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Home My WebLink AboutPermit Electrical 2009-4-28 This permit is issued under OAR 918-309-0000, Permits arc nonjransferable, Permits expire if work is not started within 180 days of issuance or if work inuspended for 180 days, ' 1r:k1rf',-;f_1!0C~I![GOSf,E~f\lMENif;WA~P'BQYAL~~!& I Zoning approval verified? D Yes D No l~iU~Ge.illI;GPRY1ilOFJjt:ONSJtBl!J,C3;10N.~1f~ I tia Residential I 0 Government I 0 Commercial 1~:JC)B'[SlmEjJINF,0,RMAiI'IONfAND]liI0t'A'lj10N~;r'~~-&'1i I Job site address: J),J50b "'^'-;)\: I City: 5'~ I State:~~ I ZIP:Q'74 77 I Subdivision: U I Lot no,: 1hi1.~1;lliiif~;JI',;'jj;~DESJ;RIRJ;10N~OliiW0RK~~~~ I r(),,'o,'It" V\(')l'Y\P ~'0-\'x:--P I 1~~~~R~OeER'I],Y.&:owNER~~~~Wm~~ I Name: "1l1- /-1/_!./I/~'rk/ J5t2(T7'~r: I Address: /;;;JJ~-;.~<?) -fI-} Sf I I city~i j n; t'L/;/ ;"LI State: ('fV I ZIP 97 y'l.f1 I Phone: - j I Fax: - , I E-mail: I This installation is being made on residential or farm property owned by me or a member of I1JY immediate family, This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479,560(1), Electrical Permit Application 9 D 225 Fifth Streett Springfield, OR 97477.PH(54I)726.3753+FAX(54t)726-3689 Signature: 1!.t~~~coNmRAGjT:br{ijINSmAL!lf~ml:ON~~~)~)~1 I Business name: rf\..; [I(-'d Y'\,(\'l;vU \ ~c.. I Address: ,-=)rl ~ I h k i \ 'E',\ l~ I City: l \S\\-~-.. ~ I State: Q;) lL I ZIP: q)q ~~ I Phone:911 - ,:J 1\1 d\ I Fax: - - . I I E-mail: I I CCBlicenseno,:157S'0(,., I BCD license no,: :)0-137(, I Signing supervisor's license no,: ~Lj d. 3~ ' I Print name of signing supervisor: I:- 1\ uv...,\ "/, 2t,'^"-1 ~ , I I Signature of signing supervisor: ~~D../~ I ~~.r 440,2584,) (9/08/COM) 11~'ji~fth~-'t1t."!~.'''''i'\"')Ho:~!G~*~...,t..~.'''.'~1 ,X;;fo;",DEP,ARTMENJi USE,ON~Y;"., S~AONGF'~~~ I'::;;::~"~;?=:;;;~~;J. I ' , I 0' _ ,?" _ (_ Date: q. ~ 0 7 1~~~~~%!~F,}:.E~~s1tIilED.uI.!ER~~_g~ 1~";~(~~~~~~~~"'~I''''''''''l!'liWfCOsf:I~I~totaI!.;\ ",~,u,m~eri~f.\n,pectto_n,s,p.!!',ltem, ,(,)~ Qtr,,' ,~, "il1il, ~;'Ji'._,'t';'"' li'!<I;,.~.....~w..",:.tC~~~.'-~~~t""d'~~.gA~~'i~, 2-eo!\,.'t; ~l_e~_.a~ &,~o~.~~j I Residential, per unit, service included: 11,000 sq, ft, or less (4) Each additional 500 sq. ft: or portion thereof $134,00 $ I I I I $ ;JjWI $ I $158,00 $ I $ I $ I $ I Temporary services or feeders: installation, alteration, relocation I I I I I I I I I I I I I I I _Each additional inspection: (I) $58,00 I $ I ~T~~jffgeRL!itA~lf,*usl:~il~~~1 $ 25,00 $ Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $ 32,00 $ $ '63,00 $ Services or feeders: installation, alieration, relocation 200 amps or less (2) $ 81,00 $ 95,00 20 I to 400 amps (2) 40 I to 600 amps (2) , 601 to 1,000 amps (2) $205,00 $469,00 $ 63,00 OV,er 1,000 '!"lPs or volts (2) Reconnect only (2) 200 amps or less (2) $ 63,00 $ $ $ 20 I to 400 amps (2) 40 I to 600 amps (2) $ 87,00 $126,00 Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee; Each branch circuit I $ 6,00 I $ b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2) $ 55,00 $ $ Each additional branch circuit $ 6,00 Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63,00 $ 63,00 $ $ Each sign or outline lighting (2) I Signal circuit or a limited-energy panel, alteration, or extension (2) $ 63,00 $ (A) Enter subtotal of above rees (Minimum Permit Fee $58,00) I (B) Enter 12% surcharge (,12 x [A]) I (e) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through C): $ $ $ $ Sjatus 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: COM2009-00570 ISSUED: 04/28/2009 APPLIED: 04/28/2009 EXPIRES: 10/28/2009 VALUE: SITE ADDRESS: 1215 36TH ST ASSESSOR'S PARCEL NO,: 1702304302200 Springlield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Mobile home service Owner: BROWN JULIANA M Address: ,1215 36TH ST SPRINGFIELD OR 97478 TYPE OF USE: New Residential I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MY ELECTRICIAN INC License 87506 Expiration Date , 11/20/2009 Phone 541-729-]454 BUILDING INFORMA!ION I # of Units: Primary Occupancy Group: Seeondary 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: n/a , Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION' , Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: , Handicapped: Compact: I PUBLIC IMPROVEMENTS I ' il\TTENTION: Oregon law reqUires you to tollo,^Si<!elY.!'IJ<.J1)ype:j by the Oregon Utility NotifiCDolinn CAnte/'DTr,ose rules are set forth , , ownspouts, rams: 2 001 In OAfi 8b".tiJl'UU I (11111 ough OAR 95, . 0090, You may obtain copies of the rules by calling the center, (Note: the telephone number for the Oregon Utility Notification rantor ic 1_An()_qq?_?~44L Street Improvements: Storm Sewer Available: Special Instruction: Notes: rWTlCE: I yaltl3tiQn Description I THIS PERMIT SHALL EXPiRE II ""L;'!.JI" , ' D 't' AUTHQTRIZEDficlNDFt,R TtHIS PERlilp'hISq'IKlT Square Footage escnp IOI~ vpe 0 OilS rue IOn . \"OMMtNL;Eu UK I;;; AtiAI~DOt\ttrj)Ifl(!,lRlher or Bid Amount ANY 180 DAY PERIOD, Paee ] of 2 Value Date Calculated _s.p., "AIN '0",,,,,_,/,, ','.,,'.'...'., ~.~ l \- . , . t $ .~_.. [1 ~" l~', " __,~ _. " ,_. ".,..... ...._.,_ d..' _'''~''_''-; ~ .; J Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00570 ISSUED: 04/28/2009 APPLIED: 04/28/2009 EXPIRES: 10/28/2009 VALUE: 225 Fifth Street, Spriugtield, 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 Fcc Manufactured Home Service Amonnt Paid Date Paid Receipt Number $7,56 $3,15 $63,00 4/28/09 4/28/09 4/28/09 3200900000000000279 3200900000000000279 3200900000000000279 Total Amount Paid $73,71 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 Insnectin~s I MH 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 true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springl1eld and 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 arc in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections arc requested at the proper time, that each address is readable from the street, that the permit CllI'd is located at the front of the property, and the approved set of plans will remain ou the site at all times during construction. Owner or Contractors Signature Date Paee 2 01'2 225 Fifth Street Sprin,gfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00570 COM2009,00570 COM2009-00570 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: Description Manufactured Home Service + 5% Technology Fee + 12% State Surcharge Paid By EDWARD N GUiDRY/MY ELECTRICIAN ~,,~,.AINO~I,no ~', :ib '\:i ~. City of Springfield Official Reeeipj Development Services Department Public Works Department 3200900000000000279 Date: 04/28/2009 1:41 :25PM Item Total: Check Number Authorization Received By Batch Number Number How Received nJ 008199 in Person Amount Due 63,00 3,15 7,56 $73,7] Amount Paid $73,71 Payment Total: $73,71 Page I of I 4/28/2009