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HomeMy WebLinkAboutPermit Electrical 2009-2-27 Electrical Permit Application V""'"'!':>~L'!>!i--' . t Ii 1,*"~~;;;;o;'~rt',Dh""".;e;;:;."'n~~'?~~;;.t;.t;tm.l~~1 ~'iDERARliMENrr;;USE,ONli<y'~j1/l.' " .-'" . .~... ~..-.~.-.:~.,. -' ~, .., .,. ',,"" "". - ""- .' . ~. jj}i''':~~'k?:'_-''"O,-._:if.i'I-=~'''_~''f_<''li!ffiqt,.1.~iI:!IllI.-~ 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. I. 11<1;<:..( 4 J),..tlA ~ 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) ~~EIk~~~~~"""EEili__SC;HEDOl!E';lS\C""T~\'f>l;1l1"'*~_'1'~-;;. if!~<)f_i:<'0;,~~-1i_~~_,,-____.,,_~___L___ _. ____;I$_k..~~~i;i:l!'iffi0lli",.2?<~~~ c" ".'*.""~'..'v'~ ~". "."..lL"'''''.. ""'.=' ..'- ""''''~~'''''=~'"-'.lkL'''''' '/11--"'111.' '~". "'. ",1'1",,,_~,'::!'''='''''''''':_'?'''''''''''' !l.~' ',:i?"J'.. ,€ost . :fatal ~~u~~~_rs:o~~gsP~ctlo~sJ.p~~;lte~~l?trf% .~tx; jf - ea~j!_ ," ~cost :. _~<\fKL~,cst.jQl,=jSj:~::ft.:a\!1_.e=~'Bt-;'~_'i_"a, ~~ _ =___~ -'1.____1 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 $ 1 I I 1 I 1 I 1 1 1 1 1 1 1 I 1 I 1 1 1 b. Fee for branch circuits without purchase ofa service or feeder fee: I 1 I I 1 1 $ 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 $ (/)~ _lFfl.~~I'I,-Ilt!l!~9. R" .-. , .. d ~ I ti~ l" G'\ LJ . \ ():j c,\oVl: ,..tv/' 'J ~;Q~\( 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 ,,~ Ii.~: '--l~rrlaJ...C: -\ -'j\' : [::_.i"'C, i . 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