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Home My WebLink AboutPermit Electrical 2009-5-12 I'W'k';"""':~R'~;'-':;;;C;~~<lH.:L;ji~:<id>~W4?.'il..~II~ ""'I j\'cs:"i[)E:BARTMEto/ili,USEIONli-Y" .' t" ""F!;;ii':I'.'1'<-:~.f.;;r.--<":"~f..,;.~~;Y::0Jk~~~i'i:iE~\!;,.;;;#-r~;ti ~~ I COj4>\ Zc:)O ,- 0065'1 I' PermIt no.: I Date: S /;(0 7 I Electrical Permit Application 8 . 225 Fifth Streett Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 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, 1~Jl;,~1~lrO:c~I-'lGO:"'E8f\1ME:f\lif"~j:n~~o:vp,:i:.~~1l\t1 ~~!'~~~IiI;E~S_C8E[j,l;)12E 1 Zoning approval verified? D Yes DNo I ~~1f'ij"'g~lt~:!1lit~~~'li'( ')~111IrQ"'~"illil!:€Os,Sif~ 'I ~"4J'~t~i~:~~ltJ3:~f=~i..~'.iiV~~ ~~~ .~_ i~~:::~~~lli~G~'~~~~~~~:;i}R~r~::~~~ll Residential, per unit, service included: 1.~J.rJ0I311SI1f:EllJJ'.l!;,O:RI\'IJl.iJ1IO:N~,,;N[)JEo:G;(l.'f;IO:N~~~,ffj I 1,000 sq ft oiless (4) I I Each additional 500 sq. ft. or portion Job site address: <L1,q ~V'<().I >) , thereof I City: 'SOt A I State: (1 ur I ZIP: c;. 7t0"7 I Limited energy (2) I Subdivisio~: I '70 z.. :s 0 0 0 I ,Lot no,: 0 ( cr Zb I Each manufactured home or modular 11'l~'fjJl:.P'ESJ;RI~mj(:)NiiO:~l!WJi)J~,~~~~~1 dwelling service or feeder (2) ) 'At.. TE::iL b L. ~~ I Services or feeders: installation, alteration, relocation I I I 200 amps or less (2) , $ 81,00 $ "~-?El?t:~<'JlI'!0!I!n'R. .O"E'R' io/,JfO. "w' 'N'E' R.~it:<;;"f&T1f?'S<<1!S'l.,<'<i~"'-'i""''''1 20 I to 400 amps (2) $ 95,00 $ ifi;i;~::..~~,12~Ji1~"",,,.r::",..,,r>> . _ ~Itlk=_._,__ ,_~hd":kci.;;g;-'iil:~;A:l~~1.1{P.t".J;: I Name: ;J6?pp rtVoAA-OL 't:...(+~_ ,_,_.. ~ I 401 to 600 "!'Ips (2) , $158,00 $ I r I~ '" IC.... '", ~,g(" ,~w I""""I~O yuu,~ Address: >l{ ~ I.::> OLY-/,4-y ( c;;.'lln',"~;r,;~ ~d~; ts. ~~~1!9,J"Qq:,,,~,,,,p.: (:):Iit~ $205,00 $ I City: S\>f',"" I State:~ tl(ZII)"al$r~'71" !t9_V.!'!i!:00.0,amps,otvoltS:t!1) $469,00 $ I Phone: e:.u (- / ll> ~ _ ~ S"Y.> I FaJc _ InYl-lti ~o.::-uu I ~U' HI' R"l&!~?~Nf]!y 12]~:~u~: , $ 63,00 , $ .....rr bU . Annn Vr." 1Tl<:)\I "I tC1.111 \..."."I'-',...........;-~ ........ .-..:.- ,-) I E-mail: --;~liingthe cent Jr. iT!..np.plJ.~rrY ~~f~is~J?refeeders: installation, alteration, relocation This installation is being made on residential or f\iiiiJl~~nytne, llrElg~QV ;,mps'pn'less(Q.)3.lion $ 63,00 $ owned by me or a member of my immediate family, Thi,,-,enler IS 1- j2&i'fi?~6uiih'M'(2) $ 87,00 $ property is not intended for sale, exchange, lease, or rent. OAR , 479,540(1) and 479,560(1), 401 to 600 amps (2) $126,00 $ Signature: lOver 600 amps or 1,000 volts, see services or feeders section above 1~~1LC:<:5Nm~GjTI<:5,RIINsJfrJi;I!l!ft.;ffillD"N~~~\Dfi~~i~ I Branch circuits: new, alteration, extension per panel j Business name: f'l1~<hJ,I-,: r-:,~('~.r.A TN' I a. Fee for branch circuits with purchase ofa service or feeder fee: I Address: 77Rv vlt.4.vSX - -tJ>.,.. I I Each branch circuit I, I $ 6,00 1 $ I City: <,.f)tv; I State: ~ I ZIP: '1?1; 77 I I b, Fee for branch circuits without purchase ofa service or feeder fee: 1 Phone: ')(1\- sa - <)(1(, I Fax: I I First branch circuit (2) i $ 55,00 $ I E-mail: Each additional branch circuit ^ $ 6.00 $ ~~-i"'- '; I CCB license no,: (<r7(,4'(" 1 BCD license no,:(o- ' ~ :~: ,_Miscellane~~ fees: s""rv,,Lce or.{"ede~J'ot included I " "/" i ;/'" r d M ~h~ l:o'?!f::1R~lr ~\:!I 7f"vn" Slgmng supervISor's hcense no,: ""1'772S, !'lITHeRI ~E :;:@Q[-,-1.TUI[O:'rtTIp~~~T $ 63,00 I Printnameofsigningsupervisor:frl,'-1ulr-i! LOMCir.nM~f~~!t\3b $ 63,00 I Signature of signing supervisor: IA. ~ /11'" - --A NY 180 t tig~iIl HirPl'it or a limited-energy panel, $ 63,00 $ /17.... ~ / ~ . aPf&.ffiI3rl.,Lbr extensIOn (2) ( I Each additional inspection: (1) $134,00 $ 25,00 $ 32,00 $ 63,00 $58,00 \~.\ \,\ 440-(r~~J~~~!?~ , tm'\-f('(,w\Vr ~' ~\# 0'\,c&~ '~ ~ t(\~ect- ') I (A), ~nter subtotal of above fees (MInImum Permit Fee $58,00) I (B) Enter 12% surcharge (, 12 x [A]) I (C) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through C): $ $ $ $ $ $ $ $ 6',)"- $ fO'ZO $ l(tS"] $ '11 ~ CITY VI< ~l'KINGFIELD .Building/Combination Permit PERMIT NO: COM2009-00654 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11/12/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3456 OL YMPIC ST ASSESSOR'S PARCEL NO,: 1702300001926 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION: Alter 6 circuits Owner: JEFF HOMOLKA Address: 3456 OL YMPIC ST SPRINGFIELD OR 97478' ....,,\\\0 tGONlIRA'Ol:OR INFORMATION I \\ \'3-'l'I \eO\e\J-e se\ \Va\- Contractor Type ContJ'llctor 'o'J \'(Ie\l~eS '3-1,., 9'6?:\j 'o'J License r-'\ v \~f\ ~ ( -.e.'" ~eS Electrical _,..","\M1Tk.HS'E"J!:G:T-~'~ 11'j~,\e \\l _"e 146745 , i'>\~~ \U\o"; c.e\\\'~O\\j\\\~~W~B'U:IL'iD~i~Q.IN\iORMA TlON I \0\ ''3-\\ 00 \'3-,(\ \. I , \,\o\,\\c;~ 9'6?: '3-'J 0'0 I \\,\0 0\\\\\'J \~~\. . # of UllItS: '(\ 01" '{ou ((\ c;e(\W' <bO(\ ~?:'iAll Stones: Primary occupand@.fOUp:,,\'(Ie\'(Ie<jJI\e.'oOO,?iHeightofStructure S d p....\\\\ \~ \O~ . ~ econ ary Occupancy "ro'lgbl (\WI \ Type of Heat: Primary Construction 'IYP1,' c.e Water Type: Secondary Construction Type: Ringe Type: # of Bedrooms: Energy Path: Sprinkled Building: n/a I ~EVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: ~<::J~~ # Street Trees Rqd: \t \\\t. S ~()\ Paved Dr~e ~~t. c.~~\\ '\ R-. ~ % of ~",\..~e~~~ "" x.\) ~<::J \\~\\~~~\1\~ ~\~\)<(.~ ,,~~~\)<::J~ itr.iJin,,}.<.'J,J;IIJi-Y.WNTS I \ l..~~.rn...:.( !\ ~ I , \1\'"\\-" \>.~ rv CO "\ 'Q\) \) ~~i Street Improvements: Storm'Sewer Available: Special Instructi.o": Commercial Phone Number: 541-688-9543 Expiration Date 01118/2011 Phone 541-521-5690 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Notes: I Yal~ation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction . Page 1 012 Downspouts/Drains: Value Date Calculated _li>~~I_N.!'3i}'ll~~;,~ ,t . ~. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00654 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11112/2009 VALUE: 225 Fifth Streel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fees Paid. Fee Description + 12% State Snrcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amonnt Paid Date Paid Receipt Nnmber $10,20 $4.25 $55,ilO $30,00 5112/09 5/12/09 5/12/09 5/12/09 2200900000000000513 2200900000000000513 2200900000000000513 2200900000000000513 Total Amonnt Paid $99.45 I Plan Reviews I To Request an inspection call the 24 hourncording 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 Reouired Insnec!ion~ I Rongh Electric: Prior to Cover Final Electric: When all electrical work is complete, By signatnre, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and [ 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 the work described herein, and that NO OCCUPANCY will be made ofany structure without permission of the Community Services Division, Building Safety, 1 further certifY that only contractors and employees who are in 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 card is located at the front of the IJroperty, and the approved set of plans will remain un the site at all times during construction. Owner or Contractors Signature Date Page 2 of2 225 Fifth Street SpJ'ingfiel'd, Oregon 97477 541-726-3759 Phone S~LD" Wit". City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-00654 COM2009-00654 COM2009-00654 COM2009-00654 Payments: Type of Payment CreditCard cReceint I RECEIPT #: ,2200900000000000513 Date: 05/12/2009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By MITCHS ELECTRIC Item Total: Check Number Authorization I,{eceived By Batch Number Number How Received djb 046609 In Person Payment Total: Page 1 of 1 IO:28:58AM Amount Due 55,00 30,00 4,25 10.20 $99,45 Amount Paid $99.45 $99,45 5112/2009