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Home My WebLink AboutPermit Electrical 2009-5-13 " 225 Fifth Strcet+Springfield.OR 97477. PH(541 )726-3753+ FAX(5-l1 )726-3689 " I DEPARTMENT USE ONLY SPRINOFIELD ~ ,,~/ _ _ _ ,f~. I Co,lM ~OO ,/-00 bb'f . ...... ~/'...... Permit no.: " I Date 5/ ~/D 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. I LOCAL GOVERNMENT APPROVAL I Zoning approval verified? DYes D No I CATEGORY OF CONSTRUCTION 1 ~ Residential 1 0 Government I dCommercial I JOB SITE INFORMATION AND LOCATION /'_ 1 I Each additional 500 sq. fi. or portion Job site address: 5 Z q "" S+ thereof City: :::'PI^",,)C,'''',IA I, State: OQ I ZIP: "l/4'I I, I Limited energy (2) 1 Subdivision: 7D s~ 52 l 1 Lot no: /OSOO 1 'l;tachl!ni'!luJ~,tf!:\"p.h?me, or mod, uIar I DESCRIPTION OF WORK ' "d":!,I~~g.s~[V1c~or-feederl(~)irp< "n.. - ~ \v\. 0 I. n ,\' , Id I' _,' {. :,Set)'ices~6;'fc~d~~:ri~.frJijatiOll,....alfel;;t;"qv(l, relocation e.. ).(L 6.\1"\ DV'eA1L--ev \...\V\'f ..,.. Cv:\ III l).t, I- (,'f. _ ....-~.':.~"~,. "'~~:'U; , .... "....wt ~ Ie; \.-.. b OOQO ", '200,amps_or~css,(2) h"~ are set fclrtl~ I $ 81,00 $ Zll Y""'^" ^,"'..'^-.-\- .I../L/ ... (0' (I Fi,lIr< ,....^..... -- ~ 0..'..... t..:...... "v'fCl,.X.'O:.ot' '1"JI~V(,~.,!:l' .... -,u'vvt:::.U(I'l I PROPERTY OWNER G~g;h~01,~_4.00amps{2)'iesOfth",,,,~_ - $ 95,00 $ I Name: 1)"",,,,,,- L, \..h\ \ "U1na'I" C40,~,t8~q9j0hl9?j',:..the teleph~-n"JY I $158,00 $ I Address: S2C) G" :)+ 1(; J~Ol'iIo'~,QOi'i.~p,5<'(it~~I~?tifjcatio~ I $205,00 $ I City: ~i~l(:",_1 J. I State: 6R 1 ZIP: '11471 lOver 1,000 amps or voIl;-(2)1" I I $469,00 $ I Phone:S~1 -1oS4 _ 0].<.3 1 Fax: 1 I Reconnect only (2) I 1 $ 63,00 $ IE-mail. d \ I -" 6) I ' I I Temporary services 01' feeders: installation, altf!rcttion, relocation . \1"\ ';:) 2. -, ~ 'Vri.V\nO ~ (...0""""",, Th" II' 'b' a) 'd' I C I 200 amps or less (2) $ 6300 $ IS msta atlOn IS e g ma e on reSl entia or larm property . . owned by me or a member of my immediate fam!ly, This I 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, leasei' or rent. OAR I 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 I CONTRACTOR INSTALLATION I Branch circuits: new, alleralion, eXlensionperpanel I Business name: OW Nevi..... I I a. Fee lor branch circuits with purchase ora service or feeder fee: I Address: MeT _~ 1 Each branch cirCUlI I I I $ 6,00 1 $ (., 1 City: 1 State: I ,ZIP: T~/; ~":C. I b Feefor branch CIrcuits wahout purchase ofa service or feeder fee: 1 Phone: I Fax; Allr~'J~_' M~T 3'Hj\"'Pl1j11wrc,,~!,<2) I $ 5500 I $ I E-mail: CO^.1;n~~]' cLjI Ue.~~~.6'rI~ JildliitWO/1h $ 6,00 $ 1 I 0.1, EilJ.r.In '\:0 r Ef,lJllllr I'~ - CCB license no,: BCD license no,: ANY 1 Rn ~ 1}T ''''''''<MJl~l'l'4J~1IJd.rv "" OYr)l}e{ljfjf>1 mcluded 1 Signing supervisor's license no,: I 11J!1iJii1Q~ or 1mgatJo~l;IctJijl $ 63,00 I Print name of signing supervisor: I Each sign or oulline lighting (2) $ 63.00 I Signature of signino supervisor: Signal, circuit or a li~nilcd:Cncrgy paneL $ 63.00 $ o alteratIOn, or extenSion (2) ~&-" ~~ ~ 440-2584-) (9/08/COM) FEE SCHEDULE I Nurnberofinspectionsperitem() !Qty.1 Residential, per unit, service included: Cost ea. Tolal cost 1.000 sq, n, or less (4) $134,00 $ $ 25,00 $ $ 32,00 $ $ 63,00 $ $ $ Each additional inspection: (I) $58,00 $ APPLICANT USE I (A) Enter subtotal of above fees (Minimum Permit Fcc $58.00) 1 (B) Enler 12% surcharge (,12 x [AD I (C) Technology Fee (5% of[A]) I TOTAL fees and surcharges (A through C): $ 81 $ 10.'14 $ I.{,''''~ $ iOI,'l' \~~ ()1 '5~\~,v ~Q CITY VI' ~rKlJ"tJI'II'..LD. Status Issued Building/Combination Permit PERMIT NO: COM2009-00664 ISSUED: 05/13/2009 APPLIED: 05/13/2009 EXPIRES: 11/13/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 529 G ST ASSESSOR'S PARCEL NO,: 1703352110500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace panel and add I circuit Owner: DONNA HILL Address: PO BOX 50434 EUGENE OR 97405 Phone Number: 541-654-0223 Contractor Type Electrical ATTENT;eONTRA€TOR'INF.0RMJ\'F10N , foilow IU......-;i--_r-........... "') ........ .....,.....~'-"" .......".y \ C t t Notification Genter. Those rules areE-~tf"'th ' on rac or Icense III OAR 952-q01-001 0 through OAR 9::>:<-uu1- OWNER ()nQn VrHI m~\1 nhtClin ,-.,..,nicc nftho rId..,.... ""I callil,>! I'; BUIIJDINGIINFOR'M)VFl0Nlle number ,......,,'..... ......,'-''::::Iv,. '....."'1.1 I'IIV~I'I....aui)ri Cente/i b'i' SI~mS?32-2344), Height of Structure Type of Heat: Water Type: I~ange Type: Energy Path: Sprinkled Building: Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a I DEVELOPMENT INFORMATION' REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: NOTlCEraved Drive Rqd: THIS PE'R'M,r'Sfjt Coverage: AUTHOR/7Fn "~I~~~ E~P!RE_'FTHE WORK lJurro-- ,~L~I;_P,;J.,;Vl" I,) I~U I A Y'PUBUleLI~I\~f}~D FOR N 'uu Uf\r ?dlIUD. Sidewalk Type: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Downspouts/I?rains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I 01'2 , _SP-A1'l'c:il, ~~eaiiil,' , "" . " ", ~I~, ;1 .". , .. . " ,. . " ,.....,~', ",'.- ..,' ,'""~,', ,...,.,' ~ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00664 ISSUED: 05/13/2009 APPLIED: 05/13/2009 EXPIRES: 11113/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Pa'id Date Paid Receipt Number $10.44 $4.35 $6,00 $81.00 5/13/09 5/13/09 5/13/09 5/13/09 2200900000000000523 2200900000000000523 2200900000000000523 2200900000000000523 Total Amount Paid $101.79 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, irtspections requested after 7:00 a.m. will be made the following work day. I Relluired Insneetinns I Rough Electric: Prior to Cover 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 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 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 of the Community Services Division, Building Safety, I further certify that only contractors and employees who are in compliance with ORS 70 1.005 '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 property, and the approved set of plans will remain on the site at all ';\;S::~;.~ DO 5!P!.(lfl Owner or Contractors Signature Date Pa2e 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00664 COM2009-00664 COM2009-00664 COM2009-00664 Payments: Type of Payment Check cReceiotl RECEIPT #: ~ji City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000523 Date: 05/13/2009 9:03:59AM Amount Due 81.00 6,00 Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By DONNA HILL Item Total: Check Number Authorization Received By Batch Number Number How Received 4.35 10.44 $101.79 Amount Paid djb $101.79 $101.79 2920 In Person Payment Total: Page I of I 511312009