HomeMy WebLinkAboutPermit Electrical 2009-1-14
.
225 Fifth Street. Springfield, OR 97477 .PH(541)726-375H FAX(541)726-3689 ,
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Permit no.: ooo6S
IDU~ I
Electl;ical Permit Application
This permit is issued under OAR 918-309-0000, Permits are nontransferable, Permits expire if work is not started within 180
days of issua'nce or if work is suspended for 180 days,
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Zoning approval verified? 0 Yes 0 No I
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I Residential, per ~nit, service included:
I D Residential I D Government I D Commercial _
1~.0Bllsl;rij!lNl.0J~l'!lAffil.0Nl1ANDlilfE)C;tUlii)NIlt1;)jBtW,il 11,000 sq. ft. or less (4) $ I
I Jobsitf..addre~s::::)');)t) mil/in ~f, I I ~~~~;ritionaI500Sqft.orportion $ I
I City:~ II d-f )"_4.t.5 l State: I ZIP: I I Limited energy (2) $ I
Subdi~ision: 'j'iOl.3JOO I Lot no.: Ol3tlO I I Each manufactured home ormoduJar I
~"~~6D;~1IP't'~~:r:;~v;R~~_"~~11 ::~:~:: ::~~::eo:s:~~:~l;::ion, alteration, relo:at::~OO $ I
, , I I 200 amps or less(2) /. $ 81,00 $ I
l\i,~~~~RB.(')gER~i(Ow..N51~1.:-lii'~,j1t!l~;rlilli' I 201 to 400 amps (2) $ 95,00 $ I
Name: /)1 r7'f~ (') f--.p ,) I 1401 to 600 amps (2) $158.00 $ I
I Address:' 'J - . I I 601 to 1,000 amps (2) $205,00 '$ I
I City: I State: I ZIP: I I Over'I,OOO amps or volts (2) $469,00 $ I
.1 Phone: I Fax: I I Reconnect only (2) $ 63.00 $ I
E-mail: l Temporary services or feeders:.installation. alteration, relocation I
Th" II' . b . d "C I 200 amps or less (2) $ $ I
IS msta atlOn IS emg ma e on restdentml or ,arm prop.erty 63.00
owned by me or a member of my irnmediatefamily. This .';.,.,.. I 201 to 400 amps (2) $ 8700 $ I
property is not intended for sale, exchange, lease, or rent." OAR !i~ livl '
479,540(1) and 479.560(1), i, . 'e ./."1", '0P) to.600 amps (2). $126.00 $ I
, Q , '-!"'I /o?" q(' ,yo, . I
Signature: ('\ _ ~)\';'J ...: &.j":J' '" C ~lJj (~yg~?~Oi.aaJPs or 1,000 volts, see services or feeders section above
I~C0~CmOR1INSJnA~l5'~W0N~~~~)E~ ~~ ;~ra)]i~cir,~~iJ.f:'fi.e;rJ.. alteratIOn, extension per panel I
I Businesswue: r~ )\J r r1 / l (J r 0 ':!!Joe: ~/]e 0:' IbllKFe.eJ~'br':~~~~"!r5~lf0Yl~purchase ofa servIce or feeder fee I
I ~ VIA In {/f 7 0 -, rl)~'9/1 ,,., ""In ""I" VI//" I I I
Address Id-@,LY-I _ ~/~. e r: ' (1\t,~~ch~~,'Ecn;rjr~ujt?t f~ Ity $ 6,00 $ I
I City:1i!1J 1~rr/i { I State: ()Yi J ,Z,IP:q 19 ;~I~~'E~V~&bt~::~if,~ttbo/{fuoutPurchaseofaserviceorfeederfee: I
I Phone: I~ _ lJJf'.J Fax: 1'#1- /0 If 7 rd,F~rS3~~S,l):~:CiJ!\f;qy $ 5500 $ . I
I E-mail: .........1 I _, I . Each adlJitional~ch Clfcuit $ 6.00 $ I
I CCB license no/ 'J&NY-Lf I\BCD li~nse n : 0 ~ ~ 'f,; ( . Miscellaneousfees.: service or feeder not included 'I .
I Signing supervisor's license no.y\ V, ~I Each pump or lITIgatIOn Clfcie (2) $ 63.00 $
I Print name of signing superv(sor: " )/ \/IIVU I Each sign or outlmehghtmg (2) $ 63.00 $ I
I Signature of signing supervisbr: - AI. I Signal circuit or a limited-energy panel, $ 63.00 $ I
'v ~(I~~'I alteratlOn, or extenslOn (2)
Ii :- p~.S Each additional inspection: (I) I I
Co OR/. '/r Sit
-41\1 ~1/'vJe/J;. 'leD U/J;. '4LL tS()~, Enter subtotal of above fees
y J 80 CEO 0 'DeR, :,1~ill" Permit Fee $58,00)
D4YPt~/S48'Ii1' .j ffdS, rge(.12x[A])
. '/00., . ( @/f)ir;i( ~.Jh1fl ~of[A]) .
I TOTAL-r[.YAmd ~lCharges (A through C):
$134,00
$ 25,00
$ 32,00
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$
$
$
$ 9L/ 2")
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440-2584-1 (9/08/COM)
Status
Iss u ed
CITY OF ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00065
. ISSUED: 01114/2009 '
APPLIED: 0111412009
EXPIRES: 07/14/2009
VALUE: '
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 MAIN ST 240
ASSESSOR'S PARCEL NO.: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Pedestal swap out
-'
Owner:
Address:
SANTIAGO ESTATES ASSOCIATES LLC
lUll GOLD COUNTRY DR STE 100
GOLD RIVER CA 9567ATTENTI.ON: Oregon lawrequires YOU to
IUIIUVY IUle5 aoopleo oy me uregon Utility
NotificaliqIl(S@NIllRAl([)1l@R~NI!0Rl.VImm/ll I
In OAk >;IO~.tI'J ,-. JHJ\",vu\,1',l,,,n ::Io'::'uu ,_
Contrac&9-90., You may obtain copies of the ruJicelille
BURRELLj~~li.N%lS~~:G~,e. .t,e}~p,r:~~ .
wi3rBlmlS[JI.NWNF.oRM~TION ~
Expiration Date
08/20/2009
Phone
541-747-2724
Contractor Type
Electrical
VB
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft t st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R,3
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:
Street Improvements:
Storm Sewer Available:
Special Instruction:
.. -....,'
I PU~~~iSi~RQrV~~~n>t~~ I~~T IS N~T
, AU1HORIIEO UNO~: ~BAN05i~~l)aroJ\Ype: '
COMMENCEO OR 1'1100 DownspoutsfDrains:
ANY 180 OAY PE ,. .
Notes:
"
I Valuation Descriotion ,
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount '
tV~lue
Date Calculated
Paee I of 2
.
Status
Issued
225 Fifth. Street, Springfield" OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Total Amount Paid
Amount Paid
$9.72
$4.05
$81.00
$94,77
.Total Value of Project
Fees Paid I
Date Paid
I Plan Reviews ,I
1/14/09
1/14/09
1/14/09
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00065
ISSUED: 01/14/2009
APPLIED: 01/14/2009
EXPIRES: 07/14/2009
VALUE:
Receipt Number
2200900000000000052
2200900000000000052
2200900000000000052
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'l"!r~,~ I ~:~?~~t,ion~ ~
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 an
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 witbout permission ofthe Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 701.005 will he used on this project.
I further agree to ensure that an 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 an
times during construction.
Owner or Contractors Signature
Paee 2 of2
Date
,.'
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Spribgfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00065
COM2009-00065
COM2009-00065
Payments:
Type of Payment
CreditCard
cReceintJ
RECEIPT #:
I:44:46PM
2200900000000000052
Date: 01114/2009
Description
Perm.Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Amount Due
81.00
4.05
9.72
$94,77
Paid By
JOSHUA BURRELL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
04561 b In Person
Payment Total:
$94.77
$94,77
Page I of I
1/14/2009