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Home My WebLink AboutPermit Electrical 2009-8-5 Electrical Permit Application . 225 Fifth Streett Springfield, OR 97477. PH(54t)726-3753' FAX(541)726-3689 l~trfDEf!;&:RiM'EN]i~"fONlli~:i,r t<~ro.;"~~':"\<:"":"i''''.':''-;''';i;'"':;:;:'1~.f''lri~..::~':2l..~~ I CO/.NIlOo9- C) 109 b Penmt no.: I Date: ~.~.cp\.. 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. 1~~r~If9:Q~j][G0}~~EBNME.NiT'~MJ~Rj:)VA~~ I Zoning approval verified? 0 Yes 0 No' I ~G*TJ;G.QR:yt1L0F.iii!'JQNS-I[8.I1[GillI0N~m ~esidential I 0 Government I 0 Commercial ~.OEl'!lSfm-E'Ii!:lrE:~RM~ill!QN.fANPII!i~G],I:ml<:ifilI~ Job site address:S, , l M-r. V(;,W~ tJ>. I City~~FS~ I StateOA.. I zIP:"~lal I Subdivision: 1 Z8 2.9 '32. 3 ~~~~ 1~~~OES:GRI~iil~'N.I<;fFAWJ)~g~~~~ ['I. _ (V KiQ ~ l\.llV'J lL =!-') 1~~RaO&ERit;,'i'.{O.vvllER~~f\W~'l) I Name: "In l-HJ /JL..MLst2 I Address:.l\qqg fV/T cJ&JJov l.2..~ I City: 912..J IOGFJl.CL01 State: (r:J!l I ZIP: CJ747/;>- I Phone5'tI"7# O?i" rl- I Fax: I E-mail: This installation is being made on residential or [ann property owned by me or a member of my immediate family, This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1)(j 479.560(1). . , I=~~~~"'"'._"''' I Addr~ ./ I City: ~ I State: ,>>IP: I Phone: ~ IF~- I E-mail: ~ I CCB license no.: ./ I BCD lic~,: I Signing supe~ license no.: ~ I Print n~f signing supervisor: ,I Sigtli'ture of signing supervisor: , 440-2584-1 (9/08/COM) ~~~~F.l;I:IS~Cliilolj.lIfltE~~~ €'''~'''~~~llJ.k~..q''iJ~I''''''''''II(rtl'II:t~''ln. ~!)'uw.\fertglli9~peCtioi1s,p_eriiitein (')'i~, 'il QTf',' , ii#J!k.,:" ,;o,t!lt.. ~~",if,;::';::>~W~~1rffii I ,b~;.,;~, ~\,,~ --.. ~'Jli'J ,1.;9S_ I Residential, per unit, service include"d: I I I I I I 1,000 sq, ft, or less (4) Each additional 500 sq, ft, or portion thereof I Limited energy (2) I Each manufactured home" or modular dwelling service or feeder (2) I Services or feeders: installation, alteration, relocation I 200 amps or less (2) $ 81.00 $ I 20 I to 400 amps (2) $ 95.00 $ I 401 to 600 amps (2) $158.00 $ I I 601 to 1,000 amps (2) $205.00 $ I lOver 1,000 amps or volts (2) $469.00 $ I I Reconnect only (2) $ 63.00 $ I I Temporary services or feeders: instal/ation, alteration. relocation .1 I 200 amps or less (2) $ 63.00 $ I I 201 to 400 amps (2) $ 87.00 $ I ,'1401 to 600 amps (2) $126.00 $ I lOver 600 amps or 1,000 volts, see services or feeders section above I I Branch circuits: new, alteration. extension per panel I I a. Fee for branch circuits with purchase of a service or feeder fee: I I Each branch circuit I I $ 6.00 I $ I I b. Fee for branch circuits without purchase ofa service or feeder fee: I I I First hranch circuit (2)' $ 55.00 $ ~ I I Each additional branch circuit $ 6.00 $ I I I Miscellaneous fees: service or feeder not included .aGO~M 1 I Each pump or irrigation circle (2) $ 63.00 $ I I I Each sign or outline lighting (2) $ 63.00 $ I I I Signal circuit or a limited-energy panel, $ 63.00 $ I alteration, or extension (2) I Each additional inspectinn: (1) I $58,00 I $ I ~,,!:j;~_~~A'''n'fl.r,.~A'~N':r~;U!'S-~E' .-., -'" or'il"IIi&lii\""""""1 ~~~~It\r.i,_IjiJ;"~_''._,JI@{___?t:~'lli~m~~!.iliej $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) I (B) Enter 12% s~rcharge (.12 x [Al) I (C) Technology Fee (5% offAl) I TOTAL fees and surcharges (A through C): $ sgPD. $ 6~ $ z'SPf $ '-1::~ _~~~J~p'~If,t!:\g/ f ;; , Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone' 541-726-3676 Fax 541-726-3769 Inspection Line ~!- (J362- CITY VI' ~rKll..GFIELD Building/Combination Permit PERMIT NO: COM2009-01096 ISSUED: 07/29/2009 APPLIED: 07/2912009 EXPIRES: 0112812010 VALUE: Springfield TYPE OF WORK: Single Family Residence SITE ADDRESS: 5998 MT VERNON RD ASSESSOR'S PARCEL NO.: 1802032308600 TYPE OF USE: PROJECT DESCRIPTION: Hot Tub/ Spa on concrete slab w/ existing fenced-in pool. Owner: Address: Residential PLAYER III JOHN R & CHARLOTTE A 5998 MT VERNON RD SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: '-, " NO J BUILDING INFORMATION. I l.t:: ' THIS PERMJt.IS1W/"S: ' RAUTHORIZ~:VM:rrE{Is6)fPNfE IF TH ~~~~~~:!ii~~:O~~~I;:r~~; Energy Palh: Sprinkled Building: No Lot Size: Sq Ft 1st Floor: Sq Ft 2nd F1001': Sq Ft Basement:, Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION. REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: ATTENTIOIIIS/teil(J'Fte6IRqlt;uires you to foHow rule!!:av'ed)Dt~vel({qd: Oregon Utility ~otlflcatlon O/o'of'EotrGiiveriige:3 are set forth In OAR 952-001-0010 through OAR 952-001- 0090. YOIl m:=tv nht~in ,..,."nioco "f th", ... ............ L..., calli'PU~EfC'IMPRbVE-M:ElNl'S'IJhone . Aumb III I -. "' r Center is 1 :SOO:3-3'i2:2344j:.Ica 1~l:Jewalk Type: Downspouts/Drains: I Valuation DescriDtion I $ Per Sq Ft or multiplier Square Footage or Bid Amount' Date Calculated Value Description Type of Construction Pa2e I of 2 Uti' OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-0I096 ISSUED: 07/29/2009 APPLIED: 07/29/2009 EXPIRES: 01/28/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid J IIIYI Fee Description Amount Paid Date Paid Receipt Number Total Amount Paid $0.00 Plan Reviews , 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. ~eonired Insn~ctio~~J Rough E]ectric: Prior to Cover 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 tbat any and all work performed sball.be done in accordance witb the Ordinances of tbe City of Springfield and th'e 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, Bnilding Safety. I further certify that only contractors and employees who are in compliance with ORS 70] .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. ,(Ju.li(. ~ 7 - dC;' - 09 Own~'r or Contractors ~igna:ae " Date Pa2e 2 of 2 225 Fifth Street Sp~ingfi~W, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1 096 COM2009-01096 COM2009-0 1096 COM2009-0 1 096 Payments: Type of Payment Check cReceintl RECEIPT #: IA:~FJ~Oj. Mr. c City of Springfield Official Receipt Development Services Department Public Works Department Date: 07/2912009 II :10:46AM 1200900000000000850 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 12% State Surcharge Paid By CHARLOTTE A. PLAYER Item Total: Check Number Authorization Received By Batch Number Number How Received 98 \ 6 In Person Paym~nt Total: Page 1 of 1 Amount Due 55.00 3,00 2,90 6,96 $67.86 Amount Paid $67,86 $67.86 7/29/2009