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Home My WebLink AboutPermit Building 2007-1-22 \: . Status Issued * .ITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01/22/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5105 MAIN ST ASSESSOR'S PARCEL NO.: 1702333206000 Springfield TYPE OF WORK: Modular Unit TYPE OF USE: Alteratiou Commercial PROJECT DESCRIPTION: Temporary modular. Owner: 5105 MAIN STREET LLC Address: 5105 MAIN ST SPRINGFIELD OR 97478 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I CONTRACTOR INFORMATION I :) ;)" ~'lO ',\1 C t . ."'C>'~ ,\\,I'E . . 0 ontrac or e.~lcenj~. v v~plratlon ate ESSEX GENERAL CONSTRUCTION ~ \I}'l'l.~ e?~53P ~e ",e\ \ ()()\1II10/2008 REYNOLDS ELECTRIC ",.O~C~O 6'0'1 '(" IJ252-a:~~ 9':>'2:' ",'02/08/2007 KEA TlNG ENGINEE~J_~~\O\" oQ~\e -<;'<;\o",e ~,(),'<;\ 0 Xle (u\0 (\e~ BARON PLUMBINg;INC" ~e'=' ::~(\w\:. C\ ....'(\~Ot4?,7,44\ :n,e9,\\O_,\!!5/14/2007 IUBiJibDiNG'INFORMi\ liON'i~; ';;I.o\'\'V- ~\U,. ('), "'~- ~'l - \. '.. \J'~\ ^ ^-Il.~' \~ O~'p ., ~ (\\0 ,,0'0- ('),~:r $\ ~\~f\Stof!~~:c,~ O\~" OJ!>~" ()()C(Heigh~of Striifture\ ,'i!,rJ -'3" . :....'" ~ \'0 l'ype.,yf.lleat:\e ,\.\\ (-,'Co" Water Type: Range Type: Energy Path: Sprinkled Building: Phone 541-342-4509 541-343-7297 541-726-9995 541-935-1081 Contractor Type General Electrical Engineer Plumbing B Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/CarjlOr1 Sq Ft OiherN-\\l" '"' -.(.",- ^~IJ\ n/a "Occupant .Loail:. (""-I. ~\\ \- ...1'1\\1\\ \ ' .... I DEVELOPMENT INFORMAT.10N"I"\..~;'\\\S ~~~t.$ 'v'- \'- "- 'i'\:."" ('\ \j'tl\) ,,~\>.~ REQUIRED PARKING . ,\\\;:> n\lt:v n \S r' Overlay Dist: ., \,\\\l" t.\) \l" IJ\)' Total: . # Street Trees Rqil:~~t.~c, t>-'{ 'i't.\\\ Handicapped: Paved Drive Rqff:\) '\ '/:,'1:1 \) Compact: % of Lot Coverag.e;\'{ VB Froutyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutsfDrains: Notes: Paee I of 3 .ITY OF SPRLr~t.t<lJ<,LD Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01/22/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Iuspection Line I Valuation Descriotion I Description Estimate Type of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 4,400.00 Total Value of Project Fpp<. PiiaJ Fee Description Plan Review Comm/IndlPublic + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Miscellaneous Plumbing Modular Building Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feet Amount Paid Date Paid $44.46 $20.34 $10.17 $16.27 $45.00 $68.40 $45.00 $45.00 12/28/06 1/22/07 1/22107 1/22/07 1/22107 1/22107 1/22107 1/22107 Total Amount Paid $294.64 I Plan Reviews I Fire Department Review Initial Review Plan nine Review 01/16/2007 01/1212007 01/16/2007 OK AG APP LLH APP EMM 01/19/2007 01/16/2007 01/17/2007 Public Works Review 01/16/2007 01/16/2007 APP JHJ Structural Review Structural Review 01/1612007 01/19/2007 01/19/2007 01/22/2007 WI JMP APP JMP Value Date Calculated $4,400.00 $4,400.00 12128/2006 Receipt Number 1200600000000001800 1200700000000000050 1200700000000000050 1200700000000000050 1200700000000000050 1200700000000000050 1200700000000000050 1200700000000000050 See Attached Approved per Greg Molt after discussion with Trish Ashley, property owner. Owner needs to sign attached agreement for removal of temporary modular within specified timelines. See MDS file DRC2006-0001 I. Added SDC Worksheet. No new SDC's (JHJ) Received final internal approval. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. ~e(]uirecUnsnections I Framing Inspection: Prior to cover and after all rough iu inspections have been approved. Fiual Fire Depar1ment. After all requirements of the Fire Department have been met. Paee 2 of 3 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01/22/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectiou Line Final Building: After. all required inspections have been requested and approved and the building is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Final Modular Set Up: After all required inspections have been requested and approved and project is complete. Special: See Plan Review and/or Inspector Notes. By signature, I state and agree, that I have carefully examined the completed application and do hereby cer1ify that all information hereon is true and correct, and I fur1her cer1ify 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 only coutractors and employees who are in compliance with ORS 701.005 will be used ou 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. '::>?, .-/\=; L Q Owner or Contrac~o~gnature , J7.Z./t,~ , Date Paee 3 of3 " . . . ., CITY OF SPRINGFIELD SYSTEMS DEVEWPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2006-01666 NAME OR COMPANY: Veterin~ Clinic LOCATION: 5105 Main St MAP & TAX LOT NUMBER: 17 02 33 32 06000 DEVELOPMENT TYPE: Modular Building T _.._.~, NEW DEVELOPED AREA (S.F.): EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): UTORM nRA~ IMPERVIOUS SQ. FT. lTE: lTE: LOT SIZE (S.F.): .......... ... 86 ".E,g e -~uJ::i .--. ~_o o '::;I .~>Jja::u x Modular Building Temporary S 0.336 PER SF 2 SANIT~Y SFWER-CITX (= rev""" side) A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's TOTAL STORM DRAINAGE SDC:! Modular .,!Iuilding Temporary o x S 26.03 PER DFU o x S 19.79 PER DFU TOTAL WCAL WASTEWATER SDC:, S .l...IRAN~_P()RT..aI!.QlS. Modular Building Temporary BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW: A. REIMBURSEMENT COST: 0.00 x 0 B. IMPROVEMENT COST: 0.00 x 0 EXISTING: A. REIMBURSEMENTCQST: 0.00 x 0 B. IMPROVEMENT COST: 0.00 x x S 19.81 PER TRIP x o NTF so.oo, SO.OO I x S 87.39 PER TRIP x o NTF x S 19.81 PER TRIP x o o S 87.39 NTF' PER TRIP x 0 NTF , SO.OO I TOTAL TRANSPORTATION REIMBURSEMENT SDC:' TOTAL TRANSPORTATION IMPROVEMENT SDC:! TOTAL TRANSPORTATION SDC:, S I SO.OO I x 4 SANITARY SFWER - MWMC Modular Building Temporary NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU SO.OO I B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU SO.OO I EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU SO.OO I B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU SO.OO I MWMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRA 1lVE FEE: TOTAL MWMC SDC:! S SUBTOTAL (ADD ITEMS 1.2,3.&4) ! I SO.OO l 5 ADMINISTRATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) S x 5% = I SO.OO I TOTAL SEWER ADMiNISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE:' S TOTALSDCCHARGES , Jesse Jones Civil Engineer, EIT 111612007 DATE SO.OO SO.OO 1178 SO.OO SO.OO SO.OO ~ SO.OO 173 SO.OO 094 SO.OO SO.OO 1054 SO.OO 1186 SO.OO 1187 SO.OO 1189 SO.OO SO.OO 1175 1190 So.OO . . , FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN. FLOOR SINK INTERCEPTORS FOR GREASElOIUSOLIDSIETC. INTERCEPTORS FOR SANDI AUTO W ASHlETC. LAUNDRY TUB CLOTHES W ASHERlMOP SINK CLOTHES WASHER - 3 OR MORE (EAl MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRJGERA TOR/W A TER ST A TlONIETC. RECEPTOR FOR COMMERCIAL SINK! DISHW ASHERlETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIOOUBLE LAVATORY SINK: SINGLE LA V A TORY /RESIDENTIAL BAR URINAL. STALUWALL TOILET. PUBLIC INSTALLATION TOILET. PRIVATE INSTALLATION MISCELLANEOUS: FIXTURES UNIT NEW OLD EQUlV ALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 NUMBER OF EDU'S' DRAINAGE FlXTIJRE UNITS o o o o o o o o o o o o o o o o o o o o o TOTAL DRAINAGE FIXTURE UNITS = I 0 .EDU (Equivalent DwellinR Unit) is a discha:rge equivalent to 8 single family dwellin~ (20 OFU) set at 167 gallons per day CREDIT CALCULA nON TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AITER ANNEXATION DATE IN TABLE. CALCULATE CREDITS SEPARA TEL Y YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATEPERSI.OOO ASSESSED VALUE S529 S5.19. .S5.12 $4.98 $4.80 $4.63 $4.40 $4.07 S3,67 S3.22 S2.73 S2.25 S1.80 RATE PER SI.OOO ASSESSED VALUE YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 . 2001 2002 2003 2004 SI.45 S1.25 S1.09 $0.92 SO.72 SO.48 SO.28 SO.09 SO.05 SO.OO SO.OO SO.OO CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AITER ANNEXATION DA TEl x x CREDIT TOTAL SO.OO SO.OO SO.OO \ 225 Fifth Street ." , Springfield, Qregon 97477 541-726-3759 Phone . -.-; . ~ C&of Springfield Official Receipt .Iopment Services Department Public Works Department Job/Journal Number COM2006-0 1666 COM2006-0 1666 COM2006-01666 COM2006-0 1666 COM2006-01666 COM2006-0 1666 COM2006-0 1666 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description Modular Building Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feet Miscellaneous Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By VET ALLERGY AND DERM 1200700000000000050 Date: 01/22/2007 Item Total: (;heck Number Authorization Received By Batch Number Number How Received djb 084075 In Person Payment Total: Page 1 of 1 10:09:52AM Amount Due 68.40 45.00 45.00 45.00 10.17 16.27 20.34 $250.18 Amount Paid $250.18 $250.18 l/22/2007 , . Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line c.v 1 \_ )'if-,U :;Sf~~ . CITY OF SPR11~t._HELD . Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01/22/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 SITE ADDRESS: 5105 MAIN ST ASSESSOR'S PARCEL NO.: 1702333206000 Springfield TYPE OF WORK: Modular Unit TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Temporary modular. Owner: 5105 MAIN STREET LLC Address: 5105 MAIN ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Contractor _ _ License Expiration Date Phone General ESSEX GENERAL CONSTRUCTION 54531 11110/2008 541-342-4509 Electrical REYNOLDS ELECTRIC 17252 02/08/2007 541-343-7297 Engineer KEATING ENGINEERING 541-726-9995 Pluinbing BARON PLUMBING INC 147744 05/14/2007 541-9-35-1081 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B # 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 Other: Occupant Load: VB - nla , u",.",,,,OPMENT INFORMATION I Front yard Setback: Side I 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: .,. dlIUll~~ yvu ~V I PUBLIC IMPROVEMENTS I . - - . - . ..~ .' ., , . . . ,'J"" ,,,Ie!. adcp'iad bV tha Oregon Utility, 1 ' '-'or C Sidewalk1T.yp.e:'ules are set fortI ',I "..HI l \:;Illvl. 1........,. \II.~{ 952-0(J)OWDSpot.'tStDnilnQAR 952-001 ~o.;(). You may obtain copies of the rules ~. call1np the center. (Note: .t~e tele?hO~e . ..Imber ,or tM 0/'8gon Utility-Notification . - n"-' rM> "344) C:3i"'lt~I"~ " -) ,. '- ~.... -'''~ . Stor~ Sewer A~ailable: 'OOltl3d AVO 09 ~ ANV Speclallnstructton: . - l:IU:l 03NOONV8V SI tlO mJN31'-JI'-JOJ Notes: iON Slill^Jtl3d SIHi tl30Nn mZltlOHinV )ltlOM 3Hi:l1 3tlldX3 llVHS 11I'-Jtl3d SIHi ::I:JLlON Pa2e 1 00 , Status: Issued 225 Fifth Street, Springfield; OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . Estimate Type of Construction Estimate Description Fee Description Plan Review CommllndlPublic + 10% Administrative Fee + 10% Administrative Fee + 5% Technology Fee + 5% Technology Fee + 8% State Surcharge + 8% State Surcharge Miscellaneous Plumbing Modular Building Sanitary Sewer - 1st 50 Feet Temp Power 200 amps or less Water Line - 1st 50 Feet Total Amount Paid Fire Department Review Initial Review Planning Review Public Works Review Structural Review Structural Review 01/16/2007 01/1212007 01/16/2007 01/16/2007 . 01/16/2007 01/19/2007 . CITY VI' ~rKlNGFIELD . Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01122/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 4,400.00 Value Date Calculated $4,400.00 $4,400.00 12/28/2006 Total Value of Project Fp..<~ Amount Paid $44.46 $5.00 $20.34 $2.50 510.17 $4.00 $16.27 $45.00 $68.40 $45.00 $50.00 $45.00 $356.14 Date Paid 12/28/06 1/22/07 1/22/07 1/22/07 1/22/07 1/22107 1/22/07 1/22/07 1/22/07 1/22/07 1/22/07 1/22/07 Receipt Number 1200600000000001800 2200700000000000089 1200700000000000050 2200700000000000089 1200700000000000050 2200700000000000089 1200700000000000050 1200700000000000050 1200700000000000050 1200700000000000050 2200700000000000089 1200700000000000050 I Plan Reviews I See Attached OK AG APP LLH APP EMM Approved per Greg Mott after discussion with Trish Ashley, property owner. Owner needs to sign attached agreement for removal of temporary modular within specified timelines. See MDS me DRC2006-00011. Added SDC Worksheet. No new SDC's (JHJ) 01/19/2007 01/16/2007 01/17/2007 01/16/2007 01/19/2007 01/2212007 APP JHJ WI JMP APP JMP Received fmal internal approval. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. . Paee 2 of 3 . . CITY VI' ~rK1r\i\J.rIELD' Status: Issued Building/Combination Permit PERMIT NO: COM2006-01666 ISSUED: 01122/2007 APPLIED: 12/28/2006 EXPIRES: 07/22/2007 VALUE: $ 4,400.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Reouired Insnections I Framing Inspection: Prior to cover and after aU rough in inspections have been approved. Final Fire Department. After aU requirements of the Fire Department have been met. Final Building: After aU required inspections have been requested and approved and the building is complete. Water Line: Prior to mling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Rough Electric: Prior to Cover Final Electric: When aU electrical work is complete. Final Modular Set Up: After aU required inspections have been requested and approved and project is complete. Special: See Plan Review and/or Inspector Notes. Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that I have carefully examined the completed application and do hereby cenify 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 funher cenify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I funher 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 propeny, and tbe approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 3 of3 City of Springfield _ectricat Authorization To Begin wore E-mailedTo:dan@reynoldselectric.com Receipt # .EC5079n 1/22/2007 2: 12:46 PM ~ Check on status of pernlit By Phone: (541)726-3753 or Email: permitceoter@ci.springfield.or.us I. TYPE OF WORK lXJ Addition/alteration/replacement o New construction CATEGORY OF CONSTRUCTION I [X] I or 2 family dwelling 0 Multi-family 0 Commercial! Industrial I JOB SITE INFORMATION AND LOCATION ]Job no.: 16343 IJob address: 5105 MAIN ST ICitylStatelZIP: SPRINGFIELD, OR 97478-6214 I Sulte/bldgJapt.no.: I Project name: Ashley Cross street/directions to job site: Main street to south 51st I Subdivision: ITax map/parcel no.: \ Lot no.: 1702333206000 DESCRIPTION OF WORK install temp power for trailer L . . SITE CONTACT IName: dao I Phone: (541) 343-7297 I Fax: I Emall: dan@reynoldselectric.com IEL De. no.: 20-155C CONTRI:~BO:e.no.:>;\7;:;' I Business Name: REYNOLDS ELECTRIC INe 1 Contact: Dan IAddre,,: 2175 W 2ND AVE ICltylStateJZlP: EUGENE OR 97402 I Phone: 5413437297 IFax: 5413454808 I Emall: dan@reynoldselectric.com I Metro lie DO.: I City lie no.: I Supervising e1edridan', Dc. no.: 25205 I Supervising electrician', name: JOHN A REYNOLDS. JR Upon review and approval by your local jurisdiction, your permit will be e.malled or faxed within one business day, with Instructions on how to schedule your Inspection. NOTE: This Authorization To Begin Work expires within 180 days If a pennlt Is not obtained. The local building department may detennlne that an Authorization To Begin Work Is null and void If It does not meet applicable land use laws and local ordinances. I I FEE SCHEDULE I Des,ription l Qty. I Eo. I Total 1:~b:~~GL.~,,(R m~~-fa~~,d~'clling ,u!lit. Incll!des 11.000 sq. ft. or Ie" I Ea. addl 500 sq. ft. or portion I-Limited energy, residential (with above so. ft.,) I-Limited energy, multifamily residential (with above SQ. ft.) I Seni~ORfeooe~}nstallation, -alteration, AND/OR ," :-:w -":w,7 I 200 amps or less I 120 I amps to 400 amps I 1401 amps to 599 amps I>TEMPO~Y seryi:~p.~f~.,,,,rnin~~latiOIl, !litera,lion. AND/OR relocation ::/"'-,,,,, :;' ,.' '," ,,: ' I 200 amps or less S50.OO 1201 amps to 400 amps 1401 amps to 599 amps I Branch circuitli - NE'\:V, alteration. OR eJ:tension. perPaoeJ I' A. Fee fOT branch circuits with above service or feeder fee, each branch circuit. B. Fee for branch circuits 1 without service or feeder fee, ~ frrst branch circuit each addl branch cin:uit 1 I MisceUa!lc;o;~I'. I Service reconnect only I Each manufactured or modular dwellinlL service and/or feeder I Pump or irrigation circle I Sign or outline lighting I Signal circuit(s) or limited. energy panel, alteration. or extension. I j I 1 1 1 I I I I 1 I S50.oo 1 I I I 1 I EL~CTRICAL PERMIT FEES Subtotal S50.OO Minimum Fee $45.00 State SurcbarRe (8% ofoeJ1l1it fee) $4.00 Ci~ Of S~~eid fees'" $7.50 I I TOTAL PERMIT FEE S61.50 I .,City Of Springfield 10"/. Local Admin Fee; 5% Local Technology Fee torn U"'r[)(p - 0\ (P0b I -"J~ _ Of NM This Authorization To Begin Work must be posted at the job site until replaced by a Permit. . . . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-0 1666 COM2006-0 1666 COM2006-01666 COM2006-0 1666 Payments: Type of Payment ONLINE CHGS cReceintl RECEIPT #: Description Temp Power 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ONLINE PERMIT CHGS . ~LJ:~~iii.'~L_....._--,... It;Ll "- . , _"."h.. . ~ ,. , . -,. "..,"" ..I" ._ _, .....~. <A of Springfield Official Receipt _Iopment Services Department Public Works Department 2200700000000000089 Date: 01/22/2007 2:54:58PM Item Total: Check Number Authorization Received By Batch Number Number How Received njm ONLINE reynolds Online electric Payment Total: Amount Due 50.00 2.50 4.00 5.00 $61.50 Amount Paid $61.50 $61.50 Page I ofl 1/22/2007