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Home My WebLink AboutPermit Electrical 2009-7-1 CITY OF SPRINGFIELD Building/C?mbimition Permit J, PERMIT NO: COM2009-00974 ISSUED: 07/01/2009 APPLIED: 07/01/2009 EXPIRES: 0'1/01/2010 VALUE: SPRINGF;IIi!'''') - ~r"'d ", '. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line' SITE ADDRESS: 3239 PARTRIDGE WAY ASSESSOR'S PARCEL NO.: 1703221306500 'I Springfield TYPE OF WORK: Electrical Work Only. TYPE OF USE: New PROJECT DESCRIPTION: Service change and 6 circuits Owner: POOLING & SERVICING AGREEMENT Address: 701 CORPORATE CENTER DR MC: NC RALEIGH NC 27607 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor License GLEN A CAM'PB!]:,L!\oIO~I' n'MM 1_... 73995 10i/OW rr . - . . _..~.. ..., .."" to Notiljc"r.~BUlnDINGlINFORM~'fWN lility in OAR 952~Or1'; ';;-~'< ~ I.~uoe rUles are set forth 0090 You # OfStorieS':1ugh OAR 952-001- R-3al;ing thmeHg~~tlo(SIi'~cturethe rules by ~ e comHr .("nh th t I number lor t,Ty. pe ot Heat: e e ephone r.l~ \!rP....r\n IltTt N " VB Cent Water'fype: II Y otlflcation eR1 10 1-8T"I',.'l32-2344) ange ype: . Energy Path: Sprinkled Building' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary ConstructionType: # of Bedrooms: I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Residential " Expiration Date OS/24/2010 Phone 541.744-0705 n/a I' II Lot Si~~: Sq Ft (st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport . " Sq Ft Other: II Occupant Load: ., I' REQUIRED PARKING , Total: " Handicapped: , Compact: I ~.I)~LlC IMPROVEMENTS I UVlf'-'C. .' TH IS Sidewalk Type: PERMIT SHALL EXPIRE IF f'\ I, AUTHORIZED UNDER @!i\En's'r\GIilIODrains: THIS PERMIT IS NOT ' COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Street Improvements: Storm Sewer A vailahle: Special Instruction: Notes: I Valuation DescdDtion I Description Type of Co'nstruction $ Per Sq Ft' or multiplier Square Footage or Bid Amount Page I 01'2 Value Date Calculated CITY OF SPRINGl'lJ!,LU Ii Building/C6mbination Permit " Status Iss u ed PERMIT NO: COM2009-00974 ISSUED: 07/01/2009 APPLIED: 07/01/2009 EXPIRES: 01/01/2010 VALUE: ' 225 Fifth Street, Springtield, OR 541-726-3753 Phone ,541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200.amps or less Amount Paid Date Paid $14.04 $5.85 $36.00 $81.00 7/1/09 7/1/09 7/1/09 7/1/09 Receipt Number 1200900000000000765 1200900000000000765 1200900000000000765 1200900000000000765 I , Total Amount Paid $ 136.89 Plan' Reviews , To Request an inspection call the 24 hour recording at 726-3769. All inspections ~equested 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. ! Reoll,ired In,s,?,e~,t.!~~s I Rough Electric:. Prior to Cover Electric Service: Approval required priOr to utility company energizing service. 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 I further certify that any and all work performed sha!1 be done in accordance with the Ordinances of the City of Springtield arid the Laws of the State of Oregon pertaining to the ,,:~rk described herein, and that NO OCCUPANCY will he made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors a;ld employees who are in complianc'e 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 Date Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Developme'nt Services Department Public Works Department " Job/Journal Number COM2009-00974 COM2009-00974 COM2009-00974 COM2009-00974 Payments: Type of Payment Check cReceintl RECEIPT #: 1200900000000000765 Date: 07/01/2009 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By GLEN CAMPBELL Item Total: Check Number Authorization Received By Batch Number Number How~Received djb 4377 In F:erson Payment Total: 11 Page 1 of I 2:21 :50PM Amount Due 81.00 36.00 5,85 14.04 $136.89 Amount Paid $136.89 $136.89 7/1/2009 Electrical Permit Application D SPRINGFIELD ~ . t._J. 1~~1~fDEPART:M'E~l\WlSE~:<<~:t'1 ;-'-f.--"''::-_,--, "_'.""'~"""";___~'_""1=.,"~Jii.lJ~F~f:l~..._..",....",,~~ 1"~~:~t.nlH'0..,~"~4~1A'~-1 I Date: 1,-. \.tf\ I 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire ifwo~k is not started within 180 days of issuance or if work is suspended for 180 days. ' :1 iI=~~~~=~~~l:g&M~t~eIiRQM6~~~~1 .'..u .El;fS=~~~::I!~:I;~ln ~1!l[c,:;Aml;<3_(?)RYll~EiIc;:1i1N$jITB,I!.J!:iiJjIQj\jJlll!'~~~~ ~., ""_,',,"""""'j"'~ b,;r;!ki!i:;:,4' ~~'lllii1m . s!,s.h." . =~~~~1~tf~~~ .! ~~~::~:i:""::~~r :'::: ! !1.~;~~~~~~~;F.ttwJ~~~~ I ~~~71~is~~~~~r~~ ;'~~:r (~)OdUli, ,: :::::: I I ~ 2. OO~. Se n/ i'>R.. VI P"i ..,f-'le I I Services or feeders: instal/ation, alteration, relocation .1 \. , J II 200 amps orless (2) II}. $ 81.00 $ 8'/ I ~'lf~~~l*eR0BER:j;;i~0WNERt>''''''tlji\;q*~,,,'t~,,:;::11' /201 to 400 amps (2) , $ 95.00 $ I . Na=5~"~~/I,:,,:~;C~~t2-V~:;",u'~:;;~:'lJ401 to 600 amps (2) $158.00 $ I I Address: 70 ( ccJ'/t1 Cur IL JQ.... I I 1 601 to 1,000 amps (2) $205.00 $ I I City:~U~1~t+ I State:)r/iAnE~P-1~~~~llr~~~~~02f~!,!RR~rvoltS(2) II $469.00 $ I I Phone: I Fax: follpw !ules "uuf"~UhCjJ Jij.Fsgn,\\<1ft.R,l\lyc.<ilJ1 Ii $ 63.00 $ 1 I' ,'C__.j..~..., r':cntAr T (S n0.1 T I E-mail: ~llVl"''''''R-9''5-2' -001-00"10 t~lrolll~empor'aJ1Ds:ervi.ce-~ or feeders: in~rallation, alteration, relocation .1 In OA ,- - rt'IT TIle IIrr,.., '"J I. . . . ... . . '-. M~_u ....... '::1.\1 ..QJ..l.~dlll ,v[ 1120v'amp.s or less (2' ,I I ThiS mstallatlOn IS bemg made onresldeIiliiil11O:. nlHl1 pn'pOJlJ (~ 0' ,: :~,: '~ln~h"n" $ 63.00 $ owned by me or a member of my 1I11medlat"'fajjll!y!I'FllIsen~r.1 )'20'1vl<?;400'iunps:(2) il $ 87 00 $ I property is not intended for sale, exchangefis~\:'EOTfnmth0ARe9c n ';'~'~~'1 ;;.1. - i. . 479.540(1) and 479.560(1). Center is 1-80)-; ,401-t060(J amps (2) I I $126.00 $ I Signature: . lOver 600 amps or 1,000 volts, see s~rvices or feeders section above Il!Ilt~~qJ~j'J'jmRA<:;iIl~R~INSjll~~IE~mlQNWR_~fiiWf~ I Branch circuits: new, alteration, extension per panel I Business nam.e: C~~ W! cz:..~ ,'- I I a. Fee for branch circuits with purch~e ofa service or feeder fee: I Address: '(J, (), ,f!;,Jt '2JJ '-I I I Each branch circuit :: I " I $ 6.00 I $ I City: W'4 \ -k ilJ ~'lt e..1 StateQv'\-l, I ZIP: <17'189' I I h. Feefor branch circuits without p~;chase ofa service or feededee: Phone: ;,p'll- 7~lt-o'7o;TFax: I I First branch circuit (2) 'i $ 55.00 I $ E-mail: I . I Each additional branch circuit i G, $ 6.00 I $ I CCB license no.: ?/f';;:?9 'i r1 BCD license no.: 2O;:-t{~~<: I I MiscellaneousJee1.~"fl'l~~Wrnotincluded I Signingsupervisor'sli~enseno.:'JGGG-;;; i~~~I~;;~I\1I~MJulii~~I~~mi\~r~1l:l~\)Til .1 $ 63.00 $ I Print name of signing supervisor: C k "V C ~~~ J~JriP^LD l\Ailtll~\gn\f~~~;~\iWi\i&Xi) ,I $ 63.00 $ I Signature of signing supervisor: fft? r _ f'''N\EN( Elh Sl~lul}bh!Ult or a hmlted-energy panel, $ 6300 $ . . /d"C.J.. . '''! "TjlVI DP* ~l.t!'il\~g,\)or extensIOn (2) I . ANY 1 \lU ~Each additional inspection: (1)!i . 1 $58.00 $ """r~~"'-"T"~'C"''''"-'''.-~...-.'''ll~ .-~ =""_ ~ :\) ~""...' .~..".. ..1KI;!~(gI.G~NjTiIJ;J:J.SE~~_~ t>-. ~ (A) Enter suhtotal of above fees ,'I ~ #'0 'b ~ \)\)(J II (Minimum Permit Fee $58.00) I, $ \ 1 ( /\ I \Y ti\ (B) Enter 12% surcharge (.12 x [AD II $ Il{ 0 f \ ':. (\ r> "'\ :\.;~~ (C) Technology Fee (5% of[AD 'I $ 5 B <' ~~ ~~~ 1 TOTAL fees and surcharges (A1hrough C): $/(,,{. ~" Ii 440-2584-J (9/08/COM) Ii !i- I' I! I I. >~ I I