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Home My WebLink AboutPermit Electrical 2009-6-2 Electrical Permit Application D Permit no.: I Date: ~-1Lo\.o W.1..(R ~{;:C\~'~;'."~-<'~;~~'l':'t!"ii,-...:ti+;;;i~"'~~S~iM'E!~7.r~\1 "i?:I},DEPAR1'MEN]'USE'ON/lLYk~ X'd-:':;ri;:",~'::'-'!'{i~""'_(ii~~:;~.i;;<"';"'~'~I'~~~::np:,~ I I 225 Fifth Street+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. . 11Ik~~({Q~~G~,t~E~t\lMl:'Niti'gliP.R~),l~~1f~,m I Zoning approval verified? 0 Yes '. 0 No' I 1~~e'Al!Ll;g€lR'YL011!Q:l[f'[Sjl;~l'I,0il1I€lf;J~~l I I I I Residential, per unit, service,included: o Residential 0 Government 0 Cornmercial I 1~.WBllslill)::IJIf;JF,J~J~M;c,;mloNf4'Nf:\jjJ;Q!!l!ft,.:ljlQf)j~~,ifl 1,000 sq. ft. or less (4) . I Job site address: \0 \D \.oD'\t"\ t)~ I 1 ~~~~oatditionaI500 sqft. or portion I City: I State: I ZIP: I I Limited energy (2) I Subdivision: I Lot no.: I I Each manufactured home or modular :~~~~ES~~~~~W~~m"~: I ::~:~:~ ::~~::::S:e/:~~l~~;ion,alterallon, relo:at:::OO $ ~~.R~~F{Q!~);~mY~OY'Lt\lE~~~~~"f~~;l~~~;&J .: ~:~ ::;oo~:: ~~~ : ::::: : '1 Name: ~~ ~o\L,-",S 1401 to 600 amps (2) $158.00 $ I Address: \C)\D _ . \D S~~ 1;:)'\ 601 to 1,000 amps (2) $205.00 $ City:~O\\.C\OJ~o.lrii I State:()t- I ZIP: Q.""\"'\19.l Over 1,000 amps or volts (2) $469.00 $ Phone: ~-tll\ \ i ~\- ff"t) I Fax: _ I Reconnect only (2) $ 63.00 I $ I E-mail: I Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property I 200 amps or Jess (2) I $ 63.00 $ owned by me or a member of my immediate family. This I 201 t 400 (2) I 'h 0 amps - $ 87.00 $ property is not intended lor sale, exc ange, lease, or rent. OAR 479.540(1) apd 479.560(1).1 401 to 600 amps (2) I $126.00 $ Signature: lOver 600 amps or 1,000 volts, see services or feeders section above 1~~G:0Ni1!Ml>jn€lBll!JNSm>>:~G'>>:1HQN~"';I*,,1~tll Branch circnits: new, alteration, extension per panel, I Business name: y=; -~ <:; -e- l.ff;ljt: .F";,::;, /14 ;c..2;;,..--k I a. Fedor branch circuits with purchase of a service or feeder fee: I Address: 'f5"'tr.z;97~, '"6A- -L vz:;;/l 1.1 Each branch circuit I I $ 6.00 I $ I City~,,<';~ j'i::;C::,f-t I State:c?"<:' . f ZIP: 9'" 7V) ffl b. Fee for branch circuits without purchase ofa service or feeder fee: I PhondYl ~rrh- -7'p,,1 'Y 1_ F~:r~f 216 -02.96/1 I FITstbranch circuit (2) , / $ 55.00 $J<~ I I E-mail:o/.d',,:,~gll,.s,,:?"'c3 P1-S~' ~M Each additioniIl branch circuit ..g $ 6.00 $,-P, I I CCB license no.: /79'7"/0 I BCD license no.: C-...."?? / . MlSeellaueous fees: service or feeder nOllnc/uded I I Signing superviso~'s license no.: '7'7" '7'0 -~ .' Each pump or irrigation circle (2) '1 $ 63.00 $ I I PnntnameofSlgnmgsupervlsor:4~/e /Y7 '-':::;~h. ~Slgnorouthnehghtmg(2) ,$'63.00 $ I I SignatUre of sign' ing supervisor: +- .Ail. / Signal circuit or a limited-energy panel, /. $' 6300 $ I ;-........ Af1?? alteratlOn, or extenslOn (2) . .~. .- =~~~~ ~ \\lv~ if- ~U\ I :::'~::~::~AlI :;1:\~ . ~. ~\~. R-'" I (C) Technology Fee (5% of [A]) $5 .1 d::, .\):" I TOTAL fees and surcharges (A through C): $B5:'\~ 'eH-EIj(ijt1E~-~'!"!""%"'~ilI"~ .~. .___-''<tll~3dM.,~'*!~~~ ~~I~(i!]i.~.lt[~-'ffiiI!i'i fb~~ 1l~~~~mJ:Jj~ I I '1 I I I $134.00 $ 25.00 $ 32.00 440-2584-J (9/08/COM) $ $ $ " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00766 ISSUED: 06/02/2009 APPLIED: 06/02/2009 EXPIRES: 12/02/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1010 65TH ST ASSESSOR'S PARCEL NO.: 1702341200417 Springfield TYPE OF WORK: Kitchen TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Kitchen remodel Owner: JANET ROLLINGS Address: 1010 65TH ST SPRINGFIELD OR 97478 Phone Number: 541-736-1776 I ,CONTRACTOR INFO~MATION I Contractor Type General Electrical Contractor PLEASANT HILL CONSTRUCTION LLC FIRST LIGHT ELECTRIC INC License 184107 179416 'Expiration Date 10/01/2010 11/27/2009 Phone 54 I -988-4938 541-726-2961 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R3 # of Stories: Height of StruCture Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lol Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VB n/a , DEVELOPMENT INFORMATION' REQUIRED PARKING Front yard Setback: Side I Selback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Disl: . Total: # Street Trees,Rqd: Handicapped: Paved Dl"ive Rqd: Compact: % of Lot Coverage:-ENTlnN " , ' " , . r . .~-J : Oreno~ 1'l'N re",:,,!i'"fJ:J YOlj to . fellow r J:dS adol'):"~ oy " c' Co" -'-'111"1'/ " ..~. . . '", . t... Ur 11' " . : "."""':':''''.....,1 VC:~Ht:1. 1 nose rUles are set 10rth I PUBLIC IMPROVEMEN'l:'SJI2-001_001 0 through OAR 952-001- W:N.. YOU ma:SideW~I[{:TYi'-e': of Ihe rules by calling the center. (Note: the Ielephone numb er for IhDoF.l!sY9,~t&,I,!,Wir,s~tification Center IS 1-800.332-2344). Street Improvements: Storm Sewer Available: Special Instruction: NOTICE: . THIS PERMIT SH' . . AlJT/10RIZED UN~~ EXPIRf/F THE WORK COMMENCED OR IS THIS PERMIT IS NOT ANY 180 DAY PERIOD ABANDONED FOR Notes: Paee I of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I V aluation De~crIDtion I Description $ Per Sq Ft or multiplier Tvpe of Construction Square Footage or Bid Amount Total Value of Project 'Fpp<, P~ilIJ Fee Description + 12% State Surcharge + 12% State Surcharge + 5% Technology Fee + 5% Technology Fee 1st Appliance Add, Aller, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid $8.76 $9.48 $3.65 $3.95 $79.00 $55.00 $18.00 Total Amount Paid $ I 77.84 I Plan Reviews I Date Paid 6/2/09 6/2109. 6/2/09 6/2109 6/2109 6/2109 6/2/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00766 ISSUED: 06/0212009 APPLIED: 06/02/2009 EXPIRES: ]2/0212009 VALUE: Value Date Calculated Receipt Number 3200900000000000409 1200900000000000599 3200900000000000409 1200900000000000599 1200900000000000599 3200900000000000409 3200900000000000409 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 Rf''1l1irprllnsnel.'tions I Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. / Paee2 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00766 ISSUED: 06/02/2009 APPLIED: 06/02/2009 EXPIRES: 12/02/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 tbe 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 andCemployees who are in compliance with ORS 701.005 will be used on. this project. I further agree to ensure that all required.inspectionsare requested at the proper time, that each address is readable from the street, that the p rmit card is)ocated at the front of the property, and the approved set of plans will remain on the site at all times durjng c struction. #:2~~/~~ D~a.t~e~ ~?~~::(7 Ow'I' ,",nct," "'"'.'" I NI Paee 3 of 3 :his permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 lays of issuance or if work is suspended for 180 days. ~~~in~ ::~~:;~~~~~d~ERNME~:r~ ~~RROV~~:~Y!'F:'{.\\ : ,'i........" .;.:......C..A;rEGO.. R";"O....F..C ONSTR.U.... CT'\ON;;:\V" , , """'1 .' ',.."'l.o .;'.::~"'.'.. '." _ ,'I. . . '1;;' -' ,"- -' _ .. .' - . ' "- . -' ",,::: ," ..'~ "'.' i5Reside~t;ai \ 0 Government '\'0 Commer~ial .. I ~~~t~tOB*SIJlEi'INtQRM~T"OIllIYANbN{l!O:c',I};'11I()III'i,~1)t..\~im1 Job site address: J6 /0 ~~ '--'h c..SC:::- -': City: \ State: \ ZIP: Reference: I Taxlot.: ., ...,.... ..... :. OESCRIPTION:OF'WORK),;:;,::::,,':;A:>Y;;.';\ /'0'z:-d~ ~~~_l J [ PROPERTY OWNER .,,~ \ Name: ~;4Ve~ \ Address: /0 \ City: . 'd I Phone: \ E--mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). lectrical Permit Application .....,. fJ ; Fifth Street. Springfield, OR 97477.PH(54!)726-3753t FAX(54!)726-3689 VO~p'~RTMENTU~E.oNL Y- :1 \ Permit no. Of! ~ 7&' V ,,\\JP Inate: ~ /o:;)-~q 1 r~?Fr-':;:"j.";JJ:-m~.~~~~~.. -~~.;..t..i,r::E"E- - "itS.. ....C....i.:J E"O"U-: - '-~..E".. ;1;:I.ij:l~;;;'i;;'~~{fiiJ1t;~~;t-!'..~u[~~~\ I" .......:;;,..,...".".'"..:,....,.,'" '-. n _ ..;'"'.. "L'..'..'''"'~,....'''..:.."".,';<r,~19 \N~in..ti,~r9f,}r~peftii~.~~~rJt~~(F,,:\Q~.\ A~~t",\. ~~~I: I \ Residential, per unit, service included: \ 1,000 sq, ft. or less (4) \ Each additional 500 sq. ft, or portion thereof \ Limited energy (2) \ Each manufactured home or modular dwelling service or feeder (2) \ Services or feeders: installation, alteralion, re/ocalion . \ 200 amps or less (2) $ 81.00 $ \ 20 I to 400 amps (2) $ 95..00 $ \ 401 to 600 amps (2) $158.00 $ 601 to \ ,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469..00 $ \ Reconnect only (2) $ 63.00 I $ \ Temporary services or feeders: installation, alteration, relocation \ 200 amps or less (2) $ 63.00 $ I 20\ to 400 amps (2) $ 87.00 $ \ 401 to 600 amps (2) $126.00 $ \ Over 600 amps or 1,000 volts, see services or feeders section above $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ :,:CONTRACTOR"INST ALLATION: . Branch circuits: new, alteration, extension per panel Business name: l=1"~S--C J ; "i:--h r 'pb?h?;/G::t-a Fee for branch CIrcuits With purchase ofa semce or feeder fee .. \ Address: f)Rc:>'7 7 ~(5;;fl L,/1 Each branch circUit I \ $ 6.00 I $ I city:<...Sfl Fd [State' C5t1( \ ZIP: 979 -b Feeforbranchcircultswlthoutporchaseofaservlceorfeederfee. \ - \ PhoneSff'3~ _ 7('~\ Fax: \ \ Flfst branch CIfCUlt (2) \ 1 $ 55.00 tS:5;~-- I '.m"" I "'" ~","" ,~. d=" -' "00 , /K 'f'" \ CCB lic,:n?e no.: ) /7<;1r..h \ BCD license no.: C _,3~/l Miscellaneous fees: service or feeder natincluded I I Signing supervisor's license no.: 'f ro/'O -....5 1 \ Each pump or irrigation circle (2) .. $ 63.00 $ I \ Print name of signing supervisor:!';/A>{p<:::-. #1 '~~H Each sign or outline lighting (2)' $ 63.00 $ j I "'"'~ "",,'" '"""". ~ / ~- -' ,,~., ",'"". · "e'""<"". ,-'. ",.., ' , '/P'" ~""/7.;.. ..~~,- alteration, or extenSion (2) 1 Y ~ C1 / l!~::~;,;:,:~t:;';~~0~'~Act~npn;"~IC1)C'"'N'T"-: -"'i':""<ii~'::;:~~"-'~<;"";~""" ~ ~. ('\.~ f"~.."",,,,~,:j\!iih,..,"",,""" .. r, ",", . _A""USE"""i...,~'.i,~..<:k~"",<iJ;i"';':" re---. \N :\.); ~ (A) Enter subtotal of above fees .... ,t-X) \.J"''' (Minimum Permi! Fee 558.00) $ j ~ _ '\:\ .\ (B) Enter 12% surcharge ( 12 x [AD $ ..,J ~ ,q,..oo".,..,,,,..nAJ) I j ~ fS\ -TOTAL fees and surcbarges (A through C): $ K~'141 ~\9"t5 ~ Signatu!:: .~ .-- ,...."". " 225 Fifth Street Springfield, Oregon 97477 54I~726~3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-00766 COM2009-00766 COM2009-00766 COM2009-00766 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: '3200900000000000409 Date: 06/02/2009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Te~hnology Fee + 12% State Surcharge Paid By FIRST LILGHT ELECTRIC Item Totat: Check Number Authorization Received By Batch Number Number How Received 055632 055632 In Person Payment Total: NJM . Page I of I 1I:59:59AM Amount Due 55.00 18.00 3.65 8.76 $85.4] Amount Paid $85.41 $85.4] . 6/2/2009