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Home My WebLink AboutPermit Electrical 2009-10-19 225 Fifth Street. Springfield, OR 97477+PH(S41)726,3753+FAX(541)726,3689 r~E'ij)~'~&,~f~~'N.fU~'E':oNCy! .. I .. CC?/ /.5~J2. Penn it no,:. ' I Date: IOff/elf Electr.icalPermit Application This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days, i.".F;'.h'."'\.;IT0C.,..A. L:.:,:.G. 0VE..RN,. .MEN. Ti.:t\..'P, P.,R. O.VA""...p..'.,1\.:.;.q.c.~.f..!..j'i..;.'{..;,';.'.., 1$.',\:~*.)j0,~;"''''~'\t''!liil~;:.iii'F.EE''SC.H' E' Dl:J""EIc~\iit8;;. f''\,ii(.\'Jl'L-1if;liit,,!'(\j... \"g..'[ . . . .. . ...... .. '_"-, ,'<;l",.'-._..~:",-o,,_...,......' ,',',",."/'}lr,,:!,.l _~ _,~ '__ L '.___ .... ... _I.;:, "_';h,...~u_.~"!"""._"<._t,,j~l{,"L._m..f>':',,,, 1 Zoning approval verified? 0 Yes 0 No I :i;<~~'.~e/~fJ.~J~'e'~;iin,i,:~~{,i!~~;'(..)i;,J:I'Ql;:1 :,P'tJi:I;,::rotal,i:;1 l:f!:;~';'~:d'i,~cArEG0R't'i;%Oliic::;oNs:n:U:J(;tI0N~;$:i);'!';;;,;'.!'::;:? '.""." ,. '0 . ",",M'. ." . .', ',,', ,.,.~a" '.' ,cost", 1 I 0 Residential I D Government I 0 Commercial Residential, per unit, service included: . Ift\fa'JfJ.OBJ;lSJJlE~1INI;ORMA:J'ION~~N15~L!C(C'A'THON~io"<,1~tfi 1,000 sq, ft, or less (4) $134,00 $ 1 i~i~zi~~ji~:;:~~~~~~ i ~;~;,~;;;;:;:~:::~ : :::: ! 1 () -J- 1 I Services or feeders: installation, alteration, relocation I I r ~,~;~~,:;:;y,/QWNER';' I i ::~ ::~oo:::: ;:: : :::::: I I Name:' J e. fJ- L e"i V l4.u..cI I 1 401 to 600 amps (2) $158,00 $ 1 1 Address: ~A...-1" I 1 601 to 1,000 amps (2) $205,00 $ 1 I City: v 1 State: 1 ZIP: 1 lOver 1,000 amps or volts (2) $469,00 $ '00 I Phone~$(- ,;1",? 2 53 t..-/ 1 Fax: I I Reconnect only (2) ( $ 63,00 1 $ G 3 . j E-mail:' I I Temporary services or feeders: installatidn, alteration, relocation Th'. II' 'b' d 'd' I c I 200 amps or less (2) $ 6300 $ IS msta atlOn IS emg ma e on reSI entIa or larm property . owned by me or a member of my immediate family, This I 201 to 400 amps (2) $ 87,00 $ property is not intended for sale, exchange, lease, or rent, OAR I 479540(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 .':.';CONl:.RAC"f;0R.1 INSTALLATION: . ,,' I Braneh circuiis: new, ai/era/ion, ex/ension per panel I Business name: fjitL-t L.. CJtA- JIJ.,t.,,7/i:J.-' LL C I I a. Fee for branch circuits with purchase of a service or feeder fee: I Address: f,. CJ f'>{lK /'2.- / 1 I Each branch circuit '1 I $ 6,00 i $ I City: CM.-s't.<-.e (( 1 State: &11.< ,I ZIP: tJ? I{ Z4I .1 b, Fee for branch circuits without purchase ofa service or feeder fee: I PhOrlJ'Wf~?b-tlr-rr71 FaxP!f"KtfJ"':..,r7z./ 1 1 First branch circuit (2) $ 55.00 $ I E-mail: I I Each additional branch circuit $ 6.00 $ I CCB license no.: J~b7 0'2- I BCD license no.: I I Miscellaneous fees: serVice or feeder :rot inciuded I Signing supervisor's license no.:. )./ f Of( ...5 I I Each pump or irrigation circle (2) $ 63.00 I Print name of signing supervisor: PAuL I~ l'vLC L--.. I 1 Each sign or outline lighting (2) $ 63,00 l Signature of signing super ;...., - I I.signal circuit or a limited-energy panel, $ 63.00 $ /' / alteration, or extension (2) . 1 Each additional inspectinn: (I) $58,00 $ 1 1:~W!l;'I'ail~,","'1:-iI~"'''1>''A~'ririi';~I'C. ''A.'N'T''''l:J'S.'E\1;~'''"'',*;t",r"",,\".qi'f.,,';r'1 [$,;#;':<';'!.'lJf.::~:~.:.ffi'!tm~';;;3..h.f.i:;<;t~_, . r;olEL;;, m L''''L,<; '_ _ h~o~~,~~t'l',;:m:!~t,"',okr~'idb:?~c; I (A) Enter sUblotal.ofabove fees $ / ,? "." (Minimum Permit Fee $58,00) (f) S ' ,I (B) Enter 12%surcharge(,12x [A]) $ 7' ~,0' ?' 1 (e) Technology Fee (5% of [A]) $ 3,/1-'" 1 TOTAL fees and surcharges (A through C): $ '7.s' 7~ $ $ ~~ 'S>".r&8' ,O'~ ~ 440,2584,) (9/08/COM) Status Issued CITY OF SPRIr\itJI'H,LD Building/Combination Permit PERMIT NO: COM2009-01532 ISSUED: '10/19/2009 \ APPLIED: 10/19/2009 EXPIRES: 04/19/2010 VALUE: 225 Finh Street, Springfield, OR 541'726-3753 Phone . 541-726-3676 Fax .541-726-3769 Inspection Line SITE ADDRESS: 3881 S FST ASSESSOR'S PARCEL NO.: 1802061103500 Springfield TYPE OF 'YORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Reconnect Owner: Address: LEGAARD JEFF & SANDRA , 3881 S F ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type . Electrical Contractor BIRCH CONSTRUCTION License 165702 Expiration Date 08/01/20 II Phone 541-895-5721 BUILDING INFORMATION I # of Units: Primary Occupaucy Group: Secondary Occupancy Group: Primary Constructiou Type Secondary Constructiou 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: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: ~ompact: fJl1rrf'r::. Street Improvements: !hlS P>'Rl.m- '" . Storm~'~'iff(11~~ilable:HALL EXPIRE IF THE W " Special}!lstructionD UNDER THIS PERM DRK "\;IVIMENCED OR IS IT IS NOT Notes: ,:Y 180 DAY PER/O;BANDONEO FOR , ATTENTION: Oregon law requires you to .< -" ::-'," rUles aaop(8Q uy L11~ VI t::~VII vLlmy I PUBLIC IMPROVEMENTIiJ:e.lion Center, Those rules are set forth in OAB 95:Sfdemllj(1-py/lepugh OAR 952-001- '0090, You may obtain cop!es of the rules by calling tR9~1!~,,-,g,~t,WJ1\!!'!I\e telephone number for the Oregon Utility Notification . Center is 1,800-332,2344). I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated \ Pa~e 1 of2 , r-~,~~I~9!~::y~;',!'n!,:~!:~!i~)" , ..~\ - \i ,,- CITY OF SPRINGFIELD. , Building/Combination Permit Status Issued PERMIT NO: COM2009-01532 ISSUED: 10/19/2009 APPLIED: 10/1912009 EXPIRES: 04/19/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726,3676 Fax 541-726-3769Inspection Line Total Value of Project Fees Pai<l I . ,1" r Fee Description + 12% State Surcharge + 5% Technology Fee Service Reconnect Amount Paid Date Paid Receipt Number $7.56 $3,15 $63.00 10/19/09 10/19/09 10/19/09 2200900000000001198 2200900000000001198 2200900000000001198 Total Amount Paid $73.7I I 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 Reouired 1 nsnections I Electric ServiCe:, Approval required prior to utility company energizing service, 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. of the 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 01' tbe Community Services Division, Building Safety. I further certify that onl con s,and employees who are in compliance with ORS 701.005 will be used on this project. I further agre ensure t II re>- ,ired inspections are requested at the proper time, that each address is readable from the s~reet, th. e permit ~a 'Iocat I~ front of the property, and the approved set of plans will rerin on the site at all ;mes ~ ~pv tr h n. j \ ~' J 6 ) j r / () 1 gnayf l ( - / rs Si~ r . Date ~, Page 2 of 2 , 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1532 COM2009-0 1532 COM2009,Ol532 Payments: Type of Payment Check cReceintl RECEIPT #: Description Service Reconnect + 12% State Surcharge , + 5% Technology Fee Paid By BIRCH CONSTUCTION, LLC City of Springfield Official Receipt Development Services Department Public Works Departmeot 2200900000009001198 Date: 10/19/2009 2:04:43PM Item Total: Check Number Authorization Received By Batch Number Number How R,eceived nJm 2101 In Person Payment Total: Amount Due 63,00 7,56 3,15 $73.71 Amount Paid $73,71 $73.71 , Page 1 of 1 10/19/2009