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Home My WebLink AboutPermit Electrical 2011-9-7 , . Electrical Permit Application D SPAINGFIE!.LO :-?:....,.,,;::'. '} ...:;~0: ::ii5:~:.~::~g~. ~ ~ ','~ ~..... . ~'- '~;;'., . " . '.'".' oii,Nt' h~,"".'?- ~-"L' ~\ r.,,-.'__::::;:j'-'~' ~,~ , ." "~ 'l' ";Ji~:j-~ "',,,;OERARlMENTfUSE'ONIlY';;t:.c'. 1-''''1''''L,_,. ;,'-"'; ',;..:,;\~." """.:;'_ 'Anno,,"::,:! "!;,,:',-,f." .~<~:~.:~ Permit no.: <;'.11- 2.0'71) '7 225 Fifth Streett Springfield, OR 97477. PH(541)726.3753. FAX(541)726.368? 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 180 days. ~")f,1~: J;:L:O!::f(t'I(GO'V'ERNMENTt'Af>I;>,RO'V',6;l~~i~~Ji'iq;gill ~!2~~t@~J~'~jS;:-t~~FEE':'SCHEDUL.E~~,;~,~;>t-",':r(, ~~~~'f~.~~: Zoning approval verified? DYes DNo ..,r~"".J...;~':f-:;"::,!"_.,,,..,,!>i~~...r. ,l'.<f,,-i-~~~....~:. ~',s~_~:~'':"c ~'., ~T'" r ' ;:!'i~~~~n;gfJ~~Rt~tle~t~'~,:~;.!~e~~]}j~ ,9ty.o ';';"e~~~~'{,~: :,'~'c~~t~;_: iif~\~J:';'.~:'.~7:iCf!.:rEGORY~~Of'~C;.0f11STRUCTI0Ni':?"~:::;F.,,,~W.;i Residential, per unit, service included: o Residential I 0 Government I 0 Commercial : JOB SITE INFORMATIONANO'(OCATION .,; ,'. : 1,000 sq. ft. or less (4) $134.00 $ , Job site address: "lL{3 h <::.<<t-cJ "ZJ e.. C /'2e r de. Each additional 500 sq, ft. or portion $ 25.00 $ thereof City::5i;::Q.Ir.ttlKd.Q. I State: t:!Ji2., I ZIP'l7'l7-7-, Limited energy (2) $ 32.00 $ Refere~ce: .J /7CJ J 23lfC.( 1 Taxlot.:l?bWO. Each manufactured home or modular $ 63.00 $ .c .,,,~,;{~:.OESCRIf>TION'!OF.' WORK..: c,,'" dwelling service or feeder (2) ,{:il::.",o., i!'..,..: lt~T ~""<A riLl Services or feeders: installation, alteration. relocation 200 amps or less (2) $ 81.00 $ '!r,~lr.}Jl::;tm? P-ROI?ERl;Y;:0WfIIER;t~;;~~'.[ti&.!"",'li.c't 201 to 400 amps (2) $ 95.00 $ Name: J ""'n 7_DI1'.10 ./zv'5> 40 I to 600 amps (2) $158.00 $ , Address: "1 '-("3 tvt<-lLc7-'~ (eE' ~-r7' , 601 to 1,000 amps (2) $205.00 $ City: <:;, f> 1=, " I State:f1d-, I ZIP: "J1'f?,' Over I ,000 amps or volts (2) $469.00 $ Phone: - !JtYI /'VA" tIv.l'(~-1 Fax: Reconnect only (2) $ 63.00 $ - , E,mail: ! Temporary services or feeders: installation. alteration, relocation This installation is being made on residential or farm property 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This 20 I to 400 amps (2) $ 87,00 $ property is not intended for sale, exchange, lease, or rent. OAR 40 I to 600 amps (2) 479.540(1) and 479.560(1). $126.00 $ , Over 600 amps or 1,000 volts, see services or feeders section above Signature: , \'!;~?.:f~(i'j(!1'CON;rRf.o.CTOR:;INSTA(jLATIONi1)~'.'~g;'";ii';lj Branch circuits: new, alteration, extension per panel Business name: If-I eLB:rrz-1<:/ a. Fee for branch circuits with purchase of a service or feeder fee: Address: P.O,$.ox 413 89 , Each branch circuit $ 6.00 $ City: 0J..h I State: f"l/C.. I ZIP:'1 b. Fee for branch circuits without purchase of a service or feeder fee: Phone: ~/ ,hilt? -'? /171 Fax: , - First branch circuit (2) , $ 55.00 $,<;- E-mail:olJ.(ol"s.flot"(Q ,(' /J/HC4St 11/&7 Each additional branch circuit G $ 6.00 $1'(" CCB license no.: 'I~BCD license no.: 2o-L17'i'C' Miscellaneous fees: service or feeder not included Signing supervisor's license no.: 'i88(~S Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: &IZ.Yh.J L, J.ftLeLE1C I Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor: -;e;. , -t; 1./ ' L./ Signal circuit or a limited.energy panel, $ 63,00 $ alteration, or extension (2) / L- '~dditional inspection: (1) $58.00 $ 'irl?",;~,gj'~~"'AF.!R[;ltXNj;' USE":'~~""'~'" ". "'~';"': m~I,;",- _,",'. ".~'l," ..J7 ^ ,\ h! 'I ~,!t;.('12.",~cf:;:...<lf,.",-t:""LS, (A) Enter subtotal of above fees ~~ (Minimum Permit Fee $58.00) $1 ( (B) Enter 12% surcharge (.12 x [AD $iO~ 6J (e) Technology Fee (5% or [A]) $Lf~ <1: TOTAL fees and surcharges (A through C): $ 10(/(2.. 440-2584-J (9108/COM) ~~ ~ . I s~~.. ..I~N.G._:IEL~ Wi::,,-- ,,;<:" ~ '-"., OREGON , , CITY OF SPRI,NGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-02077 , IVR Number: 811;116786892 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 pennitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: I ;1 1 APPLIED: 09/07/2011 09/07/2011 09/07/2011 EXPIRES: VALUE: 03/04/2012 $0.00 , SITE ADDRESS: 943 MCKENZIE CREST DR; Springfield, OR 97477 SCOPE: Electrical Only 1 ASSESOR'S PARCEL NO: 1703234406600 'WORK INVOLVED: Alteration I I TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wiring for kitchen remodel - 7 circuit'extensions OWNER: ADDRESS: ZOUMBOUKOS NEAL P & YVONNE L 943 MCKENZIE CREST DR SPRINGFIELD OR 97477 Contractor Type Electrical Contractor Contractor Name BRYAN L HURLEY , I I I CONTRACTOR INFORMATION I Lic Type I CCB Phone Number: I Lic No Lic Exp 149937 12126/2011 Phone 541~606~2797 # of Units: BUILDING INFORMATION I I # of Stories: ' i Height of Structure: Type of Heat: ! Water Type: i Range Type: I Hazmat: I I I Electrical SpeCial~ Code Edition: Springfield Fire Code Edition: Mechanical speciJlty Code Edition: , , Municipal I Development Code: Plumbing spe~ial~ Code Edition: Residential Speci~lty Code Edition: l Structural Special~ Code Edition: Site Information o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 9n12011 3.09:26PM i lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 ATTOcCuRancy Load: f0201 ~N 'liON: Oregon law requires you to ..~,~ ru es adopted b th 0 Notification Center ThoY e i regon Utility in OAR 952-001-00'10 th se ru es are setforth 0090 y . rough OAR 952-001- caliingO~~ay Otbtaln copies of the rules by cen er. (Note: the teiephone numbercfor the. Oregon Utility Notification enter IS 1-800-332-2344). I NOTICE::;...,;;.,., THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT .' COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, Page 1 of3 www.ci.springfieJd.or.us I I I I I CITY OF SPRINGFIELD ,I Building I Residential Permit " I . , I PERMIT NO: 811-SPR2011-02077 I IVR Number: 811'116786892 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 ;a · perm itcenter@ci.springfield.or.us ISSUED: I APPLIED': , I SITE ADDRESS: 943 MCKENZIE CREST DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703234406600 I I I Wiring for kitchen remodel - 7 circuit;extensions I PROJECT STATUS: STATUS DATE: Issued 09/07/2011 09/07/2011 EXPIRES: VALUE: 03/04/2012 $0.00 09107/2011 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Electrical Only Alteration Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION I ~ Overlay Dist: I # Street Trees Reqd: Paved Drive Reqd:1 , I % of Lot Coverage: H". I Ighest pOint on structurel to north property line: " I , REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer: Storm Sewer Available: Special.lnstructon: Subdivision Accepted: Notes: PUBLIC IMPROVEMENTS I I ~ Sidewalk Type: Downspout/Drains: Vaiua'tiori Description , I , , ;Unit Amount Unit Tvoe I I Unit Cost Value Descriotion Tvpe of Construction FEES PAID I I DescriDtion Amount Paid State of Oregon Surcharge (12% of ~plicable~~~s) ~~_$iO.92 ~ Technology fee (5% of permit total) $4.55 sranc.h-'c~'i'th7;ut service or feeder - 1 st circuit"'---~'~--'--"-$~5."6o-'- Branch circuits without service or feeder - each additional $36.00 Total Amount Paid $1r'47 Date Paid 09/07/2011 . ---- 09/07/2011 .-...-------.,-.-.- "..-~,,_._"'..__.. 09/07/2011 09/07/2011 ReciD. # 2011002403 2011002403 2011002403 2011002403 Springfield Building Permit I I 9f712011 ~:09:26PM ! , I I Page 2 of 3 SP~~\N. :.:~ ~!D ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-S'PR2011-02077 IVR Number: 811116786892 www.ci.springfield.or.uS 225 Fifth St Sprin9field,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitcenter@ci.springfield.of.us PROJECT STATUS: STATUS DATE: Issued 09/07/2011 ISSUED: ' APPLIED: 09/07/2011 09/07/2011 EXPIRES: VALUE: 03/04/2012 $0.00 SITE ADDRESS: 943 MCKENZIE CREST DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703234406600 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential Wiring for kitchen remodel. 7 circuit extensions PROJECT DESCRIPTION: Plan Review ~ DeDartment Application Acceptance Received 09/07/2011 Due Date 09/07/2011 ComDleted 09/07/2011' Result ! Over the Counter Reviewer Chris Carpenter "09/07/201 h,,0~/07/2g!! '09/07/2011,' .~ ':\'~"iJ~" ' '1"-:"" -~.~. . - ''''':'', . ":<'-' i,/ ',ie Iss~.ed,~'", ~. ; \., w';;t;,L,,~ Electrical Review 09/07/2011 09/07/2011 Comments: Over the counter permit llnitial Review ", ',09/07/2011,+ .09/07j2011;, r 'co~ments: . Oyer the ~6unter permit ' ~. 09/07/2011 Not Required 09/07/2011:' . .' ' .' ~ ~~ . ~ . Over, the Counter ~ :,,';."_" _';' " t .. ;, C~r!s Ciilrpenter. INSPECTIONS REQUIRED ~ Inspections 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Chris Carpenter 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 ana all work pertormed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon perta.ining 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 ~=&tion , I ~\.~; '2.0(/ Date Springfield Building Permit 9nJ2011 3:09:26PM Page 3 of 3 .. ri'.. www.ci.springfield.or.us I TRANSACTIO~ RECEIPT 811-SPR2011102077 , 943 MCKENZIE CREST DR I CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541.726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2011002403 RECORD !'lO::S11-SPR2011-02077 DATE: 09/07/2011 (DESCRIP..TIOI.j;E::,' ,:;~< '1,,,,~,f~ :f::,:,- ,.;,:<~~}i.:.t,':'::AC;COUNnCobE2.:,,;'~',,J"9\MOUNf..DUE,D,;; ',,:, Branch circuits without service or feeder - 1st circuit I 224-00000-426102 55.00 Branch circuit~ without service or !~e'der - .:.~Ch~ additi~~L_ _1~~:00000-4261 02 _ 36.00 State 01 Ore90n Surcharge (12% of applicable fees) '821-00000-215004 10.92 '. '._-j- Technology fee (5% 01 permit total) _ I 100-00000-425605 _.."..4.55 I TOTAL DUE: 106.47 LiRAx!Vt~Nkk.iY~g~MQfii.4L~~~lgR:':CCARP.tNT'ER'1i+~~7",.'fl\~z..'c~6iViJ!tr;~jS:~-. ,"~;.~ <:"/~:$;.;t0\[4:~f~~0,i~:Z:::AM0~Nlj~PAI[,)~~',~-: ',J;jj'f,s;;r:~}] Credit Card BRYAN L HURLEY 106,47 00766b TOTAL PAID: 106.47 I I I I I I I I I I I I I I i , I I