HomeMy WebLinkAboutPermit Electrical 2008-2-19
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ()om/J"jf)y;- - <:)0"2-,-+ ~
S nature Of. Supervlsmg F?)nClan i.
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/' 'Q~.. VM,A ~::~:::;t~0~~6~~~~~~~~1~~~~lfsl)~EWORK
~ - - - .......... - Each Addltioij~lj~~f~nle.rE'[Jlt R IS j ERMIT IS NOT
J. ServIce or Feeder- Perrmt' ABAND~f\1lW FCD
rs Name ~:XJ.fY\~O~ <Z~dc..:b l.LL.-- 1.1. i : :'.',' !.>W PERIOD ..
Address \ (7 II /'i ,...., \ (I VV - .~ , t, /~ ') .8:: I~. f~~i~~i~;~~.i~~~(Sm:~~ll~Yf~~d~?~~i~,~;irr~'~J{~~h~ii,jhstall~fib~ "
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City (' -d1\ (Q (}..) IA.P V Phone
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cA-
OWNER INST ALLA nON
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1. ~~l!!~~JJJ!lY~Il!1~U,~J;dliMl!!.e:!'l!h~2:,:,~
5'335 '~\.~'---'\ ~\ ~ ~40
LEGAL DESCRIPTION, ~
'IO~S'S noo 130-0
rJOB DESCRIPTION
~(;\{A~~-\-ftQ Cp .PCLLf2-
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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2 0[CO~<l1<A'cTOR;~NSTA.I;d'TrON:ONLY'<
~leC~::l:n::to' -151; "';~"~ n ~'R~ ~ C; .
Address P 0 00 y: GO; ?
City V (l11 '(fV,'})'f Phone 7 ~ 7 - 2..7;;)
Exprrat1?n Date
LL.7)}S
10 -10
/ 3 ~ tf4 ~
/6 -oq
,
SupervIsor LIcense Number
Constr Contr Number
EXpIratIOn Date
The mstallatlOn IS being made on property I own whIch
IS not mtended for sale, lease or rent
Owners SIgnature
InspectIon Request: 726-3769
'"
Date
'2 ~\'1 ~ oZ'
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3. ;::'€.OMP1iETE~i1EE'S(j;HEDu.LE.4iE.e(JW..~4'J,,,,; c / ~: ''/"/
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A. ','Newa-Resio
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Service Included
IOOO sq ft or less
Each addItional 500 sq ft or
portIOn thereof
Each Manufact'd Home or
Modular DwellIng ServIce or
Feeder
$11 7 00
$ 21.00
$55 00
~ p '*:. "~~~i~~$!f4~~:~i'/t&{~"
B. ';S~~,\ces:\>,r,.Feed~.rs:..;,;
.,t:'ii>;:, ~"'~"'1'$ik.~':'" ::::4\"'-1~ti.~_Fj;
,*~J2~k "':~~~ -'. ~1'"1:t1S' k<-'\..\7(f '!f<;:~\'" 1;..~~{g, ~ ~ '11'
o "i;~ ""11t"' ' "to" ',,-' {"JR' '1': ''''t,.ft, '':''>'
!hen ,~ra, \qps"o,~ ij :~ ,~~a IQ.~,: ,,":
1:~ }~4t iJ4.i"_- -..-il}~yn ~,.,,~ ;l.Mi~...h,,'/ """',,,..
200 Amps or less $ 70 00
201 Amps to 400 Amps $ 83 00
401 Amps to 600 Amps $13800
601 Amps to ~amON: Oregon Ii'A' re~fWsUlou..to
Over 1000 A1fMlWMotules adopted bv the ~ lUtilitv
Reconnect CWbtiflcation Center. Those rulEfS ~61@et forth
In OAR 952-001-0010 throu hOAR 952-001-
c. ~~elri~ri~~ :'~~. ~~eipt_ f .~~~.
iK,",',,'J J;l, JlI? "" T\1g1;(I\:~ I" .' (r<i'Ote: ';~j.
I t II to nwmherjor tb~IOr~on Utility Notification
ns a a lOn, JI( eran'C'e~~~I~cf-13t'Jfl-332-2344).
200 Amps or less $ 55 00
201 Amps to 400 Amps $ 76 00
401 Amps to 600 Amps $11000
Over 600 Amps or 1000 Volts see "B" above
"'< v 'fu:,>, ~.li%~~" ~t;"i r0f' '"
D. (:;Brari'ch~ei.Fe. ):i'1<''..
l'Y-r: ~./4".>f'4Yl<-~~ I"i' I:J..;,", ~
Pump or rrngahon $ 55 00
Slgn/Outlme Llghtmg $ 55 00
LImIted Energy/ResIdential $ 28 00
LImIted Energy/Commercial $ 50 00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
4. ,'sitBfo?i:1EOF-:AB"OVE" : ,'-1 00
, "h" "'" .", ", ""' ,. I 0 -
Nt -r-;%,"li"t} "'>: ",.\,'::,_h!~ ~>... ,~, (M~ """ .;)'...~l' /il;<."f ~..:.--.
8% State Surcharge "'3 . 5 Q
10% AdmmIstratIVe Fee ,;S r 4- u
5% Technology Fee "'( ,"~
g<6.. era
TOTAL
j
Shared Dnve(T )/BUlldmg Forms/Electncal Permit ApplicatIOn 7-07 doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00248
ISSUED: 02/1912008
APPLIED: 02/19/2008
EXPIRES: 02/19/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 DAISY ST 40
ASSESSOR'S PARCEL NO.: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Pedastal Repair
Owner: SANTIAGO ESTATES ASSOCIATES LLC
Address: 11211 GOLD COUNTRY DR STE 100
GOLD RIVER CA 95670
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC
License
136446
Expiration Date
08120/2009
Phone
541-747-2724
BUILDING INFORMATION I
# of Units:
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:
Sprinkled Building'
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
~ ..-~ ~t.~ 1,,,,
I PUBLIC IMPROVEMENTS I
Street Improvements:
Sidewalk Type:
ATTENTIOlNoQMOOOtI_Il~lres you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
t'~. \J\I(W~K 0090. You may obtain copies of the rules by
1\01\- ALL \:^t'lhC ff 'TI\~ - v.i.I;I\~ [I.v V""~C;I. \r~VLC;:, L11~ Lt:ltq.JIIUIIt:l
'THIS PERMII SHDER 'THIS PERMI'TI ~~~ation Descri tl6lhm er for the Glegon Utility Notification
AU'THORIZED UN IS ABANDONED r Center IS 1-800-:532.2344),
fi&\MIi"ENCED OR , $ Per Sq Ft Square Footage
Desc ANY 180 DAyVP~P!lffi)J,lstructIon or multiplier or Bid Amount Value
Storm Sewer Available:
Special Instruction:
Notes:
Date Calculated
Pal!e 1 of 2
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00248
ISSUED: 02/19/2008
APPLIED: 02/19/2008
EXPIRES: 02/19/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid ~
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$7.00
$8.40
$3.50
$70.00
2/19/08
2/19/08
2/19/08
2/19/08
3200800000000000114
3200800000000000114
3200800000000000114
3200800000000000114
Total Amount Paid
$88.90
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
I Reouired Insoections I
Electric Service: Approval required prior to utility company energizing service.
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
Pa2e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-00248
COM2008-00248
COM2008-00248
COM2008-00248
Payments:
Type of Payment
CredltCard
cRecemtl
RECEIPT #:
3200800000000000114
Date: 02/19/2008
DeSCriptIOn
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdminIstratIve Fee
Paid By
JOSH BURRELL
Item Total:
Check Number AuthorizatIOn
Received By Batch Number Number How Received
nJrn 025028 Phone
Payment Total:
Page 1 of 1
2:22:36PM
Amount Due
7000
350
840
700
$88.90
Amount Paid
$88 90
$88.90
2/19/2008