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Home My WebLink AboutPermit Electrical 2009-9-17 225 Fiftb Streett Springfield, OR 97477tPH(541)726-3753t FAX(54 1)726-3689 SPRINO....... [.. 'DEPARTMENT'LisE ONL.Y I .IP.-"- ~ I (.01ll1u>01 -0137SI ......_ '" Pennltno.: I Date: . 9 -/7-01 I Electrical Permit Application CITY OF SPRINGFIELD, OREGON This permit is issoed uuder OAR 918-309'0000. Permits are nontra~erable. Permils expire if work is uot started within 180 days of issuance or if work is suspeuded for 180 days. \'X;. '-NO '~ -\(. 1'\ r ,,\\\, I LOCAL GOVERNMENT APPROV~l,l\l\I'\:. ~'n1\~\~ 'I',,: FEE SCHEDULE 1 I Zoning approval verified?'f'1:\C.1fJ \I'f. ( c;.~l'-\..;.c1~pS ~;:.~~~\1 1" iio.'umber of inspections per item () IQIy.I' Cost Tolal I 1 CATEGOR'(.\OF-. ('lO'Nsriju~itll::;N v.t>-.1AVV' 1 .. ..." . ea. cost I I .. I '\..\"\. \0 .....O\It.V rh~~ ~ . I I Resldentl3l, per umt, service Included: D ReSIdentIal . D ~QY~Q\l])ent'".\,n 'I'D t:;:''l.wercIa' I I I I I' JOB SITEINFORI\II)ttIQIV~'tiICNIS.OGAtION 1 1,000 sq. ft. or less (4) .. $134.00 $ I b. dd ?b ~,..nC\liu.'(_ / I I Eachaddilional 500 sq. ft. or portion I I $ 25.00 $ I Jo site a ress: .;;> ~ ~\'..J "'fi6IJT rr I)&, thereof I City: s'f F ~ 1"State: ~ r ZIP: 77l(7if I Limited energy (2) I J,,$ 32.00 $ I I Subdivision: \ 702 S (4 Z. I Lot no.: oz SO I I Each manofactured homenr mOdol'lltesl'100\1\\'$I.63 00 $ I I. DESCRIPTION OF WORK dwclhng semce or feede~m, te(\~)~(\bl\ . In(W . 1(\"..... '-"-- s'O.. - ... I I Ad cl \ c ( rCJj.... "\ + Services or f~~qei~s.;r.!.ns!a!{c;.ti(fn(qJt..e.r/l!iOnl,rF!9'([;j~))~ I I 2~~1I?~~e~~(iJ)?:~~OSe.~~" O~~; (~\$S_8J"00 $ I I ,PROPERTY OWNER I ~j.!cl014l!g:~pf(~j';.,\)\() W:';,rileS.o: ~'e\e1 X'j;~:~%j)0 $ I I Name: T,limf:') & !L.C:.e-n ilL I ~jlliti\~@oJ<!iiipJ~(?l o'o\'3-'\\~OW:,,~\~: ~~'J"$158.00 $ I I Address: .:s-:Sb. ZS IIe'W/6.\}"~/"" ~'Jt~ 6~~q[jl~~~~~_~t~;e~~~ ~?,~~j~~1 $205.00 I $ I I City:lN~ ko~ 04-\ I State: lAJ A I ZIP: 98671 I Ovcr<!;00q,'\IRPe:or.v.\'Jt~J2) '6 I $469.00 I $ I I Phone: I Fax: I Reconn~l:\'~nIYii)\"- I $63.00 I $ I I E-mail: I Tcmporary services or feeders: installation, ~lteration, relocation I Th" II' . b . d 'd' I f: I 200 amps or less (2) $ $ I IS msta atlOn IS "ClOg ma e on resl entIa or ann property 63.00 I owned b~ me or a l11ember of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ I property IS not lOtended 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 services or feeders section above I I CONTRACTOR INST ALLA TION I Branch circuits: new, alteration, extension per panel I I Business name:, "P,H yYl E \..e....t....l-Yr ~eO I l.~. Fee for, branch circuits with purcha<;e ofa service or feeder fee: I I Address: \J.b .00)( c9.5~4 I I Each branch circoit I $ 6.00 I $ I I City: r 11.1' ~ -U\~ I State: D t I ZIP: q I) L\ 0 I I I b Fee forbran. ch circoits withoot purchase of a service or feeder fee: I I PhoneSl\~-Oc(05 I Faxf.f{\-lv.~-c3060 I I First branch circuit (2) I /1 $ 55.001 $ s;sr I E-mail:~~mE.\.e.~+vt'~Cb@ ClO\ ,('OYY\ I I Each additional branch circuit $ 6.00 $ I I CCB license no.: \ t6't005 I BCD iicense no.: (' ~43~ I Miscellaneous fees: service or feeder notincluded I I Signingsupervisor'~ license no.: \hlJt~S _ I Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signing supervisor: 'vhlls.\<,u;e I Each sign orootline lighting (2) $ 63.00 $ I I Signature of signing supervisor: ~.. /J/~ I Signal.circuitoral~ited-energypanel, $ 63.00 $ I -,.~--t.4.... ~/? alteratlOn,orextenslOn(2) --: , ~()I Each additional inspection: (I) $58.00 $ I 11\ ~()O.IV APPLICANT USE I ('\(1 ~,)V'1' \: (A) Enter subtotal ofabovefees ...-0... ~ (Minimum Permit Fee $58.00) $ j U (\ .\~ \0 I (B) Enter 12% surcharge (.12x (A]) $ 6~b v\,\ I (C) Technology Fee (5% of [A]) $ Zt;:O I I TOTAL fees aod surcharges (A through C): $ /;; 78t/. ~ CX8~'~ ~~ ~ 440.2584,J (9108/COM) _.,~!M!!~~;'2,,1 "i ,~- '--o-'~;'+-'L ,~ . , Status Issued CITY OF SPkmlJJ1lJ<.LD Building/Combination Permit PERMIT NO: COM2009-01375 ISSUED: 09/17/2009 APPLIED: 09/]7/2009 EXPIRES: 03/17/20]0 VALUE: 225 Fifth Street, Spriugfield, OR 541-726-3753 Phoue 541-726-3676 Fax 541-726-3769Iuspecli,ou Line SITE ADDRESS: 3650 MAIN ST ASSESSOR'S PARCEL NO.: 1702314202501 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Add 1 circuil for Coffee Cart Owner: GREEAR JAMES D Address: 35625 NE W ASHOUGAL RIVER RD WASHOUGAL WA 98671 I CONT~CTOR INFORMATION' Contractor Type Electrical Contractor BHM ELECTRIC COMPANY License 184005 Expiration Date 09/19/20 I 0 Phone 541-686-0905 BUILDING INFORMATION I # of Unils: Primary Occupaucy Group: Secoudary Occupaucy Group: Primary Couslructiou Type Secoudary Coustruction Type: # of Bedrooms: ~ ~(;S~ *~~ ~ ^'#' '\~<<;- .(3~( <{$" g ,<)~J ~v 0' ^' ~ I DEVELO.PMENTINFORMATION , .'>..'f~~ , <:y' ~ ~" Froutyard SetbaC$' #' .::::,~~" :f:><::)' Side 1 Setback;~ ~ ~ ):) (;S ,,0' Side 2 SelbafR? r_~ "i:' ''-0<<:; ::\ "- ,- '0.,,,> ,'>.." ~ ~ Rearyard Setb~ck:~' ~<<:; '0<::) Solar Selbacks: ~ ~~ ,,'0 r. .-1 ~- # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Euergy Path: Spriukled Building: Lol Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basemeut: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Haudicapped: Compacl: Street Improvemeuls: Storm Sewer Available: Special Iustruction: ATTENTmN1 P..VBLI~?MPB-QYEM.El'1l~' 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 ('ont~r io 1-ROO,332,2344\. Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Type of Constructiou SPer Sq FI or multiplier Sq uare Footage or Bid Amouut Value Dale Calculaled Paee 1 of2 CITY VI' .srKll'll.'1'lELD Status Issued Building/Combination Permit PERMIT NO: COM2009-01375, ISSUED: 09/17/2009 APPLIED: 09/1712009 EXPIRES: 03/17/2010 VALUE: 225 Fifth Street, Spriugfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Iuspectiou Liue Total Value of Project ~~~.~ .Pai~ , Fee Description + 12% State Surcharge + 5% Techuology Fe~ Add, Alter, Exteud Circ MiuimumJAdjustmeut Electrical Amouul Paid Date Paid $6.96 $2.90 $55.00 $3.00 9/17/09 9/17/09 9/17/09 9/17/09 Receipt Number 1200900000000001074 1200900000000001074 1200900000000001074 1200900000000001074 Total Amouut Paid $67.86 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 Relllli.red I nsnections I Rough Electric: Prior to Cover , Fiual Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed applicatiou aud do hereby certify that all informatiou bereon is ,true aud correct, and I further certify that auy aud all work performed shall be doue iu accordance witb tbe Ordinauces of IheCity of Spriugfield and the Laws of the Slate of Oregou pertaiuiug to the work described herein, and that NO OCCUPANCY will be made of any structure wilhout permissiou of Ihe Commuuity Services Divisiou, Building Safety. I further certify that ouly coutractors aud employees who are in compliauce with ORS 701.005 will be used ou this project. I further agree to ensure tbat all required iuspectious are requested at Ihe proper time, that each address is readable from the slreet, that Ihe permit' card is located at Ihe frout of Ihe property, aud the approved set of plaus will remaiu ou the site al all times during construcJion. Owner or Coutractors Signature Date Pa2e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-01375 COM2009-01375 COM2009-01375 COM2009-01375 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200900000000001074 Date: 09/17/2009 Description Add, Alter, Extend Circ Minimum! Adjustment Electrical -1;,5% Technology Fee + 12% State Surcharge Paid By BHM ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received DJB 898161 In Person Paymenl Total: Page I of! IO:54:51AM Amount Due 55.00 3.00 .2.90 6.96 $67.86 Amount Paid $67.86 $67.86 9/17/2009