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Home My WebLink AboutPermit Electrical 2009-9-25 t"") EI~c!rical Permit Application 225 Fifth St.-eeH Springfield, OR 97477. PH(541)726.3753. FAX(541 )726.;.3689 i , . ' j .,. . . 1~~~:~~'f.O;";''-i'~"",''>::;_!f>l~'''\.\~'''''''''':l,,;~,j0fY:;':~:';Yf-"~~:',",ir:';;~~Jll $PR~:C,A':-D ~. il"j:;'iR~f;,~~J?"~~~~~~;g!:t~~;'R;;1 Wir e; I Permit no:: a cJ .0/ 'ld- -r I , ' . IDate:o/Bdo9 .] I This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance orif work i~ suspended' for-I.80 days. 'Ji;:~~:~~::~~:;~~~ERNM~~:~RRO"~~:iilifi&t~~~l \~:;::~:~~~~TEG1R~~~~::~~TRor~o~~:::~:~tit4~1 \tr~:~~~~:;:~Ei~:~R~:~N~;;~~ATIO~~~1~Vi.~i;1 I City:f:.p:-\~.c:Ye.I(t I State: 012 I Z1P:C/74-71 Reference: V,O'b'4.\.g/4. \ I TaxlotDQAOO j,'(;,~~'~T:,;~!::,DESCRIPJIONi:OFJiWORt(\l:~!k1till"~~~~liif~l - Kl+e-he...1'") ~~rt'ode.I, ,1 I "1 l~f;~::~~~:;fI*;~~~1~l~~~~RRORE~~i~:'ovVNEat~~~~i1~~~1~;{~'g~~~l.~ I Name: I JlV\('I~ S( h I ( ynboyr" - 1 Address:c;;>\4\ ) 5~ 5 -r J :1 I City~t?;fY)k,Qd- I State:.oV I Z[PQ7<.f77 :1 I Phone: - - I Fax: :1 1 E-mail: This installation is being made on residential or farm properly - owned by ine or a member of my immediate family. This ....Up~HJ is not intended for sale, exchange; lease, or rent. OAR 479.540(1) and 479.560(1). Signature: ' ~~~,~#Xf4~~,~tC:O_Nrr~ClId~~INSTAgIfAIiQ~1\1ftl~j~~1!lk~~~ Busi,ness iIame1?b ,<;ni,#l G1eilnau t'..DIl-l1t<di~, lilt, I Address:5Um ~ lYnllOrY1LL-+tJ "'?,\v . · I City: (If)nlli1i " r State: nr2.. I Z[P: a7~ I Phone:811-7S1-I-oR'bD I Faxf)41-7SZ1-'1:~ i I E-mail: CCB license no.:/lf)~qq I BCD license no.: Signing supervisor's license no,: r1=)/ I ~ Print name of signing supervisor7Tm Ham b/I i1. Signature of signing sup~l i'Y"- ,'-..[ . '.~" t\... j~.,_._. '.. .. "!~.~, ,,'.... ...., ~ .- :/c.k~T."~'(J..~..,\.~t.::l:' ~ :.i:~;:~:~{~~~~~~! ,-?;t~;?..~' u.~". .~: .~ ~~. 1,""_-',; 7: "~..- .: . ri"'- _I: .. ,..... ..,~..y.,,;. ;" ..- -.,'-",,- -,,'~~r8',' .-..:; (\; , - "'-. ~\V -~. ~ 440-2584-1 (9/08/COM) 1~~~~~~~-tj;k~~2S;i~~~EEqSt::-HE[j_UtE~if~1t}z,~7~~~fli~~,1 l~eAt::Y~P1;<<-!Zt~~~;'~friJft1~i:'~'~;1~1!~Ji::~ti4'i~'~'-~'~~I'~~"'!!!i~I:~'pf--'cost:ii~I:~~Totir;jl ;;Number"oflDspectlODSIpc;r..ltem:(!)-}'li'iif QtY; ;;,.,~ll:~"-""...t~,,-'i l{~;"'M"'t)t.j ;,;~,:-~~~,T,'":t:".~'i.~r~::;'1~,;;Z,,\\m~','t1,<;~',,D;;!::'o:;,%"t;-;~i~.:~\-,;~!t1 ,t.,,;r-;',,^,"y, ~~ea;";~~ r;,~4;9S..,:~ I Residential, per unit., service included: - 11,000 sq)l. or less (4) $134.00 $ I Eachadd~tional 500 sq. ft. or portion $ thereof '_ $ 25.00 I Limited energy (2) $ 32.00 $ I Each marlufactured' home or modular dwelling service or feeder (2) $ 63.00 $ 'I Servi~"" o~'f';'de'r;; insialla/ion. .a//era/ian, relocation 200amp'sode:s (2)' .' . .. .... _ $81.00 $ 1 201 to 400 amps (2) $ 95.00 $ I 401 to 600 amps (2) $158.00 $ I 601 to 1,000 amps (2) $205.00$ lover 1,000 amps or volts (2) $469.00 $ I Reconnect only (2) $ 63.00 $ I TemporAry services or feeders: installation, alteration, relocation I 200 amps o~ less (2) _ ' -." '. $ 63.00 $' I 20 \ to 400 amps (2) d $ 87.00: $" 140uo600.amps{2l'. ..', $126.00- ,:'$ , 'Over 660 amps or'tO()()\rolts, see "...." ;.........:. or feeders'section above ;1 :1 11 1 1 1 I 1 1 j 1 I I I Ii l' .11 I' 'Branch circuits: new, 'alteration, extension per pane! I '" Fee for bmnch Circuits with porchase of a service or feeder fee: . l' Each branch circuit I $ 6_00 I $ I b. Fee for branch circuits without purchase of a service or feeder fee: j First ~ranch circuit (2) I 1 I $ 55.00 I $55, J Each additiooal bmnch circuit 13 $ 6.00 $/8".pd I Mis<ellaneous fee>: service or feede~.nol uic/uded j I Each pump or irrigation circle (2) $ 63.00 $ 1 Each sign or outline Lighting (2) $ 63.00 $ I 1 1 Signal circuit or a limited-energy panel, alteration, or extt?nsion(2) I Each a4ditional inspection: (1) $58.00 S '1Aii~~1~)~~~~~~{~8~'iijeAN11llifiSE'i~~\t'$ll'J~if'~~~ (A) .En~: s~~to",!ofabovefees: ....~.:. ;::, __, $ .-! _(MlOllOU.ID_ Per,,!,lt !ee $58.00) , '-" ','.. ,.,;_:' """,..;73;00: (B) Enter 12'i;'s~~ru.u-ge (.12 x [A]) . , -_~.~ 7i~ - $;,~-;7 iJ:) 1'(C)'Tecb;,oISgy'F.~e(5%of[A]) ," rr:; :,:,~ $'3:'i'Sl .1 TOTALfeesa'Dilsurcharges(Athrougbcf,,'~' $S5.4Ii . n+: $ 63.00 $ , " ,. '?"':~; CITY V1< ~rKll~uFIELD Building/Combination Permit PERMIT NO: COM2009-01427 ISSUED: 09/25/2009 APPLIED: 09/25/2009 EXPIRES: 03/2512010 VALUE: . Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2181 5TH ST ASSESSOR'S PARCEL NO,: 1703262102400 Springtield . TYPE OF WORK: Electrical Work Only TYPE OFUSE: Remodel Residential PROJECT DESCRIPTION: Kitchen Remodel Owner: Address: SCHULENBERG LARRY D & S M 2181 N 5TH ST SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION 1 Contractor License RG SMITH ELECTRICAL CONTRACTING I 16699 BUILDING INFORMATION I Expiration Date OS/21/2010 Phone 541--754-0880 # of Units: Primary Occupancy Group: Secondary 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 DE~ELOPMENT INFORMATION ,I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: . I PUBLIC IMPROVEMENTS 1 Street Improvements: Sidewalk Type: Storm Sewer Available: Downspouts/Drains: Special Instruction: NOTICE \ requires you to Notes:: ATTENTION: Oregon b a':'he Oregon Utility :~~ ,~~R_~I! S~~~~ ~XP~R~ ~~ THE WORK tollow rUles~:~?~,te~hJs~ rules are s_e~ t.?~:h ,.\U IIIUIIILL-U UI\lULIl . t ,,-, ...., .....",,,, '-, """ \\IUUllvUL'....." - th ugn v.....n ............ -- COMMENCED' OR IS ABIWillillatwo[D'escription lin OAR 952-0~y1-~g~~n :~Pies 0\ the r~\es by ANY 180 DAY PERIOD' ,.. 0090, You m (Note: the telep one , olrng the center, " N litlcatlon . . $ Per Sq Ft Square Fooragel th ,,-p(:\On Utility 0 Description Tvpe of ConstructIOn It' I' B'd A nl1mt ber tor 6yalueoo 332_2!,l~\~.Calculated or mu lp ler or I muun Center IS 1-1:) - Page 1 of2 CITY OF SPRINul'lJi.LD Status Issued - Building/Combination Permit PERMIT NO: COM2009-01427 ISSUED: 09/25/2009 APPLIED: 09/25/2009 EXPIRES: 03/25/2010 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 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add . Amount Paid Date Paid Receipt Number $8.76 $3.65 $55.00 $18.00 9/25/09 9/25/09 9/25/09 9/25/09 3200900000000000670 3200900000000000670 3200900000000000670 3200900000000000670 Total Amount Paid $85.41 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 R,efjIJiredlnsn~ctinns I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, By signatnre, 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 be done in accordance with the Ordinances of the City of Springfield and the. Laws ofthe 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 times du..ing construction. / Owner or Contractors Signature Date Paee 2 of.2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-01427 COM2009-01427 COM2009-0 1427 COM2009-0 1427 Payments: Type of Payment Check cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 3200900000000000670 Date: 09/25/2009 I :58:25PM Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By RG SMITH ELECTRlCAL Amount Due 55,00 18.00 3.65 8.76 $85.41 Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid njm $85.41 $85.41 24805 In Person Payment Total: Page 1 ofl 9/25/2009