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Home My WebLink AboutPermit Electrical 2009-6-9 225 Fifth StreeltSpringfield, OR 97477+PH(54t)726-3753+ FAX(54 1)726-3689 11:i}~~i;,~MMENt:US,'EpNLy,' .01 I Pennitno. 0A~\~ .1 I Date: \Q'C\;CC\ I Electrical Permit Application . This permit is issued nnder 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 J 80 days. I":,'~;; '.. "";lOCJ1.L;'G0VERNMENJ::J1.P'RRQVAl3jf;~~~1;;!'1Tli":JYI 1(!\li~~i~~I;1(ff~J~i:1I;'EE~SCHE[j.l:Jl!!Efu~~~1(l\'ii\ilri\~~l;\-~ji I Zoning approval verified? . .. 0 Yes. 0 No 1 I;Nunt~eri!.i~;p~M;~ti;.p~J~firt'()';~.iIQ1~:1 ';:fOs,t:':;:I,;:rotii~: \;,~M.:(,:":;:(!:\CJ1.TEGORV.J0F,,;tCONSTRl:JCTION~;\}".':::;!;,,';";'.1 . ..:..,~' '..'.' "ir......'~. .'..' .". ".,ea"" cost", I ~ 'I ' l 'I I Residential, per unit, service included: ~~~.~~~~ll'E~INF,~R~;;~;~;AN[j~E~C~;~~~~~~l~1 11,000 sq ft. or less (4)' $134,00 $ 1 Job site address: fo 8!:,r;- t!-,Sf- . . . 1 I ~~~:ritional 500 sq. ft. or portion $ 25.00 $ 1 City: <<;cx-~~ 1 State: 012... 1 ZIP: CfiL/?8 1 I Limited energy (2) $ 32.00 $ I .~~;.:~~nd~) ?~~:~~~ON: 0F.wd;~~~~~:~~~;;~~",i I ~~~I~:nS~~~~~';~~ Pe~~:r (~)odular I $ 63,00 $ I. Ik jMJ/ Jl.r:G."l~Lw, .> tf ~ I . I Services or feeders: installation, alteration. relocation I . ~ l' 1 I 200 amps or le~s (2), ._ $ 81.00 $ I .".,...1("\1\1. r relJ'"' ItlV" ''J~UlIC;u YVl,A .v I I . 'PRORERTY. OWNER, .. , .;',:"", oril'f n2~\-'~9iWg ~'P.~J\}.~), lHililv $ 95.00 $ 1 Name: -::s- A:5cY\.. 6'..1 ~'2>c>/\ " , '" - .ion Cen .er 4qkto[600'ampsl~2)3et forth $158.00 $ 1 1 Address: ('ll; 3 ~ c..5.t j~ U:-\H ;~,,-uu I UL l~o'r:{~'lY,q~ollfiRU~)~~~U~~ $206.00 $ I I City c<:O~kW~ 1 State Or<... 1 ~iK~lii,~4:;~, ~Flr~OYfJd~90Qi~pi:~f..'I~~~I(-j)\ 1 1 $469.00 $ 1 1 Phone5ij~ Q.s-4 -lv'j ~ I Fax: number lor Iml. Cir'R~con~eC'~i\E~!?\ifiCallon . 1 1 $ 63.00 $ . 1 j'l '"'--........ IS 11,;,Ouu-vvc.-c.V"T"Tl. 1 I E-mail: Il)c.o/v~~ (Ji1l1tt4;) , ~Oh1 ""'..... "-'1 I emporary services or feeders: installation, alteration, relocation Th" II' . b . d v 'd . I c I 200 amps or less (2) $ $ I IS msta atlOn IS emg ma e on resl entia or lann property 63.00 owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ I property is not intended for sale. exchange. lease, or rent. OAR I I 479.540(1) and 4~1).:9 h ./.. 401 to 600 amps (2) $126.00 $ Signature: ~~ 1f:?J(.,(:::l...- lOver 600 amps or 1,000 volts, see se~ices or feeders section above I .>. . ;~TRACTOR' INST AllArI0N'. " 1 Branch circuits: new, alteration, extension per panel I Business ~ame: 1JCJ.A1t/f I I a. Fee for branch circuits with purchase of a service or feeder fee: I Address: I I Each branch circuit I $ 6.00 I $ I I City: I State: I Z~~l:nTH"S:. I! b. Fee for branch circuits without purchase ofa service or feeder fe e: I 1 Phone: I Fax . T-HI~ 'P~RMlrI S~Afir'!=~f't1:oifFujtlW WORK . ( $ 55.00 $. 5"' r 1 E-mail: AUTHORIZED! uIJDmIfMlFlltil"&Rl!!'MiF~@~T 2 $ 6.00 $ ILl CCB license no.: 1 BCD license no.:COMMENCEQ QFMGcAI#.NliS(}ltIEQehMor feeder no/ included Signing supervisor's license no.: ANY 1 tlU UA~ P~i3Jrn:p.,mp or irrigation circle (2) I $ 63.00 $ Print name of signing supervisor: 1 1 Each sign or outline lighting ~2) 1 $ 63,00 $ Signature of signing supervisor: I Signal. circuit or a li~ited-energy panel, $ 6300 $ alteration, or extensIOn (2) . Each additional inspection: (1) 1 $58.00 $ I'""""''''''~'''''''i'[~."".".;;.v-- -.. "--'.' -,- ,...., ....,.."",.. ,,-."i"'-".."". . ~~'im~:t~~;:.'frA~t1!iti.AR~I1_ICfi.~I~U5E~~~t~$~~\~fi~~i'i~d~~~ .~~\) ,QC\ .\9'\~\J/ ~ -S (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [AD 1 (C) Technology Fee (5% of [AD 1 TOTAL fees and surcharges (A through C): $ 67 $ S"'I( $ ~ ~f $ 7 S2, l' 440-2584.) (9108/COM) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6835 C ST ASSESSOR'S PARCEL NO.: 1702353203400 CITY OF ~rKINl.rl'IELD' Building/Combination Permit PERMIT NO: COM2009-00812 ISSUED: 06/09/2009 APPLIED: 06/09/2009 EXPIRES: 12/09/2009 VALUE: Springfield TYPE OF WORK: Heating System PROJECT DESCRIPTION: Install healing system Owner: JASON SHADDON Address: 6835 C ST SPRINGFIELD OR 97478 Contractor Type Electrical Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: TYPE OF USE: New Residential Phone Number: 541-954-1898 I CONTRACTOR INFORMA T10N 1 Expiration Date Phone nla Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Contractor Kffense OWNER oN 18o.uiles ;o~lili\'j OWNER """,,nol\ \a ."" OlegO _n\ \Olln p;f\E.\'ll \(i~'inJ\\iDiNG;1NFo~q~'l'm~l~i \o\looN 1~01\ Ge\l'vo~O In{Ou.,," 01 Ine IV" l\e \'lo~l\ca gS2,00~#')<(M1!!r.iC~:\e~ne le\e?n~liOl\ iIR-3\\'\ "ou (!\a~H'eight ;;f...<Stt\uctu ne.ol\\lC gO' -n\v"" \ .1\\"" ) 00 ",. l\g ,ne C'Nne{ofJlft'al:,,, "'344 . a\ \ \~t.r-v ........." ~~1..;,;(,.~(,. VB (!\pel 101 ~w~,1)yjie. l\U Gel\'Range Type: Energy Path: Sprinkled Buj.lding: I DEVELOI'MENT INFORMATION 1 REQUIRED PARKING Total: . Handicapped: Compact: ..,;...,,'" t&:: ~::~~?\~~~f'~~~~~~' ~~~~~1~::~~~;~~~U fO~ l\\f\\1. ~Mr.~tl OR 15_<, I pJ~U.~;IMJ>R5VEMENTS I I . Page I of 3 Sidewalk Type: Downspouts/Drains: , _~PvAINli!f;IIi!I'r>' 'n ;1: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Total Value of Project Fpp< P~irIJ Fee Description + 12% State Surcharge + 5% Technology Fee I st Appliance Add, Alter, Extend Circ . Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $17.52 $7.30 $79.00 $55.00 $12.00 6/9/09 6/9/09 6/9/09 6/9/09 6/9/09 Total Amount Paid $170.82 , Plan Reviews , CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00812 ISSUED: 06/0912009 APPLIED: 06/09/2009 EXPIRES: . 12/09/2009 VALVE; Value Date Calculated Receipt Number 1200900000000000635 1200900000000000635 1200900000000000635 1200900000000000635 1200900000000000635 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 wOl'k day. ~~p,1Iw:r,frtrjJn\l Rough Mecbanical: Prior to Cover Final Mechanical: When all mechaniCal work is complete. Rough Electric: Prior to Cover Final Eleclric: When all electrical work is complete. ? Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00812 ISSUED: 06/09/2009 APPLIED: 06/0912009 EXPIRES: 12/09/2009 VALVE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax' 541-726-3769 Inspection Line By s.ignature, I state llnd agree, that I have carefully examined the completed application and do hereby certify thaI all information hereon is true and correct, and I further certify that any and aIlwork 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, llnd that NO OCCUPANCY will be made of any structure without permission of the Communi~ Services Division, Building Safety. I further certify tbat only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensore 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. .~~ ~r Contractors Signature 6- '1-0 J Date Pae:e 3 of 3 *~ City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Strcct Springfit!ld, Oregon 97477 541-726-3759 Phonc Job/Journal Number COM2009-008 J 2 COM2009-00812 COM2009-00812 COM2009-00812 COM2009-00812 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200900000000000635 Date: 06/09/2009 10:12:05AM Description I st Appliance Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Amount Due 79.00 55.00 12.00 7.30 17.52 $170.82 Paid By JASON SHADDON Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb 061113 In Person Payment Total: $ J 70.82 $170.82 Page I of J 6/9/2009