HomeMy WebLinkAboutPermit Electrical 2009-7-22
225 Firth Street. Springfield, OR 97477 +PH(54 1)726.3753+ FAX(541)726-3689
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Electrical Permit Application
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This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuan!=e or if work is suspended for 180 days.
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I Zoning approval verified? DYes D No I 111~.I~~~1I
:=:~~;~J'E~:~R~~~~:~:~;roRwlr~0~~~~~.1, Residential, per nnit, serviee inelUded'1 I
1:ID;,~I'JOBl\'SliTiE&lINi;.0RM.,6;JI(;)IIIlJ)~NallI!Q:C.6;mIQN.iltJi!il1 1.000 sq ft, or less (4) $134.00 $ I
I Job site address: fi?'3 5 ~ ~ 'l.r::L) I I ~~~~o'ritionaI500 sq ft, or portion I $ 25.00 $ I
I City: ~f'Q.~ I State: O~ I ZIP: ct"K11 I I Limited energy (2) '., $ 32.00 $ 'I
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l;i'd:liim"it&';~"'m"'!lRRc:lI?ERT;Y110WNER2~fi,1tiirtli:"'!!*~""-~"'.Jli~i1l1l I 201 to 400 amps (2) $ 95.00 $ I
Iw~::::n~.\\o.o.O 'i;,~!<<"",w'-~''''''I I 401 to 600 amps (2) $158.00 $ I
I Address:\\"J.,.\\ GD\.:t> rcr,..,~~ ~~.....\OO I I 601 to 1,000 amps (2) $205.00 $1
I City~~ ~; \l~ I State:~ 'I zlpq'() \"10 I lOver 1,000 amps or volts (2) $469.00 $ I
I Phone: I Fax: I I Reconnect only (2) I $ 63.00 $ I
I E-mail: I I Temporary services or feeders: i~stal!ation, alteration, relocation f
This installation is being made on residential or farm property I 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) $ 87.00 $ I
property is not intended for sale, exchange, lease, or rent. OAR I 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 I
i~:~~::Wt~(;)~~'iw~l!~Ti;h~~-~~: : :r;::~o:i:::~:S~ :::~~:':~~opn~r:~'::::fn:S:~i::e~r feeder fee i
I Address, fJ 0 h I) X (IJ q 7 _ I Each hranch circuit I I $ 6.00 I $ I
I City:W AI t! r v,l/lf I State: (j 'L-f J ZIPf1 1 b. Fee for branch circuits without purchase of a service or feeder fee: I
I Phone: l~ l Fax: -,. 0 I First branch circuit (i) $ 55,00 $ I
I E.mail: hvv tilTfirosr; ,nlftltil6n /n'l.( lnY Eachadditional branchcircu;t I $ 6.00 $ I
I CCB Iic~nse no.:/~{ n~ I BCD licellle no.:~{) -1ft.} ~C I Miscellaneons fees: service or feeder notincluded I
I Signing supervisor's Iicen~e -no,: 47 .::2 J 5 . I Each pump or Irrigation circle (2) $ 63.00 $ I
I Print name of signing superviso I4'S~-VI1 ~VYv:J-f)A I EachslgnorouthnehghtlOg(2) $ 63.00 $ I
I Signature of signing supervi~4: itA, I Signal circUit or a limited-energy panel, $ 63.00 $ I
'f01. 0 \':.w'v \) ,alteration, or extension (2)
II Each additional inspection: (I) $58.00 $ I
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I (A) Enter subtotal of above fees ] $---
(Minimum Permit Fee $58.00)
I (B) Enter 12%surcharge(.12x [A]) I
I (C) Technology Fee (5% of[A]) I
I TOTAL fees and surcharges (A through C): I
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$
$
$
440-2584-1 (9/08/COM)
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I
Status
Iss u ed
CITY OF SPRINGFIELD.
Building/C~mbination Permit
PERMIT NO: COM2009-01058
ISSUED: 07/22/2009
APPLIED: 07/22/2009
EXPIRES: 01/2212010
VALUE: .
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 MAIN ST
ASSESSOR'S PARCEL NO.: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Space #250 Replace main breaker - Emergency Request Josh Burrell
Residential
Owner: SANTIAGO: ItSTATES ASSOCIATES LLC
Address: lUll GOLD COUNTRY DR STE 100
GOLD RIVER CA 95670
I CONTRACTOR INFORMATION I
Contractor Type
Contractor
License
Expiratibn Date Phone
Ii
B~ILDING 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 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Qther,
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Fronlyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
. Compact:
,.
Street Improvements:
I PUBLIC IMPROVF:MENTS I
ATTENTSiCf<iwBIk'Wype'3w requires you to
follow TUD'es adopteclmov ihe Oregon Utility
N t'f. t. ownsp'outs Tams:
, 0 I lea 1011 v~II.~'. II,u,e I ules are set forth
in OAR 952-001-0010through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
numhAl fnr ,thA OrAnnn 1:ltilih, I\lntifi,...~ti"n
Center is 1-800-332-2344).
Storm SllWel-,,\...ilable:
. ~~uf~~C. .
Spec131 II;IStr.1lc.tJOp:
'HICl r'cKMIT SHALL EXPIRE IF THE WORK
Notes: AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONFn FOR
AI~Y 180 DAY PERIOD.
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e I of 2
Status
Issued
CITY, OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01058
ISSUED: 07/22/2009
APPLIED: 07/22/2009
EXPIRES: 01/22/2010
VALUE: ' ,
225 Fifth Street, Springfield, OR
541- 726-3753: Phone
541-726-3676 Fax
541-726-3769'lnspection Line
Total Value of Project
Fee,_ Paid D
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$7.56
$3.15
$63.00
7/22/09
7/22/09
7/22/09
2200900000000000832
2200900000000000832
2200900000000000832
Total Amount Paid
$73.71
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. will be made the following
. ,
work day.
I Re?yked Insnedio,nsJ
Electric Service: Approval required prior to utility company energizing service.
By signature, I 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 and all work performed shaWbe 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:
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will'be used on this project. '
1 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
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01058
COM2009-0 1 058
COM2009-0 I 058
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
JOSH BURRELL/BURRELL
BROS
City of Springfield Official Receipt
Development Services Department',
Public Works Department
2200900000000000832
Date: 07/22/2009
1 :40:33PM
Item Total:
Check Number Authorization
Received By Batch Nun:aber Number How Received
Amount Due
63,00
3,15
7.56.
$73.71
Amount Paidi
njm
03595c Phone
$73,71 '
Payment Total:,
$73.71
Page I of I
7/22/2009