HomeMy WebLinkAboutPermit Electrical 2009-2-27
Electrical Permit Application
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1 Permit no.. (H -- 2231
.1 Date: 'Z - 2-7- ~ &cr I
225 F;fth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
. This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issua~ce orif work is suspended for 180 days.
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Phone:
E-mail:
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:
1~1I~1>.:zn:::0Nili~Gm0R1INSTl')l;I!&"~'ji]0N~':0'till;~11~11~
1 Business name flahlWo I l/efWiJr!c ~;'/'I::" ~
1 Address: s07... . s)'dL, Sf.r. S/A'/c b
I City: 5[)( Mc' -Rie l-I. I 1 State: () r I ZIP: q.N77
Phone:91I: 126-" 92.09 I Fax:StJf- 726- 'Pi 20
E-mail:
CCB license no.: ! <)iJ JOt? 1 BCD license no.: I
I Signing supervisor's license no.: L.j l L( / L F r1 I
, Print name of signing supervisor: Scoff Jhu.5 lev I
I Signature of signing supervisor: ~,.;r Jk/fiJ!; I
~.of:
lb''- dJ..'
~~
. 440-2584-) (9108/COM)
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~~u~~~_rs:o~~gsP~ctlo~sJ.p~~;lte~~l?trf% .~tx; jf - ea~j!_ ," ~cost :.
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I Residential, per unit, service included:
11.000 sq. ft. or less (4) $134.00 $
I Each additional 500 sq. ft, or portion' $ 25.00 $
thereof
1 Limited energy (2) $ 32.00 $
I Each manufactured home-or modular $ 63.00 $
dwelling service or feeder (2) I Services or feeders: installation,alteration, relocation
1 200 amps or Jess (2) $ 81.00 $
1.201 to 400 amps (2) $ 95.00 $
40] to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
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b. Fee for branch circuits without purchase ofa service or feeder fee: I
1
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1
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$ 63.00 $ 'f,'S I
I
Temporary services .or feeders: ins(allation, alteration, relocation
200 amps or less (2)
$ 63.00
$
$
$
201 to 400 amps (2)
401 to 600 amps (2)
$ 87.00
$126.00
Over 600 amps or 1 ,O~O volts, see services or feeders section above
Branch circuits: new, alteratio~, extension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
QJ
Each branch circui~
1$6.001$
. First branch circuit (2)
$ 55.00
$
$
Each additional branch circuit
$ 6.00
Miscellaneous fees: service or feeder not included
I
Each sign or outline lighting (2) I
I Signal circuit,or a limited-energy panel, I
_ alteration, or extension (2)
I Each additional inspection: (I) 1
Each pump or, irrigation circle (2)
$ 63.00
$
$
$ 63.00
$58.00
$
(A) Enter subtotal.ofabove fees
(Minimum Permit Fee $58.00)
1 (B) Enter 12% surcharge (.12 x [AD
I (C) Technology Fee (5% of[AD
I TOTAL fees and'surcharges (A through C):
$
$ (P 'J!t.
$ J-:Y
$ (/)~
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CITY OF ;:o,r'Kll~\..FIELD
'Building/Combination Permit
PERMIT NO: COM2009-00283
ISSUED: 02/27/2009
APPLIED: 02/27/2009
EXPIRES: 08/2712009
VALUE;:
~_.
Status
Issued
215 Fifth Street,Springlield, OR
0'11-726-3753 Phone
5,1] -726-3676 Fax
,41-726-3769 Inspection Line
s(n: ADDRESS: 2109 J ST
,\SSI':SSOR'S PARCEL NO.: 1703361200100
Springlield TYPE OF WORK:
TYPE OF USE:
I'I,O.lYCT DESCRIPTION: Low Voltage: Voice and Data
0)1'11(,'1':
l\clrlrcss:
SPRINGFIELD SCHOOL DISTRICT 19
525 MILL ST
SPRINGFIELD OR 9747'7
COlli ractor Type
Elt:ci rical
I _~~~~.!_~~,~TOR INFORMA nON .IllJ to" ~:J
. ".,' ~:JO,l ,Utility, :'1
Contractor . . License~et fo!:V,wiration Date
NATIONAL NETWORK SERVICES OF ORE054300 ~52;o'01l.l1102/10/2011
.. . . . lIe"rules'oyuy
. 1.~,1.!.~~?~\jG INFORMA nON I11Ypn6Rene
. r.~n(~~'ls~; ~6C;6~g;jt!1cdtiM!Mti6non ,
# 2t Stones: ",.J~ 0,,<"df;'4y.4). Lot SIZe:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
'Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
Phone
541-726-9209
1I,'fUniIS:
PI ilH.'Iry OcclJpaJJl~Y Group:
Stl'ulldary Occupallcy Group:
P,'illlary Construction Type
Sl'l'on<lary Construction Type:
I! ul' Iledrooms:
Fi'tllllyard Setback:
SHe I Sejhack:
~;;l!e 2 -S('lhack:
It -\:'~:trcl Sl'lhack:
S, ;11" Sethacl,s:
I DE,~~L.~':YI~NT ~NFOR~T!ON ,
THIS PERMIT SHALL EXPIRE IF THE WORK
AUT~N\'i~y[p~fm~R THIS PERMIT IS NOT
# Slrpc'tTrel:S qd'
. corvlP'A~~HjHv~\q'd:ABANDONED FOR
ANY '~~'\\\2&tYd'~[;\J.QP: '
REQUIRED PARKING
Total:
Handicapped:
Compact:
I P?!3.~~.~...~~,PROVEMENTS'
~:lll:(~t Improvements:
Sidewalk Type:
Downspouts/Drains:
Storm Sewer Available:
Sp(\ci:lIlnstrtlction:
N .H's:
I Valuatio~~.!les.~~.iption I
'", (Tinlion
Typr of Construction
$ Per Sq Fl
Or l1lultiplit'f
Square footage
or Bid Amount
Value
Date Calculated
Paue 1 of2
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CITY OF SPRINGFIELD
Building/Combination Permit
~. -
Sl:ilIIs
Issued
PERMIT NO: COM2009-00283
ISSUED: 02127/2009
APPLIED: 02/27/2009
EXPIRES: 08/27/2009
VALUE:
2l~ Firth Street, Springlicld, OR
:':1] -71G~J753 Pholle
".1 J. 7,6-.1676 Fax .
",11'1'6-.1769 Inspection Line
Total Value of Project
Fees Paid I
Fl'c DeslTiI)!ioll
Amount Paid
Date Paid
Receipt Number
To(al Amount Paid .
$0,00
I Plan Reviews I
'1'0 nt'quest an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
'1.1.1, will he made the same working day, insp'ections requested after 7:00 a.m. will be made the following
work da)'.
I~eoiiircd liiso.~~ctinns ,
By signatllre, I state,and agree, that I have carefully examined the completed application and do hereby certify that.all
i.1! forlllation hcrconJs'true and correct, and [further certify that any and all work performed shall be done in -accordance with
Ihe On!in:llltPS uf thl.' City of Spl'ingt1eld and the Laws or theS1ate of Oregon pertaining to lhe work described herein, and
l!l:ti" t':O OCCUPANCY will be'made of any strudurc without permission ofthe:Colllll1unity Services Division, Building Safety.
! h!I'jhL\1' t'{'rlify Ihat 01' I C ntractors and employees who are in compliance, with ORS 701.005 will he used 011 this project.
I lllllhi'r agn'(' t~el sure at all required inspectIOns. are requested at the proper time, that each address is readable from the
<Ireel. Ih.1I (he pe nit. rd is located at the front of the property, and the approved set of plans will remain on the site at all
Ilnl("d"ring:::tion')L~L Z-z 7-()9
O\\'llrr or COlltril~tOI'S Si,gnrlturc
Date
Page 2 of2 .
225 Firth Street
Sprillgl'ic!d, Oregon 97477
541- 726-3759 Phone
Joh/Journal Number
CO,\'12009-00283
COiv12009-00283
Cm'12009.00283
P;l ~'!1ll~1l ts:
'I\pl' pI' Paymenl
CrcdirCard
c!':cc(:iI11]
RECEIi'T #:
City of Springfield OfficialReceipt
Development Services Department.
Public Works Department
2200900000000000208
Date: 02/27/2009
Description
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 12% State. Surcharge
Paid By
SCOTT HOUSLEY
Item Total:
Check Number Authorization
Receivl'lJ By Batch Number Number How Received
KI.K
047283 In Person
Payment Total:
Page I of I
9:23:20AM
Amount Due
58,00
2.90
6.96
$67.H6
Amount Paid
$67.86
$67.H6
2/27/2009