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Home My WebLink AboutPermit Electrical 2009-3-23 Electrical Permit Application D 225 Fifth Street. Springfield, OR 97477tPH(541)726"3753tFAX(541)726.3689 1~~DE'F!'ARTM'EN~USE!QN'irf~~ ",Vb..;:J:1.!..~,;;t.h",~'ft-J!'iF:"~;;,,::,'i(;:;P~i;~;'~,!~~~ I Penmt no. (!9 - W5%q I Date: 3/2. 3/07' I This permit is issned nnder OAR 918-309-0000. Permits are nont~ansferable. Permits expire if work is not started within 180 days of issnance or if work is suspended for 180 days. 1~~1!'CfCAL'I[G0VE@I\IIENfI'l!lr~~aROV~L"I:~ I Zoning approval verified? 0 Yes ' 0 No 1~f-'~:t~'l1EGORY,(01",1C:QN$j!IRt!J:t;li10N~~"j~4~ I Residential, per unit, service included: I tsl. Residential 1 0 Government I 0 Commercial j 11,000 sq. ft, or less (4) ~f!JQS:~SlmE~IN~0RI\IlAi]j10NfAN);)lil'10C*ljI.0N~1li~~ . I lob site address: '.'2.,1..1 1. ~,~J. NA PI(~c..-e.... 1 I ~~~~oaritionaI500Sqft,orportion $ 25.00 $ 1 City: Sf! { " Y\ ("'\ -\' '<->-..IAI StateO ~ 1 ZIP: '17 ~ 79 1 1 Limited energy (2) 1 $ 32.00 $ ildl=;jji:~jjESCF{IF'mIONiliOI"J\WJ~~~.1llI~"'i~i 1 ~~~~I::nS~~~~r~~ ~~~~r (~)odular 1'$ 63.00 $ \\" '" I I I Services or feeders: installation, alteration, relocation I\. n.,"" ;::-,Q,-.( \)\ c-e.... l~r,,'\.R. 1 '1 200 amps or less (2) I 20 I to 400 amps (2) 1 N} \ 'i' (( 1 401 to 600 amps (2) ame: \ 11 -c Y\ ". \. A V'\O " I Address: '<,!..j 'l\ SLj d.- N fC'1 Q CA> . 1 601 to 1,000 amps (2) I City8;) < \ y, ~ .(2'\--Z..\;l r StateS) Q 1 ZIP:Ci;'"1 7<6 I lOver 1,000 amps or volts (2) 1 14-( \ J C' "\ "\ 1 1 Reconnect only (2) Phone8; , - n:.o 1 old.. Fax: I. E-mail: I Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63 00 $ This installation is being made on residential or farm propet1Y . owned by me or a member of my immediate family, This 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchan e, lease, or rent. OAR :::~::~l~~), it, :. ~~~;t::~:::;~~OOO volts, see services or fee:~r:6~::tion :bove ~..::~",",,<~,~..,.P-I i :~:~:;:~:; :;::~::"'::::':~'::".':::~M'~ 1 A~ress: ___ I 1 Each branch circuit I $ 6.00 I $ I City: _________ I State: ~ zIp; "I I b. Fee for branch circuits without purchase ofa service or feeder fee: I Phone: ~ ~: 'I I First'bran.ch cjrcuit(2) I E-mail: ~ ~ I I Each additional branch circuit $ 6.00 I CCB license ~ I BCD ~ no.: I I Miscellaneous fees: service or feeder not included Sig~ervisor's license no.: ---- I I Each pump or irrigation circle (2) $ 63.00 . pfint name of signing supervisor: .1 I Each sign or outline lighting (2) $ 63.00 I Signature of sigo.ing snpervisor: I I Signal CiT. cuit or a limited-energy panel, $ 6.3.00 $ alteration, of'extension (2) , I Each additional inspection: (1) 440.2584.) (9/08/COM) ~~8' 'D't~ ~~ ""1k'i'~~?~~~11C"~EEE:<Y$'effiEjjtJil!Ei~~llf4!''''''''''F',";;:r''I1h'''',, ar:t1j'!iffiw'i:i!f""..._~.-=~__~illr.:.~"O) .~.."_W',, .... '._n A_....__,,,H~~~~ ~*'!Ii(0',~,,~"'m.~4l!iW"l~:l3.-j ""~ iI!!i€osfY ,'>tot.ljll 5;Number::ofiIDS ectIonSi er;'ltemty; . ~,;. ' t ~;.,. '_.. . ~. '*': .......- \t ' f!"""'l'{j!"ili.\"-",p'''~~~~'WET4!&~\!1lI11~"l,,IJ9l.eaJlII~0.sJI $134,00 $ 81.00 $ 95.00 1 $158.00 1 1 1 $205.00 $469.00 $ 63.00 $ 55,00 $58.00 1 $ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00). I (B) Enter 12% surcharge (.12 x [A]) 1 (e) Technology Fee (5%0f[A]) I TOTAL fees and surcharges (A throngh C): $ I I I, 1 $ $ $ $ $ $ I $ $ $ $ $ S'/ 00 $ 1", DI~ $ '7',12-. $ 94 VI Status Issued 225 Fifth Street, Springfield, OR '541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00380 ISSUED: 03/23/2009 APPLIED: 03/23/2009 EXPIRES: 09/23/2009 VALUE: SITE ADDRESS: 348 S 42ND PL ASSESSOR'S PARCEL NO.: 1702323300402 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Replacinbg service panel Owner: VERNA UPHOFF REVOCABLE LIVING TRUST Address: 5729 MAIN ST # 361 SPRINGFIELD OR 97478 TYPE OF USE: New Residential I CONTRACTOR'INFORMATION I "Contractor Type Electrical Contractor OWNER BUILDING INFORMA~ION I # of Units: Primary Occnpancy Group: Secondary Occnpancy Gronp: Primary Constrnction Type Secondary Constrnction Type: # of Bedrooms: # of Stories: Hcight of Strnctnre Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Bnilding: I DEVELOPMENT INFORMATION I ) Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Slrcet Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ~lnTl...r::. T~~~ PE~MIT SHAI r~'~~l\'Ifflw\\\M,~,~TSI Street Improvements: II.- I ,IORIZED UNDER THIS PERMIT IS NOT . COMMENCED OR IS ABANDONED FOR Storm Sewer A va,lablc: , I P Special Instruction: f.I!~\ j ,~O DAY PERIOD, Notes: I Valuation Description .1 Description Type of Construction $ Per Sq Ft or mnUiplier Sqnare Footage or Bid Amonnt Page 1 of2 License Expiration Date Phone n/a Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occnpant Load: REQUIRED PARKING Total: Handicapped: Compact: ATTENTION: Oregon law requires y~uto follow rules adopted llY tl~e Oregon Utility ... .. _ """__.h~ ThnC"Cl.rldj::l.l::.::lI'p.setforth i~vO/~ft952-001-001 0 through OAR 952-001- " J)()qn YC'I may obtain copies of the rules by . ~1~ewlalk TIYE,e:'enter (Note: the telephone ca ling ..v v . , . . 'f" t' D " '"t"D'"" "regon Utility Notl Ica Ion uwnspou 51-' rams: Center is 1-800-332-2344). Va'ne Date Calculated _l5!~RIN<ilil'lal,tll~ f , Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00380 ISSUED: 03/23/2009 APPLIED: 03/23/2009 . EXPIRES: 09/23/2009 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 54]-726-3769 Inspection Line Total Valne of Project Fees Paid I ,. , Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amonnt Paid Date Paid Receipt Number $9.72 $4.05 $81.00 3/23/09 3/23/09 3/23/09 2200900000000000289 2200900000000000289 2200900000000000289' Total Amonnt Paid $94.77 I 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. ReO,uired In~'ltc!i,on~" Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is trne and correct, and I fnrther certify that any and all work performed shall be done in accordance with the Ordinances 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 structnre withont permission of the Commnnity Services Division, Bnilding Safety. I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project. I fnrther agree to ensnre that all reqnired inspections are reqnested 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,ring constrnctio:>1 I/~/ 1A v' Owner or Contractors Sfgnat Date Page 2 of 2 225 Fifth Strcet Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Serviccs Department Public Works Department Job/Journal Number COM2009-00380 COM2009-00380 COM2009-00380 Payments: Type of Payment CreditCard cRcccinll RECEIPT #: Date: 03/23/2009 2200900000000000289 Description Penn Serv/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge Paid By DALE ADHEY Item Total: Check Number Authorization Received By Batch Number Number How Received njm 09217c In Person Payment Total: Page I of I 1:33: 15PM Amount Due 81.00 4,05 9,72 $94.77 Amount Paid $94.77 $94.77 3123/2009