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Home My WebLink AboutPermit Electrical 2009-5-15 'Electrical Permit Application . 1.~DEi'ARTMENT,~USEroNi!Yfl':1 ~I~~ I Date: 5\ Isl Og 225 Fifth Street. Springfield, OR97477+PH(541)726-3753+FAX(54I}726.J689 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. 1R!'~1ltt\lllI!OCAI!:1!GOYERNMENT:i!'ARRRO\lAll\il1Mi(W,_ I Zoning approval verified? EJyes EJ No 1~i\ll:*i.~CATEGOR'(,!!O~{;,CONSTRUc;nONI'F~l~*.i:~%1 I tii:I Residential J D Government I D Commercial 1::;;~~~~:~TE~~~~A~ONflAN01~~nON~;~~ I City, %n ~dd I S~CF<...- I ZIP 47-+13 ~~u.;;,;"L l'iI,..z..~\ ~tL I Lot~"\c.:v I i~~~~I~rW~;::~~; ~'lllJ~l11VllC~PoRORER:t;Yi!;:OWNER~il'i.I'~~'_ I Name l<::.},.ellEli\ H-)l! 'Address .3~G:::U:~:JY"ECh\) .-AJ-e:...; I I City ~hof1 eld '-Jjtate cR.. I ZIP 97-!-72 I I Phone - l~ - cR15 I Fax: - I.PaP - I Cf.8 I I E-mail: - I This installa~. illhAAlall'ade on residential or farm property owned by m r a-ttYerlllie't:ojJffiYJllfld1W\~w::t\tintlyfilhi~o property is .liiWendljin"jlrSal:eloe8iab~ 1l:lJ~l;ln rmM~AR 479.540(I).lliil9t (It)mte. Tho rules are set forth Signature: In 01 0 . I ugh OAR 952-001- f~H,kol'lii ..1' .'~m~Q~~\i!1J',Jit.g~~~1 Business nalil\jmb~r for ~ O;~go;;-U;i~t: N~;;ii~~~'i~n .1 Address: \.;enter is 1-800.332-2344), I City: , State: I ZIP I Phone: I Fax: I E-mail: I I CCB license no.: I BCD license no.: , Signing supervisor's license no.: I Print name of signing supervisor: I Signature of signing supervisor: FA-~ [Qg{j - \ a&) 440-2584-1 (9/08/COM) . ~cf' ~:)' \ tfRCV ~~ 1~~i\iR~li).'It\F,:EE~~SCI-lED,UI!E~~~Il;"!'Jl\~:1';1 I~.'N. . ,,',. :!It.L MlI!P.f"ii..~~,..1I!l,~l!Ik"',' "'''''''./'N.l1li!;'('''.')'.'1!!(Ij;I''''Q.' ""!'l1Ii1,leostl'/lil:"'T..otii~-"'..1 :if umucr,o,'lDs~:",,:lons,~riltem'), ~'f';;!, ~; JiJ:~'-"'2''ffii./f, ,~;t;r-"'t' ':,: ,,''':'*'.;#!H.~-:''7.>,)',j[('';~~..;.:((~-.:.\.'.t;;,',\M'..,.,-il1ilJi';<',l::!t~~\'!u. {::ro. ,"_\l~.d;! ?1~9'l.~~"Th(~ iS~1i;!1~_S __ Al I Residential, per unit, service included: I 11,000 sq. ft. orless (4) $134.00 $ I Each additional 500 sq. ft. or portion $ 25.00 $ I thereof Limited energy (2) $ 32.00 I $ I Each manufactured home or modular I I dwelling service orfceder (2) $ 63.00 $ I Se~ices or feeders: installation, alteration, relocation I 200 amps orless (2) , $ 81.00 , $ I 20 I to 400 amps (2) $ 95.00 $ ., 401 to 600 amps (2) '. $158.00 $ I 601 to 1,000 amps (2) $205.00 $ lOver 1,000 amps or volts (2) $469.00 $ I Reconnect only (2) I I $ 63.00 $ I Temporary services or feeders: installation, alteration, relocation , 200 amps Ot less (2) $ 63.00 , $ I 2011't/>@1\l.IrnPl(2) $ 87.00 $ I 40IUi6lio9.D~if SHALL EXPIR~ IF 1 rlflWQlG $ I Ovof\l;bbhllJpilrilti,btllJ~~@BPso{;ldl.siBi~d.'i &.\!illn above I Bra~W~~t[;:.'~~,l;M, 1IJt!~Jil.~MA'iJt.Vp!iW/l I a. F'ct! 't~r 6ii.f!ch>~.f~ linrehase of a service or feeder fee: I Each branch circuit I' $ 6.00 , $ lb. Fee for branch circuits without purchase of a SC'rVicc:or,feeder fee: I I. Firstbraneheireuit(2),. - I t 1)(; 55.o,~'I)$ 931 I Each additional branch circuit I $-6:00 $ io -. I Miscellaneous fees: service or feeder not included I Each pwnp or inigation circle (2) $ 63.00 , Each sign or outline lighting (2) $ 63.00 I Signal circuit or a Iimited-cnergy panel" $ 63.00 $ alteration. ar extension (2) I Each additional inspection: (1) I $58.00' $ 1\!M~,~r,,~~P-j:iIlICANT,tUSE=~~~';&"''' I. (A) llnter suhtotal of above l'ees , I $ lo \ (Minimum Pennit Fee $58.00). i (B) Enter 12% surcharge (.12 x [All I $ 'l,2,J. I (C) Technology Fee (5"10 aflA!) I $?-1. Qt=) I I TOTAL fees and surcharges (A through C): I $ (j I .2{11 ~ $ $ ", I Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00672 ISSUED: 05/15/2009 APPLIED: 05/15/2009 EXPIRES: 11/15/2009 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769.lnspection Line SITE ADDRESS: 3550 OREGON AVE ASSESSOR'S PARCEL NO.: 1702314205700 Springtield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: . 'o(l,lONLJ-') #yo ~+~, h Owner: HILL SHELLEY D.. Address: 3550 OREGON AVE SPRINCFIELD OR 97478 I. CONTRACTOR INFORMATION I . Contractor Type Electrical Contractor OWNER . License Expiration Date Phone BUlLDlNC INFORMATION I # of Units: Primary Occupancy Croup: Secondary Occllpancy Croup: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Strncture Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor; Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I . f~T:;~Ji~~~regon law requires you to. REQUIRED PARKINC Frontyard Set~JlSl~kalio C fpted by the Orego(j)vJ\d~r Dist: Total: Side I Setbaclih OAR 95~O;1~;~.1~hose rules are#_lStire.l\t!Trees Rqd: : Handicapped: Side 2 SetbaclO090. You may obtainthrough OAR Sj!:iY€dIDrive Rqd: NOTICE' Compact: Rearyard Setbatl&i1ing the center ~~tes of the PAI<l~ b9t Coverage; . Solar Setbacksllumber for the or~g( Uet..lthe telephone THIS PERMIT SHALL EXPIRE IF THE WORK _ on I It v Nohfli!~ffnn ^ flTl II""., .""''-3 .. I __ vv,",e, ,~ I-OUU-;;;j~.:r' ..' .. _. .._- :X,C...n Inl':> r-ttilVlIl /::1 NOT ., . I'PUB'LIC IMPROVEMEi'(J[SfIMENCED OR IS ABANDONED FOR Street Improvemeuts: ANY 180 $lrl.~I.!fffiYID:: .. Storm Sewer Available: Special Instruction: Downspouts!Dra~ns: Notes: I Valuation Descriotion I Description Type of l':onstmction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I on Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00672 ISSUED: 05/15/2009 APPLIED: 05/15/2009 EXPIRES: 11/15/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541~726-3769 Inspectioll Lirie II Total Value of Project Fees Paid I 11 :1 Fee Description I + 12% State Surcharge ! + 5% Technology Fee il Add, Alter, Extend Circ : Add, Alter, Extend Circ EJ Add II Total Amount Paid :i 'I I ,I Amount Paid Date Paid Receipt Number $7.32 $3.05 $55.00 $6.00 5/15/09 5115/09 5/15/09 5/15109 3200900000000000367 3200900000000000367 3200900000000000367 3200900000000000367 $71.37 Plan Reviews I To Request an inspecti~n call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the s~me working day, inspections requested after 7:00 a.m, willbemade.the following 'I . workday.:'. I. ~e'J..1I ired I nsnectionsj , Rough Electric: Pri~r to Cover' Final Electric: wheh all electrical work is complete. II By signature, I state and agte, that I h~ve carefully examined the completed application. and do hereby certify that all information hereon is,true ~nd correct"and I further certify that any and all'work performed shall be,done in accordance with the Ordinances of the City i: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 permissioll of the Community Services Division, Building Safety. I further certify that only c~ritractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure th!~t 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 times during constructioO'. :: _ . . I! O C S. II woer or on tractors 'gnature Ii Date Paee 2 on I, II > . 225.Fifth Street Springfield, Oregon 97477. . , 541-726-3759Phone Job/Journal Number COM2009-00672 COM2009-00672 COM2009-00672 COM2009-00672 Payments: Type of Payment CreditCard cRcceintl :1 RE~EIPT #: .GP...~_AI.~~F,1.~. '. ...... -1).- City of Springfield Official Receipt Development Services Department Public Works Department 3200900000000000367 Date: 05/15/2009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add " + 5% Technology Fee , + 12% State Surcharge Paid By SHELLEY HiLL Item Total: Check Number Authorization Received By Batch Number Number How Received kr B31421 Phone Payment Total: Page I of I 9:44:29AM Amount Due 55.00 6.00 3.05 7.32 $71.37 Amount Paid $71.37 $71.37 5/1512009