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HomeMy WebLinkAboutPermit Electrical 2009-9-16 225 Fifth Stree"Springfield. OR 97477+PH(541)726-375HFAX(541)726-3689 1!:{":'\q~~~5f~~~'f,u~1~,9Ng~: ;)'1 pr~ 't- O(sG~ I I Date: 9 -16 .0'7 Electrical Permit Application This permit is issued under OAR 918-309-0000. Permits are uontransferable. Permils expire if work is not started withiu 180 days of issuance or if work is suspended for 180 days. ~\y., 1');; '''(({OCAL;~GO\i'ERNMEN;rr,AP,I''~0VA8;'!\'t\l1-I,i~'i!f;;\4!;.1 1'};iJ~r,~ij'~&"!l"~'.~~~g>l,ITEE~.Sc;HE[j,UJ.\jEi[il!tiJlit1f{i~?"1i~'!!:~~31 I Zoning approval verified? DYes D No I 1~;~,~,~~:~~~f~-~~1~~~~lg:fi]J-~~:~i.~~~~~:!~~~f;~~18,1Y~;[i.:.it~~~,~a.~~rE1%t~~~~:1~; i~~~;::~::~~~r;EG,Rb~~~:~~~;;r:RO~T~O~;::~:;~~;";<;:: 'II ~~~~::ti:I,:~::n(:; service included: '. II ~Jli(ii.:tOI3,lS ITElllN I;;ORMAq;IONfiAN[jllI!Qc'NTrloNmit~1r'tlj~1 $134.00, $ I Job site address: 1::l.\D t<Af:~~ ~J I I ~~~~oaritional 500 sq ft. or portion $ 25.00 $ I I City: <;Drf n. c:, Ir\ State: 0 It I ZIP: 1''7'/ 7 '7 I' I Limited energy (2) ./ $ 32.00 $ 5' Z I I ReferenC'~':";:<DESCRIP'tION'iOF:,,^,J;~:~~~;''i:?;<i'\f('.'j:;g;"i;;ll J~~~I~:ns~~~~~~r~~ Fe~~:r (;)'odular $ 63.00 $ I 7>~.... ~ / c:lr6LF / 'i\IA " l ~ . Services or feeders: installation, alteration, relocation I I ' . I I ,. f:;~~.~~T.lm : dl,2Jlg~~~~.~r,I:~,~~?"" $ 81.00 $ I L . ;P R' . . y' 'OW": . . ..-', .~.~" ,d )20,], to'400 amRs (2) YOlltO $ 95.00 $ I I~am~: ' C-vv ,,_~~,\~;E~: ,;...... ;~R" .' . j~'~J;~~i2~~1:1n ~{g~~~~d'~:i:.~;fZ~e~;~:;rh $158.00 $ I I Address 3Zto (~! !........e.o.J::u:"~;;~;0~,~~'~,~Ii:.~2,rr!q:j;9R2'g~i!~:~~~~~~~Oo1- $205.00 $ I I City: t^.. r,.l I State: 0 (l... I ZIIllu1i'iZ<Jnf7 , ,!0ve(II:Ooo. ~ft)RslVi,';?,l,tM~l- Y $459.00 $ I .'XN "'-,,~~ L - IL'V( tI P. ..I' ~uon "tilib, .. .". - I I Phone: '-' I Fax: Cente' j. ~!'S?~r~c~2n1:C~!tlflcalion I $ 53.00 $ I E-mail: Temporary servic~~ or fee_ders: installation, alteration, relocation I Th" II' . b . d 'd' I ' I 200 amps or less (2) $ $ I IS msta atlOTI IS emg ma e on resl entIa or larm property 63.00 owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ I property is not intended for sale, exchange, lease, or rent. OAR I' I 479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $ Signature: lOver 600 amps or 1,000 volts, see seryices or feeders section above I I . ::'",,:',:,;::rCONTRAC1;OFf' INSTAI.!.l.!ATION.i ..1 I Branch circuits: new. al/era/ron. extension per panel ' I I Business namel)tl',~ \\.y=t: r '10 c..~ Io""\b )o'~'\ c... <:.. I I a. Fee for branch circuits with purchase of a se'rvice o~ feeder fee: I I Address: e ib i3~ 4 cS3 (p - I I Each branch circuit I I $ 6.00 I $ I I City: -r: ):l~""'- I State: 0 (l I ZIP: ~~Tlr E.I b. Feefor branch circuits without purchase ofa service or feeder fee: I I Phone:.)4{ - 913-1..fl/?7 - I FaxSV/ -?1r-SI)'O THI,~ .p~ R' p F~st branch circuit (2) I $ 55,00 I $ I I E-mail: AUTHOI!I{~~~Ej~~~jlcklitilirlili.Ji.!i!l<IFcjr~ "'''f'l.j $ 6.00 I $ I I I ..W:! Ivi -~ .UI"f IrK 'I ",,- .\..;, I" CCB license no.: ItI'lS8' BCD license no.:)o-Y?;l.MME (~i)'I,IS0~a'.!,eous f...:f?[rYlMPr .f"lio/.rrM' included I I I-1IVY 18 I -~" I", Mp."'~nf)~'r '_'1. I Signing supervisor's license no.: 3~" 3 Lf A C D ~fiial!h:TP.'lIJbo ,rng""'n..,@lfGR - $ 63.00 $ I Print name of signing supervisor: C'y,.,>, hnll(V" D .~..t?1 Each sign oroudine lighting (2) $ 63.00 $ I I Signature of signing supervisor: (wS~ t \ - I I S.ignal. circuit or a limited-energy panel, I $ 63.00 $ I > ~ alteratIOn, or extensIOn (2) I Each additional inspection: (1) I $ I 1~\f4i~"1ft1~lQq~tE!'~;AR~i]icgN'[~ti5 I (A) Enter subtotal ofabo~ (Minimum Permit FP$58.00f.-/ ,I (B) Enter 12% surcha~'rf2x [A]) , (C) Technology Fee (5% of[A]) I TOTAL fees aud surcharges (A through C): {v/ ~ C\. \~ .aC\ ~~~ ~ ~ 1\t..Q, ~ 0 D--V A,. ~ ~~ $55 674 7*1> -b7~ $ $ $ 440-2584,J (9/08/COM) _~Ii!R'Ni:ilI?I!ii~9J' ~. . ;. I & rfI\ V' (' r {\ ('\IiJ# ~ CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-0I365 ISSUED: 09/16/2009 APPLIED: 09/16/2009 EXPIRES: 03/16/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phoue 541-726-3676 Fax 541-726-3769Inspectiou Liue SITE ADDRESS: 3210 RALEIGHWOOD AVE ASSESSOR'S PARCEL NO.: 1703221318300 Spriugfield TYPE OF WORK: Electrical Work Ouly TYPE OF USE: New Residential PROJECT DESCRIPTION: Low volt - phone, cable aud audio Owner: Address: Contractor Type Low Voltage Eleclrical BURNETT GARY R & NANCY A PO BOX 7547 . . you to EUGENE OR 97401 ' ON' Oreqoll laW reqUIreS Il Utility ,,-r.,-r:MT\ . ........ ,j.l.-."" ('lIP-OO . . \ s aautllv........1 resellUIUI loHoW rll a, r _'- _-:'"' ..Hip!=; a. , . - I. NotilickC0N.'fRi\CT.OR.INFORMATlON". . OAR 8~"~-Uv' .v~ . ~ ies 01 tne ,VOV~ ' Y III Y obtalll cop 1..~hMe Contractor 0090.. You ma t (Note: the \llilcense , , ~\,-" ,..an p.r., . . Nr-t"i,,....QUOn DEVLOGIC TEeHNOI\pG.I):;~(I.\'!~OIl UtilitY _' 19,1458 flUII" "-,, .-. . "'...." .... "'J_~ u-, . ,. ,I BUIIJDING INFORMA nON, Expiration Date 09/16/2010 Phone 541-913-4487 VB # of Stories: Height of Slructure Type of Heat: Water Type: Rauge Type: Euergy Palh: Sprinkled BuHdiug: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basemeut: Sq Ft Garage/Carporl Sq Ft Olher: Occupaul Load: # of Uuits: Primary Occupancy Group: Secoudary Occupaucy Group: Primary Coustruclion Type Secondary Coustrucliou Type: # of Bedrooms: R-3 uta I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Selback: Rearyard Selback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: OlGaved Drive Rqd: N o/~JWi>oIH1'eragetXP\RE \F 1HE WORK THIS t IVII UN';ER 1HIS PERM" IS NOT ^ I'TI-lnPI7FD ,. ._~ rn" - "':.::' n: '~."."''lJUUI'tL-1.J . _.- I PIQ:I!I\\I0ILMIlROVEM.I!;~TS' ANY l'tlu 01'\\ fL,.J-, Sidewalk Type: Downspouts/Drains: Total: Handicapped: Compact: Street Improvemeuls: Storm Sewer A va Hable: Special Instructiou: Noles: I Valuation Descriotion .1 Description. Type of Coustructiou $ Per Sq FI or multiplier Square Footage or Bid Amouut Value Date Calculated Page 1 of2 Status Issued 225 Fifth Streel, Spriugfield, OR 541-726-3753 Phoue 541-726-3676 Fax 541-726-3769 Iuspectiou Liue Fee Description + 12% State Surcharge + 5% Techuology Fee Low Voltage - Resideutial Miuimum/Adjustment Electrical Total Amount Paid Amouut Paid $6.96 $2.90 $32.00 $26.00 $67.86 Total Value of Projecl Fee.s Paid I Plan Reviews I Date Paid 9/16/09 9/16/09 9/16/09 9/16/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01365 ISSUED: 09/16/2009 APPLIED: 09/16/2009 EXPIRES: 03/16/2010 VALUE: Receipt Number 1200900000000001066 1200900000000001066 1200900000000001066 1200900000000001066 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. Low V ollage: Prior 10 cover. I Re(]lJir~d Insn~c~io~,~ I By signature, I state and agree, Ihat I have carefully examiued the compl~ted applicatiou and do hereby certify that all iuformation hereou is true and correct, aud I furlher cert,ify that any and all work performed shall be done in accordauce witb the Ordiuances of the City of Spriugfield and Ihe Laws of the State of Oregon pe~laiuing to tbe work described hereiu, and that NO OCCUPANCY will be made of any structure without permissiou of the Community Services Division, Buildiug Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I furlher agree to eusure Ihal all required iuspectious are requesled al the proper.time, that each address is readable from Ihe street, tbat the permit card is located attbe front ofthe property, aud the approved sel of plaus will remaiu ou the site al all time.s during construction. Owuer or Coutractors Signature Pa2e 2 of 2 Date 225 Fiftli Street Springfield, Oregon 97477 541-7'26-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0 1365 COM2009-0 136'5 COM2009-0 1365 COM2009-0 1365 Payments: Type of Payment CreditCard cReceintl RE<;EIPT #: 1200900000000001066 Date: 09/16/2009 Description Low V ollage - Residential Minimum! Adjustment Electrical + 5% Technology Fee + 12% State Surcharge Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received DEVLOGlC TECHNOLOGIES djb 051495 In Person Paymenl Total: Page I of I 9:25:48AM Amount Due 32.00 26.00 2.90 6.96' $67.H6 Amount Paid $67.86 $67.H6 9/16/2009