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Home My WebLink AboutPermit Electrical 2009-3-10 .! . ..'}. .- ZON 11l'L-- INITIALS I H . r. DATE -~'. \. \ . V""1 ~. . SOURCE Y;.",\,~ ~~ ?//O/()'j ~I 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 EU';CTRICAL PERMIT APPLICATION City Job Number '/1 Cj -3'7' 1. LOCATION OF INSTALLATION: 1819 Havden Bridqe Sorinqfield 97477 LEGAL DESCRIPTION: ,,,,,....,,,,) \m1~~\ \v lY JOB DESCRIPTION: Service Chanqe Permits are non-transferable and expire if work is not started within 180 days of-issuance or if work is Suspended for 180 days. 2. CONTRACTORINSTALLATlON ONLY Electrical Contractor Olsson Industrial Electric Address 1919 Laura Street City Springfield Phone 541-747-8460 Supervisor License Number 3334S Expiration Date 10/011 0 9 Constr. Contr. Number 63473 Expiration Date 1 /? h /? 0 11 Signature of ~iSing Electrician A~ rL-.. /C- ~/ Owners Name Ben Barnes Address 1819 Havden Bridqe City ?orinqfie1d Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. -;;Z:;;!;t'bMMJA- -=-- <. Inspection Request: 726-3769 SPRINGFIELD ." :;-,- Date 3. COMPLETE FEE SCHEDULE BELOW A. - New Residcnthll-'Sin~~~ ()J: Multi~F~lInilyp~r {hrelling ~nit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home M Modular Dwelling Service or Feeder SI21.00 S 22.00 $57.00 B. SC.I"\'iccs or.Fe(>ders -Jnstallation,.Altcnttions or Rclocatioli:.. . '3'\ ~ 1)\00 200 Amps or less 1 $ ~ 'J-3-:1l1f 201 Amps to 400 Amps S 86.00 401 Amps to 600Amps $143.00 601 Amps to 1000 Amps $186.00 Over 1000 Amps/Volts S426.00 Reconnect Only S 57.00 c. .. "."'i' ."!'" :', '~.. ~ ':.." -:;. .:-. '. -" - ~' .-- .- .'.- Tcmporarv.Sc'rvices or Fecdcrs' .,. "- . .. .' .'~, "_c ..'_ ';!"._ ....--.!..,. - ~'; . ,.,'. In~tallation,_.Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600Amps Ove, 600 Amps or 1000 Volts see "B" above. D. Branch Circuits " $ 57.00 $ 79.00 S114.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit 6 S 50.00 (..00 ~ -710 CO ~ 'i"'<;'7>::",~-,-~. .-:-;~--,.- ""-". :. .~, E. ,Miscellaneous'(S~h'i~~jf~ed~.;' "no't !rid\~dcd) -'::E.aclf Ii.i~tarll~~ion. " . " '... '.. " " _ '. ,'- . , ,; . -., '. ,)". -;,;, .,;~- .",... ~ "'.'.. Pump or irrigation $ 57.00 Sign/Outline Lighting S 57.00 Limited Energy/Residential $ 29.00 Limited Energy/Commercial $ 52.00 Minimum Electric Permit Inspection Fee is $52.00 + Surcharg20 4. SUBTo.TAL OF ABOVE ."" ~ 12% State Surcharge ~ /~/rt:l- ~~;-,-,- J~ Q) 5% Technology Fee 5 . 15 '" ~ TOTAL .l3..O...-&4 I ?/a ~ Shared Drive(T:)/Building Forms/Electrical Permit Application 7-08.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00319 ISSUED: 03/10/2009 APPLIED: 03/10/2009 EXPIRES: 09/10/2009 VALUE: 225 Fifth Str~et, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1819 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703252112700 Springlield TYPE OF WORK: Single Family Residence TYPE OF USE: . Alteration Residential PROJECT DESCRIPTION: New 200A service and6 circuits Owner: Address: BARNES BENJAMIN J & TRISHA M . 1819 HA YDEN BRIDGE RD SPRINGFIELD OR 97477 , ... ........,.......~ .......,....., ...... Contractor Type Electrical ,.. .-....-.., -'~::l~" .~.. ,....'1.....,,""..... J............... 'I:C" -OHNTRicTO' - R:iNFOR'i\1A:TI0N' .,Utility ~. - , ,. 't forth' in OAR 952-001-0010 throuail.OAR 952-0Qj-. . Contractor 0090, You may obtain copiG~'5,e,~~~'ulesti~PlratlOn Date OLSSON INDUSTRIe\.\'1i!\"I:1<;eTcty,~er. INote: M~T!:lenhonp. 01/26/2011 j-' ~Bmr:DiNG'iNF?RM'AT~O!':ttiCatiOn Phone 541-747-8460 VB # of Stories: Height 01' Strnctnre Type of Heat: '->-> Water Type: _. Range Type: Energy Path: NOTIC~prinkled Bnilding: n/a ji DEViD6PM~Nfr4INF'OR~ (j1ifiNE.wORK ku 1"v"\I'duuNu',J1" r,J f thf"i, rv NOT GOMME~<'fvmag%A~: ABANDONED FOR ANY 18~lSti:(:l(qf;lbw:Rqd: Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq .Ft Garage/Carport . Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: /I of Bedrooms: R-3 REQUIRED PARKING Frolltyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: . Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descrintion I Description Type of Construction $ Per Sq Ft , or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e I of 2 _'irii~.Il!I...~..!:'D'~.".'....'.'....'.....'..-........'.... Wtr" .\ { ,., I., :., -'. . /, ....." II " \'. .~! ."'. ...."...._.." "" _.-w Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00319 ISSUED: 03/1012009 APPLIED: 03/10/2009 EXPIRES: 09/10/2009 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid' Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $14.04 $5.85 $36.00 $81.00 3110/09 3/10/09 3/10/09 3/10/09 2200900000000000242 2200900000000000242 2200900000000000242 2200900000000000242 Total Amount Paid $136.89 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. . I R~ouire.~ Ins.9~c!i?it.~ . Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I h~ve carefully examined the completed application and do hereby certify that aU information hereon is'true and correct, :Ind I further certify that any and all work performed shall be done in accordance with 'the Ordinancesof the City of Springlield arid 'the Laws of the State of . Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission 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 ensnre that all reqhired 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 remain on the site at all times during,construction. JAtflrJA jA, 6m~ B/lO !tOO J O(lner or Contractors Signature Date Pa~e 2 on City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street ,Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00319 COM2009-00319 COM2009-00319 COM2009-00319 RECEIPT #: 2200900000000000242 Date: 03/10/2009 9:36:33AM Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Amount Due 81.00 36.00 5.85 14.04 $136.89 Payments: Type of Payment ,Paid By Cash TRISH BARNES Change Item Total: Check Number Authorization Received By Batch Number Number How Received cJc In Person In Person Payment Total: $140.00 ($3.11 ) $136.89 Job/Journal Number COM2009-00319 COM2009-00319 COM2009-003 19 COM2009-00319 Payments: Type of Payment Cash Change cReceintJ Amount Paid Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Amount Due 81.00 36.00 5.85 14.04 $136.89 Paid By TRISH BARNES Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid cjc In Person In Person Payment Total: $140.00 ($3.11) $136.89 Page I of I 3/1 0/2009