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Home My WebLink AboutPermit Electrical 2009-6-4 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-368~ ELECTRICAL PERMll' ~rLwATION City Job Number {\ Y\/D\9' V Date New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with lO $ ~ LQ(),W Owners Name ~(\.ll. \ >r ~t\~\ f', ~t\.\Yk illX'd Service or Feeder Permit . /"'" Address P>ntQ\tJ ~t'l11f(\ ~ E. ~~t~~~~~~~1~n:d;~rt1Wl~~l~~P~itfliJliJ!ll'!~ ci~,ii,\d Phone\'2.lo. \'fA'\ 1. ~;i!6GAi:IO~OF7'fNstAiJiiAiii5N1rtJ;ilif:1~ ~~!~h-~~w;.;:""""'~"""""""""'~.\;;f<:~'~~:E1~:-;:~~~ \y\\n \ 'h"W'\ CSf . LEGAL DESCRIPTION \I1)'?AS~ '0 D~'dXJ JOB DESCRIPTION \en ~~\\~i \ ,-\-~ Permits are non-transferable and expire if work is ,;;. not started within 180 days of issuance or if work is Suspended for 180 days. ~~mR\4.GTORg.iNk"fXEfltffi5NY6&~ 2. ~t""'''''''J\\;lr,;;-~'I'''''''~~'k;:;:'f'~~\i~J'g".-;::.:t'~:i'aiS'':tIi:~t~~v,l/,~ Electrical Contractor tt.r J;;;f, ~~.~. Address &.Jo t:~.ID./ v City~,u)..,ftJ Phone e;LI/ -ri-tt! f.~lr Supervisor.License Number Expiration Date I D /0 I / cJ 7' I / Constr, Contr. Number f? 7 2.-tJ 2-- Expiration Date 0 I.f /3 6 / tJj, " I e trician ~~ OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, leas'8\ ~ Owners Signature:~' <\ \.'0 -~ ~. 'm","" ",,00," ~ ~:k~\J 3. ~eOM,ji'f1!TE.tiijfErSCHEDiJiJEYf1wMI{l\f~1\iii'~,,~~~<r-l t~ll'\o,ii:';;~L:j:f.ri.~~~~'"~I;F~"i~ii.~~;~~~~ A. ~~~~~1~~it~!l~t1~~~.llim[~'WiffJ,~~p.~~~~~~tt~ti~"~~i~ ~~~-.:h~~~~'''''.m~ "",,,_,~,~.,fij Service Included 1000 sq. ft. or less Each additional 500 sq. ft.,or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19,00 $50.00 . , B. IWl~~1ffi~~rF~fd1f~f~iN;t~Y1iit~AJT~~if~~'EltJl~{;fi~:;,~~~ ~"""''':FP.i,'''';}N.''',''''. ;""l'""'Y~':e,~4,~-~""~,-;-:<.l.r.:.:.-_,_"f}lh"':"r"-"'.i~'"f:""''''''~'' -:".:;,,=.~ . ....,~,'", ,,,,j 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/VollS Reconnect Only $ 63.00 $ 75,00 $125.00 $163,00 $375.00 $ 50,00 c. ~lffi~1!P:Wt~1~~~~~~~[~~tr,i'~J~]f!f~~~~ Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69,00 $100,00 Over 600 Amps or 1000 VOllS see "B" above. . ,~r;n;~"'~?f;:;rr;~1:~"Mii..~~~fi~r'''*-'Jf?UPi'' i'J-iJdb"')1I<i)!:~1J'-;tl0{iJ'::!:t,*<g'~Yid<'" D. ,z~~a.nc~:~G!r~~~'i~~~1J,~]~m,~lr~~~;'~~~:;~i~~~iti.k~::1~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 Minimum Electric Permit Inspection Fee is ~ + Surcharges 4. ~rM'ffi'f~~OVH~~'" \ 1\ ,-{~ ~l',.;~.~~~~~{~~'V;~'lr~xr\fl-~j;;.W,; 'i'-~~r-v ~ll1te Surcharge '\. W ~ Administrative Fee ~01~ (!,.nU fl () ,W TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application 1-03,doc Electrical Permit Application ,. I 225 Fifth Streett Springfield, OR 97477. PH(541)726-3753t FAX(541)726~3689 I:'," DEPARTMENT USE ONLY SPRINGFIELD~" ' ", ,";,",'. '" , '-M~"A '" '//,' -- '. . ~I ic: I Pennlt no, (!o; S ~ ~ I Date: &,-if /u 1 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, ' Signature: Over 600 amps or 1,000 volts, 'see services or feeders section above 1 ',.CONTRACTOR INSTAllATION, 1 Branch circuits: new, a/leralian, eXlensianperpane/ I Business name: j::: p" ,I:::- tf~ ~ _~r A ! I a, Fee for branch circuits with purchase of a service or feeder fee: 1 Address t 7___) r;, rfpt2- PL,~ I I Each branch circuit I / /)[ $ 6.00 I $til ~ 1 City' ?~I ii/ I State, oi:- 'I ZIP17Lf7! 1 b. Feefor branch circuits without purchase ofa service orfeeder fee: 1 ov I - I ' I I I I Phone: .' srl-- 7'11 -7Iff:,t3 Fax: First branch oiceui! (2) $ 55,00 $ I E-mail: I I Each additional branch circuit I I $ 6,00 $ , CCB license no,: 9'7 2 tJ '2--- [ BCD license no,:h -s3t; J I Miscellaneous fees: service ar feeder na/included I Signing sup~rvisor's license no.: I I Each pump or irrigation circle (2) $ 63.00 I Print name of sign ing supervisor: 1 I Each sign or outline lighting (2) $ 63.00 I Signature of signing supervisor: I I Signal circuit or a limited-energy panel, $ 63,00 $ alteration, or exten~ion (2) I Each additional inspection: (I) $58,00 $ 1~t;;ft~~Yi~~~1K-~~~~AR~il'iCi'Nt~:U:S~Elti~it~::~~~~~r:;:i;~I;:::~{ ,:' 1" .' YOCAL;:G0VERIiIMEIiIT':A~PROVAl!\:"'{",'.(;';51 I Zoning approval verified? 0 Yes 0 No 1 :;:,,':..;;:,CMEGORy,OF:CONSTRUCTION';,,', 'I 1 ~esidential '" I 0 Government , 10 Commercial , I 1~~r~.O,Bif>SIJiEmNFORMMIQNt:'",Np~I!~.>-CA1iIOIil~~,:,~f.i}1 1 Job site address: 1f'7o /~ S'-r; 1 1 City: ?iW4d 1 State, I/-tL I ZIP:97<1 I I Referente: 1- Taxlot.: I I' DESCRIRTl0NOF' WORK' ,,,-I 1 dld.# /0 C~ I 1 1 1 PROpERTY OWNER' I 1 Name: I 1 Address: , I 1 City: State: I ZIP: I 1 Phone: I Fax: I I E-mail, .1 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), 440,2584,) (9/08/COM)' 1~(~~~,O';\~O~~,;,i~~~:~~~f,~~=I!'FEE~S'C Hi:P.W l!1Ef::{lJt~~ttr~fJif~~~~~~~~~~1il I.Nu~~er ?rjn;p~cil~'~i p'~r,it~~.p:',;}i'iy,I;~~~~:1 ~~~~I ,I ! Residential, per unit;service included: ! [1,000 sq, ft. or less (4) $134,00 $ I Each additional 500 sq, ft, or portion $ thereof " $ 25.00 I Limited energy (2) $ 32.00 $ I Each manufactured home or modular' dwelling service or feeder (2), $ 63.00 $ I Servic,es or feeders: installation, alteration, relocation 1 200 amps or less (2) $ 81,00 $ 1 20 I to 400 amps (2) $ 95,00 $ 1 401 to 600 amps (2) $168,00 $ 1 60 I to 1,000 amps (2) $205.00 $ lOver 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 53.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) I $ 63.00 $ 201 to 400 amps (2) $ 87,00 $ 401 to 600 amps (2) I $126.00 $ $ $ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) ,I (B) Enter 12% surcharge (,12 x [A]) I (ej Technology Fee (5%of[A]) I TOTAL fees and surcbarges (A through C): I ,I o $ 0 (]. 1 $ I $ "70, b) () $ _$,P-,"I!I.I,N,.,..!l',.."F:I.~t~,'iitI, ....' ' "..'... W1c' (~11l ,ii .', ,....,....,.'..'~....iJ i' Status Issued CITY OF SPRING" l.t.LU Building/Combination Permit PERMIT NO: COM2009-00S62 ISSUED: 04/2812009' APPLIED: 04/28/2009 EXPIRES: 10/30/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726.3753 Phone 541.726.3676 Fax 541.726.3769 Inspection Line SITE ADDRESS: 1870 15TH ST ASSESSOR'S PARCEL NO.: 1703252302500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Replace existing service with new 200 amp overhead service and add circuits Residential Owner: SANDLAND PAUL & BONNIE J Address: 85510 MCCUMBER RD 'SPRINGFIELD OR 97478 Phone Number: 541.726.1894 I CONTRACTOR INFORMATION , Contractor Type Electrical Contractor K & K ELECTRIC INC License ' 87202 Expiration Date 04/30/2010 Phone .541.741.2663 BUILDING INFORMATION. # 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 Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: I PUBLIC IMPROVEMEN~S ,'::N IIUI~: uregon law requires you 10 , -.,' I" rules adopted by the Oregon Utility NotificatiorSWewalk Type" rules are set forth in OAR 952,001,0010 through OAR 952,001. 0090 Yo DownspoutslDrains: f th I b . U lll.....y V'_ lU.I" ...>.11-""........ :) e ru es y calling the center, (Note: the telephone number for the Oregon Utility Notification Center is 1-800,332-2344), Storm Sewer!~'1iiI',;ijle: ' C IF THE WORK Speciallnstruction:ERMIT SHALL EXPIR... \I1IT IS NOT AUTH'ORIZED UNDER THIS PERI Notes: COMMENCED OR IS ABANDONED FOR , ......" ..... "'\/ occnnn t'\llll lVV...... I Valuation DescriDtio~ I Description TYl,e of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount , Value Date Calculated Paee I of 2 -,..."Ii',"~'I",'G..I;I,~..iiI ,.' .,'.....'. ~' '!' rJt - j .,...",.., ,\ f" , !i '...,."X' ,,!' "." ..... ~".', -" Status Issued' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Amount Paid $11.16 $4.65 $12.00 $81.00 $7.20 $3.00 $60,00 Total Amount Paid $179.01 Total Value of Project, Fees Paid I Date Paid 4/28/09 4/28/09 4/28/09 4/28/09 6/4/09 6/4/09 6/4/09 Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00562 ISSUED: 04/28/2009 APPLIED: 04/28/2009 EXPIRES: 10/30/2009 VALUE: Receipt Number 1200900000000000306 1200900000000000306 1200900000000000306 1200900000000000306 2200900000000000607 2200900000000000607 2200900000000000607 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 Reollirerllnsnectio~s I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do bereby certify tbat all information hereon is true and correct, and I further certify that any and all work performed shali 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 ofthe Community Services Division, Building Safety. I 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 property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Paee 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00562 COM2009-00562 COM2009-00562 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000607 Date: 06/04/2009 Description Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By K & K ELECTRIC INC Item Total: Check Number Authorization Received By Batch Number Number How Received njm 076114 In Person Payment Total: Page I of I 8:23:56AM Amount Due 60.00 3.00 7.20 $70.20 Amount Paid $70.20 $70.20 6/4/2009