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HomeMy WebLinkAboutPermit Electrical 2009-5-11 225 Fifth Streot+Sp,ingfiold, OR 97477 +PH(541)726-3753 +FAX(541)726,3689 If~,:":~":r~;~",;,;t2:_q~"i~~"W~*'fI~~UfJ'-'l~~'I?\T,~:: ~ '.'ii,({\ilDERA~TMENm.:USEj0Nll:)); ,'~ 14i~E'~~'09f.7:0"ot;'~I; I Date: S - (( ~ 0 7 I Electris:al Permit Application 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. I~z-o-n''':l''~n'g a'ptipl!1r~Oo'v:Ca.fJil'v\l!1\'1le'~n--.GfiI0e'd-V?.E~NI\IIEDt-lmY~eAs'~P.B.0VfJiD:~N;-O:"~.,.r~1 ~,,"~~Fi~E1'tS:CBEt:5_l!Ji.!E~~~~~$,iW I ~:Nfr~i~1fp~'1fle-~)W{~I'mw'~I~~i)sf~lfI;1:i)J31~ tG;~*Zi\*~:_MI{r<~~~ltF;;tYti,,..~;y,;;'~:i{.it'~bl ~'i"i ~~~~W.f~~~JB 1r~~C~f:EG,0B.Ylli.O~CONs31j~l!J.G5IiION~_~i I I Residenti~l, per unit, ser~iceincluded: I t~~~~:~~;;E~~~~~i1N(~~1~~~~~~~j i i~;;01:i:~:~:~s;0(:~ ft. or portion :1:::::: \ 1 City: .s p(-~ L State: tAL- 1 ZIP: ., 7c{ 2'~ I Limited energy (2) $ 32.00 $ I Subdivision: ./ !:>OZD ~ 2 2 I Lot noD B.?()() I I Each maoufactured home or modular $ 1~~7~;~~SC[{lf;~(O~W~B.~~1I~~~~: 1 ::~:~:: ~:r;~::Oo:S~ei::;~l~::ion alteration. relo:at::~OO i~~~t~~~i.1 :::::':::::. i I ;,::: : ~( 1 Address:' z.. S-O s. '> Z.... ~ Sri 601 to 1,000 amps (2) 1 $205.00 $ I City: c;.T>,c~ I State: ()l..L-1 ZIP~I'5'74:1.?,':,leov~r.i\0~0'~p~ror,vO!tS.(i? I $469.00 $ or,II,...", l'U..'I~ lr-v.;.r;:u uy lilt:: '.JtJ:;:'jUII ULllllY I Phone: I Fax: -. ,NoIiIicaIion Ce ntf,R~~qr,'<'iI't,?N!Yo\6)'o 00' fndh $ 63.00 $ E.mail: In UAK 902-UUII-( ure;rrli]o~ar.~lseEvic'i!s~orJ'e~~~r~: installation, alteration, relocation . . ." .. ~~~~. ','::;~ ~::;,. 0 )QOOlamps 100i'less ~2)1 rules by ThIs mstallatlOn IS bemg made on residential or farm1pr9p'eR:Yhe c' lnl,;:.. '''I_~_. ..1-_ .._1___1.. _._ _ $ 63.00 $ owned by me or a member of my immediate family. TiMb'\oJ ~ .. -;i01\i~406.';;;'p;i2V' .~.:~ property is not intended for sale, exchange, lease, or%\W OA)2r t~ e'): "9u'/ ~'~'~n,"u:lflcatlon $ 67.00 $ 479.540(1) and 479.560(1). Gente' I~ 4OJCl/i1600.amps1(01), $126.00 $ Signature: lOver 600 amps or 1,000 volts, see services orfeeders section above RlI&~iIc5DNmR1(GffiQR~INSmlX~ll~~N~~$~~~ I Branch circuits: new, alteration, "extension per panel Business nam..., 1,-) 1/ .y r y II 10 (0 S . 1 I a. Fee for branch circuits with purchase of a service or feeder fee: 1 1 Address: / fJ 0 ,n () '-J.. (PVJ 7 . j' [ Each hranch circuit I I I $ 6.00 \ $ b \ I City: \tV ~ 11 'f {If I II <..L, I State: () y'f I' ZIP: f.j 7 L/... (P-I 1 b. Fee for hranch circuits without purchase of a service or feeder fee: 1 I Phone: 7.Jf:J? 72-'-!- 1 Fax: ,-tfl.f J 0'4 -, I First branch circuit (2) $ 55.00 $ I E-~ail: I I , . j Each additional branch circuit $ 6.00 $ I CCB license 00./ jl,'f~LpI CD license no.: ~ O.-.:-~ ..;:;; II Miscellaneous fees: service or feeder not included [ Signing supervisor's license no.: I 1 ::ach pump or irrigati9n, ci!,cI!'.(2). rk-' I $ 63.00 I $ I Print name of signing supervisor tach SIgn or outline h@.~tm~ ~l. " I $ 63.00 $ I . .' . \ I 1 ......; I 'al 1 !tlh~rs1frr!!i1:~- r I it I I I SIgnature ofstgnmg supervlsor.0 AIITH() - tl.l>N@HhlrblMD ~ 'fVfiTp~ T $ 63.00 $ . -~ ~ If 7 )) ~~~8Effi:~~~~&..~1 n.l\ Qj ..IJ......[\ I I (8) Enter 12% surcharge (.12 x [A]) $ /0 C{q& C) \\;J':J . ~'V ~ [CC)TechnologyFee(5%of[A]) $ l{:sr o t5 ~ 1 TOTAL fees and surcharges (A through C): $ /0 ( ~, ~~ 440,2584-) (9/0S/COM) Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00646 ISSUED: 05/11/2009 APPLIED: 05iII/2009 EXPIRES: 1111 1/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 890 MOUNTAINGATE DR ASSESSOR'S PARCEL NO,: 1802032208300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Service and circuit for pump Owner: WILLAMALANE PARK & RECREATION DISTR Address: 250 S 32ND ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BURRELL BROS ENTERPRISES 1NC . License 136446 Expiration Date 08/20/2009 Phone 541-747-2724 # of Units: Primary Occupancy Group: Sccondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I BUILDING INFORMATION I ATiliiStlRills:Oregon law requires you tnot Size: follHeigiilPo'i' SfruciUfeby the Oregon UtilS'q Ft 1st Floor: Not+yp~;'Of Heai:9r. Those rules are set fC$'<\1Ft 2nd Floor: in OWaa,~:?r9~~:001 0 through OAR 952-0\5~-Ft Basement: 009RaX~~lfY,,'b:obtain copies of the rulesSlYFt GaragelCarport C2EtnV tl)p:'ilioter, (Note: the telephonlS Ft Oth . nUgJ'bVlidne"?J.8oon Utility N?tificatioaq . t"{' d Pru~"'~lLer% t!1J\jO'332-23<?4t ccupan oa: I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: I'aved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Notes: I PUBLIC IMPROVEMENTS ~ NOTICE: Sidewalk Type: THIS PERMIT SHAll EXP1REd~Jl~WOB\Cnins: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. . Street Improvements: Storm Sewer Available: Special Instruction: I Valuation Descri,otion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e I 01'2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid $10.44 $4,35 $6.00 $81.00 Total Amount Paid $101.79 Total Value of Project Fees Paid I Date Paid I Plan Reviews I 5/11109 5/11/09 5/11109 5/11109 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00646 ISSUED: 05/11/2009 APPLIED: 05/11/2009 EXPIRES: 11/11/2009 VALUE: Receipt Number 2200900000000000509 2200900000000000509 2200900000000000509 2200900000000000509 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 Renllirerllnsnectinns' Electric Service: Approval required prior to utility company energizing:service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further 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 thc work described herein, and that NO OCCUPANCY will be made of any structurc without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. ] 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 card is locatcd at the frontofthe property, and the approved set of plans will remaiu on the site at all times during construction. Owner Of Contractors Signature I / Page 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00646 COM2009-00646 COM2009,00646 COM2009-00646 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000509 Datc: 05/11/2009 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee - + 12% State Surcharge Paid By JOSHUA BURRELL Item Total: Check Number Authorization Received By Batch Number . Number How Received djb 03560c In Person Payment Total: Page I of I 11 :36:56AM Amount Due 81.00 6.00 4.35 10.44 $101.79 Amount Paid $101.79 $]01.79 5/\ 1/2009