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Home My WebLink AboutPermit Electrical 2009-9-18 Electrical Permit Application . " . ...::<. ~ '~1. ,.- ...,~ 'C' ~'!' ~ .' t "," ""- CITY 0FSPR1~GF"IEED,:OREG0N,~,,": ....:...'J .""~~ ~""". t.., ,,,'0',,> ~- ..' l : .',.'~" Ii \: ' 225 Fifth Street.Spriogfield. OR 97477. PH(541)726-3753. FAX(S41)726-3689 ................. . I': DEPARTMENT USE'Pt>ilj:">' ,I r~ I p' C/2f ~ O/JcfOl a_~ enmtno.: ~ 'IDate: 9/1t'/o! I This permit is iSsued under OAR 91~309-0000. Permits are nontransferable. Permits expire ifwork is not started within 180 days of issuance or if work is suspended for ~80 days. . I>:'::'~;;, )LOCAl: GOVERNMENT,,'APPROVAl- .' I Zoning approval verified? Dyes DNa I', ;:';;' .'CA TEGORY OI"CQNSTRUCTION" o Residential I 0 Government .1 0 Commercial :JOB :SITE.INFORMA TION: AND 'tOCA TION Job site address: ~t{1 ! J t; ~ r _ _ 1 City:~~U{ r State: (){( I zt#7Cf77 . I Refere~ce: / 1 'Jn1!?J\,)A- r Taxlo\.\ \~ I"~:' ,::,:',,~':'.' DESCRIPTION;OFI'WORK, . . ., i "1, :"PROJ:>ERTY,OWNER'[':' Name: l-al6 dA~ JI,,~;~-, Address: City: Phone: E-mail: 1 State: I Fax: I ZIP: This installation is being made on residential or farm pIVp....l~j owned by me or amernber of my immediate family, This l'wy......J is not iritended for sale, e'fchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: I ,':CON"(RACTOR,INST4LLATION' r ,,',' I Businessnarne:~~k:^" ~ I Address: <2S"?~lAr,r ~"t'<< City: /-r"u("-,,^-. . I Sta. te:t:7l . I ZIP: ~~ Phone:~{t~'1t.( I Fax<ll/-1!j/ ~1C/r , ' E-mail: CCB license no,: lftz9Y I BCD license no.: 1t:>-t/t/~C Signing supervisor's license no.: q-I'q-"~r> , Print name of signing supervisor: {!~1 /..Jf"',r/f,~i"f { I Signatureofsigningsupervisor:"f -" JilL ' {~,---t/ ~~~~ ~ fb~ ~'t- ~cfX ~ 440-2584-J (9/08/COM) FEE SCHEDULE Number ofiDspec~oDs per item () IQty.1 Cost Total , ' ea. cost Residential, per unit, service ioduded: 1,000 sq, ft, or less (4) $134.00 $ Each additional 500 sq, ft, or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufuctured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation .'! .,... 200 amps or less (2) 20 I to 400 amps (2) 40 I to 600 amps (2) 60 I to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) $ 81.00 $ $ 95.00 $ $158.00 $ $205.00 $ $469.00 $ $ 63.00 $ Temporary senrices or feeders: installation. a/teralion. relocation 200 amps or less (2) I $ 63.00 $ L 3 201 to 400 amps (2) $ 87.00 $ 1 401 to 600 amps (2) $126.00 $ I Over 600 amps or 1,000 volts, s,ee services or feeders section above I Branch cirtuits: new, alterqtion, extension per panel a Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase ofa service or feeder fee: Finlt branch circuit (2) I $ 5500 I $ Each additional branch circuit $ 6.~0 $ I Mistellaneous fees: service or-Jeeder not i'}Clude'd I Each pump or inigatioo circle (2) $ 63.00 I Each sign or outline lighting (2) $ 63.00 I Signal circuit or a limited-energy panel, $ 63.00 alteration, or extension (2) . 1 Each additional inspedion: (I) . 1 li~ C', ,) ,," "APPLICANT USE ... I (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) I (8) Enter 12% surcharge (.12 x [A]) I (C) Technology Fee (5% of [AD 1 TOTAL fees and surcbarges (A tbrough C): $ $ $ $58.00 $ $ & 2" en.:> I $ I $--1, <" 17 ( $ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01380 ISSUED: 09/16/2009 APPLIED: 09/18/2009 EXPIRES: 03/1612010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 431 35TH ST, ASSESSOR'S PARCEL NO.: 170231241.1900 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Temporary Electric Owner: AUXIER THOMAS EARL & MAZIE Address: 644 S 35TH ST SPRINGFIELD OR ~7478 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor BEAR ELECTRIC INC License 20919 Expiration Date 02/20/2010 Phone 503-678-1355 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Strnctnre 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 DEVELOP~ENT INFORMATIO~ , REQUIRED PARKING Frontyard Sethack: Side I Set hack: Side 2 Sethack: Rearyard Sethack: ' Solar Sethacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements:, ~TTr."~'''N' 0 I ' Storm Sewer 1\vaIlahle: ' regon aw requires you to Special Instt\l~ti'on:ules adopted by the Oregon Utility Notitlcation Center. Those rules are set forth Notes: in OAR 952-001-0010 through GilR 952-001- 0090. You may obtain copies of the rules by __/I~__ __ H_ . ,., .. _ Sidewalk Type: Downspouts/Drains: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK .....<=./ ...- ~~,.........,. \,......,...... "I..... ".",~"""".... number for the Oregon Utility ~I.cv"'j('IOti~t" D . t' , Center is 1-800-332-234 ': a ua ,IOn escno IOn . ,....... .........,-........ "~r............ "T'"III..... l"'\!"'"r"\1IJ11T II"' I\I(\T r"-'II'VIIIL...l..lJ V'~LJ""" .,.,..... .........".- ..-- Description Type of Construction $ Per Sq Ft or multiplier COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sqnare Footage or Bid Amount Valne Date Calcnlated Page I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01380 ISSUED: 09/16/2009 APPLIED: 09/18/2009 EXPIRES: 03/16/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax S41~726-3769 Inspection Line Total Value of Project ":e~~ Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $7.56 $3.15 $63.00 9/18/09 9/18/09 9/18/09 2200900000000001060 2200900000000001060 2200900000000001060 Total Amount Paid $73.71 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 , ,Re/ll~ired J.nsnedio~;~ . Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that 1 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 he done in accordance with the Ordinances ofthe'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 co ractors ind employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure tha II requi red inspections are requested at the proper time, that each address is readable from the ::::::'~;:':~l' , "".') "~~".,., ,m""",~. ", ."m?j/~;;;' ...;.00 ., ..""." Owner or t,..n~ractors SigKature Date Paee 2 01"2 225 Fifth Street I Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number cOM2009-01380 cOM2009-01380 COM2009-01380 Payments: Type of Payment creditcard cReceintl RECEIPT #: Description Temp Power 200 amps or less + 5% Technology Fee + 12% State Surcharge' Paid By CHAD PERKINS City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000001060 Date: 09/18/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 031716 In Person Payment Total: Page I of I 9:02:08AM Amount Due 63,00 3,15 7,56 $73.71 Amount Paid $73,71 $73.71 9118/2009