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Home My WebLink AboutPermit Electrical 2009-8-4 Electrical Permit Application D (iJi.j~W{DE'pJ;!RT"ME'N']~usSONTh,y,r~~1 ~l,:.~,g':"fJ;!o";~;~m;'!:ltli..-#""'.:!~~SW~~~ - Permit n~;: r: '1 - 1 t Z-k? I I Date: 8(/4-1 ~ 1 I 2,5 Fifth St.eel.Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire ifwo~k is not started within 180 days of issuance or if work is suspended for 180 days. ! . ... 1\ 1~~~II0:t~~iGOMEf:{t'lMEN[f#~P.~R~M~I.t:"~~ '~~~~~F"EE~S_C:HEDl!JI!!E~~ 1 Z ., I'fi d? 0 YON I ~""~"'-'~\!;"'''''''''Wi!~~~~'l''''''''''''f"''?I'''~I'''''€'-t'?!il!leT'n!''' omng approva verI Ie ,es 0 N~mber o1'inspeCtions;pe"'item~('),1fji";1/' QtX.1'1l~oS E!r"., o,a!J;ifI 1'''',''''''~,1lf'''''''''''A'''',''E"G'-0''R"V,~O"w'''O'N" S""R"'''"T:IO' 'N' ~0F'.d!.~E""'''''~1 ~"".t)'f,",b',_"A""""'''''''''''lliF"",,,,~,,,,~, "';31_~IDJ?ifiiij ,. fQs!:~ ~~:&%i?;j:~a.\J 111 '. Hi 'r,;-\J'. 11; u\Jiil!' l'P;t,~^''Z:%P'~;dj,^'IS'" if. ." ..,0, ,._.oN." .__._L-'._ ,m_" - ",,, ,=!," " ,j _.L, u'_ "'___d'n~'v",,,,,,,y;,ljlf I Residential, per unit, service includ'ed: 1 D Residential I D Government l'rzl-.Commercial I I ..' ~'!.J~ElN!SlmlOl!liIIli.~BM~'lII@~A'r'l[j.lor~~'~"I]IOIll.i~J!",!1 1,000 sq ft orless (4) . 1 $134.00 $ - , q q 7 , 1/ I I Each additional 500 sq, ft, or portion,,: $ 25.00 $ Job sIte address: j, tl I") I'uf'c:. w/f--(/ thereof i: ICity:5nr/I'l'i'?'~Lc( lState(Q~ Jzfp:97'177I 1 Limited energy (2) "$32.00 $ ,1~;~1~;C~~~iIIl());~wJ~~~~~~i I ~~~~I~rS~~~~~r~~ re~~~r (~)OdUI~' $ 63.00 $ I A-dd 5' u6 ./.J ~ J1 c, / ? tL}CJ fi:; (; I I Services or feeders: installation, alt~ration, relocation , r r h." r' :J_ 1 I 200 amps or less (2) 1: $ 81.00 $ tl.-tLat 014. rC.-C (V/Zetu T.S . ~~~~f:{~FfI;B.ffi;(lQWNER~~)~~~11-~.J!~;~J!1!~11 201 to 400 amps (2) $ 95.00 $ 1 Name: f)!"ti I/L- A4 ~ E"' I 401 to 600 amps (2) $158.00 $ 1 Address: q'if 7 k'P L/Je W f'k'/ ' 1 I 601 to 1,000 amps (2) $205.00 $ 1 City: ..5nul 1 StatetJ.L. J Z(P:97'f77 1 I Over 1,000 amps or volts (2) $469.00 $ 1 Phone: '! - tj /5' CJ ~ 9' '1' 1 Fax: 1 Reconnect only (2) $ 63.00 $ J E-mail: I Temporary services or feeders: instfzllation, alteration, relocation This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ owned by me or a member of my inimediate family, This I 201 to 400 amps (2) $ 81.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479,560(1). I 401 to 600 amps (2) $125.00 $ Signature: lOver 600 amps or 1,000 volts, see serVices or feeders section above l~c~Glt'l!l1BKc:;"Ii()B:INSm~U!~ml~N~;,~~1 I Branch circnits: new, alteration. ext~nsion per panel I Business name: /;1.,//.1/ ? h~~~ I I a. Fee for hranch circuits with purchase ofa service or feeder fee: 1 1 I 1 I I I 1 I 1 1 1 1 I I I '1 1 I I Address: 'i?77 C:;t) f!A M -~ & J I Each branch cIrcuit ,I I $ 5.00 1 $ I I city:b.l~.A/lL/ 1 Statel)M[ ZIP: .97~~ I b FeeforbranchcircUltswllhoutpurchaseofaserviceorfeederfee I I Phone..)"0" <50/- 56 S-D 1 Fax:.5tI15r3 -1353 1 I First branch cIrcuit (2) $ 5500 I $:5'5-1 1 E-maiL 1 I Each additional branch circuit $ 6.00 1 $ 7,??4 CCB license no,: O? 1657 I BCD license no,: ;/ () g tJc I I Miscellaneous fees: service or feede" not included 1 Signing supervisor's license no.: . 9' I? 1\ s 1 Each pump or irrigation circle (2) $ 63,00 $ 1 1 Print name of signing supervisor: 'l3.) II t1!. /r <Lf \". 1 Each sign or outline lighting (2) $ 63.00 $ I I SignatureofSigningSUperviso~~"'A/J_~. r"L--V' I Signal circuit ora limited-energy panel, $ 63.00 $ I ,-. -r.... V U AA7J _ alteration, or extension (2) , . ~ -r.c y additional inspection: (I) $58.00 $ 1 ~ti\ <oS~V ~~ $85~ $L0~ $ <<~I $ Cf '1 :t1 I (A). ~nter subtotal of above fees (MInImum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) (C;) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through C): 440-2584-) (9108/COM) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 987 KRUSE WAY ASSESSOR'S PARCEL NO.: 1703222000910 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2009-01126 ISSUED: 08/04/2009 APPLIED: 08/0412009 EXPIRES: 02/04/2010 VALUE: Springfield TYPE OF WORK: Commercial Miscellaneons TYPE OF USE: Commercial PROJECT DESCRIPTION: Electrical Permit: Owner: Address: DFZEE'S INC 3930 ARABIAN WAY SHINGLE SPRINGS CA 95682 ,Contractor Type Electrical Contractor BILL DWYER # of Units: Primary Occupancy Group: A2 Secondary Occupancy Group: Primary Construction Type VB Secondary Construction Type: # of Bedrooms: Frontyard Setback:' Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I CONTRACTOR INFORMATION' License Expiration Date Phone ATTENTION' rroNM '^... _h . Tr"-... -- . . - - - ::-"....... yvu lU N I ; BUIT:'DINl'}'INFOffNNlliCOiN'ton Utility in "OAR q52- J!\ (.J,. Wu,,, lUres are setforth 0090. \,K1f~Po~I~1~through OAR 952-001_ Lot Size: CalJinJWgJWof,sWllt/1fl!e1es of the rules by Sq Ftlst Floor: numbeh'BletC~frnf~: (Note:. the telephone Sq Ft 2nd Floor: 'tYl'M~ . Pf:~~~ UtIlity Notification Sq Ft Basement: Range ype: 0 332-2344). Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: No Occup~nt Load: I DEVELOPMENT INFORMATION. REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: NOTICE: DownspoutslDrains: THIS PERMIT SHALL EXPIRE IF THE WORK , . AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR HIV 1 An nav D1=Rlnn I Valuation Descrintion I Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Date Calculated Value Pa2e I ofl -~~~:~~i~!~r;~ijh~'h>>"h'<' ~iJ ':. I", -;i: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fee~ P,,;id . Fee Description Amount Paid Date Paid Total Amount Paid $0.00 I Plan Reviews I CITY OF SPRINGFIELD I Building/Combination Permit 'l PERMIT NO: dOM2009-01l26 ISSUED: 08/0412009 ' APPLIED: 08/04/2009 EXPIRES: 02/04/2010 VALUE: Recei~t Number " " 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. williibe made the following wMk~~ I I R,~,\~ire~ Insn~ctions I Rough Electric: 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 that any and all work performed shall be done in accordance with , the Ordinances ofthe City .of Springtield and the Laws of the State of Oregon pertaining to tbe work described herein, and that NOOCCUP ANCY 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 will be nsed on this project. I further agree to ensure that all required inspections are requested at the proper time, that each ~ddress is readable from the street, that the permit card is located at the front of the property, and the approved set of plans wi;1 remain on the site at all times during construction. .;, a Owner or Contractors Signature Pal!e 2 of2 ::b I '-1 I 0::1 Date I ! '", 225 Fifth Street II -0- Sprirlgfield; Oregon 97477 541-'126-3759 Phone Job/Journal Nurnber COM2009-01126 COM2009-01126 COM2009-01126 COM2009-01126 Payments: Type of Payment Check cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Departmcnt Public Works Department ,. E 1200900000000000876 Date: 08/04/2009 , 2:01 :56PM Item Total: <":heck Number Authorization Received By Batch Number Number How Received Amount Due 55,00 30.00 4,25 10,20 $99.45 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5%Technology Fee + 12% State Surcharge Paid By TOM G WIRFS ENTERPRISES, lNC Amount Paid 16527 $99,45 In Person Payment Total: $99.45 Pa,ge 1 of 1 8/4/2009