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Home My WebLink AboutPermit Electrical 2009-8-27 .. City of Springfield Electrical Authorization To Begin Work E-mailed To: mgehrke@cselectric.org Check on status of permit By Phone: 541-726-3753 or Email: pcrmitcenter@ci.springfield.or.us I D New Constructil?n" 0 Addition/alteration/replacement ""~~ - ~~Jt1~~~lCATEG6RYT{jtCONSTRUCTION~r~' i., I [~} o,2f=llydwolliog DMO"i.f,milY DCo~o"i'l D A"",my "~'-; ...:;,;-- . .~:i~,;~;t!'JoB'siTEiNFORMATION.AND:[OCATION':f;;;" I Job Address: 2580 23RD ST I City/Slate/ZIP; SPRINGFIELD, OR 97477 I Suite/bldg.lapt.Do.: -I Project Name: Martelle Derrickso~ Ie"" S."otldl",rioo. "jo. ."" I Tn.plp",""", \t}Do(j"t~ CO\cx.> 1~-:.;,it~~'?~2~i7~:;q~~~P~~C8fp)-'IONIqF;)N:QRki~t~~~?f~t...,~:;t~~,~;~\Y1 newpancl I': ;" ..;:yr" '~:;i:Tf;>':'~~"'~.t";-:,,:.'{SiTE~C()NJP:C:r:'lr~.?~'.2":,':: -;~~'~;~ Nllme: Martelle Derrickson Phone: 541-747-2218 Fax: 541-741-2473 Email: mgehrke@cselecuic.org :\'\.: ;4,Cf'~:~*"\,: :"~~C.6NiRA"CT6R"c . ",,~ .. ~: '''L_ EleClic.nll':~i(IfTI"~" CCBlie.no.: 3849 B"ln~'N'..:f0tS~~If~l-'f'-'- ':':DI",: IC TU,: wnoJ( COO,"', ,^.'.'::-'2P.!:::"'~ ~~~~m TI-'!: p,:".nIT Ie 'InT Add",,, PO!l'0!.j!\~~,:~~~",~ ~R I!:^~^'''Y;''I':~ cno Clty/S"'dZ'~i ~r!llNGIi\~LP, l/& ~W!b I () n ..... L_ ,",I. _ _...__. Phone: 541-741-2236 Fax: 541-741-2473 ..:mail: CSELECf@CALLATG.COM Melrolic.no.: City lie. no.; Supervising ":Ieclridan's lie. no.: Supervising Electrician's!"ame: 48945 DavidE,Gehrke Number or inspections included in pllid services: Residential Service: 4 Reconnect Only: I AllOthcrServiCes: 2 Upon review and approval by your local jurisdiction, your permit will be ..mailed 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 permit is not obtained. The local building department may determine that an Authorization To Begin Work is null and void if it does not meet applicable land use laws and local ordinances .:..... ""'j-", ~~~- "'A~_~~I ~~w?;f:"....:.-:J~.~."-!~c'" -~'~",f~;iiPL'AN REVIEW.~:&;':' ,;'5 Pleaseroeck aJl that apply: DHazardouslocalions o A service or fC<lder beginning a1400 DA service or fceder ral~d a1600 Amps where lh~ a~ailable fault amps or mor~ cuncntcxceeds 10,000 Amps al ISO Vol1s or less 10 groWld exceeds 14,000 Amps for all olher installations I~:'"f~~'';~.-;[-::;;~~~:;,; i~;f:_$E'ScF~'bu(E~. I Dcserilltion I Qty. ISe~!c-('sor:f<<ders --';'~;. -.'t::~~' <it:- -"~~_' ... 15ervices 200 amps or less IE.~~~tricriIP,erndtJ<e~: .- ISubtotal I State surcharge (12% ofpermil tOlal) ITechnology fet:_(5% ofpennillotal) I TOTAL PERMIT FEE Y~,I I o Firc-pumps o Emergency systems o Addilion ofa new molor load of 100 HPor more o Six or more residential unilS in one structure o Hcalthcare facililies :~5'<r e Cj - I Ol.Q LP 69600- BE L-09-00 I 02 8/27/2009 9:49 am Approval Code: 986000 "- -;" DBuildings morc than three Slories DMarinas and boal yards DFloatingbuildings [3 Comm~rcial-usc agricultural buildings DlnslallationofalSOKVAorlarger . seperalely deri~ed sys D'A",'E",or"I.2'or"I-3" DR~crealional Vehicl~ Parks DSupply voltage for more than 600 supply volts nominal ~T;,-,\,_ I Total ''''''"'~''"''"' '~:I $81.00 I $81.00 r -:.., -",.:1 '81,00 I $9721 S4.051 $94.77 kilL 51 en [09 E., .,--:';:," , ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800.332-2344). ~0"-- CO fv $~ ~~ j This Authorization To Begin Work must be posted at the job site until replaced by a Permit I ;:....;.~I I ~ .~_.~. ".; "-I . :.:t:.. I I I .~~ ~@ ,.~ 6-(' . ...P.RINQPllitLD , -- ~r';"'-~1;,,';<Ji-"<.W'~"i'~'!;'.lrJ_F' ~'''.''., :- t1 - ._"..' Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01266 ISSUED: 08/27/2009 APPLIED: 08/27/2009 EXPIRES: 02/27/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2580 23RD ST ASSESSOR'S PARCEL NO.: 1703244200100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: New electrical panel Owner: DERRICKSON RHONDA M Address: 2580 23RD ST SPRINGFIELD OR 97477 Phone Number: 541-747-2218 ! Contractor Type Electrical Contractor C & SELECTRIC I CONTRACTOR INFORMATION I License 3849 BUILDING INFORMA nON I Expiration Date 09/01/2010 Phone 541-741-2236 # of Units: Primary Occupancy Group: Secoudary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Street Improvements: F~onlXN".dI~~ack: Overlay Dist: Total: S,de !l,Se!~~ck.; . EXPIRE IF THE WORK: Street Trees Rqd: Handicapped: Side 2 S~tba[RlMIT SHALL ofaved Drive Rqd: ATTENTION: Oregon (;dmpliti,.es you to Reary:trlllSeilibcm UNDER THIS PERMIT IS N % of Lot Coverage: follow rules adopted by the Oregon Utility Sola'l,~tbac)(s:GED DR IS ABANDONED FOR Notification Center. Those rules are setforth """~.. . ___.__ inOAR!'l!'i?-nn1-nn1(lihrn"nhnAI'lQ~?_nn1_ I-\I~ I ,au un' I ..., IIVV. I PUBLIC IMPROVEMENTS~90. You may obtain copies of the rules by I calling the center. (Note: the t(llephone numlSidC~alk€f~p~:Jon Ut,ility Notification D Center is/bRClO<J32-2344). ownspouts rams. Storm Sewer Available: Special Instruction: Notes: I Valuation Descrilltion I DescriPtion Type of Constructiou $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e I of2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid. Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr.200 amps or less Amount Paid Date Paid $9.72 $4.05 $81.00 8/27/09 8/27/09 8/27/09 Total Amount Paid $94.77 Plan Reviews I CITY"OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01266 ISSUED: 08/27/2009 APPLIED: 08/27/2009 EXPIRES: 02/27/2010 VALUE: Receipt Number 1200900000000000997 1200900000000000997 1200900000000000997 . 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. wilt be made the following work day. I Rell~ired Insnections I 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 1 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. 1 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 times during construction. Owner or Contractors Signature Page 2 of 2 Date 22Sl<ifth Street Springfield, Oregon 97477 541~726-3759 Phone Job/Journal Number COM2009-0 1266 COM2009-01266 COM2009-01266 Payments: Type of Payment ONLINE CHGS cReceint I RECEIPT #: ~'c'!NQ"'IlU>. '._. _~..' '... ,V - .. ..... ~,.... 1200900000000000997 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + ] 2% State Surcharge Paid By ONLINE PERMIT CHGS Received By KR Page I of I City of Spri~gfield Official Receipt Development Services Department Public Works Department Date: 08/27/2009 Item Total: Check Number Authorization Batch Number Number How Received , ONLINE C & S Online ELECTRIC Payment Total: 10:20:20AM Amount Due 81.00 4.05 9,72 $94.77 Amount Paid $94.77 $94.77 812712009