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Home My WebLink AboutPermit Electrical 2009-1-20 Status Issued CITY OF SPRINGFIELD '. Building/Combination Permit PERMIT NO: COM2009-00083 ISSUED: 01/20/2009 APPLIED: 01/20/2009 EXPIRES: 07/20/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 839 3RD PL ASSESSOR'S PARCEL NO.: 170335211 ]418 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: ,New Residential PROJECT DESCI!-IPTION: Reconnect Only - Emergency Owner: Address: GARY A SMITH LLC 1348 CLEARWATER LN . SPRINGFIELD OR 97478 I CONTRACTO.~ IN,FORM.ATlON I Contractor Type Electrical Contractor CRAFTSMAN License 170183 BUILDING INFORMATION I Expiration Date 05/30/2010 Phone 541-954-7589 # of Units: Primary Occupancy Group: Secondary Occupaucy Group: Primary Coustruction 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 GaragelCarport Sq Ft Other: Occupant Load: nla c, I DEVELOPMENT INFOR~ATIo.N , "REQUIRED PARK]NG .f ..~ d Front yard Setback: Overlay Dist: Total: - Side 1 Setback: # Street Trees Rqd: Haudicapped: Side 2 Setoack: Paved Drive Rqd: . Corwact:. S you to Rearyard Setback: . % 'WcMfi:overage: ATTENTION: Oregon la re6ulre on Utility Solar SetbacksNOTICE: . HALL EXPIRE IF iHE aT . follow rules adopted by the I rea~e set'forth ..~ nrn.nlT c; , -fn1 niT Ie; N I' .""M"M rpntft[_ Those ru es - - J: ~'UTriO'-R\ZED UNDER I:: ;\.I,>,I,f,\iimU\IiPROVEMENTS I i~ -OAR 952-001-001 0 throu~~ ~~he~:u1e~ by . I' _ ED OR IS Aun Ii' I ".., 0090. You may obtarn COpl Stree.t Improven!.e!ttsMENC E"\OD ~ ' . ~i~,~~'H\)1.rP~N, (Note: the telephone. ^ ,,\\1 i 80 DAY P n . - ~ C tho OrPQon UtiHty Notification Storm Sewer Available: ~ . m@olw'lfStm:ufS{~lai~6o_332_2344), Speciallnstructiou: '~ Cente Notes: ~ ~ - . -. I Valuation Descrip"ti?n I Description Type of Construction $ Per Sq Ft or multiplier Sq uare Footage or Bid Amount Value Date Calculated Paee ] of 2 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phoue 541-726-3676 Fax 541-726-3769 Inspectiou Line Fee Description + 12% State Surcharge + 5% Technology Fee Service Reconnect Total Amount Paid Amount Paid $7.56 $3.15 $63.00 $73.71 Total Value of Project . J Fe~.s P~irl I Plan Reviews . ~ Date Paid ]/20/09 1/20/09 1/20/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00083 ISSUED: 01/20/2009 APPLIED: 01/2012009 EXPIRES: 07/20/2009 VALUE: Receipt Number 2200900000000000066 2200900000000000066 2200900000000000066 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I ~e(l~jred rnsn~~,ti~~,~ . Electric Service: Approval req uired prior to utility' company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaiuiug to the work described herein, aud that NO OCCUPANCY will be made of any structure without permission of the Community Services Divisiou, Buildiug Safety. I further certify that ouly contractors aud employees who are in compliance with ORS 701.005 will be used on this project. I further agree to eusure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, aud the approved set of plans will remain on the site at all times during construction. (:;;Lv,D2 Owner or Contractors Signature ~. "'., t ~- ~ Pa2e 2 of2 Date / -dL ,;:2Q'-n-~ / i , Request to EI(~rgize an Electric~l Jnstallation 1_~~_IRE;~!!lE;SmlfilQ!SI!lBE;BNlI$lflGjEI!Eli;~l1BI~I~Ill~I~Ii(!)BMJ111T;I(!)Ntilllll.~~ , Name of supervising electrician: .1);4 A i'LS / J(?;')s ';'..., Date of request: jj/lf/..::'C-n9 I Supervising electrician's license number: .17.5'6:5 Date installation \-vas completed: / 1J812l'o7' '-Electrical permit ho_,; If a temporary permit is posted at the job site, please ,include a copy of it with this form. '1Ii~';"'Xi!/fJiIi'__. ~"4" ".'1fIf .'~ .... """llt...'i"":r,,,,vA'~"l'i""l!!I'I"''i'''''M''A1''''1t;\''-__,'''-:.-l\lit'''''-1 ___J$jj!.!!I..w=,,~E;Mel!(!)li'iI,;<.G1!!lIiOl!!E;~,l1al~~1!~6>;l1~/I("~!o>AliS~~.I~.r"-,,,"..~:ll>;lJ'il:lil"'''''IlE1_'l!ltllS'~''''_ Name of electrical contract~r: C~?7 5Ju/IHrJ t:1 ~.,..'7::iO;..... .. License no.: ) 70/8' 3 I Business add~ess: .~_ J,y.:; c _II eI /J fl):J ~ A-d'1- , - --- 'I City: ~tJh State C9~_ ZIP:_!i2.Y'/,/ I Phone5$;-9$-~- /fi~L Fax:5<j1-?~-?3 t}7,) E-mail: '1 Customer's name: I I I State: ZIP: 1 .. .. ...... ~1lIIIlI1~S~E;~JI1INGIf~l!lmt-l'@BlffikY.llllE(!)BM~iJjl(!)N.IUlil.I.lii.IIIII.~.1 ~~ In:. fLl Phone: I / I ~ .~k W: I ~~BE~BI>>;IRGIEl!E~11lBI~ll!ImJl!!lffikY.INIi(!)BMJ111111'l!),NIiIllIlr~~_ Name of electric utility receiving request: Springfield Ut'llity Board Phone: 541-726-2395 1 Address: . 1001 Main Street City: . Springfield _--:J^ h,A) ~i(U~.n , Customer's address: 8':-3 9 '3 JQsf jJ Z". d City <::::. tLJf j. . Address O~ll,rtio~ if different than cu~tomer's ;dd~~~s: City: State- ZIP: Authority having jurisdiction to inspect: Address: , State: OR ZIP: 97477 A. Restoring electrical service t!Jat was interrupted or disconnected because of either a: : t!(fUncontrollable event, such as fire, flood, or severe weather; . ' or B: Electrical service at a remote location needs to be: o Restored ~~]B:$}(!)M2I11Emll!),ril!llINSmRI!J~ml(!)Ns.~~rilElIlSIGNlXim!JBE_Iir~'II1 Supervising electrician Electrical contractor Note: After sending this form to the electric utility Note: By close of business on the first business day following named above, you must send a copy ofthis form to: energizing of a completed installation in response to the aboye (1) the electrical contractor, (2) the customer, and request, you must: (1) notifY the authority having jurisdiction ~t inspe~tin auth orr"n . that the installation has been energized, and (2) request that the .. _ f/'., =-- J -l'i< _ .~ ~~ authority inspect the completed installation, ,____ 1. .~ _ _ ~ . SupervISing electr; n's signature Date Electric utility Note: Please consider notifYing the inspecting authority identified in this request when an installation is energized before inspection. I'i.I DEPARTMENT OF 'gj CONSUMER I,. . ,(' ...BUSINESS 1lIi. \.)LSERVlCES 440'0948-COM (1O/08/COM -. This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started withiu 180 days of issuance or if work is suspended for 180 days. =~~~~~~;;;~~~E~~M6tr~~ep.RQ\76~~~l ~~:~~mgG:l~~~:~~~~JJ~m~~0~~::::~~1 !aJ~OB'I$lmEIlIl'-:lij<:jRM~iJiION~P;NI)])I!QC~'liION'li7i~~i Job site address: 7 ~ 9" 3 /1<>1 fJ/ ~ - City: 6/JPI.-J, T State: I ZIP: Subdivis?on: I Lot no.: Electrical Permit Application 225 Fifth Street. Springfield. OR 97477+ PH(541)726.J75J' FAX(541)726-J689 I ~"./I/A.-? )W7'~ kse. (J ~<:"f/Y2.jJ)~, I I ,1m _ r ~. -~ 1~41~IiJ~J~-Rb'~~_f{!11N:Q[0"W,~_t;a:~~'i~t;t~'~i~:'~~~~ I Name: I I Address: I I City: I State: I ZIP I I Phone: I Fax: I I E-mail: I This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479,540(1) and 479,560(1), Signature: I"""""";~~'c, 'O.N' i'i""'?C,;r,O' . RllINs"m" ,''''tl1i'';r,IO'N' ~.''''-:W;,.~~::l!1J!i mmJft+~ " ," Jlir;v:\ JIL""". _______ _,1';\ _ 1;'\;1; >. ,Jfkk\ti~;f'~";;,t"""",.;,,. I Business name: (?x2~<::u~A7f) DJ'.... 7' I I Ad'ff~Pr$l.~c. ~"jd~9<t ~ I I Cir;; "-- HAll Ekgl1lf~~E W~19 ? SO /)1 I Pho~ RllGl.l)t3Jf THI~f~%\')_~~-~3SD I E-mflillMMENCED OR 1_ AtW.jUUI~tO F I ccIA~~nl,\lgoLJI155~~ I BCD license no.: I Signing supervisor's license no,: :5 7 s--c., -.S I Print name of signing supervir-{\411.F1' / Jf?G3..t.,x) I Signature of signing supervis~~L;,/JrYi)~ - 1 -- . 440.2584.J (9108/COM) , 1.",-" 'M'V'~'''_'''''''.'' '-""""11\"''''1 }Ji:1F1tDEP'ART:MEN't.lllIsEl0NEY,FiI>.~ ;;.kt;)~n"',.",,,~-,,....,,,.-:.:,,,,\.~,. "'~~" ~,;",',,,,-~,,._:=-4:."" '.,":~" l',._:"''i$1J", .>'"0"".M.~".'" ,..,..,...:,"",....."_,.,,,...."'"A!Ii,...,.;~"'~...,'!\i eo',,5~:_.. I ~ermit nol\C1f 'b3 I I Date: \ -20-0CJ' I I Residential, per unit, service incl~ded:, 11.000 sq, ft. or less (4) I I Each additional 500 sq. ft. or portion thereof I Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) I Services or feeders: installation, alteration, relocation I 200 amps or less (2) $ 81.00 $ I 201 to 400 amps (2) $ 95.00 $ I 401 to 600 amps (2) $158,00 $ I 601 to 1,000 amps (2) $205_00 $ I Overl,OOO amps or volts (2) '$459,00 $ I Reconnect only (2) ,/ ' $ 63.00 , $ Ltq I I Temporary services or feeders: installation: alteration, relocation I I 200 amps or less (2) I $ 63,00 $ I I 201 to 400 amps (2) $ 87,00 $' I I 40 I to 600 amps (2) $126,00 $ I lOver 600 amps'or 1,000 volts, see services or feeders section above I I Bra_Deh circ~~Erm8e{tt~~,:;e!~~s{~~.P~Eg~1~bo 'Z::; ta I a. Fee forbri'(,'fiM}'r~V(,if\\.~\)'l5ffiJf'b'if f1ferbl'1Jffd,~e~elil\tG' I . Each brahbhtillrilolion Center. Th.o~e ru'e~al6;OO3J f$rth _ I b. Fee for ~fWli't!rt\)\tS-\?\t~o\Jl-'r\l,!cI\a~'e'l:ifla's\.?VlEl:'i\?fi;eli.1l fee: ':'.('l?0_ Vnll n"lplV nhr;:n ,..ror'O,C' ;;t'thCl nllo;h~1 I First branc~m~\!J(!1le center. (N lte: t~es.(~~pOlbr$} I Each additllJiI\lIlil~tflrc.lr~!1jtO:eg,o; ~}~;I~J.J~:r\D~il,tl$'n I V"I'~vl I":> , VVV vv..... <:.......-'T"T/. Miscellaneous fees: service or feeder not included I Each pump or irrigation circle (2) $ 63_00 I Each sign or outline lighting (2) $ 63,00 I Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) r Each additional inspection: (I) $134.00 $ $ 25,00 $ $ 32,00 $ $ 63.00 $ $ $ $58,00 $ (A) Enter subtotal of above fees (Minimum. Permit Fee $58,00) I (B) Enter 12% surcharge (.12 x [AD I (C) T,chnology Fee (5% of [AD' I TOTAL fees and surcharges (A through C): $LP3 $ /,5lpl $3.15 I $'J3:lJI 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone -.' Job/Journal Number COM2009-00083 COM2009-00083 COM2009-00083 Payments: . Type of Payment Check cReceintl RECEIPT #: Description Service Reconnect + 5% Technology Fee + 12% Slate Surcharge Paid By CRAFTMAN ELECTRIC City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000066 Date: 01/20/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received kr In Person Payment Total: 1267 Page I of I 9:08:14AM Amount Due 63.00 3.15 7.56 $73.71 Amount Paid .$73.71 $73.71 1/20/2009