HomeMy WebLinkAboutPermit Electrical 2009-3-16 (2)
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225 Firth Streett Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
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'Co'Electrical Permit Application
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Penmt no.:
I Date: >;00 7 I
This permit is issued under OAR 918~309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuan~e or if work i.s suspended for,l80 days.
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f~~~~~~~~,~~~~~:~~kor~o~~~~;-I Residential, per unit, seITiee included: I
i~:~~~~:~:-I;E;~0iM~1m'01!f:Ne~~jmI0N~~i ,I ;;';~Oo;d:i~O::II:S~O(:~ ft or portion :1::.::: I
I City: .sPF~ I State: D(L I ZIP: 171(7K I I Limited energy (2) $ 32.00 $ I
i~=~~~G~:~~~0~J1W~:~~~~! ! !;~::~~~;~::::s~~:~;~~~C:~:::rotion re{o:at~:nOO $ i
I I I I 200 amps or less (2) $ 81.00 $ I
I 20 I 10 400 amps (2) $ 95.00 $ I
Name: -mWl~L.A ~rcl:n.V/A,"", I I 401 to 600 amps (2) $158.00 $ I
Address: 3S'Z S 4s(l.d.,;JL 160Itol,000amps(2) $205.00 $ I
I City: Sl'r=~ I State: ~ I ZIP: ..,71.(78 IOverl,OOOampsorvolts(2)' $469.00 $ I
I Phone: I Fax: I I Reconnect only (2) $ 63.00 $ I
I E.mail: I I Temporary services or feeders:.installation, alteration, relocation I
Th" II' . b . d 'd' I r 200 amps or less (2) I $ 63.00 $ 1
IS msla atJOn IS emg ma eon reSl entia or lann propertY~TlO \J' ,-
owned b~ me or a member of my immediate family. liw,s '.~'_. , .. ~WI<t.4~6;ar!!~lIreS you to I '$ 87.00 $ I
property IS not Intended for sale, exchange, lease, or rent~rOAR:lle. a~', -'.. \ W; ~~':;;C.-l L:~;I;lY ,
479.540(1) and 479560(1). Notltlcation ;eh~91. tCfM(,~mi'~I~ RrA <pi f",'h I 1 $126.00 $ I
Signature: . ~{\~:RJ.52~ 10 ilJG:1-l6d91limpgolll!gQQ tQJIMJIH<rvices or feeders section above I
1~:~~'~bt;e~~~)m~~~Ti~~~:~~:~!: ~\'~~~~W~~~~~~~~I::S:;:.:~;::e~r leeder fee i
.1 Address:.!] 0 hr;X /,,07 _ Cene~jSIlaaooa'il81?o1iG<il41. uq 1 I $ 6.00 I $ I
_ City:W Art! r V I' J Ii I Sta~e-: d Lf J ZIPr1 (,; I b. Fee for branch circuits without purchase of a s,7rvice or feeder fee: I
Phone: 14-7 ') 11 t.f I Fax: f () I First branch WCUlt (2) I I' $ 55.00 I $ I
I E-mad'hVVW1brOS(JI'nfftlr~O(l }'ni.( Eachaddltionalbranchwcun I. 1.$ 6.00 $ I
I CCB IJc;nse no.:/?;lD~ I B~D liceR6e no..riD - tfLJ. ;U:.I Miscellaneous fees: ~ervlce or feeder not Included I
I Signing supervisor's license nS\. .Lf '7 J. I -5 -:l I Each pump or lITIgation Circle (2) $ 63.00 $ I
1 Print name of signing supervisor JIj]' .1/ fI V y r'" J.' . I Each sign or outline lighting (2) $ 63.00 $ I
I Signature of signing supervis: I U I ~;, SIgnal CirCUit or a lImned-energy..,p.anel, $ 63.00 $ I
, \j' '--' ' f SltUtflnpl!"'Ml\'f1si!h~II: WuRK
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ANY 180 DAY PtJRfa~.subtotal of above fees 67
{\ " .....0--... (Minimum Permit Fee $58.00) $::'1
\ \:\'t(' Il,U . I (8) Enter 12% surcharge (.12 x [A)) $ e ~ _
~ 'V ~ I (C) Technology Fee (5%of[A)) $ '3~.
. J ~ I TOTAL fees and surcharges (A through C): $ 7 B ~ '}
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440.2584.) (9/08/COM)
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CITY OF~rK1J'Il.J:<IELD .
Building/Combination Permit
PERMIT NO: COM2009-00303
ISSUED: 03/16/2009.
APPLIED: 03/05/2009'
EXPIRES: 09/16/2009
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 352 S 43RD PL
ASSESSOR'S PARCEL NO.: 1702323404302
Springfield TYPE OF WORK:
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: BWOP Pluming I Elect
Owner:
Address:
FREEMAN PAMELA J
352 S 43RD PL
SPRINGFIELD OR .97478
ATTENTION: Oregon law rel1u","" yuu:.u
follow rules adopted by the Oregon Utility
Notifioation Center. Those rules are set forth
in nAR ~,,2-001-001 0 through OAR 952-0~1-
nOQO_ You may obtam CUIJIt:tl VI \-1 I\;; ,...,.........-J
I CONTRACTOjl,;INE0RMmTION~"te: the telephone
. number TOr ",e v'o'"u" Utility Notlfrcatlon
Contractor CenteLie~Ii~~O-33Ei11~~tion Date
BURRELL BROS ENTERPRISES INC 136446 08/2012009
COMPLETE PLUMBING LLC 163794 03/2112009
. Phone
, 541-747-2724
,541-688-0355
Contractor Type
Electrical
Plumbing
BUILDING INFORMATlONI
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction 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 F12nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupa'lt Load:
nla
Front yard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVEUIDI'NI'll:llIT INFORMATION I
. tf{fs PER .
A~hi&' M!~.SHALL E
CO~I1I11~~JJfR/qIfR T~~~E IF THE WORK
ANIP~wI ~,ljVelRlq"S ABAND ERMIT IS NOT
% ot'~ t~JW&ri. ONED FOR
REQl!IRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
. Sidewalk Type:
Downspouts/Drains:
Storm Sewer Available:
Special Instruction:
Notes:
Paec I Of 3
Sta tus
Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspectio~ 'Line
I V alu~,"ion Oescriotion I
I 1111
Description
Tvpe of Construction
$ Per Sq Ft
or mnltiplier
Square Footage
or Bid Amount
Total Value of Project
"flrr" p~ irl I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend'Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Penalty Fee - BWOP Electrical
Amount Paid
Date Paid'
$8.04
$3.35
$55.00
$12.00
$8.04
$3.35
$67.00
3/16/09
3/16/09
3/16109
3/16/09
3/17109
3/17/09
3/17/09
Total Amount Paid
$156.78
I Plan Reviews I
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00303
ISSUED: 03/16/2009..
APPLIED: 03/05/2009
EXPIRES: 09/16/2009
VALUE:
Value
Date Calculated
Receipt Number,
2200900000000000267
2200900000000~00267
2200900000000~00267
2200900000000000267
"
2200900000000000275
2200900000000000275
2200900000000000275
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.
~e(llliredJnsnections _
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Paee 2 of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726'3676 Fax
541-726-3769 Inspection Line
CITY OF'SPRINGFIELD .
Building/Combina~ion Permit
"
PERMIT NO:' COM2009-00303
ISSUED: 03/16/2009
APPLIED: 03/0512009 ,
EXPIRES: 09/1612009
VALUE:
By signature, I state and agree, that I have carefully examined the completed application and do hereby certif';' 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 Ordiuances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure withont permission of the Community Services Division; Building Safety.
I further certify that only contractors and employees who are in compliilllce with ORS 701.005 will be used on "this project.
I further agree to ensure 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, ;lIId the approved set of plans will remain ori'the site at all
times during construction.
Owner or Contractors Signature
Paee3 of 3
Date
\
21,5.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00303
COM2009-00303
COM2009-00303
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000275
Date: 03/17/2009
Descrilltion
Penalty Fee - BWOP Electrical
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
JEREMY BURRELL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
00511 c In Person
Payment Total:
c
Page I of I
11 :05:02AM
Amount Due
67.00
3.35
8.04
$78.39
Amount Paid
$78.39
$78.39
3117/2009