The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2009-6-2 1'>1""""'""" ,""",c",._",. ,"'0. ""'1 ' "ff',~DEI'1ARTMEN1j;USE:ONLYc;,!.:: ~~ 1~::::'~:':F(~~q'~F;'l;s~rFI Date: Co.t.Oq.. I This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started Wit~ days of issuance or if work is suspended for 180 days. . ii' . Signature: ;"':~'.~ltCONTRACT.O~.';1INSTALC'A[ION,t;;t(t:~?-:;~:t~' Branch circuits: new, alteration, extension per panel I Business name: T) IV\. l.- ~ ~\.<- a. Fee for branch circuits with purchase of a service or feeder fee: I Address: '11.1 tJl</ 51'lI.K-tF pC Each branch circuit I $ 6.00 I $ I City: ~~O I State: 6CL I ZIP: 'M"7('(, I b. Fee for branch circuits with9ut p'urchase ofa service or feeder fee: I Phone:S'o(l ""1' ?t'97 I Fax:('",,{. 9;q- 1'17"1 I First branch circuit (2) I $ 55.00 I $ t E-mail: I I Each additional branch circuit $ 6.00 S I CCB license no.: IlDt jfo'" I BCD license no.: ,...,,.,e:... I I Miscellaneous fees: service orfee4.er notinc!llded I Signing supervisor's license no.: 'l1Of"{' I I Each pump or irrigation circle (2) -I: S 63.00 I Print name of signing supervisor: .f\A,Qj..wJ 1.1I,. ~..e:fS I I Each sign or outline lighting (2) $ 63.00 I Signature of signing supervisor: ),. _ _ - -...... ~ ,J I Signal circuit or a limited.energy panel, I $ 63.00 $ v'\.___._. ,-, ~ ~!!.~ration, or extension (2) NOTICE v '1>.' 'ti':I'!.~'~J"'I"'M__.. ""1) . J I .<5800 $ : ,...~,,~., ~l;'~I~I~na ;lDspectlOn: \' 'eqwrflS VO J ta . . THIS PERMIT SHALL EX ~ljifjjl1i<'~~'';1,~i!l~~'''*~RUfcAN"t..tl!JSEUti!itv:;;: , ~ AUTHORIZED UNDER PIRE IF n R"Aj1@lilets~liqt;h~s~&~~':R~1~"'~Aare set forl/' /.~ ~ ~OMM THIS PERM/lIQl'liiiiilium Permit Fee $58.00) R 952.001. $ \,Q.;> _ill 0 ,. I ENCED OR IS ABANDO . - ..~, 1.., -_.~,,, w"," ~ nftho ",,-- c . ...'t.~~.n'. ('\'~ .::V 180 DAY P~R/OD NED, ':f~Y~~~~~2~!U'r~n~~~~I(;'I:;~,[A]) telepho'~e-I $'7~. 't)J'"" (l)",~ .cf.::-. I (C) Te"~!!91~gy f",~:(S.'YovOf~~J2'J~~~~;[lfICallon I $ '1,.. \ ~. \J .~/C)~ I TOTAL fees and surcharges (A through C): I $,3>.1 \ I '. ~"b, ~ 'Ei~ctrical Permit Application ~", -,~. "',,," "_~ ~~.........." ~-l1$"" "" _ ~ f_ . -'I'- , CITY; OF SPRIN6FIELb; OREGON'... ,-"~1J.. ""1;f"~ "7A!":;' ;;-~~"" . '"'''''~''' 225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 . ',,;iLOCAL,i~OVERNMENT"APPROV AI:>', :::;., I Zoning approval verified? 0 Yes 0 No '0mt'CA TEG.ORV" OF~CONSTRUCTION:=':S'" I !;i.Residential I 0 Government I 0 Commercial .~I,';';a" 'JOB:!SITE1.INF;ORMATION:i.ANDILOCATION<:. Job site address: i'2 ~'- W Qv,oJ r>ri.-T I City: SPn-"""F~ I State: 0;2.. I ZIP: "17477 I Reference: Lo-r ".3 I Taxlot.: 1".."~."rl4L' '''DES CR' IPTION'OF"WO' RK'" "-'';X:,' "",c:.:.., ,J' _.,. J" ~"i~-- " . ,'.' w . ,..~" ,,~._~,~. ..-~"" e..i:, - """"'~"'..,:::':'J':t._.. . ~" ..:':1~ .'. ".' ,"",."..._.,.',._~" ,,'-~^i'-'. 11"1=",^p OflJ,,'.="- II" ..-. ""'''-''RO PER"""OWNER""'''''' -,. ,:....".1 ~?'-. /"""'~,<;)5'7:::;~_ ,''71'7,.' ..r!.''':' . . _ . .... .. hjj;."~l~-":f>J":,,"~~,~":.,'7~'fu12 I I I Name: Address: I City: I Phone: I 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). I State: I Fax: I ZIP: 440.2584.) (9108/COM) I' . . FEE-SCHEDULE . . .""':1 jlNuniiFe~i~f,ins$~~~'s'per"ii~in-i(S~,,:_I(it;.1 ' . CeOa~L :'I'~Tcootsat~'~1 "",'11<"'21t< ",- .,itt(o"..it;t;p-i0*,-",;;::r:iiMW" . ,. , ;'cc j <;:p~,~"" ,_ ."Y'k. "., ... .L. :r:;.,,;, Residential, per unit, service included: I t,OOO sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft. or p.ortio,p $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modul~r $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 40 t to 600 amps (2) $158.00 $ 601 to t,OOO amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) 20t to 400 amps (2) 401 to 600 amps (2) \ I $ 63.00 I $(i!>~ I $ 87.00 $ I I $126.00 I $ Over 600 amps or 1,000 volts, see services or feeders section above $ $ ,~~hJ Status Iss u ed eIT\! OF SPRINGFIELD Building/Combination Permit ji PERMIT NO: COM2009"00768 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 SITE ADDRESS: 1232 W Quinalt St ASSESSOR'S PARCEL NO.: 1703273106900 " " Springfield TYPE OF WORK: Elec\rical Work Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Temporary Power Only Owner: NORTHWEST BANK Address: 4900 MEADOWS RD'STE 410 LAKE OSWEGO OR 97035 I ,CONTRACTOR INFORMA TION I Contractor Type Electrical Contractor DML ELECTRIC, INC License 161264 Expirati'on Date 0812712010 Phone 54 I -923-9897 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: . Energy Path: Sprinkled Building: Lot Siz.e: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: OccnpJnt Load: I' n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: .' REQUIRED PARKING I Total: , Handicapped: I' Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer A vallable: Special Instruction : Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Type of Construction $ Pe~ Sq Ft or multiplier Square Footage or Bid Amount Valu~ . Date Calculated Paee 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00768 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 Total Value of Project. Fees Paid I $7.56 $3.15 $63.00 6/2/09 6/2/09 6/2/09 Receipt Number 1200900000000000602 1200900000000000602. 1200900000000000602 Fee Description + 12% State Surcharge + 5% Technology Fee Temp Powe~ 200 amps or less Amount Paid Date Paid Total Amount Paid $73.71 Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Relluired 1\Wle~ti?~~ I Temporary Electric: Approval required prior to Utility Company energizing pole. 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 w6rk 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 emplovees who are in compliance with ORS 701.005 will be used on this project. I further agr~e to ensure that all required inspections are requested at the proper time, that each a'ddress 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.construction. /:WAu' ~. o ner or Contractors Signature o/Vo~ Date Page 2 of2 225 Fifth ~treet Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00768 COM2009-00768 COM2009-00768 Payments: Type of Payment Check cReceintl RECEIPT #; Description Temp Power 200 amps or less + 5% Technology Fee + 12% State Surcharge Paid By EQUITY HOMEBUILDERS ~~ji "_,,,,,,~'-"""y':'""'cC"":""'" .. . 1200900000000000602 Received By Check Number Batch Number llh Page 1 of 1 City of Springfield Official Receipt Development Services Department. , il Public Works Department , Date: 06/()212009 " Item Total: Authorization Number , , How ,Received 3465 In Person Payment Total: ,: I , ii , I' " IO:40:I2AM Amount Due 63.00 3.15 7.56 $73.71 . Amount Paid $73. 71 $73.71 6/2/2009