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HomeMy WebLinkAboutPermit Electrical 2009-5-1 225 Fifth Street+Spdngfield, OR 97477+P~(541)726-3753+FAX(541)726-3689 I'F""" ",M,,"" '" '''''-~~''''''''''''I :-:<(\'DE'p;6:RtnifEN;J;5USE'ONllV, "l ~:'JTIi?t~",1(.:f'~''J'?'i~;,'{if,i,.j,2S,<,,:;!~hi~,:;',sc~0:~Y~,_''. .:j.~ Electrical ~ermit Application I P~rmitno" {1C; - s-'7 f !I I ,Date: 5/1/ () '/ This permit is issued under OAR 918-309-0000. Permits are nontransferahlJ Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. II, ~~[QQ~!-!11:GO\l.ERNIIiIEN1f1lf~RP'R(;WA!!:~~~ Zoning approval verified? 0 Yes ~ No ' ~ 1'&~0t<mEGiRX4IOF;;lllC~()rII$5r:I:l.l!JlmIOrll~l!l\!\ii~1 I Residentiil, per unit, service included: I ~;~~~~~lmEWJlrIIF.~B~i;:~;ANDlil!:C~;';N;~~!~1 /1,000 sq, ~, or less (4) $134,00 $ I I Job site address: '3o~( rKMJkL;j Blvd I '1 ~':,';~:ldit!onaI500Sq,ft,orportion $ 25,00 $ I I City: :JPJ::A,>-, ,c,_'/d I State: O/'l.. I ZlP9} '10:" I I Limited eri6rgy (2) $ 32.00 $ I 1~;=~~~'lQE$_QRIe,TiONIQFJlWJ~~~~L~~ I ~~~71~:"si~~~~~~~ ~e~~:r (~)odular 1 1 $ 63.00 $ I ('l _ __.J.t 3' ~ b. -t":. 1 Services or feeders: installati?n, alteration, relocation ! ~'V.elA,.~"J,O'~ ,If') Ill.., J--LA ' - -- . I 200 amps ?,r less (2) $ 81.00 $ I ~'l~~P.ROP,E;R'Ii\l'llir().vv:NE8l1-~~~ii!,~i'iI,~! I 201 to 400::amps (2) $ 95,00 $ I I Name: anD' :t-5 w,ll"...df, 1(.,~ BL 1401 to 60diamps (2) $158.00 $ ,I / Address: "B....t:>.d I.:: 1.'0.0 I 601 to 1 ;oqo amps (2) $205,00 $ I I City: I State: I ZIP: I Overl,OOq amps or volts (2) $469,00 $ I I Phone: I Fax: I Reconnect::only (2) $ 63,00 $ I \ E~mail: I Tempora~y services or feeders: installation, alteration, relocation I This installation is being made on residential or farm property I 200 amps pr less (2) , $ 63,00 $ I owned by me or a member of my immediate family, This I 201to 40Q:amps (2) / $ 87,00 f2 7 I ' property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479,560(1), I 401 to 60Q:amps (2) $126,00 $ \ Signature: Over 600 ~mps or 1,000 volts, see services or feeders section above I f~=:::~~N~~~~~!~;~~;~~:7:~~!\~~rJ: I :r;::~o:i~::~~~ ~i::~~:t:~~::r:~:s:s~~~:~::e~r feeder fee : I Address: PO, B.:.)c / Z'l -, I I Each bri;nch circuit / I $ 6,00 / $ I City: Pt'>/ZCSt ~ IZ"V,._ I State: 0 IL I ZIP: ~ 7 J J b. I I b, Fee for ~ranch circuits without purchase. of a service or feeder fee: I Phone:5;.;-~7 -060'1- 1 Fax~;J-~5-7-0Zo<;. I I Firstbra!ochcircuit(2) $ 55,00 $ I I E-mail: C\ehe.. &, S...",rl~....el~c.+':';c. _ C^AJ\ I Each ad~itional branch circuit $ 6,00 $ I I CCB lice~se no,: A7 442- I BCD license no,: I Miscellan~ous fees: service: or feeder not included I I Signing supervisor's license no,: t3Tf::J..7 - !.S I Each pump or irrigation circle (2) $ 63,00 $ I I Print name of signing supervisor: Ge. he. l_ ....\e.1s oU I lEach sign ?r outline lighting (2) $ 63,00 $ I Signature of signing supervisor: }w{ I"?_ v? n P. _ I' 1 Signal circhit or a limited-energy panel, $ $ I~ l _ ~ _ a]teration,~r extension (2) 63.00 11~~~~~=~::~tio_~:I(:~Y:#T:__~_:~~_,,1 WfXtlTi"'f!iS!l,~IAFmI!IC-AN;r/!J\l'J,SEIiJi!?~rl!&,",ill ",~,,--~l I (A), Enter:rubtotal ofabovdees $ (MlllImu'l' Permit Fee $58.00) I (B) Enter 1'2% surcharge (,12 x [A]) I (C) Techn~logy Fee (5% of [A]) / TOTAL (ees and surcbarges (A tbrough C): I I ~ ~t~ /h\.,6^- /\,;"J \~\v ~~ rf'- ~~ $;0 s&' J $ 1(:JSl I!O/'Z'1 I 440-2584-) (9/08/COM) \ " T!~PE OF WORK: Electrical Work Only Ii l1i\'PE OF USE:' New Temporary elect for 15 hridge project trailers " ~' ir Ii Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3001 Franklin Blvd ASSESSOR'S PARCEL NO.: 1703334402600 PROJECT DESCRIPTION: Owner: Address: ~ ~ [.PU"~ .:> r- :e;p:v ~~ ~ iCITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00598 ISSUED: : 05/01/2009 APPLIED: 05/01/2009 EXPIRES.: 11/01/2009 V ALUE: .~ Engene Puhlic ORECON DEPT OF TRANS HWY COMMISSION 355 CAPITOL ST RM 119. SALEM OR 97310 Owner: STATE LAND BOARD Address:, 355 CAPITOL ST RM 119 SALEM OR 97310 Contractor Type Electrical Contractor CENE NELSON # of Units: Primary Occupancy Croup: Secoudary Occupancy Group: Primary Construction Type Secoudary Construction Type: # of Bedrooms: Front yard Setback: Side I Setback: Side 2 Sethack: Rearyard Sethack: Solar Setbacks: Street Improvements: Storm Sewer Availahle: Special Instruction: Noles: , ATTENTION: 9regon law requires you to follow 'rules ad.opled by the Oregon Utility "I_..:.t~__...:__ .....___'''-_.. ......,_ _ _ _ I ., .. I CONTRA2ibk~FQ~~fAoN~I--O-U9h:OAR- 9-52-00 i' ~ . , . ... . 'pies ,of the rules by calling the center. (Note: the telephonj1. number for t~Mi~[l~~n UtiliifP'j5!!~ll!.Q;Mlate Cente157!14iZ-800-332-23,0i71.3l/2009 . BUILDINC I:"FORMA nON I 11 # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq'Ft 2nd Floor: Water Type:' Sq Ft Basement: Range Type: Sq Ft Garage/Carport ''''~:''r"~~E Energy.Path: :,' Sq Ft Otber: Spri~1fl~g 1l~\t!t!~1f SHhL f?)(fI'IRE IF<m~~M{ad: I DEVELOPMENT.iN'EOR,J\'iiif[6~~IilI" t-'tliIVIII I:::> I~U I . ---- - " - .~J,NDONED FOR REQUIRED PARKING ANY 180 DAY PERIOD.: ~ Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: ' Phone I.PUBLlC IMPROVEMENTS I II Sidewalk Type: Downspouts/Drains: Page 1 of2 -':l!O~RINGI'1I,~~1 i '- l~ Status Issued CITY OF SPRINGFIELD BuildiJ)g/Combination Permit PERMIT NO: COM2009-00598 ISSUED: 05/0112009 APPLIED: 05/01/2009 EXPIRES: 11101/2009 VALUE: 225 Fiflh Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726'3769 Inspection Line Description Type of Construction :1 I Valuation Descriotion 111 " !I $ Per Sq Ft Square Footage or multiplier or Bid Ari\ount !I II Total Value of Project ',I Value Date Calculated Fees Paid' ii I; II Date Paid il 5/1/09 5/1I0~ 5/1109 Receipt Numher Fee Description + 12% State Surcharge + 5% Technology Fee Temp Power 201 - 400 amps Amount Paid $10.44 ' $4.35 $87.00 2200900000000000466 2200900000000000466 2200900000000000466 Total Amount Paid $101.79 I, Plan Reviews I To Request an inspection call the 24 hour recording at 726-376~. 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 Reouired Insuee\'o 1S -il I I .....;1 Temporary Electric: Approval required prior to Utility Compauy energizing pole.' II II By signature, 1 state and agree, that 1 have carefully examined the completed application and do herehv certify that all information hereon is true and correct, and I further certify that any-and al'. work perfonried shall be done in accorda'nce 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 structure without permission o[the Community Services Division, Building Safety. I further certify that only contractors and employees who are io eomplianc~:with ORS 701'.005 will be used ou this project. 1 further agree to ensure that all required inspections are requested al the proper time, that each address is readahle from the street, that the permit card is located at the front of the property, and the approved set of plans will remain 00 the site at all times during construction. :1 ~~ e. JILUl--- 5 - I - 00; Owner or Contractors Signature Date Page 2 01'2 229 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00598 COM2009-00598 COM2009-00598 Payments: Type of Payment Check . cReceintl RECEIPT #: .~ji: Wii:......... :1 II II I II il II Check Number Batch Numb~r " 2200900000000000466 Description Temp Power 201 - 400 amps + 5% Technology Fee + 12% State Surcharge Paid By SUNDOWN ELECTRIC Received By cjc Page 1 of 1 22,m City of Springfield Official Receipt Development Services Department Public Works Department Da,te: 05/0112009 Item Total: Authorization Number How Received In Person Payment Total: 1l:02:13AM Amount Due 87,00 4.15 10.44 $101.79 Amount Paid $101.79 $101.79 511 /2009