The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2009-2-12 Electrical Permit Application I ~"."'i"".'''V'F*''''''''''''"''.'' '''''''''4~<>~j;1 ~~,,~~~~~J;~Jl'i~~;~~L~1t;;!;:g~ I Permit no.: C!~-(X);)c& I I Date: ;2//..l-j::2&v '/ I . . " "~w.', 225 Fifth Street t Springfield; OR 97477 tPH(541)726-3753 t FAX(54t)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontrausferable. Permits expire if work is not started within 180 days of issuanee or if work is suspended for 180 days. 1~"'i!tfe~I!i!GO)/,I:RNI\IIEN:rIV~~eRQV~~~ I Zoning approval verified? DYes D No ' ~~~(;;~mI:.G~0B.Y/LQ~i{0NS5[Rl!J,CJ1ilo.N~~.J1IlI~!1~;; I Residential, per unit, service included: I D Residential 1 D Government 1 D Commercial 1~(;)Bi!SlmEl!lINiiQlfM~Tjo.NrAN[):!!ili'QG~'I\IQ~~tl 11.000 sq ft, or less (4) I I I Each additional 500 sq. ft. or portion Job site address: I OC1 9 P\....J-..oAS d.J . thereof 1 City: ~'" ,~:;'.qL'" -a'-ell 1 State:0 It 1 ZIP: 1 1 Limited energy (2) I - I Subdivision: U 1 Lot no.: 1 I, Each manufactured home or modular $ 63.00 $ i~~Y~~[)ESGRII~mlo.NfE)FJ\WORKmliili~,'~i~4~111 ::::::: ::~~::eo:S~ei::;~I~~;ion, alteration, relocation ~"~~~~~:~-I i::iE=~: ;,:: : 1 Address: <1 '1 <:::> }\......,..., 9 q ~. ~ I' I 601 to 1,000 amps (2) $205.00 $ 1 City: C.... _~..... 1 Stateplf\.. 1 ZIP:97'2j u'?l I Over'I.OOO amps orvoits (2) $469.00 $ 1 Phone: -2:: -}r' y- 'j( 1l'9 ..., 1 Fax: ~ r 'if - q 26 'f 1 1 Reconnect only (2) $ 63.00 $ r E-mail: .1 T~mporary services or feeders: installation, alteration, relocation Th" II' 'b' d 'd' I < . 1 200 amps or less (2) $ 6300 $ '- ? IS msta atlOn IS emg ma e on res! entIa or larm property . . ~ owned by me or a member of my immediate family, This 1 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange. lease. or rent. OAR I 479,540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $ Signature: lOver 600,amps or 1,000 volts,see services or feeders section aboye 1~::~::~NG~;~~=IN~~~lf.6:~I~N~~~r~t~1r;~ : :r;::~o:i:::~:: ;i::~~:':i:~::r:~::s:~:~::~::e:r feeder tee I, Address: C\ "\ "" i.\ "" "1 q q N ~ 1 1 Each branch circuit 1 1 $ 6.00 1 $ I City: € ...., _ A....... 1 State: 0 ~ 1 z1P':9 7 LJ <>....1 b, Fee for branch circuits without purchase of a service or feeder fee: I Phone: -b~~'1s' 'l' cr.? I Fax: ~~;y. q2>O'-( I First branch circuit (2) $ 55.00 $ I E-mail: I Each additional branch circuit $ 6.00 $ [ CCB license no.: J 'i 30;J I r BCD license no.: I. Miscellaneous fees: service or feeder not included I Signing supervisor's license no.: I I Each pump or irrigation circle (2) $ 63.00 I Print name of signing supervisor: I I Each sign or outline lighting (2j' $ 63.00 IS' f" I I Signal circuit or a limited-energy panel, $ 63.00 $ 19nature 0 slgnmgsupervisor: alteration, or extension (2) 1 Each additional inspection: (I) ~"I''i'~'''~~-~''EEMS-CI'IE[)tmE!':-""""g''_''J1VC'ifji_d,",-' nok~~lai~,'i~jlffi2ii#~'J4._ _~_ ~. _'. ... ..~_.__ ~~Jlt~~"'mi'J ~'N"m\'il!l!..f'~. .','Jl.t'!T~1\\))~t "'i'('I1')'llI1~.lrQ'~t"'I'f~€Q.st '.'I~ota~'~ ,~, umuer:i-o"mspeclons'tper:tem. &'g~' y,:'~~i?:' - '''"-'*Jt?~-"t~- . ~.:<~'S~:.,.~&i'$;'!'ikt~t:;,";i~15it't2~'tS:"i;j~~; ~"'{:+; mJ1.~~'Jl:i'~ ~~ ~"tqJ WJ;j $134.00 $ $ 25.00 $ $ 32.00 $ $ $ 440-2584-J (9/08/COM) ~~^,s5^-^ / ~~ ~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) I (B) Enter 12% surcharge (.12 x [A]) I (C) Technology Fee (5% o[[A]) I TOTAL fees and surcharges (A through C): $ $ $ $ I I I I I 1 I I I I 1 1 1-- Status Iss u ed CITY OF SPRlN\.JJ:<lELD Building/Combination Permit PERMIT NO: COM2009-00203 ISSUED: '02/12/2009 APPLIED: 02/1212009 EXPIRES: 08/1212009 VALUE: 225 Fifth Street, Spriugfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectiou Liue SITE ADDRESS: 1099 ANDERSON LN ASSESSOR'S PARCEL NO.: 170333II02400 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Temp Power Owner: Address: BENSON VERN W 940 HWY 99 N EUGENE OR 97402, I CO~TRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secoudary Occupaucy Group: Primary Constructiou Type Secondary Constructiou 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 Fl Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Froutyard 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: I PUBLIC IMPROVEMENTS I _ Sidewalk Type: ATT-EN liON: Oregon law requires y,ou to faHaw rules adapterP1)}"!'.~e'\91~~J,~'e,~iljty Notlllcatlon Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001- Notes: 0090, You may obtain copies of the rules by NOTICE: calling the center. (Note: the teleDhone THIS PERMIT SHALL EXPIKt It. I Hq-'I';'Ui il\ ""mM. .~~ :~e uregan Utility Notitication AUTHORIZED UNDER THIS PERMIT I~Wation DescriD~uli~iS 1-800-332-2344). COMMENCED OR IS ABANDONED F~fl, S Ft , Desc'Mf!tIlJj 80 DJWvfltJ~l!OOustruction' erl ,ql' . or mu tip ler Street Improvements: . Storm Sewer Available: Special Instruction: " , Square Footage or Bid Amount Value Date Calculated Page I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00203 ISSUED: 02/12/2009 APPLIED: 02/12/2009 EXPIRES: 08/12/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Proj,ect Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Temp Power 200 amps or less AmouutPaid Date Paid Receipt Number' $7.56 $3.15 $63.00 2/12/09 2/12/09 2/12/09 1200900000000000095 1200900000000000095 1200900000000000095 Total Amount Paid $73.71 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. Reruired Insnections I Temporary Electric: Approval required prior to Utility Company energizing pole. 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 Spriugfield 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 permissiou 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 nsed 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, and the approved set of plans will remaiu on the site at all times during construction. Owner or Contractors Signature Date Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00203 COM2009-00203 COM2009-00203 Payments: Type of Payment Check cReceintl RECEIPT #: Description Temp Power 200 amps or less + 5% Technology Fee '. + 12% Stale Surcharge Paid By BENSON DEVELOPMENT 1200900000000000095 t:heck Number Received By, Batch Number njm Page I of I City of Springfield Official Receipt Development Services ~epartment Public Works Department Date: 02/12/2009 8:30:04AM Item Total: Authorization Number How Received Amount Due 63.00 3.15 7.56 $73.7] Amount Paid 381 $73.71 $73.71 In Person Payment Total: 2/12/2009