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Home My WebLink AboutPermit Electrical 2003-8-25 ::,~.h' ", . " ,Verry bF.~. rdNGFIEID, OREGON' < ", '. .. ~ / 225 FIFTH STREET. SPRlNGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 bmitted has the tollowing ihe following prolacf as SU d ELECTRICAL PERMIT APPLICATION z~nl11g. and does not require specific Ian use CityJobNumber CVW\2003-DOl.f0'7 Date 2?_'z.z-C>~;PlOval.. I'J.)(L , Zoning 15 .; :).-j5:jl.3 3. COMPLETErr;I;;EJif:flFnJ" J.' BELEnl c:K, h....I.UIIZ60 Signature . /58'0 LOCATION OF INSTALLATION O,A , ~ A- [(-- LJ l. LEGAL DESCRJPTION ;703273,Z JOB DESCRIPTION >1.-\ ~ " b C-I ~,,: ~ Permits are nontranSferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. A. New Residential- Single or Multi-Family per dwclling unit. 00(/3 Service Included . 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Maoufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19.00 $50,00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: Address 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 A~~ 601 Amps to I~~ ~~\ Over ~0~%.N~ ~ R\:~~ ~~\&.~ ~ ~. S~'r~ rx.. '\~"...~'V'V~ Supervisor Liceose Number /,n,\\1\J ,~'\}-v. ~'V'ii~fllry Ser\'ices or Fe~ders fY. l,..- \"- ~S y" ~1.'t.'V ,i" ~\). V" ~ \~ ~'\~C\~'t.~c.'t.\)J~lation, Alteration or Relocation o ~ c.C\~\ <01,) 'V'r)00 Amps or less I ~-.J. 20 I Amps to 400 Amps 40 I Amps to 600 Amps i $ 63.00 $ 75.00 $125,00 $163,00 $375,00 $ 50.00 61 Electrical Contractor City Phone Expiration Date Constr. Contr. Number $ 50,00 $ 69.00 $100.00 Expiration Date Over 600 Amps or 1000 Volts see "B" above, D. Branch Circuit, \0 ~O\} ,,' New Alteration or ExtenSiO&j1A-<;Pa'!1'iI\I\:' 0 One Circuit I~\j4 ~e O\(!l~P~ ..e\ '~rJ 43.00 Each Additi~~t~~~Qr\~it(1J~ ~\~ ''!l&.v, \ I S -..-' _ 1~1' /, 1/ Ie Se[Vic~o&feede!l:l!ennit-e \\} Ob.~ fi?Ie $ 3.00 Owners Name I oM V J ri r.4.d /1U11.,1~ii~ \ '" 0-60\' \ :<i.'(\1.)~\0\}Q,'(\ 0\ \'(\e '~o(\e Address / 5 g () lJ CD) ,A a .,(-1- !E. 'ol)1iJ~\~laii.s~~(S~::'vireJfeid'.fr uo~i\fc?ude~)O~E"Ch Installation - ,y , I \0\\ '!..IO\' - OV"- \(\ ,,-. . \(\~ ~\O\I\\- C f / a- .~\C~ c,,'l..1J 0'0\'0 I~O\e. 'XI\'! \~ City d.9r;11rJ ;:/<;jPhone 7i/(,. 7o~(~m1?,.rrirril!~ti;;n,,\a\" (\0\\ nn,6.6.,\' $50.00 I .~ 0"" .,}",,\} . -e" aQ,O n,':)<-' r I'SI~Oulhne.l,lghtmg)\ r:F:J''' $ 50,00 OWNER INS'FA LATION ll.~m~ediE'r?e;~~~Wdeni;ii~ $ 25.00 oJ A"\'O~\ ;(\\e\ Limitell'EnergylCommercial $ 45.00 Signature of Supervising Electrician The installation is being made on property I own which is not intended for sale, lease or rent. . Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee 'ZJ 567 '3/0 9'1?!..- ;::;ZII-O'ThF Inspection Request: 726-3769 4. SUBTOTAL OF ABOVE TOTAL Shared Drivc(T:)/Building Fonns/Elcctricnl Pcnnit Application I-03.doc - _ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00407 ISSUED: 06/19/2003 APPLIED: OS/23/2003 EXPIRES: 12/23/2003 VALUE: $ 4,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1580 W QUINALT ST ASSESSOR'S PARCEL NO.: 1703273200113 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition and remodel Owner: HUNTFORD THOMAS E & LINDA D Address: 1580 W QUINAL T ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION. Contractor Type General Electrical Contractor OWNER OWNER License Expiration Date Phone BUILDING INFORMATION' # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: ~Energy Path: :\)~ -S- ~ _~,0.'\ ~Y., ~ \~';~~LOPMENT INFORMATION' SETBACKS ctJ.'I. ~Y.,~ ~\:) . . \.." $1S f:)~ Frontyard Setbac,k: ~~~ ~ "\'3 ~!i:l Overlay Dist: Total: Side 1 Setba~~v~' ~'\ S~~\:)~ S . 0 # Street Trees Rqd: \} \!landicapped: Side 2 Se.t1f@Fli. ~Y.,~ ~Y.,\:) \)~ '\ f:)\:)' Paved Drive Rqd: ,teS 'l~ ,\,\c;\qmpact: ~ ,~S ~v <.\:) <..~ teo,\} 0(\ v t' Rearyard setua~ ~~'V" ~ ~" % of Lot Coverage: 0(\ I~\j'l ot0g Se\ \0 Solar Setbac~'s? \ ~~ ~ \)'f. ~'.Ot0g 0 'O'l \'(\0 ~0S a.te 9~.-{l.'00 ...C'\ .~ ,.,.,0 ._~10 .ot\} _,,9, ..c \ - ~~' I PUBLIC IMPROV.EME~jS_;I[.-\~\~tOI,}~(\s~o\ \'(\0 '~~(\e W"- \,0" ....vO... coQI0 ,10\09, '1,0(\ \,\iCa. <;'i-OO ~\~Sidewal!':<ryp.e.:o\i\IC~ ~o ~ 9:.> a.'l 0 l~O\,:,,,..,\\\1 ~ , i(\ 011' '1o\} ((\ 0(\\0tDow...~pouts!Dralns: 0090. , ,,\'(\e C Ole~\l O:~,'~'i-t." C~\\,'(\" \ot \'(\e. ... _eO "",'Oet ,,\et ,S (\\}'" cep R-3 VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basemcnt: Sq Ft Garage/Carport Sq Ft Other: ImpervIous Surface Area: Path 1 REQUIRED PARKING 2 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee 1 of3 - ;-~8I;!R'r~,'I'l.' ~ I ", ., Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Bid Amount Use Bid Amount Fee Description Plan Review ResIdential + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Clrc Ea Add Building Permit Plan RevIew - Planning + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Initial Review 05124/2003 InitIal Review 06/0212003 Plannin!! Review 06/0212003 Public Works Review Structural Review 06/12/2003 06/02/2003 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 4,000.00 _ CITY OF ~r1Ul'\jut<l~L1J Building/Combination Permit PERMIT NO: COM2003-00407 ISSUED: 06/19/2003 APPLIED: OS/23/2003 EXPIRES: 12/23/2003 VALUE: $ 4,000.00 Value Date Calculated Total Value of Project Fpp< PIilLI Amount Paid Date Paid $4,000.00 $4,000.00 OS/23/2003 $39.39 $11.56 $8.09 $43.00 $12.00 $60.60 $59.00 $8.10 $5.67 $18.00 $63.00 5/23/03 6/19/03 6/19/03 6/19/03 6/19103 6/19/03 6/19/03 8/22103 8/22103 8/22103 8122/03 Receipt Number 1200200000000001322 2200200000000001085 2200200000000001085 2200200000000001085 2200200000000001085 2200200000000001085 2200200000000001085 1200200000000002003 1200200000000002003 1200200000000002003 1200200000000002003 Plot plan not submitted with plans. David Bowlsby has requested plot plan in order to route/review plans. Plans on hold until plot plan has been received. Plot plan submitted by owncr on 5/30/2003 ZonIng confirmed as LDR. Addition outsIde of any Flood Plain Hazard along the channel. No SDC fee's required. To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. $328.41 I Plan Reviews I OS/24/2003 WE LLH 06/0212003 APP LLH 06/13/2003 APP AJD 06/1312003 06/17/2003 APP DJW APP TCM Pa!!e 2 00 - _ CITY OF SPRINl.NI!.LD Building/Combination Permit PERMIT NO: COM2003-00407 ISSUED: ,06/19/2003 APPLIED: OS/23/2003 EXPIRES: 12/23/2003 VALUE: $ 4,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~irp.d InSDp.~tions , I. , 1 Footing: After trenches are excavated. 2 Foundation: After forms are erected but prior to concrete placement. 3 Floor Insulation: Prior to decking. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 5 Wall Insulation: Prior to cover. 6 Ceiling Insulation: Prior to cover. 7 Drywall: Prior to taping. 8 Final Building: After all required inspections have been requested and approved and the building is eomplete. 9 Rough Electric: Prior to Cover 10 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 of Springfield and the Laws of the State of 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. Owner or Contractors Signature Date Paee 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-o0407 COM2003-00407 COM2003-00407 COM2003-00407 Payments: Type of Payment Check _~'''''CIFJ. .,~.. .' '. ~,. I ;..~. ; .w.,." _......, .~. _ Receipt #: 1200200000000002003 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By THOMAS HUNTFORD Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 08/22/2003 1I:15:20AM Amount Paid Item Total: 63.00 18.00 5.67 8.10 $94.77 How Received In Person Payment Total: Amount Paid $94.77 $94.77 - - , C~nstruction contra!!s Board 700 Sununer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us I). . . \. ./ '. " " ,.' I pennit#:/'r'l1/l'17.v"- eXY--l.07 Address: I)' to L-f Qv..,....... I+- Issued by: ~t3 Dale:g-Z'Z- 0:\ Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnction permit applicants who are not licensed with the Constrnction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit, Fill in the "pp.vp.;ate blanks and initial boxes I and 2, and either box 3A or 3B: ~I. -er 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name ofthe contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. /~ fl~A/!~_Y ~ ~/03 (Signature ofP~it applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) L_r_nLowner.doc 03/11/03 " ':. - A~ttnnng ~~ '%1illIr (Q)wnn Gennell"~n CC~nnttIr~~tt~Ir? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ,. . ~ NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can pr~vent many problems by being aware of the following responsibilities and concerns. Employer RespmnsftbilW,es You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improyement of a residential structure, As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For a State Business ill number, call the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488, Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance. you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer. you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. ~tlhter ResponnsilbiRities and! Areas of Concerns Code Compliance: As "the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property ,Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray. water damage from pipe punctures, fire or work that must be redone: , Time: Make sure you ha~e sufficient time to supervise your employees, Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work ofrough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner. doc 03111103