HomeMy WebLinkAboutPermit Electrical 2009-1-7
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00021
ISSUED: 01/07/2009
APPLIED: 01/07/2009
EXPIRES: 07/07/2009
VALUE:
225 Fifth Street, Springfield, OR
54]-726-3753 Phone '
54] -726-3676 Fax
54]-726-3769 Inspection Line
SITE ADDRESS: ]4]0 T Sf.
ASSESSOR'S PARCEL NO.: 1703252300607
Springlield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Replace 200A service
Owner:
Address:
PHILLIPS BRUCE A & MARGARET J
]410 T ST
SPRINGFIELD OR 97477
ATTENTION: Oregor. law requires you to
.f"^n....",....,___...J_._',~_I'- ".... ,._,".
d -.,.--_ -J ".~ ..........::1.....,., ......11.\1
I CONTRA~;;~'R'I'~.~;RMA1:i8N'li' rules are set forth
, . ' '11gl1 OAR 952-001-
0090, You may oQtain copies nf tr~e n I!es hv
Contractor calling the cel~!~,e~,~~(e: tI~X.~/[I~,~\?n,"Uate
COMPLETE ELECTRICAL INSmAI:;bAmIOn<}]84~7,4J1l Utilitv NdP.(~~i~Q,\O
BUILDING INFORMATION rUU-332-2344).
Phone
54] -225-7827
Contractor Type
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
r,.....-".,.........
Sprinkled,Buildin'g.
Lot Size:
Sq Ft ]st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VB
n/a
Front yard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Sqlar Setbacks:
I DEVELOPMEiNiii-iNFORMAiioN~ICN'lnt I~ I lit VVUKK
. , rHIS PERMIT IkilrolRED pARKING
COMMENCED OR IS ABANDONED FOR
Overlay,1IislJ 80 DAY PERIOD ' Total:
# Street Trees Rqd: . Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instruction:
~:!;I-
Sidewalk Type:
Downspouts/Drains:
Notes:
I V aluation Descri~tion ,
Description
Tvpe of Construction
$ Per Sq Ft ,
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of2,
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00021
ISSUED: 01107/2009
APPLIED: 01107/2009
EXPIRES: 07/07/2009
VALUE:
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
Total Value of Project
Fe".s Paid J
$9:72
$4.05
$81.00
117/09
1/7/09
]/7/09
Receipt Number
3200900000000000005
3200900000000000005
3200900000000000005
Fee Description .
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Total Amount Paid
$94;77
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 Re'1"i~erl Ins\'~~ti,o~s'
Electric Service: Approval required prior to utility company energizing service.
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 Ordinauces 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 coutractors and employees who are in compliance with ORS 701.005 will be used on this project.
I furth'er ag~ee 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. .
, ;/"
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1'-- ?,--O~
7 ,. ...-
Owner or Contractors Signature
~
Date
Page 2 of 2 '
225 Fifth Street
"
Sprin~f.ield, Oregon 97477
541-7i6-3759 Phone
Job/Journal Number
COM2009-00021
COM2009-00021
COM2009-0002 J
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield'Official Receipt
Development Services Department
Public Works Department:'
3200900000000000005
1l:33:3]AM
Date: 01/07/2009
Item Total:
<"':heck Numbe-r Authorization
Received By Batch Number Number How Received
Amount Due
81.00
4,05 '
9,72
$94,77
Description
Penn Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
COMPLETE ELECTRlCAL
Amount Paid
cjc
, $94,77
$94.77
320554 In Person
Payment Total:
Pagel of 1
1/7/2099
Electrical Permit Application
ZZ5 Fifth Street>Springlield, OR 97477 +PH(541)7Z6-3753t FAX(541)7Z6-3689
1"'fm~~~:'>}~ii"!;:ii)!1!L""";;<"4;W.f{t;;;"'~~~~~~1
s~:tr,wEeARTMENT4USE(0N~Y; ~'
,'-'.-,. ''*''''~''T ".;-""""','-" "~".. ". .. ~.~ ,,'," ",'.'
S'%.1"^~!$~M",.,j!'!I>""'1,,,",,f'::,"""~N:.T.{~].~~~
I Permit no,:U;>ry .2.d'( - caU I I"
I Date: te) 7/c) Y' "I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Pe~mits expire if work is not started,within ]80
days of issuance or if work is snspended for ]80 days.
1l!f~L!0t~IL~G0:V;ERNI\IIEJ,jT.i~FIFIRb.V~Ii"~~"1ll1
1 Zoning approval verified?' 0 Yes 0 No' I
,1~~G'~mEG~0Ry;lj0I;l1CJjNSmR(jtmIQN~I!If~'i~
I'BJ Residential 1 0 Government , " I 0 Commercial "I
I~J0E1i.SIjf:E~INF.<:jBI\IIAlliIQNIANDl!I!i0QJ,\'I!10Nill!1jl1i'~tl
I Job site address: Vi /0 T .shee.T I
1 City:9i'I'\M.\;; <.\..1( 1 State: Cl(Z 1 ZIP: I
1 Subdivision: 1 Lot no,: 1
1i1;~~!!.IBBEStRIFI,f~ONl!<:>F;JiW.a>R[<~l'~~'1I:~lill
1 1
1 1
11i:~~1Ij:?RORERmY4:0vvNER;~~-i'~'\':!t~~~1
1 Name: :b~,. c- ;j;,,1JtlfJ?A~ ?H/Lt:-r/"'.5 1
1 Address: r 1
,I City: I State: 1 ZIP: 1
t Phone:- I Fax: 1
I E-mail: 1
This installation is being made on residential or'farm property
owned by me ora 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: ,
11__~(),ONlI1RJl;ciliOR1INSII1A~l1'A]ION~rJ!!i!~~1 1 Branch circuits: new, alteration, extension per panel
I Business name: C.c"'9\~te. ~\...rt r-~ c,c.\ ~..,}).rr ;r,,,..,=+tf.-I a, Fee for branch circuits with purchase of a service or feeder fee:
I Address::.-:!.o2.'1 c.."..,a"" ~--...o.\.. {(). I 1 Each branch circuit 1 I $ 6,001 $
1 City:(,,<< -c...\\ r State: o~ I ZIP: 0,'142 ~ I I b, Fee for branch circuits without purchase ofa service or feeder fee:
1 Phone:5't f2K:b - ?<i? 2. '7 I Fax: 1 First branch circuit (2) $ 55,00 $
1 E-mail: I Each additional branch circuit $ 6,00 $
1 CCB license no,: ISLl :2..1'1 I BCD license no,: C 44 } I Miscellaneous,fees: service orfeeder not included
1 Signing supervisor's license no,: 5''3'''7 S I Each pump or irrigation circle (2) $ 63,00
1 Print name of signing supervisor: 1"\4ft' G ro....t:.r I Each sign or outline lighting (2) $ 63,00
I SignatureOfSigningSUpervisor:~~ I Signal,circuitorali!llited-energypanel, $ 63.00 $
. alteratIOn, or extensIOn (2)
,lEach additional inspection: (I) I $58,00 $
IE~llIl1rg~~iQ7&Nif,mu~gt~];.~~
$"6 l /
440-2584-J (9/08/COM)
N~,lY~A~"EEiSCHEBtlI!E-~_'~~..w:li1
~.,3.SS;~~~1~JlA____",.~__.L....____. ____~~~!Io:;'
"~""7',,"f~;ff"\l~ ' "'liIiiimr~'~,B"" ",;'C-"I'c;h'!i!iil"""€' '~t'l!!l! lif": ~T' ~t"I;I'1
~Nuinber ofcinspectionsfpe':item'/,r/@ QtyJ' \1:'1 .us ,!!!'l flii'!:o ,,!~
~vt{M,';,,,,'fi.ff%'j,S;t~~Jt;t.d9G,~W~:B~k~'RiiLij 'x'~-",'4! ~~!!~~ ;0..~,~.Qs!~,
I Residential, per unit,-service included: I
11,000 sq, ft, or less (4) $134,00 $ ,I
I Each additional 500 sq. ft. or portion "I
thereof $ 25,00 $
1 Limited energy (2) $ 32,00 $ I
lEach manUfactu, red home or modular 1
dwelling service or feeder (2) $ 63,00 $
I Services or.feeders: installation,.alteration, relocation I
, I 200 amps or less (2) .i. $ 81,00 $ 13),1:.
[ 201 to 400 amps (2) $ 95,00 $ 1
I 401 to 600 amps (2) $158,00, $ 1
I 60 I to 1,000 amps (2) $205,00 $ 1
Over\OOO amps or volts (2) $469,00 $ 1
Reconnect only (2) , $ 63,00 $ I
I Temporary services or feeders: installation, alteration, relocation I
1 200 amps or le1s (2) $ 63,00 $ I
1 201 to 400 amps (2) $ 87.00 $ I
1 401 to 600 amps (2) $126,00 $ 1
lOver 600 amps:or 1,000 volts, see services or feeders sectiol.) above I
1
1
1
I
I
I
I
1
I
I
$
$
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
1 (B) Enter 12% surcharge (,12 x [AD
I (C) Technology Fee (5% of[AlJ ,
I TOTAL fees and surcharges (A through C):
$fJ:!"
$~'S- I
$ 'iL/~1