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Home My WebLink AboutPermit Electrical 2009-8-25 225 Fifth Street. Springfield, OR 97477+ Pt1(541)726-3753 +FAX(541)726-3689 IgC';::~~~~T~ENfu~'E. o NC'( " -I I COvYl z..,00 'i - () 12i.{ I2t Penmt no,: V I Date: f{ ~zS -0 7 I Electrical Permit Application o 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. I;'.;" :.'" "Tt!bCAL',GOVERNMENT .'.AP,RROVAlEo,\,t4Xi'rf,~,';~'1 1~;oj::':W#(1'%~;ii~iiR'':*r.FEE~,SCHED.U~Eifw~A\;~~~~~F.',;m~!1 I, Zoning approval verified? ,0 Yes 0 No 1 1,,~umi,er'ot'i~;peiii~~i'pe~:i;~;';;():';~iIQiy:1 ':F6s!::il',Total,:r 1'~?;~!!l:!;;:S;i[CATEGORY,ifOF?CONSTRUCTION[\:%"":,";i;' ":-'~:,I""""'" j,,",'.,-,,' "",,owl', """,.,,~. ',""',: '..',,' ",;,,'ea;,",.,.. 'c()stU" I Residential, per unit, service included: =~~~~ITEijJNk~R~~~7;~~AND!1~~C~;~~~;~t;III,000 sq ft, or less (4) $134,00 $, Job site address: L;' / '71' c: ;';' /' ,I I ~~~~:ritional 500 sq, ft, or portion $ 25,00 $ i,;.~J:~~~c~J~f~R~17F:U~~,i:,:::~Z~~ I ~~~~:;~~;;i~~;~ Fe~~~r (~rodUlar : ::::: : 1 c..1+A'i\I6-c-~ .f /t-r./E"L... I 1 Services or feeders: inSlallatio\~ alleralian, relocalion 1 I 1 200 amps or less (2)\'es ~ou .\'\" ' A $ 81,00 . _". rPl:.!1.:o I Ilh \ \I ;' I" ~, :PROPERTY;OWNER '" ' ._..-ct-.\1\G)\'l1 '20Ili<[-'{b,q~~psJ'2fe?~'~;\10(\\\ $ 95,00 $ 1 Name', n 5. / "\'\':.. rU\ ,5 1''ii6'Vt';6QO:affip's\('ij~-;R 9S2.\JU,~-, 'I $158,00 $ /./e;,ert ;"'''7dO,:'' In a.. (,_.Q,' -,,,,,.., ,._n\ 1 Address: tj', / '71' E 5 r \'lo\i\iCa."~ ~_(lC:6PIJto~l~oo<iA~~m\ \\\:~~~~e . $205,00 $ I City: '}"'~c( 1 State: O/( I ZIP: ?'Z:?i~~) r1~:?~~~fOOQ\~~S::.~~I)~((?hca.\iOn $469,00 1 $ 1 Phone:i'if ~a( "6', I Fax: ca.\\i~~I\~ ':~:!'F'p~.!Jec:~E~'f2h.2.344). $ 63_00 1 $ I E-mail: I1W\''''-l'c ~{T~niporlry services or feeders: installation, 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 immediate family, This I 201 to 400 amps (2) $ 8700 $ propmy-',ot mtended for sale, exchange, lease, or rent. OAR' I ' 479540(1) a d ~,560(l), () _ ~ 401 to 600 amps (2) $126,00 $ /S~gnature. 4') /?~, ~./~ lOver 600 amps or 1,000 volts, see services or feeders section above (I-__-.---.~::,CONTRACTOR.' -INSTAl:~ATION - _'" ,I 1 Branch circuits: new, alleralion, eXlension per panel I Business name: I I a. Fee for branch circuits with purchase of a servic~ or feeder fee: 1 Address: ( i/'(L 1 I Each branch circuit 1 $ 6,00 1 $ I City: r f'J v I State: I ZIP: I I b. Fee for branch circuitsn1J\fout purchase of a service or feeder fee: Phone: ,,,\ V' I Fax: ., ".,.,r.f... 1 I f:i("I>~rWCIFcl;~~)~\'nl I $ 55,00 $ ~ I~U" .,- '--'j\P.r~\. '" r.fioll'\' \ Iv . 1 E-mail: ;~\C. PERMI \ ~ :~\':.,?,E~~~\~~iji 'O~~lt~\:<hCircuit , $ 6,00 $ CCB license no,: I BCD license no~, \11-10R\It~~ .IJP \ll!tw.:!Jlin~1>> ifes: service or feeder nOllncluded Signing supervisor's license no,: COMMt~~~~ 't ~\iI\CJJ,pump or irrigation circle (2) $ 63,00 I Print name of signing supervisor: p,N'I -\ QU v' .. 1 Each sign or outline lighting (2) $ 63,00 I Signature of signing supervisor: I Signal. circuit or a li~ited-energy panel, I $ 63.00 $ alteration, or extensIOn (2) I Each additional inspection: (I) I $58,00 $ l~i~~~~~~f~~A'RF?,CnC'ANT!~:US_E~JJ~f~ii;~~~~1;'~::'~ (A) Enter subtotal of abovefees $ 'J I (Minimnm Permit Fee $58,00) ~ ,I (B) Enter 12% surcharge (.12 x [AD $ 9 7 f 1 (C) Technology Fee (5% of[AD $ 'f '''1 1 TOTAL fees and surcharges (A through C): $ 7Y ~ _' I $ ~ ( $ $ ~r:5" ~~ ~'* 440.2584.) (9/08/COM) Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01249 ISSUED: 08/25/2009 APPLIED: 08/25/2009 EXPIRES: 02/25/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5171 EST ASSESSOR'S PARCEL NO.: 1702332402400 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Change service panel TYPE OF USE: Repair Residential Owner: SANDERS DAREN W Address: 5171 E ST SPRINGFIELD OR 97478 Contractor Type Electrical I CONTRACTOR INFORMATION 1 Contractor OWNER License BUILDING INFORMATION 1 # of Units: # of Stories: Primary Occupancy Group: R-3 Height of Structure \<. Secondary Occupancy Group.: 'nee' Ty.geR'~~~a1':\E \NOR Primary Construction Typel'tO ES,BI-r S\-\i',ll Wat~rTy~e':\'\-r IS NOI ~'IIS n ,,\VI I -, Ole n~0\V \ Secondary Construction Type: r 2EO UNOERlh~~~ <J;~r.,'t:j) fOR # of Bedrooms: i',UI \-\0 HI OR IS 1'.[ergf)Fath. COMMENCEO EDIOV!rinkled Building: nla ,....nnJ\VPn 1-\1" 'V_ - I DEVELOPMENT INFORMATION I Front yard Setbac!>: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Loq;overage: to ATTENTION: Orego~ ~a~h':Or~g~n Utility . ,,~... ....Io.c ~rl()ote Y _ __...f^rth N;iification C I'PUBLI2'iMi!~Q:Y~E.MEN'fS t in OAR 952.0L btain copies 01 \11" 'v'v_ -; 0090.. You may 0 Note: the telephone calling the cen~r. (on Utility NotificatIOn number for the rjesgOO'332.2344). Center IS - Phone Number: 541-501-4655 Expiration Date Phone Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutsfDrains: I Valuation Descrintion I $ Per Sq Ft or multiplier , Square Footage or Bid Amount Type of Construction Page I of 2 Value Date Calculated Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01249 ISSUED: 08/25/2009 APPLIED: 08/25/2009 EXPIRES: 02/25/2010 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 1 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 8/25/09 8/25/09 8/25/09 2200900000000000960 2200900000000000960 2200900000000000960 Total Amount Paid $94.77 I Plan Reviews 1 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 Rl'ollired Insnections 1 Electric Service: Approval required prior to utility company 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 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 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 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 time()ing construction. /~~~-_ ~ f-,zer-Of v Owner or Contractors Signature Date Paee 2 of 2 225, Fifth Street Springfield, O.regon 97477 541-726-3759 Phone GP_~~lJoj'~,F1'.'BLD_,.,',}""'_.'"",, '.',,:,,' 11 '.,,'t ~'..: ~ City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0 1249 C0M2009-0 1249 COM2009-01249 RECEIPT #: 2200900000000000960 Date: 08/25/2009 . Description Perm ServlFdr 200 amps,or less + 5% Technology Fee + 12% State Surcharge Payments: Type of Payment' Paid By Item Total: (;heck Number Authorization Received By Batch Number Number How Received Cash Change Job/Journal Number COM2009-01249 COM2009-01249 C0M2009-01249 Payments: Type of Payment Cash Change cReceinll DAREN SANDERS DAREN SANDERS djb djb In Person I n Person PaymentTotal: Description Perm Serv/Fdr 200 amps or less ,+ 5% Technology Fee + 12% State Surcharge Paid By DAREN SANDERS DAREN SANDERS Item Total: Check Number Authorization Received By Batch Number Number How Received d j b In Person djb In Person Payment Total: Page I of I I1:53:16AM Amount Due 81.00 4,05 9,72 $94.77 Amount Paid $100,00 ($5,23) $94.77 Amount Due 81.00 4,05 9,72 $94.77 Amount Paid $100.00 ($5,23) $94.77 8/25/2009