,-_ t ___.___ ___ .____.__,._.0___ $16.08 09/06/2011 $156.78 Reciot # 2011002393 2011002393 2011002393 Springfield Building Permit 9/6/2011 i 1:14:38PM Page 2 of 3 .. SPRING, FIE, ;.ij 0 - 'p ~ m:._ OREGON CITY OF SPRINGFIELD I Building I Resid~ntial Permit www.ci.springfietd.or.us I PERMIT NO: 811-S,PR2011-02068 IVR Number: 811163252238 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED; 09/06/2011 09/06/2011 Issued 09/06/2011 EXPIRES: VALUE: 03/03/2012 $0.00 SITE ADDRESS: 4245 CAMELLIA ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702323300700 SCOPE: Electrical Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Fire Damage Repair ~ Deoartment Application Acceptance Pia n Review Received Due Date ComDleted i Result 09/06/2011 09/06/2011 09/06/2011 Over the Counter l~~~mit'ssu~~ce~_,,;,__ _" f - "'. I ,09/06/201F, 09/06/2011:', 'Issued, ~; ~,'._ ':"', '.,c- ."'~"""; "- . " fl ~09/06/2011 .~4< -~. Electrical Review 09/06/2011 09/06/2011 Comments: Over the counter permit Initial Revi~w' . ' ,,-,, 09/06/~011'. :.q9/06/2.~11~. Com~ents; Over the counter permit". " .' - 09/06/2011 I Not Required ,0'1er the:Counter.'" '-c.. r" ~"~',., . " 09/06/201'1". ~ ~"\ , ." 1 INSPECTIONS REQUIRED ~ Inspections 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When ~II electrical work is complete. Reviewer Kip Kaufman Kip Kaufmaij , ....."'".."". Kip Kaufman Kip"Kaufman, ' 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 ofthelCommunity Services Division, Building Safety. I further certify that only contractors and employees who are in compliance wit~ 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 ca is located at the front of the property. and the approved set of plans will remain on the site at all times during , , construct n. q-&-(( Date Springfield Building Permit 9J6/2011 1:14:38PM Page 3 of 3 www.cLspringfield.or.us I I TRANSACTION RECEIPT I 811-SPR20,11-02068 4245 CAMELLIA ST CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-72&-3753 S~_~~NG~E~ ~.~ _'", ;;JIfJ ''''''' OREGON permitcenler@cLspringfield.or.us RECEIPT NO: 2011002393 RECORD NO: 1111-SPR2011-02068 DATE: 09/06/2011 IDESCRII~.T10N ;; .L:- >-::, ~';-"; . d, :::.. ';'.,K',i'ACCOI.JN'tCODE'" .' .:P..MOUNJ:iDUE,"'. Residence wiring 1,000 sq. ft. or less , , 224-00000-426102 134.00 - "'''-'-r---''-----' _~te of Oregon Surcharge (12% of aeplica~fees) __ ..:......L~?1-0~E?:3.15004 16.08 Technol09Y fee (5% of permit total) I 100-00000-425605 6.70 TOTAL DUE: 156.78 UA Yr~lEN:fTY'PE ./.~ ::#"F?AiQR.#'{cAsHiE"RTKREEOER.:;:t~'fW";c6M~t~NT~kJ;~T".~J:~,s4r":>~~:f;:i~'.f\MO.UNT'PAJQ~ -'.,,';,~~~~:!J<;i; Credit Card JEM Electric, INC 156.78 ',-1 ] 120118 TOTAL PAID: 156.78