HomeMy WebLinkAboutPermit Electrical 2009-9-30
Electrical Permit A
.
225 Fifth StrttttSpringfield, OR 97477+PH(541)726-37S3+FAX(541)726-3689
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~ ,.. Permit no.:\._ -( - ,'--::>
I Date: cr/30/ d'i I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuan~e or if work is suspended for 180 days.
1~'1i','6~t4!L!b"C'Al:.ii[G0'f1.ERNMENTtlfJl\I?,P.R0S1/i,LllI\Ji(.!r~!1 ll\!.im~~il.~F;:EEiiiS~IilEO.I!J();Efj[~1~1
I Zoning approval verified? 0 Yes 0 No I l~rr&~.',!1~:W;~1'(;)~IQ~I~e:Q~~Il:\'''F1!a\il'l1
1~"~~CAiI'EG0RYli~f)"'"C0NS:rRUC:r10N;";"'I'~~111!~Ii'~!W:1 "'L"".,,,,i,!;_~~'~'"i"""";;""'!~ k><;" i11lie~~ ~.!'9st~
cI'r,""'L.~~",, ii, .. I" .. ~.. . ,,,.X .;;;9;':, . " " . I,. - ~l$h1W_,",,,~,~'iU~\!i I Residential, per unit, service included: I
~~~~~~~~~lmE%IJF.~R~;~~;;~ND;~k~~~li~;~;~~!~i 11,000 sq. ft. or less (4) $134.00 $ I
I. ,e-:. ':":>5 j , I'IA.... ,/ -I-C- pc). l Each additional 500 sq. ft. or portion $ 25.00 $ I
Job site addres.... )-=>-=~ '-.,l.-/rf f~ \." ;.--r (\ II thereof
I City<~ cL-r I State: {)'V I'ZIP:974i7.( Limited energy (2) $ 32.00 $ I
I Subdiviliot. \'11)1.. ?pOD j Lot no.: 0 \..~ Each manufactured home or modular $ 63.00 I
1~~~DESCBI~mI0N!1!0FAW(:j~K~~1 dwelling service or feeder (2) $
~m./.,.c~~'J_ 'fJRd",.,- \AcJZ.- ..l 200 amps or less (2)
. 11.:s~a ~ ,,-'iJOb ')f:)~ 8'J?0
il!k'!!,",,!;i](211Iii,W~R~0eERl'i'I:~0WNER~}~yii~~\?''li1
I Name.:.-'i.lffJl?/lhJ f~<,.k.c:t.it.ty {,LV I
I Address!idL/~-.1};~,u/}U/J.A/ .Uf/) I
I Cit(,-5dfLh Juuz) I Stat~7 JJ- 1(iIP:</:.-~.'St7 4
I Pho~e: I Fax: I
I E-mail: I
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale. exchange. lease, or rent. OAR
479.540(1) and 479.560(1).
Ji. r.-..
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Signature: Over 600 amps or 1,000 volts, see services or feeders section above I
1~~ii'IlC0~e!T,08llN.S;PP.iL!~JiI0NiIf~e~~1 Branch circuits: new, alteration, extension per panel I
I Business name: [) U y V~ J I n r I) ~ . I a. Fee for branch circuits with purchase ofa service or feeder fee: I
I Addre'ss..() 0 h r; 'J. (/) t?J f I Each branch circuit I $ 6.00 I $ I
I City:W 11/ t! r V )' Ilf I State: (') y ZIP. b. Fee for branch circuits without purchase of a service or feeder fee: I
I Phone: l1fL2ULI Fax: First branch circuit (2) I $ 55.00 I $ I
I E-mail: hVytiIJoroS?' ,. ar~O(7 ,'nf.( 1 Each additional branch circuit I $ 6.00 $ I
I CCB lic;nse no.:J?J{o~ I BCD lice e no.:ri.D - 4-4 ~tl Miscellaneous fees: service or feedernol included I
I Signing supervisor's license no.: .W..7::11~' I Each pump or irrigation circle (2) $ 63.00 $ I
I Print name of signing superve.so .U~', h.lIf/ I Each sign or outline lighting (2) $ 63.00 $ I
Is f "aF \/ \1 I Signal circuit or a limited-energy panel, $ 63.00 S I
ignature 0 signing supervij'<":' V .~ alteration, or extension (2)
~ \SJV &\ ~~~~'"""~D
" ~ ~ ~~.^ n' \, \ \ \,\'\i I (Minimum Permit Fee $58.00) $, _
~ :\..Y \.\J';'~ (B) Enter 12% surcharge (.12 x [A]) $ ~,a;
.. \.. \{,'\ I (C) Technology Fee (5%0f[A]) $ '1'-"74-
~ - I TOTAL fees and surcharges (A through C): $ Sf "7- 711
~
440.2584-J (9108/COM)
Services or feeders: installation, alteration, relocation
/
$ 81.00
201 to 400 amps (2)
401 to 600 amps (2)
60 I to 1,000 amps (2)
$ 95.00
$158.00
$205.00
Over 1,000 amps or volts (2)
Reconnect only (2)
$469.00
$ 63.00
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 63.00
201 to 400 amps (2)
401 to 600 amps (2)
$ 87.00
$126.00
$
$
$
$
$
$
$
$
$
Status
Issued
CITY OF SPKH~uFIELD
Building/Combination Permit
PERMIT NO: COM2009-01453
ISSUED: 09/30/2009
APPLIED: 09/30/2009
EXPIRES: 03/30/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726~3753 Phone
541-726,3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 DAISY ST
I '
ASSESSOR'S PARCEL NO:: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJECT DESCRIPTION:, Emergency 200 amp pedastal-SPACE #89
Residential
;~
Owner: SANTIAGO ESTATES ASSOCIATES LLC
Address: 11211 GOLD COUNTRY DR STE 100
GOLD RIVER ,CA 95670
I CONTRACTOR INFORMATION ,
Contractor Type
Electrical
Contractor
,
BURRELL BROS ENTERPRISES INC
License
136446
Expiration Date
08/20/2011
Phone
541-747-2724
BUILDING INFORMATION I
# 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 DEVELOPMENT INFORMATION'
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyar.d Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped: .
Compact:
Street Improvements:' E'
l'IUI!v .
Storm Sewer ~.;~j.talil[::iMIT SHALL EXPIRE IF THE WORK
SpecialInstru~jg~HORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
ATTENTION: Oregon law requires you to
,. """.. rultlS auup18U oy meuregon UlIlIlY
I PUBLIC IMPROVEM,E~TS Ilion Center. Those rules are set for1h
in OAR 952-rsldeWal~ Type,gh OAR 952-001-
0090. You may ob1ain copies of the rules by
calling the1!<!1':~po~t:s~p"r;a,\'!~:telephone
number for the Oregon Utility Noliflcatlon
Center is 1-800-332-2344).
Notes:
I Valuation Descriotion I
Description.
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
, or Bid Amount
Value
Date Calculated
Pa~e 1 of 2
GP.R1NG&;Im.:D'.
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Status
Issued
225 Fifth Street, "Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~.f
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or Iess
Total Amount Paid
.,
.. Amount Paid
$9.72
$4.05
$81.00
$94.77
Total Value of Project
Fee..~
Date Paid
I Plan Reviews I
9/30/09
9/30109
9/30/09
U 1 i' OF ~r lUNGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01453
ISSUED: 09/30/2009
APPLIED: 09/30/2009
EXPIRES: 03/30/2010
VALUE:
Receipt Numher.
2200900000000001118
2200900000000001118
2200900000000001118
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 ReOl,irerll nsrections I
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 I further certify that any and all work performed shall be 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 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. 'IJ
Owner or Contractors Signature
Paee 2 of2
Date
..:;;:._-,. ;2.-'1:'-:
225 Fifth Streef';" ..
. I . _ .
Springfield, Oregon 97477 .
541-726-3759 Phone.
,;
"'~c_.'!!....!">_.ELD.__.......;,........."."" ........
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City of Springfield Official Receipt
Development Services Department
Public Works Department
. . . .. -
.:~:RECE"pf#: . 2200900000000001118
Date: 09/30/2009
12:34:03PM
Received By
njm
Item Total:
Check Number Authorization
Batch Number Number How Received
Amount Due
81.00
4.05
9.72
$94.77
Job/Journal Number ,; . Description
COM2009-01453.". .,Perm Serv/Fdr 200 amps or less
COM2009-01453 ';ii.:..;'+5,%T~~~n~10gy Fee
COM2009-01453. + 12% Stiie'Sw:charge
Payments:
Type of Payment
CreditCard
Paid By .
.BU'}RE.LL BROS. ;:
Amount Paid
JOSH B. 03537c Phone
Payment Total:
$94.77
$94.77
" '..
~...
cReceintl,
Page 1 of I
9/30/2009