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HomeMy WebLinkAboutPermit Electrical 2009-1-14 . 225 Fifth Street. Springfield, OR 97477 .PH(541)726-375H FAX(541)726-3689 , IffU'OEe~RTNfE~J:ruSElON~~~!<1 n.."....,....".,...."..., ,.... _.;' .""".. - "."..,....,.. , '''"Q\,.~,w~..r~jt','<I>~,~_':'E"~!:!:~~;~lY,,.,.ll!'1tJ I COlM~OO' -, I. 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, .~~lliC:fe~[,'\!G.0j1.E8NMENiI"i'~EP..RQVAI...T~m Zoning approval verified? 0 Yes 0 No I Ir~~_~A711f::G()RYilElF.!C:.0J\lSjlJB.l'J(;,mfQJ\l~~~1 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 ~\v ~c&~~ 'f\N $ $ $ $ 9L/ 2") . . .f'. 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