HomeMy WebLinkAboutPermit Electrical 2009-2-27
225 Fiftb Street. Springfield, OR 97477. PH(541)726,3753. FAX(54t)726.3689
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I Permit no.: Cc:r - 2-8 L I
I Date: "2--/2-7-/ Y1. I
Electrical Permit Application
This permit is issued under OAR 9]8-309-0000. Permits are nontransferable. Permits expire if work is not started within ]80
days of issuance or if work is suspended for ]80 days. .
i~=:~~~~~~;~~~ER~M~~~~geRE>VbL~~l!~!ii '1;;..~.=.;2~.r.~~p....~~~.~;.w~il~:I'~~I~t~~1
~~!f::,.~J'.wlT0,iJ3a7Jit;~~&T~ci%?lth,~~~~~~ ~~'flJ'j~~-,.t, ~~t(!sJ:~1
1~~Gt\ifE~b~X4foF..lC:;}:>N$mRl!JQ:ijlqNI"'.Jjr7l~!J1'li1!
I I Residential, per unit, service incfuded: I
D Residential I D Government I ~Commercial
'1!!i.iif19.0a'SIiJ;ElliINIi0RM~mjQt\jf~t.,Il'1:ti\~QG'A-111E>N.Ilt_~i . 11,000 sq. ft. Dr less (4) $134.00 $ I
I Job site address: 7:3. Lj 5 TI--..^ f S ~ Rd-. I ~~~~:ritional 500 sq. ft. or portion $ 25.00 $ I
I City: C:;.() r ; "co.. .l:': ( IrA I State: Or I ZIP: ~ 7477 I Limited energy (2) $ 32.00 $ I
\=~;I:S:CRII:'~tlbN[E>~W~J~~~~~ I J~~~I~:"s~~~~~~r~~ Fe~~~r(~)odular $ 63.00 $ I
I . / ..t- ~ I I Services or feeders: installation, alteration, relocation I
Vr>;cp q, J )011""0..
I I 200 amps Dr less (2) I . I $ 81.00 $ I
1--'iE"'-l'!I;"""I?R'0'~.ER"""'ii'0'W N' E R"""<"~_"""..,,,,>,r''Y"'1 I. 201 to.400 amps (2.) I I $ 95.00 $ I
~!'j51.1h4141Wi't%b'~FJaj;%3_","_ ,'liL___'lv-'iUl', __ - _ __,'d~i~.$l?t.'Aj}"J&~TffM:;~;--kf.r",J;!;:~ -
IN" I) I J n II S I I I 140lt~600amps(i) I $158.00 $ I
ame: '>rr;"'1+'H rA V,Ah';C c..hc""~
I Address: 5"["5 01: I \ st.r. I I 60] to 1,000 amps (2) I $205.00 $ I
I (\ f\ \ I I r> I lOver ],000 amps or volts (2) I $469.00 $ I
City: . )Or ~ "5 l-N' r,\ State: 0 r ZIP: -,7477
Phone: ~ _ I FIDe' I I Reconnect only (2) I $ 63.00 $ I
E-mail: I I Temporary services or feeders: installation, alteration, relocation I
This installation is being made on residential or farm property I 200 amps Dr Iess'(2) I $ 63.00 I $ I
owned by me or a member of my immediate family. Thi~ I 20] to 400 amps (2) I $ 87.00 I $' I
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). I 401 to 600 amps (2) I $126.00 I $ I
Signature; lOver 600 amps or 1,000 volts, see services or. feeders section above I
liIP'~C:0Nm~Cjli:0~~IIiISJ"rr~I!!l!AmlE>I\I~.l~il;lm1i! Branch circuits: new, alteration. extension per panel I'
I Business name: (! al;cMli ( , (lof+ tJr)( k: Ser I;c.( ~. . a. Feefor branch circuits with purchase of a service or feeder fee: I
I Address: 30Z. 5'h.ell/ S'L_ SLo\.:+( b I I Each branch circuit I $ 6.00 I $ I
I City: S.nr >\c- ~>f i/A I I State: O( I ZIP: q 7 477 I I b. Feefor branch circuits without purchase of a service Dr feederfee: I
I Phone: Sqt 72b .J C12D9 I Fax: SI.j}-72/' lJC) 'l,q I I First branch circuit (2) $ 55.00 $ I
I E-mail: I Each additional branch circuit $ 6.00 $ I
1 CCB license no.: / <:; C;]PO I BCD l!cense no.: I Miscellaneous fees: service or feeder not included I
I Signing supervisor's license no.: J 42. Lj I L E It I Each pump or irrigation circle (2) $ 63.00 $ I
I Print name of signing supervisor: '.Sc..o H- H-o /A ~ Ie..; I Each sign Dr outline lighting (2) $ 63.00 $ I
I S. f" .. JI J II I I. Signal circuit or a limited-energy panel. I $ 63.00 <? ~
l~natureo slgnmgsupervlsor: AortA'- )~/Jf/M../" alteration,'orextension(2) , ~(J F '1--
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(A) Enter subtotal of above fees
(Minim'um Permit Fee $58.00)
I (B) Enter 12% surcharge (.12 x [AD
I (C) Technology Fee (5% of [AD
I TOTAL fees and surcharges (A through C):
$
$6 t'~
$2- i.M I
$br~1
440-2584-) (9/08/COM)
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CITY OF SPRIN9FIELD
.
Building/Combination Permit
PERMIT NO: COM2009-00281
ISSUED: 02/27/2009
APPLIED: 02/27/2009
EXPIRES: 08/27/2009
VALUE:
Status
Issued
"''; Fiflh Slret'l, Springfield, OR
:'~~ 1-726-3753 Phone
5.11-72fi-}676 F:IX
S:II-726-<n69 In~pcctioll Line
_"iTE ADDRESS: 7345 THURSTON RD.
,;SSESSOR'S PAHCEL NO.: 1702350002600
Springlield TYPE 01' WORK: Commercial Miseellaneous
TYPE OF USE:
Public
!'IW.lFCI'DESCIIIPTlON: Electrical: Voice and Data
,),,'n('r: SI'IUNGFIELD SCHOOL DISTRICT 19
,\ddress: 52:'11:11LL ST
SPRINGFIELD OR 97477
Cuutrador Type
t'.;l~l: I !'ii.'al
ICONTRACTOR INFORMATION'
. Contractor License
NATIONAL NETWORK SERVICES OF ORE<154300
Expiration Date
02/10/2011
Phone
541-726-9209
II or Unit:;:
"rima!'y On,.'up:lllty Grollp:
~.~'Cf'lltI:lry Oi.'i.'lIp:'tIJc)' Grollp:
l'J"illl:lry COIlSIJ'udioll Type
Secondary CnllstTHclioll Type:
t, oj' Bedrooms:
A~~~P~.~~:~~lV'~J~I}S~-!s you to
foU~w rll'lS ~dc~' t,ed by the Oregon Utility
E ~oliflcatrQ\\ ee?~! il.' Th~sfhrules are set forth
In OAR ~~-~~~; c)ift)'\'r%ugh OAR 952'001.
0090. yotrllta~Mll.lh copies of the rules by
caUing'tti~'Ce1irw.: (Note: the telephone
numbe~1l!J1l~f\l~gon Utility Notification
Cal\{lJY i%atb800-332-2344).
Sprinkled Building: n/a
Lot Size:
Sq Ft Ist.Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
REQumED PARKING
F i'OIl iyardScthilrk:
,t..:;dc 1 SpjhaeJ.::
."':tdl.' 2 Sl'lhad-::
,~i.';ir,\'ilrd Sl'IIl:H:I(:
. dIll!' Sctbacl~.~:
Overlay Dist:
U Sired TrcesRqd:
I'a"cd Drive Rqd:
NOTICE: '1.,'01' Lot Coverage:
THIS PERMIT SHAll EXPIRE IF THE WORK
^"~I~lJ@~t if ....
COM~.tll!~\v[~FO~I~UI
ANY 180 DAY PERIOD. Sidewalk Type:
Downspouts!Drain~:
Total:
Handicapped:
Compact: .
~;1 r~~('l' I mpro\'l'l1w!lts:
Slorm Spwl'r Availnhl{\.:
Spel'iallnstrul'!ion:
;.:tlles:
.1 Valuation Descriotion I
ij(~.st'!'iplion
TYlJl' 0'1' Construction .
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page 1 of2
,.. ~j,~~y.!rtr,-~~:~J
CITY OF SPRINGFIELD
Building/Combination Permit
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ISSlIl'd
PERMIT NO: COM2009-00281
ISSUED: 02/27/2009
APPLIED: 02/27/2009
EXP'IRES: 08/27/2009
VALUE:
'225 Fifth Street, Springfield, OR
5'1 [-726-3753 Phone
0.11. 726~J676 Fax
5'11-726-J 7ti9 Inspection Line
Total Valllc of Projcct
~. Ee~" PaiU .
l'~(' Des('riptioll
Amount 'Paid
Date Paid
. Receipt Numher
Tot:J1 Amot!llt Paid
$0,00
Plan Reviews J
To Rerlllcst "II inspection call the 24 houl' I'ecol'ding at 726-3769. All inspections requested before 7:00
:\.111, will he made the same working day, inspections requested after 7:00 a.m. will be made the following
\'iork dny.
I' Relll1il'edlnsnectionsJ.
n,\' signature, I slate and agree, that I have carefully examined the completed applic~tion and do hereby certify t.hat all
;t1l'ol'llIation 11'('1'('011 is true and correct, and I further fcrfjfy that any and al~ work performed shall be done in accordance with
~hc Onlill:llll'(','l or fill' C,ify of Springfield and the LllWS of the State of Oregon pertaining to the work described herein, and
thaI l\fO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I f1l 1"1 III 'I" (,l'rlif)' 111:11 Ollly eontrllctors "nd employces ,\'110 ",'e ill compliance with ORS 70I.005'will he used on this project.
I III r l hl'r :lgn'l' 10 l'IlSUI c that all required inspections 31 C requested at the proper time, that each address is readable from the
",I {'cl, I h.lt the !>l'l)n1t)card is located at the front of lh(-' property. and the approved set of plans will remain on'the site at all
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P"2e 2 of2
22SFifth.Street
Springlleld, Oregon 97477
541~ 726-3759 Phone
,Job/.Journal Number
COi\.12009-00281
COM2009-00281
COM2009-00281
PaYJI1{'llts:
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Crl:uitl,lru
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RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000207
Date: 02/27/2009
Description
Low Voltage - Commerciallndlls
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
SCOTT HOUSLEY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KLK
064358 In Person
Payment Total:
. Pa.~e I of 1
9:10:17AM
Amount Due
58,00
2,90
6.96
$67.86
Amount Paid
$67.86
'$67.86
2/27/2009