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Home My WebLink AboutPermit Electrical 2009-7-8 ~filtr([Q~U\(G:lll)ZJ:Et!lMJ:Nifil'JgP"~gl1.l~~~=1 Zoning approval verified? 0 Yes 0 No 1~~l\']!:G~bR.>YilbFA!3~Q&~jIiR.l!J.(;:;lIllbt:jlij~!!i~~l\\l'\S~J I D Residential I D Gdvemment ..... LQ C?n;merc.ial . . I r_i~IJ.QJ3ISlmEjjINF..l:1B:M~;j"tlQNl~NI;lII!<D.GJ,\ml<D.N~.(fi;~1 $134.00 $ I Job site address: b S- 0 MAL \ Ira ~ I $ 25.00 $ I City: s':1> r= h I State:.:>L. I ZIP: I $ 32.00 $ ~=_~~~S=~~~~~I~~wJ~~~~~i~;~ I ~~~~I~~S~~~~:~~ re~~:r (~)odular I $ 63.00 $ e.EP,AIL mA.... r /} I ~c..a.AV\.f!:C- T I I Services or feeders: inslallation.alteralion. reloc~lion I ' I 1 I 200 amps orless (2) $ 81.00 1~~:::igt<Q~~~~N~~~~~~~~::.:r~ro 1'~;:I~:;~~::c;:~jOU to :1::::: I Address: l/f::. 20 i?Oy.A-L A-V;~I,~;';~i~s adl);; t6_01J\OI1;00~ampr(~~[;~;Yh $205.00 _ . . . -.- hn"8 n'lt::::" C.I,lv v'-''- .. . I City: ~-u..(.-(:-Al~- I State: oL-l zIpjrC):"'2qd.zI~~ ;g~~:~8~o,,"!'1P}':pr~~oJt~(7l- . 1 $469.00 1 $ J.... I Phone: I Fax: .1" un.. ~~- -a' 'IDlt~F,Ce\'n!,.cJconlY'f2)) rules by \ I $ 63.00 I $ b~ nnon You m V I fI_ I............. tho. Tr:lRUI IV' IV I E-mail: ca!\iDg~~e ~:l:t( 1~~~,~~U;;::~~~~~~~~ig~f~(~~ers: installation, alteration, relo~ation Th" ... . ,. _m1mr11-'1 IVI U' . \. rZOO"amps or less (2) $ IS mstallatlOn IS bemg made on resIdential ,or farm proper;tY. t I i~ <i of'H \~'.,~";"""~L0'1".1. 63.00 $ owned bJ: me or a member of my immediate family. This ven e ~ '201 to 400 amps (2) $ 87 00 $ property 1S not mtended for sale, exchange, lease, or rent. OAR I . 479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $ Signature: lOver 600 amps or 1,000 volts, see services or feeders section above 1~,J!j~~:G,NjIj~GiliGB:ij!INSm~l!l!.(\mIO:N~_~~i\*~1f~ I Branch eircuits: new, alleration. exlensionperpanel I Business name: (1 (,)/i./kl//I# C~r:7J!2/~ LL c:... I I a. Fee for branch circuits with purchase ofa service or feeder fee: I Address: dig") r'C:<;("' ALAA/"/"T" 3-r, I 1 Each branch circuit 1 I $ 6.00 I $ leii)': DJ("'rNtE: . I State: OR.. I ZIP: 97.vo.v I I b. Feeforbranch circuits without purchase ofaserviceorfeederfee: I Phone;9TI-;559-//q~ I Fax5't1"f'tI. 05'07 First branch circuit (2) $ 55.00 $ I E.mail: r.filVJt..t.H_.-<6}f.!::1-.Y!;.J<i!T.lv67 Each additional branch circuit $ 6.00 $ I CCB license no.: /(/<?<;7)'7' I BCD license nO':cNJ-t/R2. L 1 Miscellaneous fees: service or feeder not included I Signing supervisor's license no.: "/:P 79 oS I I Each pump or irrigation circle (2) $ 63.00 $ 1 I Print name of signing supervisor: l?uV44.-<?A :; /l A;Me I I Each Sign or outline lightmg (2) $ 63.00 $ 1 I Signature of signing supervisor: d:/~ / I j /) ;' /If "01., .i'ignalcircUlt or a hmited.ene!JlJ:,PilDEoI"ORKI $ 6300 I $ I r,./_.f/h~ '" 1\ ,ilkeratlOn"o\p;f~n~:m='\r \t1eW..,. , THIS ':E.~'h~I1f1lt\\~~.~W!~tlojlf&\jIA\I_I:' 1~0\J $58.001 $ I AU1Hr4r!;i~4;.j;,,~ ~1i\1~Rl~ljjiG'~R";' '~~-E;.~[~I -.....<:[:9 ~ ff:.' COM'I ~ R~r~'E'ffiW\Jfabovefees - L 1!It.fi(:) ~,"- rJA'IJ\Y ANY 1\ i imum Permit Fee $58,00) $ b"""5:. ~ '" ' ~ \...1:>\ '(8) Enter 12% surcharge (.12 x [A)) $ 75"61 ~ 0J "'. ~ I (C) Technology Fee (5% of[AD $ -:sra I \)' I TOTAL fees and surcharges (A through C): $ 7 ~ 7/1. Electrical Permit Application I r~~Ji~p':;;;Rf~~~~~1O'N'~Y.l . COtMl-fJO 'f~O Ic)O~ . I Permit no.: I Date: "7/1' A' '7 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689 r , This permit is issued under 'OAR 918.309-0000, Permits are nontransferable, P~rmits expire if work is not start~d within 180 days of issuance or if work is suspended for 180 days. 440-2584.1 (9108/COM) $ $ $ $ I I I I I I I I I 1 _&~611!l~1~1'!?;:' 1f i CITY OF SPKll~uFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009.0100S ISSUED: 07/08/2009 APPLIED: 07/08/2009 EXPIRES: 01/08/2010 VALUE: 225 Fifth Street, Springfield, OR 541.726.3753 Phone 541-726.3676 Fax 541.726-3769 Inspection Lhie SITE ADDRESS: 650 MALLARD AVE ASSESSOR'S PARCEL NO.: 1703221314300 Springlield TYPE OF WORK: Electrical Work Only TYPE OF USE: Residential PROJECT DESCRIPTION: Repair mast and reconnect Owner: Address: MICHAEL PALERMO 4620 ROYAL AVE EUGENE OR 97402 Phone Nnmber: 541. Contractor'Type Electrical . "01.1\0 __.\\\,es, .,".1",:"" _._r\nn \B.\j'l, I ~ n\'eOO\\ '"':.~""'f\n 1.,eONIFRACTORlINFORM'ArrION ~I,~- p.l1 le"~" 'I nuo- 01''' 0- '0" \ IIO-N yU cen\e\. oug'rl . p (uleS l Contractor 0 ,'\',ca\\on ,.OOWt'rll 'leS cL'icens~ne Expiration Date ,,\f'\ \ -0_ nO \ . - CO? ~,",\QO\ \ CONRICH ELEl;;TlPc,UEG.a" o\)\3.ln..\~le'. \M,!~~Q,~.ca\\on 11102/2011 - ~,...... -'-'.'" . ,~..,," .- O\.J'I~.BUHJDlNG "INEORM-AT.l0N.IJ' (.,-- {1U1 ~.. . '~_bvv - ,. nuf\i'oe.\el IS ", #!Of;Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Phone .541.607.3447 VB Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occnpancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R.3 n/a , DEVELOPMENT INFORMA nON I REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: ' \N~~~pact: % 1{J&n{9'i~rage: Lt. t"t.PIRt IF l\-\t NOl 1\-\\S PERM~~ ~.~\~t:1< 1\-\\S I'tR~:lr~Q I PUBLIC IN1PR'Qyi:M'J~1\$jt IS !\B!\NUU""~ . ' I.N""'- "1'i:"RIOD ANY "\80 D!\, Sidewalk Type: Downspouts/Drains: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description Type of (:onstruction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of 2 Status Issued 225 Fifth Street, Springfield, OR 541.726.3753 Phone 541.726.3676 Fax 541.726.3769 Inspection Line Fee Description + 12% State Snrcharge + 5% Technology Fee Service Reconnect Total Amount Paid Amount Paid $7.56 $3.15 $63.00 $73.71 Total Value of Project I<ees Paid I Date Paid I Plan Reviews I 7/8109 7/8/09 7/8/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009.0100S ISSUED: 07/08/2009 APPLIED: 07/08/2009 EXPIRES: 0110812010 VALUE: Receipt Number 1200900000000000789 1200900000000000789 1200900000000000789 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. , ReOl!i~~d Inspections I Electric Service: Approval required prior to utility company energizing service. 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 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. I further certify that ouly contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure th~t all required inspections are requested at the proper time, that each address is readable from the srreet, 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 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009.0 1 005 COM2009.0 I 005 COM2009.0 1 005 Payments: Type of Payment Check cReceintl RECEIPT #: Description Service Reconnect + 5% Technology Fee + 12% State Surcharge Paid By CONRICHELECTRIC LLC City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000000789 Date: 07/08/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 3247 In Person Payment Total: Page I of 1 1 :59:53PM Amount Due 63.00 3.15 7,56 $73.71 Amount Paid $73.71 $73.71 7/8/2009