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Home My WebLink AboutPermit Electrical 2009-7-6 225 Fifth Streett Springfield, OR 97477tPH(541)726-3753t FAX(541)726-3689 I CO u.f z...o 09-00 "f{'!r Permit no.: I Date 7-1. -0 ." 'Electrical Permit Application i . 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 Residenti ~sq. ft. or less ~) I ( Each additional 500 sq. ft. or portion ~ .. I Limited energy (2) :1 I Each manufactured home or modular dwelling service or feeder (2) 1.1 $ 63.00 $ I Senrices or feeders: installation, a~reration, relocation I 200 amps or less (2) $ 81.00 $ I 20 I to 400 amps (2) $ 95.00 $ I '"1-0.1 T"' 1 401 to 600 amps (2) $158.00 $ Name: 1) w or ~+ ,)ft.. '1."'-"" I Address S Zdr LittLE SIne- MOo I I 601 to 1,000 amps (2) $205.00 $ I City: 8.l G-6ilC' I State: C)L I ZIP: ., 74'() (I 1 ()ver 1,000 amps or volts (2) $469.00 $ '1 Phone: _ ~~5S71 I Fax: I 1 Reconnect only (2) $ 63.00 $ 1 E-mail: 1 1 Temporary senrices or feeders: in~tallation, alteration, relocation This installation is being made on residential or farm property 1 ?OO amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). 1401 to 600 amps (2) $126.00 , $ Signature: lOver 600 amps or 1,000 volts, see s~rvices or feeders section above ,~~:=:;;~nv~f0jr~o~~~~~:re~~GI I ~r;::~o:i~::~~ ~::~~:t:~~::r:::s~:f":':~i::e~r feeder fee I Address:, 10 - a1,(J;::;.:~~~tJj,q':j~';~,,:!::~~~~~~lilY.0 ' Each branch circuit , $ 6.001 $ I City: W f-ll1.f-r\i i~n-()OI'State" 6}[iu11tl~iilf,f9U.U6tJ I b. Fee for hranch circuits without p~rchase ofa service or feeder fee, I Phone 7 L.J.''l:\:1'j,).14X ~,lllln~:~Df'rtf llJe 'f.(jJI;../JY[ 1 First branch circuit (2) I $ 55,00 I $ 1 . ~~ ...::.' - .- ..~",....,. \"'-'~""", tl.C: l~If;:::r'IIUIJe - 1 E-mail: number for the Orpnrm f Itilit\1 f\lnti["''''t:,,_ Each additional branch circuit $ 6.00 $ I CCB license no../ 71.f'~P:P{;'P I, 'cB)I~' ense rio.6.1'- {5q--l/-~} ( 1 Miscellaneous fees: service or feed,~r /lot included \ Signing supervisor's license no: _ ~ 1 Each pump or IrngatlOfl circle (2) I I $ 63.00 $ J Print name of signing supervis~ I' li~ j I Each sign or outlme lighting (2) $ 63.00 $ .. I l Signal CirCUit or a IUlllted.energy p~nel, SIgnature ofslgnmg supervisor' U 7'1 S '1 alteration. or extension (2) $ 63.00 $ . ~ ~ I Each additinnat inspection: (1) \\~~~~~ \\lQ..I--i\ (A) Entersubtotalofabovefees :: \SY ' \ IJ 11 ~~inimum Permit Fee $58.00) , (')fb)' NOTICE: S1-1/1.ll EXt'~ 1-1E IN) '~nter 12% surcharge (12 x [A]):: D 1\-lIS t'ER~i6 UNDER 1\-lIS) MIl IS (C) Technology Fee (5% of[A]) ;, ~~;:~~~CED OR IS AB/l.NDONED FO, I TOTAL fees and surcharges (A ,'hrough C); ANY 180 DAY PERIOD. lJIIIrili111j,'!IIiIf<Z>G~~Gl:)ME:8.f,lME:,f,lifgf~P'R~Q\l~!1!I:!!'!lf111j,i2!:~'!IlI 1 Zoning approval verified? JZl Yes 0 No . I_G'/f,:nE:Gl:)~N\.,<'>.t-llc.::<Z>I\!S):nBl!I.c.::ifl!E>,Nl~~~. I, D Re~ide_~tiaI_______ ___)gCi?~_~r~ment _ _ __ J _@'.~om_~~rcial liIi11'~;J:i',')B-IlSlmE:'ll\!tQBM~ml,<Z>f,I'l~NJ1ljIf0G~mIQl\!iil!iIllf1lj,~1 I lob site address: 52:"0 "b'liH 11-_,,> I 1 City: !'.o~ltI. I State:{)t. I ZIP:Cj'14')fi I I Subdivisi~n: {70 Z. ! Ill.{ Lot no.: 0 1 f 00 I - -$ 32.00 ---- -------- I $134.00""$...1 ~ $ 25_00 Y I I I I I I 1 1 1 1 1 I I 1 $ e", WI iL\c.. UA.llr {l,,~ ')(~_n - I $58.00 $ $ (3Lt $ Ih ot.) $ b 7;) $ "bI7O 440-2584-1 (9/08/COM) elT); OF SPRINGFIELD II. . Building/Cdmbination Permit - -Ii Status Issued PERMIT NO: d'OM2009-00988 ISSUED: 0~/07/2009 APPLIED: 07/07/2009 EXPIRES: Oi/07/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 luspection Line SITE ADDRESS: 523 39TH ST APT 3 ASSESSOR'S PARCEL NO.: 1702311403100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Rewire unit complete Owner: DWIGHT JANSSEN Address: 3208 LAKESIDE DR EUGENE OR 97401 J. Phone f:lumber: 541-485-5571 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor .r . -;-:~!TIaN: Oregon law rJrJf,f.IJ~e"ou t~xpirati?n Date BURRELL BROS ENTERP,RISESJUOSQd bv the~i4li,1n Iltilill, 08120(2009 :, ;BuiLDING.INFORMATlClN I're set forth I: If " '"' '" v _' H 952-001- 0090. You may,obtain copies of the rules by , I' callirl!J'\fl~te!;I,~~br, (Note: the telephone Lot SlZr numbRe!g~\,~[ ~f!!~t.~P\Jtility Notification Sq Ft I~t Floor: Tl::R.~I~H'~af:800-332-2344), Sq Ft 2~d Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft G,arage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupa'nt Load: II Phone 541-747-2724 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R2 VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % ,of Lot Coverage: NOTICE: PUBLI' ":" "J "V'" "'''if'' t!\t-'IKt I~ I Ht VVUMI\ , (;_INlp!,~::=-~~E;~ttrHIS PERMIT IS NOT COMMENCED OR IS ABA[I,~t~wt\'rG'Re: !, ANY 180 DAY PERIOD. Downspouts/Drains: Tntal: 'Handicapped: I' Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descrintio~,,1 Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value' Date Calculated Page I of2 CITY OF SPRINGFIELD " Building/CQmbination Permit JI Status Issued PERMIT NO: COM2009-00988 ISSUED: 07/07/2009 APPLIED: 0:7/07/2009 EXPIRES: 01107/2010 VALUE: '. 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~e~~ p~W $16.08 $6.70 $134.00 7/7/09 7/7/09 7/7/09 Recei~t Number 1200900000000000780 " 1200900000000000780 '120~900000000000780 Fee Description + 12% State Surcharge + 5% Technology Fee Residence Wiring 1000 Sq Ft Amount Paid Date Paid Total Amount Paid $156.78 Plan Reviews I " To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. willibe made the following work day. II I Re9"ired Tn.sl.~~cHolIs I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company euergizing service., Final Electric: When all electrical work is complete. :1 By signature, T state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that any arid all work performed shalllbe done in accordance with the Ordinances ofthe City of Springlield and the Laws of the State of Oregon pertaining to the wo'i'k described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 willi 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. 'j Owner or Contractors Signature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~ City of Spri'hgfieldOfficial Receipt Developme*t Services Department Public Works Department RECEIPT #: 1200900000000000780 Date: 07/07/2009 , IO:OO:28AM Received By djb Item Total: Check Number Authorization Batch Number Number How Received " Amount Due 134.00 6.70 16.08 $156.78 Job/Journal Number COM2009-00988 COM2009-00988 COM2009-00988 Description Residence Wiring 1000 Sq Ft + 5% Technology Fee + 12% State Surcharge Payments: Type of Payment Cred itCard Paid By BURRELL BROS Amount Paid 05559c In Person " Payment Total: $156.78 $156.78 cReceintl Page 1 of I 7/7/2009