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Home My WebLink AboutPermit Electrical 2009-4-15 Electrical Permit Application 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753' FAX(541)726-3689 . 'l~fDEFfARTME'Nj,usETO>NI!:~~1 I~Ybi'fi":ji"f,')[;-i_:";:"'~~;:;",a~t':iI:;,~J'i#&fM7?N(~~' I Permit no,: 0'1- 50:2- I I Date: If /I')j{)( I , This permit is issued under 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. Branch circuits: nel-ll, alteration, extension per panel I a. Fee for branch circuits with purchase of a service or feeder fee: I I Each branch circuit I $ 6~OO I $ I ZIP~7rcYo I I b. Fee for branch circuits without purchase ofa service or feeder fee: I I I ~~lf~J;~l!I(;!DSlE:BNMj:Nit"~J::&BQYA~r~il'~1 Zoning approval verified? 0 Yes 0 No 1 ~~GA'I1El3:t:>B-Ytf;QFJ!C:QN$m8.l!J.Q;ljfQN~_~ m Residential I 0 Government I 0 Commercial r~"1J,0B'IIslmEI1INi;.QRMP,.mIQNWlAN[)11!c:ie'~"liIQNII11tat4I:;!'':lit 1 Job site address: ( f .3 B "7 i' 51. 1 City: cZ, P Jl-I,vb PI 8'>>1 State: 612-, 1 ZIP: ~UbdiViSio~: 1 Lot no,: "''''~',~''''''\!:~DESeRJRmf~N'''0FtW0RK~~-'''''10''!f';;J! ~~jm~l _,__ __.......,___..1'=,..".1'4.1 _ ~. '. _" .,/]3Z~~>.,.:~~?""~"",,,;t;:i 1 13l/lt-p~- /.;v:J P/hVR7- k,Pwrz...t;; I ' . 1 Name: ~Il/ W?7?-t/C:;7'L- 1 Address: f I <::;'r? !)A--t2..LC/v't' U./ 1 City: W6.Ervt: 1 State: c:;l'x:- 1 Phone: 1 Fax: 1 E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, This property is notintended for sale, excbange, lease, or rent OAR 479.540(1) and 479,560(1), JIIff /&f 1 ZIP: o/T'IO / Signature: 1~~CdNi11R).:CJTIOBIIN:SjMI!I1'~i1110N!l!Jl!~~&?t':\J\~ 1 Business name: L J1E f:fZ.ez..m/L. S'e>'Z'VI?G: 1 Address: PO. 15-0 X- I II ~ Cj I City: ~r:,~& 1 State:~. 1 Phone: I Fax: 1 E-mail: I CCB license no,:~q7 V~ I BCD license no,: 'ZiJ'-Z-f{C 1 Signing supervisor's license no,: ~ '5 ')3.5 I Print name of signing supervisor: 17J,v: r,- ILO TH I Signature of signing supervisor: c.r: 14:.,~/ () 'Si~ ..r:f\ bc.~~ ~ ~ 440-2584-J (9108/COM) """"J!i!'_ml!!L~i!i"EE'EfS"C"'E"'" ""-<<'"",^"",,-=c'!iil ~~'f.S:tg~'ks;"",,i%?iliYLg~~~ ... _Wtm .~,f,l__..L!._l:U!!eJ%!~~H"~~1 i<'''~'''I-''i''~Y''!!Il;lil#:-'''''~'''' .....'''1'.'-'1-' -"""'11- ~"'" I "N', J!t""b.~~C"f ,"~",.., ","-"'''''''''''','' ,"" ,(",)'*:c'","' b"-' .~"'€, OS!"". ::f<o, tii I~"," " urn er>o ,lOspectlons:per"lteml "~sP ",lY: .. ",."""gj'~--t,,;((i ~"l:'i'1;~'.w.:(tA4:i!~ffiill.!fj\I+fft.IZ~,:;~~~:",i-;jti~: ~~ "-1~~_~;MY:~ W;.AS,O~S...:;m I Residential, per unit, service included: 11,000sq, ft, or less (4) I Each additional 500 sq. ft. or portion thereuf , 1 Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) ! Services or feeders: installation. alteration, relocation I 200 amps orless (2) I / $ 81,00 $ f7 1 20 J to 400 amps (2) $ 95,00 $ 1 40 I to 600 amps (2) $158,00 $ 1 60 I to \.000 amps (2) $205,00 $ lOver \000 amps or volts (2) $469,00 $ 1 Reconnect only (2) $ 63,00 $ I Temporary services or feeders: installation, alteration, relocation I 200 amps or less (2) $ 63.00 $ I 201 to 400 amps (2) $ 87.00 $ I 40 \ tn 600 amps (2) $126.00 $ , $134,00 $ $ 25,00 $ $ 32.00 $ $ 63.00 $ Over 600 amps or 1,000 volts, see services or feeders section above First branch circuit (2) Each additional branch circuit I I $ 55,00 $ 6,00 $ $ Miscellaneous fees: service or feeder not included I Each pump or irrigation circle (2) $ 63.00 I Each sign nr o~t1ine lighting (2) $ 63,00 I 'Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) 1 Each additional inspection: (1) ,I I $58,00 1 $ 1~\~~~N,ii[~e~f~'ANif~ili.sI~~~~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ $ (B) Enter l2%surcharge (.12 x [AD (C) Technology Fee (5% of[AD 1 TOTAL fees and surcharges (A through C): $ Sf $ '1 '7~ $ '1 ~ $ C}t.f z.:;: CITY OF SPRINGFIELD Building/Combination Permit Sta tus Issued PERMIT NO: COM2009-00502 ISSUED: 04/15/2009 APPLIED: 04/1512009 EXPIRES: 10/15/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1138 T ST ASSESSOR'S PARCEL NO.: 17032614013{6 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Owner: Address: WEA VER KAREN L 1150 DARLENE LN APT 168 EUGENE OR 97401 Replace "burned-up" panel ATTENTION: Oregon law req'uires you 10 tollOW rUles aaoplea oy me uregufl UlIlIlY Nolifiealion Center, Those rules are sel forlh in OAR 952-001-0010 Ihrough OAR 952-001- 0090, You may oblaineopies of Ihe rules by catllng me CtHlll:;lI. V\lUlt:. 1I It:: It::H:;!J1 tUllO' I <roNfIlR[.\fQIffiR 'lNFOR'M"'il'lONJ1ieation ....wIH..... "j't, ...'....... ~...'_ !!' 'j' Contractor Type Electrical Contractor LITE ELECTRIC SERVICE License 59748 Expiration Date 08/01/2009 Phone 541-688-8996 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: NOTIDlf~ of Heat: Sq Ft 2nd Floor: THIS ~M$'~f1ALL EXPIRE IF THE WO~ Ft Basement: AUTH \mge. Y,1/~iDER THIS PERMIT IS N Ft Garage/Carporl c.w{J\l iii". q Ft Other: GOMr8~PiI;'1hQj<miISi.I\P.ANDONEPIOR Occupant Load: , 1\t..IVion nAV DCDlnn t DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Selback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Slreet Trees Rqd: Paved Drive Rqd: % ot: Lot Coverage: , Total: Handicapped: Compact: I PUBLIC IMPROV~MENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: .J I Valuation Descr!ntion I Description Type of Construction $ Per Sq Ft or mnltiplier Square Footage or Bid Amount Value Date Calculated 'Paee I 01'2 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-00502 ISSUED: 04/15/2009 APPLIED: 04/15/2009 EXPIRES: 10/15/2009 VALUE: ; 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 In'pection Line Total Valne of Project F~e.~.,P~i~ J Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Numher $9.72 $4.05 $81.00 4/15/09 4/15/09 4/15/09 2200900000000000387 ,2200900000000000387 2200900000000000387 Total Amount 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 Renuired Insneetions I Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete, By signature, I state and agree, that I have carefully examined the compleled application and do hereby cerlify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance wilh the Ordinances of the City of Springfield and the Laws of the State of Oregon perlaining 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 iu compliance 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 c~lrd is located at the front of the property, and the approved set of plans will remain 011 the site at all . times during construction. l' r\ / ! ~ f? '1- / S - 6-'7 Owner or Conlraclors Signatur I " ' , ^, /' Date Paee 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200900000000000387 Date: 04/15/2009 9: 11 :30AM Paid By LITE ELECTRlC SERVICE Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 81,00 4,05 9,72 $94.77 Job/Journal Number COM2009-00502 COM2009-00502 COM2009-00502 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 12% Slate Surcharge Payments: Type of Payment Check Amount Paid cjc 6919 In Person Payment Total: $94,77 $94.77 cRcceintl Page 1 of 1 4/15/2009