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Home My WebLink AboutPermit Electrical 2009-4-16 This permit is issued ander OAR 918-309-0000. Permits arenoatrBDderable,.PermiU expire if work. is not started within 180 days of issuance or ir~ork is suspend~~ror 18~ days. r'",.:': ", 'c"'LOCAL:GOVERN'MENT'APPROVA\J ,,,,,, I Zoning approval verified? 0 Yes 0 No I I;..;~ 'c'-,:~A o',>CATE.GORY;O"'.,CONS'J;RUCTION;:~;:,;;,o.-;'/}':'('; I )gResidential I D Government \,1 0 Commercial I ,...,. JOB SITE, INFORMATlON ANDJ:OCATION,':', ,.: IJobsiteaddress; 24hS ConJl.AL.. be.. I I City: St>~t-D ,) State: 012.. I ZlP:'i,'t-n I I Subdivision: . t Lot no.: I,;~..'o ';';"'~:: .rD;,:"..PESCRIP.1'IONf'QF!'WORK'<i',;;,...:,"t~.,,;:'; ,'.~, ,--.M.Cl-\1.'V') (OR1\0Q ,; ~s.. "JDiX'~~o~~#"dWNER .., ' ' Name:..TASO.V G\JSr\ I Address: 2-4 b C; Co'(2.{LA. L 't'\ Q.. I City: <S PFLI') I State: ~ k:. I ZlP:'1 "7'+77 I Phone: I') 7\fb-470 ~I Fax: - - 'I " ,- , mad: _ )r? <;Of\@ .prtK ,,6~S. \lS Ibis instalIation is being made On residential or farm,.............1 owned by me or a member of my imme<liate,farnily., This propetty is not intended for sale, exchange, lease, or rent OAR 479.540(1) ""d 479.560(1), Signature: b....c" ,,;i,-';,'CONrRAeJOR; INsTALt'ArIOH':'E'>,:<,; ',;;',:'(:'j I Business name: ('oN ,qi./~ji Gft-:rR.l.t7 1''->'-, I I Address: ;;), <.-:>" ;~::~,04LAN~ :'';ii~ I' ICily: ~?,,;;;;U;:::" I State: Oe !ZIP:97q'a<J'1 I Pho.e: ?,srq-,/'7.::... I Fax: ,WI.:I '-If>S>D-; I .-mail: (l..oAJ.;..IC~-R-Q..(.~J. ..u::;..r I CCB license no.: NlJ.5b"l I BCDlicense,no,: ;;?rD--tff,$.~ I Signing supervisor's lieenseno,: tI'R79S '" ' , " ,_ ~intDameof,Signi.,gsupervisor;~, ,qZI!%! I I Signature .fslgnmg SUpervISOr: ~ .~ ;:: , "~4 Apr 14 09 09:21a Connie Hpr 'l~ u~ U~:11a ..Jason Jjusn, l,;,1jU Electrical Permit Application ,:!' _. - CUY. OF SPR,tNGFIELD, OREGO!\' - - . 215 Firth Strect. SpriDgiidd. OR "'477. PH(S41)'77.6-J7SJ. FAX(S4I)TZ6.368!J I - ATTENTION: Oregohlaw requires you'to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. Y.ou may obtairi copies of the rules by calling the center. (Note: the telephone 440.ZSM.J (j1illiiCl)Mj for the Oregon Utility Notification Center is 1-800'332.23~ <f.:- ~~ cJf: ~~ 541-461"()507, p,1 ",. J =-'"t.L) ,-..tt-::I ,..,., '....Q.....:D'..'''''''", )':<DEP AlitNioo'uSEOm. v-: """1 '::". <,~:",:""':;~ I ' fl to: A tOTl I '.~:~:;}~:~~~;,. Jfhi."i~ Perrrutllo.: \ ').1 "1l.AJ "'.......,.- 'IDate: I I 'HJ .FEESCHEDULE~(>" /,1 'N;;;'b~t~ti~;;~;i;,.'p.j.li~~i I:;' rqlil~~~~U:J;;1~t':I~1 I Residential, ptr unit.a:etyj(t includtd: . I 11.000 sq.l\, or less (4) I $134,00 $ I . Each additional 500 Sq. ft. Or portion S 25.00 I ther-cd . $ Limited energy (2)$ 32,00 I $ I I Each rr.anufactured horne Ol.modular I dwelling service or feeder (2l $ 63.00 S I Ser:viccs or fceders; instailalion. alteration, relocarion I 2ooamp' ""less (2) I 5 81.00 I $ . I I 201 to 400 amp,(2) I $ 95.00 I $ I I 401 .. 600 amps (2), I $'58.00 ) $ I /601 .. 1.0110 amp5 (2)' I S205,OD I $ I Over 1,000 amp"r volts (2) I $"MD I $ 1 I Rec.nnect on:y (2) I S 63,00 I' S , I TempDrarY services.r (eed~rs: mstaU"lio,," a/tuqrion, ,-eloctJlion r I 200 amps or I",s (2) I $ 63.00 I S I 120110400 amps (2) U7.00 I $ I 4Dl to 600 amps (2) I $126.00 I $ I Ovc:r 600 amps' or J,OOO 'Volts. see s~rvic" or feeders scttion above j Branch circuih: nelr. oltel'Qcion. Ulemio'lper panel . j a. Fee for braACh circuits with puriChase of a ier\-'!ce Dr feeder fc:e: I Eacb branch oircuit I I $ 6,00 I $ I b. Fce for bra:nch circuits witho\:t purchase of a seryicc or feeder fee: I Fir" b<~noh ciro~il (2) . I' I S 55.00 I $ {; SO') ! Each aciditiO<lalbranch oircuit l' 5 6.0,0 S iCZ;O 'P I I ; MiJMlaneous fee3i: ~ice or ftederl1o; inclwied_ I Eacb pump 0' 'rrigalion ci<<I,e(2) ..1 S 6100 I S I EllC~, signor outline ligllling (2) , ". $ 63,00 $ , SigJIal. eirCU, it OJ _a li~,itcd~ener8y_pancl. ., $ 63 00 I $ alteratIon. or cxtc:nslon(2) . . I Each addjtio~al'in,p.'ti.n: (I) I I $58.'0 i 5 I 1~';;!*')~~;,,{~:~if;;>~~~'PPUtANt}.-tJSE!~(~.'"~~l~j5~n- (Ar EntersubtouJofabovcfecs I S..,.., _CO (Miniml/lID. Permit Fee SSS.oG) I':; ,(B)Enlu12%surch"'1l"(.l2x[A)) t'7 'it> I S (C) TcclU,ology Fee (5% oflAll I I TOTAL lees..and s.rchargeS (A tbroogh C): I :<755 :4 NOTICE: THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS A~ANDONED FOR ANY 180 DAY PERIOD. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone , City of Springfield Official Receipt Development Services Department Public Works Department _ i-r .. Job/Journal Number COM2009-00480 COM2009-00480 COM2009-00480 COM2009-00480 Payments: Type of Payment Check cRcceintl RECEIPT #: 2200900000000000389 Date: 04/15/2009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By SUSAN BUSH Item Total: Check Number Authorization Received By Batch 'Number Number How Received 4413 In Person Paymenl Tolal: \lh Page I of I ] 2:57:20PM Amount Due 55,00 18,00 3,65 8,76 $85.41 Amount Paid $85.41 .$85.4] 4/15/2009 City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00480 COM2009-00480 COM2009-00480 COM2009-00480 Payments: Type of Payment Check cReceinll RECEIPT #: 2200900000000000389 Date: 04/15/2009 ]2:57:20PM Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Amount Due 55,00 18,00 3,65 8,76 $85.4 ] Paid By SUSAN BUSH Item Total: Check Number Au~horization Received By Batch Number Number How Received Amount Paid 4413 In Person Payment Total: $85.41 $85.4] IIh Page I of I 4115/2009 225 Fifth Street. Springfield, OR 97477'PH(541)726-3753tFAX(541)726-3689 1~~rPEp.:&:RliME'NmJuSEr0N~Y"'~1 AJi;"'~fi?:>V';;~"i\tV?li':'VN;j~2;t:g,:;ji:~id&~~~i-;i.i"~ I Permit no.: I" I Dale: I Electrical Permit Application This permit is issued uuder OAR 918-309-0000, Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. t~I!cD:G~l!'itt>:(:l)lt:.BN.Mt:.J~ljrl1~gBR(,!,JA~~ EE:!:\[$~CPBED.tJI!.t:.~~~_ I Zoning approval verified?, 0 Yes 0 No 1'l':\""t~~I!1i,' '!€Ost~I!I;tOfal~~ '" Y'lJ1illf'~ r'l1I-'~t~ 1R"~1lilIi.lCP*]EG~€lR-YslElI"Ji:cp~f\l$mB\!J~<;;;l!IElN~_\~~ ' ~,.'" ,,,.,l;.:!J \l2!a.cos~, ' I...... I ! Residential, per unit, service included: I ' E'J Residential 0 Government I 0 Commercial . 1i;;'L.JOB'I!SlmEfjINFc,0.RI'iIi~tloN!!A.f\l[)]JI1(;)<:::P"l11tORi'~~j 11.000 sq ft, or less (4) $134,00 $ I I lob site address: 2-Y:hS CoR-ltAL be... I I ~~~~:ritionaI500Sq,ft,orportion $ 25.00 ,$ I I City: 5 PFL-D I State: V f2.. I' ZIP: '1, Ur7/ t Limited energy (2) $ 32,00 $ I i~;~Dt:.S:<::BIt'4ljIQN[OIi!lV!lJ~~~.~~ I ~~~~I~:"S~~~~~r~~ re~~:r (~)odUlar $ 63.00 $1 I I I Services or feeders: installation, alteration, relocation 1 I ' I II 200 amps or less (2) $ 61,00 $ I I~B'{!f__'!i.,~RR(;)gER;t,){4!.0W~r;R~'f~E~1!1;~~Jtl1ll 201 to 400 amps (2) $ 95,00 $ IName:SASOA.! B\JSrl I I 401 to 600 amps (2) $158.00 $ I Address: 2- 4 b S Co (2..(LP> L b 12.. I I 601 to 1,000 amps (2) $205,00 $ \ I City: <3 PFL-D I State: (!) e... I ZIP: q 7'+77 I lOver 1,000 amps or volts (2) $469,00 $ I I Phone: I') iY-\:,-L1,0 -S I Fax: I I Reconnect only (2) $ 63.00 $ I 'I) ca I 1 Temporary services or feeders: installation, alteration, relocation I mal: ',- 11"')0(1 _procnde.'s.\JS ,nis installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ I owned by me or a member of my immediate family, This I 201 to 400 ampi(2) $ 87,00 $ I property is not intended for sale, exchange, lease, or rent. OAR 47~,~40(1) and 479,560(1), I 401 to 600 amps (2) I $126.00 $ I Signature: I. Over 600 amps or 1,000 volts, see services or feeders section above I ~~~G~€l~i11~eiIlbR!\'INSmA'll!ItAml<:)N~!iil\I@!!klf'~;liH;.\1!l1 Branch circuits: new, alleralian, exrension per panel I Business name: 1 a. Fee for branch circuits with purchase of a service or feeder fee: 1 I Address: I I Each branch circuit I $ 6,00 I $ I I City: I State: <9 e I ZIP: I b. Fee fOf branch circuits without purchase ofa service or feeder fee: l' I Phone: I Fax: First branch circuit (2) II[ $ 55,00 $ G S <l'p I E-mail: Each additional branch circuit $ 6.00 $ l'ti'O 'P I CCB license no.: I BCD license no.: I Miscellaneous fees: service or feeder not included 1 I Signing supervisor's license no.: 1 Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signing supervisor: I Each sign or outline lighting (2) $ 63.00 $ I I Signature of signing supervisor: I Signal circuit 'or a limited-energy panel, $ 63.00 .. $ I alteration, or extension (2) I Each additiunal inspection: (I) $58.00 I $ lii~~.di~jfeF?:i~IG;6iNit~~HsElI"~~__ I (A) Enter subtotal of above fees 00 - (Minimum Permit Fee $58,00) $73 _ I(B)Enter12%surcharge(.12x[AJ) V7 "Ie $ I I (C) Technology Fee (5% of[A]) $ I 'I TOTAL rees and surcbarges (A tbrougb C): $ S 5 ':iJ\- 440-2584-J (9108/COM)