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Home My WebLink AboutPermit Electrical 2009-6-4 Electri~al Permit AJlplication , ~~1lfD~~~ilfll n5 Fafth Strftt.s~td. OR 97477.PH(541)7t.3753.FAX(stl)71&,3689 , ;OEPAR'rMENT;USE 'ONLY ~2'1 ~ Pe~~ZOO'~ 00705 \ - . I Date. 6 ~ l( - 0 or 1 This permit is bsued under OAR 918-309-0000, Permits are nontransferable. Permit. expire if work is not ~tarted ,,'ithin 180 daY5 ofissuan<< or if work is suspended for 180 days. $ 63,00 , ,", ,_I 'I . T~;a;^ j s' cost.__ 1 1 1 I 1 I 1 I 1 \ $ ,,,:' ' . "FEE','SCHEDULEii ,~?;> ;.- :::~~~,~r O!,~,~,;cti"~.~;,~~:i.~E,:i')" ,~;~~\Qt~1't~~5:.~t. I Residl!'ntial, per unit, sr-rvice included: I,' ,LOCALGOVERNMENT, APPROVAL: ' Zoningupprt;val verilled? 0 Yes 0 No I :'-':CA TEGORY OF, CONSTRUCTlON~ c, " '1 I 0 Residt.."Jltial I 0 Govcnunent , I ~onimercia) I . JOB'SITE INFORMATION'AND'LOCATION:.r, 1.000 sq. fl,mkss(4) I ?O"7 S Sf""'- , 'l' ') r..ach additional 500 sq. ft or portion Job site address: =:>;::.' C-- <hereof I City; Sl8.lflIt!-HeLA I St~te: &'L I zw;Cf7<l.T1 I Limitedenergy(Z) \ SubdivisiOl): 1 Lot no.: Each manufacwred home or modular 'c, ' ::' DESCRIPTION"OF'WOR~,.<" ,;'; r,/"ellingseNiceorfeeder(Z) I ov~aJ/1~cl B' (t<"-t..f +;.i ,.. .iA,~/,)~ ,~P.~9~!eed..s: nlSla/lanoll. alleralloll, relocalioll , }C'f1,\"", 71""" \- -s~ ''1.." 1 'I Ie.' k~-IP:A . , !n OA I~ '~,r! 5;::S!-.,:" {JI.la",.-", ' $ 81.00 $ . "PROPE~TY 'OWNER ....' . , . ~"&O.' V; ;'Ob1f':IfOOP.ID1'~!~ th" ~~res J'e" j $ 95.00 $ I, Name: C, -+,'T ..,. r .--+ S,or,~1-i!tE-'d n~:~Zn ) t 1~I"~J~Il'l!~~~/e. ~,~o; I bi/; ~ $158,00 $ Address: Z- Z. S- ~ ' 1.0. S et f( . t/) Eu1t1!)I"vt1lllJb\~ OAp 2:; et fo~ 9- $205.00 $ City s.?f=b I_State:c<L! ZlP9'7((7ifel &r%~B~~~t!I'fi'~~ler'J~:OOl 1$469,00 $ Phone: 7Zb _ :57 S~ I Fax: : _ I .Re=.,1,1!8OrJ'Iiff.-lty ~/2~epho.,,:: 0,)> , $ 63.00 '$ I E-mail: r~mporary.s<rvl~.f.I;;.yinl1toHallallon.alleralioll.relocatiOIl This instollation is being made on residential or farm property I zoo omps or less (Z) $ 63,00 $ owned by me or a member of my immediate tamil\'. This 1201 to 400 amps (2) .... v......., is not intended for sale. exchange. lease, or rent. OAR $ 87.00 S 479.540(1) and 479.560(1), ' 401 t0600omps(Z) $126,00 $ Signature: \ Over 600 omps or 1.000 \'oli., see sef\'ices or feeders section abo\,'e 1 1',. ,. "CONTRACTOR INSTALLATION' '. ,-" I Brooeb circuits: new, alleration, e;dension perpallel 1 Business name:,,} Kk. t--J 11 r+VI ( ...I ~( J I ., Fee fmbroocb citeui" with purehaseofo sewiceor feeder fee' j I Address .2.1"51 \)c>f1, ~D{}::f l' _ I I Each brooch circuit I $ 6.00 I $ \, Clly: ~~,g rLl I State. OV I Z1~;:~ll:a b. Fce forbrnnch circuits without pureh:1se ofa seNice or feeder fee: j Phone' 6<+1 -1~b-%~ I Fax:"S<H -~ Firstbrnncbcircuit(2) 1./1 $ 55'001 $ ~' E-mllll'1p'(Q)jK~lf::;(....c...o1V\ Co~;:I/' l~ch.dditiOl1albranchcin:uit $ 6,00 $ j I CeB license 00. 4'5 I z.G 1 BCD hcense1A'~~~~ ~ roes: se;"ice or feeder nol mcluded 1 I SIgning sUpervISOr's license no,: L\-'il;~:S U D4v." ~ /':1;- ,~~/J;;'/!1!j!,circle(Z) I $ 63,00 $ 1" Printruuneofsigningsupervisorc...)~q..L{ w'xp,nkloJl ilIJHl, ~ I IIlIi ltl $'63,00 S 1 Slgmlture of signing supervisor: ~, . Sallgnal......uco _r~ s 63,00 $- \ c.-- ...,.,.r ./ r ! teratlOll. or e),,1 lIJf (2) ~ i,~~~~ additional ins':~;~~~ANT'USEo<;"$,:'O~,, _$:., 1 ~ !'(A) Entersubtotalof!lb~ ~,I,,/:,.,{j (Minimum Pennl' F~ $ sB 'r ,S ~-~ I (B) Enter IZ%surcharge (,12 x lAD $ bYO \<1 ~V I (<)TeehnolngyFee(5%ofIA]) $ Z ;OJ ~ I TOTAL fees and surchaf'l(es (A througb C): $ b ' $134,00 $ 25,00 $ $ 32.00 $ $ , ~~~ ~~ , t\~~Q b<V -\.40-2584-J (9i08iCOM) Status Issued U 11' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00705 ISSUED: OS/2112009 APPLIED: OS/2112009 EXPIRES: 12/03/2009 VALUE: $ 25,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 303 S 5TH ST STE 120 ASSESSOR'S PARCEL NO.: 1703350000307 Springfield TYPE OF WORK: Fire Damage TYPE OF USE: Repair PROJECT DESCRIPTION: Fire Damage - Northwest Door and Sash Suite 120 & possible 127 Commercial Owner: CITY OF SPRINGFIELD Address: 225 N 5TH ST SPRINGFIELD OR 97477 Contractor Type General Electrical A?-" I CONTWACTQR,J.NFORMATION I i 'viti; '. l'iI/, V/V,' 0 Contractor O;"O-'1;<lliOI) es <Ilia "e4;~cense Expiration Date EHLERS CONSTRUCTJ(ilNCiNF9S<'G??l)le:Ole!J42:h~ 11119/2010 J K GUCKENBERGERr,ErEG;r%,IfJ)!Hton;Ji\!~'t9):~9'iti"~, 04/2412010 I BUlLDfN6:INF.0RM;ri!JN,f/e:~e.90~'Z'it 10 !\"~/I;'/:~ Or~' r7v0 4.J'es I O-'1;{e Sel ~/'it!y #ofStone<$ 1. '.90I)Ze:'lf}eO/lf}e 9S<.;'~Size: Height of Strutffu'l;>a ~ll;ly IWe rilles ~ Ft 1st Floor: Type of Heat: :?-<.J' 1v0liff}Ol)e ~ Ft 2nd Floor: Water Type: -1'1). O<lliOI) Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Phone 541-689-6177 541-746-4656 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: /vO,l DEVELOPMENT I~FORMATION I l'/tl." I I.e.. <4 up . (;11-;. 'l:ft41, Overlay Dist: COIt141, Oft{>f; '//~~ reei Trees Rqd: <4tj1y I ctjlCf; tJ {;, l~ !?5!ve Rqd: 80 {) tJ Oft ~1f~~~nge: '<4y P[',Q,%.<4f?;IS P;::~ l'/t;:: :" , I PUBLiC'IMP~~t~.t uft Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Oescriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project );'~P' P~iliUI Fee Description + 12% State Surcharge + 5% Technology Fee Building Permit + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend'Circ Minimum/Adjustment Electrical Amount Paid Date Paid $6.96 $2,90 $58.00 $6.96 $2.90 $55.00 $3.00 5/21/09 5/21/09 5/21/09 6/4/09 6/4/09 6/4/09 6/4/09 Total Amount Paid $135.72 Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00705 ISSUED: OS/21/2009 APPLIED: 05/21/2009 EXPIRES: 12/03/2009 VALUE: $ 25,000.00 Value Date Calculated Receipt Number, 1200900000000000513 1200900000000000513 1200900000000000513 2200900000000000609 2200900000000000609 2200900000000000609 2200900000000000609 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. IRpm~ FinalBuilding: After all required inspections have been requested and approved and the building is complete. Drywall: Prior to taping. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, Paee 2 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ClTYOF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00705 ISSUED: 05/21/2009 APPLIED: OS/21/2009 EXPIRES: 12/03/2009 VALUE: $ 25,000.00 By signature, [ state and agree, that [ have cai-efully examined the completed application and do hereby certify that all information hereon is true and correct, and [ furtber 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. [ further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. [.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 3 of 3 Date 22;; Fifth.Street Springfield, Oregon 97477 541-726-3759 Phone ~r1~Q~~~ - City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-00705 COM2009-00705 COM2009-00705 COM2009-00705 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200900000000000609 Date: 06/04/2009 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 12% State Surcharge Paid By JKG ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 00598d In Person Payment Total: Page I of I IO:10:IOAM Amount Due 55,00 3.00 2,90. 6,96 $67,86 Amount Paid $67,86 $67.86 6/4/2009