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Home My WebLink AboutPermit Electrical 2009-8-10 E~ectrical Permit Application 1'~~~?~';~',>>"~,\.'.",;'(-j~'~1,","'m::t<:':'9~0':~~:-i~~~1 ~J,'(;ii;8tg~~J\~~;];ill~~Cj1lt!1i,;t~~i I Pe~~n~z-oo 9 -Ot/6fl I Date: ~-lo -0 i I 1~1!f0:t'I)b;~G.Q,\'ZE:B/IlMENifiil1t,;P'J~B~)/,~~~ 1 Zoning approval verified? 0 Yes 0 No '. _, _:1'1 liBIIIII!!i~i'IJ;;l;i!IEGg>R1(~I~J7iiir~:0/1l.SjTIB.I!!~rIjl0N~~~~ 1~~~!~fiU~E)JIN~~B~~~11;~;~NPll~~G~~;~~11 : 7.~~~::ti:I,:,el:;'~:; service included: I I Each additional 500 sq. ft. or portion Job site address: ,;;z2}fz-' Vv{h.(C;,~. ~ - thereof $ 25.00 $ I City: -y?V>-7 . 1 State: Qtr- 1 ZIP: C?7't 77 I 1 Limited energy (2) $ 32.00 $ Subdivision: 1701 Z Zl{l .... J Lot no.: O(r~ I Each manufactured home or modular . $ 63.00 $ ~~ . ,,:~~i=.=~~F~~;I~~ll ::~:::: ::r;~::eo:s~ei:~;:I~~;ion, alteration, relocation 1 I 200 amps or less (2) t $ 61.00 1~~A~~l~~E;~~NEB.~;'~5~~~!fi?~1 : ~~: :: :~~ ::: ~~; :1::::: I Address: Z-8'/S'" Z (;.]/ty Sf~~ Lf. ... ., I. 160.1,t?},P99,'ffi'P~P)JOU to $205.00 I City: <;t> r:'l\ I Sfate: o<L. I ZIP: 774'77-1 I,Oveb!"OOO'aIDpsjjfJvoit~'ii)1. $469.00 1 I . '''''JlltEr'RMb~ri~cP6H:lY(2Y;t.t:lIUI1l1 $ 6300 Phone: Fax: - - '. .~n() ~C~~~~:--.~:,--'~""'_i..I",Qt:;':'-()()1- . ) E-mail: OU~J. YOLl ma~l 0' )it~H1P..<!..~!lrYi.S~rjvi.~~s .o.rl{eedels: installation, alteration, relocation Th" II' . b . d 'd' I (O"",n0 'ne (;, ilI13200amps'ofl]ess(2yphone $ $ Ismsta anonls emgma eonresl entIa orfarrnpropert): '. ' ........, ..,,__,,__ 63.00 owned by me or a member of my immediate family.rr.J:iisoer..for It e '1)2{Wt~'4b'6;;,',rip;'(2\"'w"~,, property is not intended for sale, exchange, lease, or rent. OAR'nte' I' '_M(" ,-'''-c,~ ,Y. $ 87.00 $ 479.540(1) and 479.560(1). 1 40] to 600 amps (2) $126.00 $ Signature; lOver 600 amps or 1,000 volts, see services or feeders section above l~c:~~tri~<::m0'BlINSIr;J8I!!~J,(mi$j/ll~;;Jl\)~;wi 1 Branch circuits: new, alteration, extension per panel I Business name; M ~ \.-- .~_ HE 7J\.c.... I ! a. Fee for branch circuits with purch"ase of a service or feeder fee: 1 Address: 27 A'v/h>"lMK- A 1 I Each branch circuit 1 $ 6.00 1 $ I City: 5ttO I State:o>",,- 1 ZIP: i 7 '-t 'iI? I I b. Feefor branch circuits without purchase of a service or feederfee: 1 Phone5lt )->)'2/- 5'C9o I Fax: I 1 First branch circuit (2) $ 55.00 $ J E-mail: I I Each additional branch circuit $ 6.00 $ I CCB license no.: IL(r$7'-t)" I BCD license no.2:Y-4C;'9 L I MisceUaneous fees: service or feedernotincluded I Signing supervisor's license no.: L{7.7:JS III n' "1l1.j;aCh pump or irrigation circle (2) J' I $ 63.00 1 Print name of signing supervisor: fr\ .\..fH<<. <-(kArt- THlt pr~R!!lsiggp;rN1!!!i€:l!jgljtjligl125fHE Wp~'" 1 $ 63.00 I ~ I rS'--a1'cIrl:!"~,,n -li'J.lC,D~"J\IIII '" ,'JuT I Signature of signing supervisor: ,;,_ A.-. t A.Ul H( l.l!l'L.. ~ .~1! ,,~'a mltea,energ.y pane!, $ 63.00 $ . r/2-.$-' r ,/ .<>-. .a1\9r~qqn"or ,'!.te!l'.!.ol'l~jn~IFD FOR / GUIVlr. k'Wk_ d\._ .. ANY 1 Q!';aF~.l.,d<!!,!ion~II~~pec~on:_~1) '_ ~ =1 $58.00, I $ I , . ~1V,I!:I;tR~I.lil"'A:~;rd'DsE"'~.~~ _~ r I (A) Enter subtotal of above fees <? r ~ \ (Minimum Permit Fee $58.00) $ 0 . !\ t\ q, .\.\ 1 (B) Enter 12% surcharge (.12 x [AD $ '17Z I ~ '\,\ (C) Technology Fee (5% of [AD $ LfO)] TOTAL fees and surcharges (A through C): $ yl.f n 225 Fifth Street< 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 if work is not started within 180 days of issuance or if work is s"spended for 180 days. $134.00 ..~ G:t~ ~~ 440-2584-J (9/08/COM) $ $ $ $ $ $ $ $ $ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01l61 ISSUED: 08/10/2009 APPLIED: 08/10/2009 EXPIRES: 02/10/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 2882 Wayside Lp ASSESSOR'S PARCEL NO.: 1703224101800 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION, Replace meter base and mast TYPE OF USE: Repair Residential Owner: CLIFFORD ALVIN C & MARTA L Address: 2882 WAYSIDE LOOP SPRINGFIELD OR 97477 I, CONTRACTOR INFO~ATION , Contractor Type Electrical Licen'se 146745 Contractor MITCHS ELECTRIC INC I BUILDING INFORMATION' ATTl;NTION: 1.-.....:,...." ........ '''''1U1'p;:;;,::o yvu LU", # fU 't . follow rules adople#:;! hf'"S' tth~. nregon Utility' ( oms. N I'f' , ,0 oneS. , ' . 0 Ilc~ttnn Center. . nr';'lC"O polr.:c:- :::IrA t:j::lt,fortn) Pnmary Occupancy Group: 'In OAJU 2 001 001 HeIght of StrAucture, . i ., ,n:;o, . " m,,)lIfJHh () .H'952'00,1-' Secondary Occupancy Group'0090 'Yh'j m bl Type of eat." '''I' 15' . . , ' "" ay 0 air, ,;ODIOS m:tne'ru esl YI Pnmary ConstructIOn Type callinY.Bhece nler,.w'later JYI!~. 'I'--h'" , . IOUll '::.Il , ' . I \/UleT'118 Ie ep one. Secondary ConstructIOn Type: numl5ue'r' fo'r" Ih' 'e' 'O're'Rangel' 'Yl!e;,'o'I"f" 't" 1 ( . lJU11 >..J P.LY' l~ Ilea IOfil # of Bedrooms: c'~~rg/ j'g n:.j1S!$X&~Uli4~, Sprinkled Bui(ding: n/a I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: , Expiration Date 0111812011 Phone 541-521-5690 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: , Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: liJJBLIC IMPROVEMENTS I ~~~lpERMIT SHALL EXPlRE If THE W~i~talk Type: ' AUTHORIZED UNDER THIS PER~6Tf~~~wnspoutslDrains: COMMENCED OR IS ABANDON ANY 180 DAY PERIOD. Notes: I Valuation Descrintion I DescriPtion $ Per Sq Ft or multiplier' Square Footage or Bid Amount Type of Construction Page 1 of 2 , Value' Date Calculated _~", ,'Nq~~, '~,:: I' ", "'," 'I !' ..' .W . '. .=r, CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-01161 ISSUED: 08/10/2009 APPLIED: 08/10/2009 EXPIRES: 02/10/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line, Total Valueof Project Fees Paid I . Fee Description + 12% State Surcharge + 5% Technology Fee Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $9.72 $4,05 $81.00 8/10/09 8/10/09, 8/10/09 1200900000000000895 1200900000000000895 1200900000000000895 Total Amount Paid $94.77 I Plan Reviews I 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. I Reouired Tnsoections I Iliff I I, I r I '" 1 , Electric Service: Approval required prior to utility co'mpany 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 aud correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springlield 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 contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure thai all required inspections are requested at the proper time, t~at 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 on 225 Fifth Street .. . Springfield, Oregon 97477 541-726-3759 Phone ".....~.. ~JN.,~ F1..E....~G1i> -..' ...,...."....... ~{ . '~. :i +:.., ., lIE '~,',. ' .-",' - 0'" ','," "B'" City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0116] COM2009-0] ]6] COM2009-01 ]6] Payments: Type of Payment . CreditCard cReceint 1 RECEIPT #: 1200900000000000895 Date: 08/10/2009 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge Paid By M]TCHS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 076322 ]n Person Payment Total: Page 1 of 1 2:30:24PM Amount Due 81.00 4.05 9.72 $94.77 Amount Paid $94.77 $94.77 8/1 0/2009