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Home My WebLink AboutPermit Electrical 2009-6-18 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689 ['<~,\:;ii'Ji:Jo,l.:!"'~Tt~~..."",)"~~.....twt~~1i1 ,~,;;1iDEI?ARTMEN;r,USE'ONI;':'t\ ',.. tgli>,h:"H.","~wl'3:.h~'#~;u~!w,*,)ai'l;ry("_<;i'f:$:;~~~~. ~. I Permit no.: c?P ~ 0' J'-S- I I Date: h ~ I ? ~ CfJ I Electrical Permit Application D 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. I lii'iitz'i.r;;o"n"~"n-g:a\.:p~p'[r"Oo'vCaAI-vl!e!'('r"I..Gfi'-Oe'dAv?.EBNMEDf;l;r,y.iWe~s'F!..RROVADJ-~N'0-3W~.~~~II' '~~~11:'j:,~F.EE;1{S:cliI!:t>,l'JL!E~,1{:f~~'1f[fol7";t1k~ ~~t~'b'~~'TIl~WilW~m"J1i\>lii(,)'~~I!Q'~)~I~g%~Ii,t!lJa,'!1ii ~:;."\."'I:(-i,-;I;"'C".firl'lff:i.~'::oi:n~~~';;i~~J~ ~~~~ ~~~.~~ ~,~.ost~ l~f;::~~~I~TEGiR~~;;~~~=~~Jl:R~r~O~~;::~~' Residential, per ~nit,service included: I I~Wd6B'i1SlifE~IIi1I;J)RMAmIQNfAIliD~aOCP"'I110N~~! 11,000 sq. ft. or less (4) $134.00 $ I I Job site address: 9,1./ C!l L 'St- I ~~~~oatditiona1500 sq. ft. or portion' $ 25.00 $ I ~::~~;~~:;F.iJ~~~=~i [~~~~:;~~;~~~~;; ~~~~r(~)OdUIM : :::::: ,I tJ A ~ 1./1 I 1 Services or feeders: installation, alt#ration, relocation .......i) ~AIIVI^' eff'/h:lta1 <:.P.....UiM_ rV\~ U ~ '. . J . I 200 amps or less (2) I $ 81.00 $ /fl 1!f~~~~F1ROeERt,Y€.:0WNER~~~~-iji~1 1 201 to 400 amps (2) I $ 95.00 $ 1 IN 0 \/ "'- , I 1 401 to 600 amps (2) 1$158.00 $ 1 ame: \+~ ~V\ \).., Y 1 Address: ~ 4a L ~-I- I I I 60 I to 1,000 amps (2) I $205.00 $ I I City: S.onll\6'ptlA I State: OR I ZIP: q7417 lOver 1,000 amps or volts (2) 1 $469.00 $ I I Phone:~1-7d1. (~12 7 1 Fax: I Reconnect only (2) I $ 63.00 I $ I I E-mail: I Temporary services or feeders: insfallation, alteration, relocation 1 This installation is being made on residential or farm property 1 200 amps or less (2) $ 63.00 $ I owned by me or a member of my immediate family. This I 201 to 400 amps (2) I $ 87.00 $ I property'is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). I 401 to 600 amps (2) $126.00 $ I Signature: fl.;6, (}- 1)~ \p-, jL . lOver 600 amps or 1,000 volts, see services or feeders section above I 1~:Jl!iil~~j::0NmRft,:CjT;OR~INsm,l\IEIi;o;mJ.0N~-'"ii'l~' 1 Branch circuits: new, al/eral/on, ex/~nSlon per panel I I Bu~ess name: ./ 1 / a Fee for branch circUits with purchase of a service or feeder fee: j I Addres2""""" ...~ I 1 Each branch circuit I I $ 6.00 I $ I 1 City: .......~ I State: .....................1 ZIP: 1 I b. Fee for branch circuits without purchase of a service or feeder fee: I' I Phone: ~~I""F~: 1 First branch circuit (2) $ 55.00 $ I I / ......... /) / JoO E-mail: ...../............. Each additional branch circuit .- $ 6.00 $ 'J I CCB license no.:/................ I BCD licen-;e-no..,; I Miscellaneous fees: service o~ feeder not included 1 1 Signing s.upeiVisor's license no.: ::-, I Each pump or irrigation circle (2) $ 63.00 $ I I Pri!lt'r;~e of signing supervisor: I Each sign or outline lighting (2):: $ 63.00 $ 1 I Si~ature of signing supervisor: I Signal circuit or a limited-energy panel, $ 63.00 $ I alteration, or extension (2) 1 Each additional inspection: (I) I $58.00 $ I 1S'~~gp.p.Ili~AN;f~US'~jb~~~1 (A) Enter subtotal of above fees , ' 9? I ~ (Minimum Permit Fee $58.00) I' $ ~ ~". __ I (B) Enter 12%surcharge(.12x [A])' $ Lj- r ':> I (C) Technology Fee (5% of[A]) " $ II _ (~ 1 TOTAL fees and surcharges (A through C): $ /0 Q.j1S" / ~d\ \sJ.\~ ~\k\ 440-2584-) (9108ICOM) -Wtr~P.RINll!PI~LpI ~ ,"" , ' : , .: ~ ---- CITYOF SPRINGFIELD Building/Co1llbination Permit PERMIT NO: C0M2009-00885 ISSUED: 06/]8/2009 APPLIED: 06/18/2009 EXPIRES: ]2/]8/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectioo Line SITE ADDRESS: 849 L ST ASSESSOR'S PARCEL NO.: 1703264300200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New" Residential PROJECT DESCRIPTION: Replacing Service Panel Owner: VANDYCK'iuTA G Address: 849 L S1' . SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER License Expiration Date Phone 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 Size: Sq Ft I!t Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft C'arage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I 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: Ii Total: Handicapped: il Compact: I PUBLIC IMPROV~MENTS I Street Improvements: Sidewalk Type: Storm Sewer Available: I equires you to DownspoutslDrains: Speciallnstr~i'tiori:ITION: Orego; ba~hre Oregon Utility , . tallow rules adopte Jse rules are set torth , Notes: Notiticatlon ce~:~~16~hrOUgh OAR 9,52-001- NOTICE: EXPIRE IF THE WORK In OAR 952-00'_'~:~'Mn;"s o1the rules by T,"e DI'RMIT SHALL ~...n nro~nlT IS NOT UU'clU. lUU II......} - -. 0 f . ,__...,-u..... ,. 0 UNUtn 1111""' ' - calling t~~ f~~~;'eci~~t~iil;~;I~\i~'iii9'tRlh Descriotion I'J~~~~Zrr:D OR IS ABANDONED FOR numberc~nter is 1_800-332-2:1......', . ~~,v 1 no DAY PERIOD,: . $ Per Sq Ft Square .."OIage-> Description Type of ConstructIOn . It' I' B'd A Value Date Calculated or mu Ip lef or I mount Pa2e I 01"2 ._S.~A!~,~FiI!'f:~f ~! - Status Issued CITY10F SPRINGFIELD' Building/Co'mbination Permit PERMIT NO: COM2009-00885 ISSUED: 06/18/2009 APPLIED: 06/18/2009 EXPIRES: 12/18/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Tota(Value of Project Fees P,Ilid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $11.16 $4.65 $12.00 $81.00 6118109 6118109 6118/09 6118109 2200900000000000686 2200900000000000686 2200900000000000686 2200900000000000686 " Total Amount Paid $108.81 Plan Reviews I 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 leOl i -<'(I I nsoections I ...Ii.lII. III , . 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 hereby certify that all information hereon is true and correct, and 1 further certify that llny 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 w~rk described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building,Safety. I fnrther 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 ~ddress is re~ldable 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. Ph 0 (J,/h-~ j~ Owner or Contractors Signature LP ' I ct. n Ot Date Pa2e 2 of 2 G~,~ ~I:"'~~.' .., ", 1Ii:[ · ,. - . -:0., ,_' C. 225 Fifth Street Springfield, Orcgon 97477 541-726-3759 Phone Job/Journal Number COM2009-00885 COM2009-00885 COM2009-00885 COM2009-00885 Payments: Type of Payment Check cReceintl City of Springfield Official Receipt Dcvelopment Services Department Public Works Department RECElpr #: Date: 06/18/2009 10:24:52AM 2200900000000000686 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Cire Ea Add + 5% Technology Fee + 12% State Surcharge Amount Due 81.00 12.00 4.65 11.16 $108.81 Paid By RITA G VAN DYCK Item Total: Check Number Authorization Received By Batch Number Number Ilow Received Amount Paid In Person Payment Total: I: $108.81 $108.81 NJM 2311 Page I of I 611812009