HomeMy WebLinkAboutPermit Electrical 2009-10-27
225 Fifth Street+Springfield, OR 97477+ PH(541)726-3753+FAX(S41)726-3689
'~DEp.~RTMEN:i'~USE!1)Nlly$.!'~11
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I Date: . 10'17-<11
I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180
days ofissuance or if work is suspended for 180 days.
1~~.l!0.C;t(L"lGO)/Ea.NMENmfAIi1Ii1a.O)/~L~1 Hli.lli!(liillllil.igI;EE!l$CI-lEa,l!Jl!E_.li~
I Zoning approval verified? 0 Yes 0 No I 11a!~~I~II:1t~II}~~j
~'~C;t(1iEGOIR;f,iOF.iiCONs;rRl!JCI' JION~I I Residential, per uni4 service inclnded: I
esidential 0 Government 0 Commercial I
'I~JOBISlil;~~~~7F.~M~:'/I'. JOI:,~J~~OCM;ION~11 I ~C:Oa::i:~:~I:S;O(:~. ft. or portion $134.00 $ II
Job sIte address:.,..., J u, J / .J1Ji'-e:c; I thereof $ 2S.00 $
I CitY~;(/N6r1el~ I State:c::!I? I Zll':t::17t!T71 I Limiled energy (2) $ 32.00 $ I
i~~i~~~ioFJ\W~;;~~ , ~~~~I::;~~~~~~e~':;;r(~)odular / $ 63.00 JFG3.1
I /'11. /7. <)~ VI t!.G If QtA-cg)?1eAJ nl Services or feeders: installation. alteration. re/oco/ion I
I ~~(It..~'lr~~ D{ ~ . I I 200 amps or less (2) $ 81.00 I $
:=J:h~~Om:;~~L~Z~T"lili_j: i ~~: :::~~:::;~; :1::::: I :
I Address: ~'175' ,jj/tI5'V5'f"; .JiI( I 1 601 10 1,000 amps (2) I $20S.00 I $
I City51A'/A/6/:-;etD I St,te: 01( I Zll':Cf71/1i Over 1,000 amps or volts (2) 1$469.00 $
I Phone: 5 f./I . 7'17 . g1791 Fax: _._ I Reconnect only (2) I $ 63.00 I $
I E-mail: I Temporary services or feeders: installalion, alteration. relocation
This installation is being made'on resideniial orfarm property 200 amps or tess (2) ,. U, ....<-.- I. I $ 63.00 I $
owned by me or a member of my immediate family. This I 201 to 400 amps (2) I 1$87.00 1$
proPettJ'J.U1.01wtended fo, r sale, exchap.ge,leaset.or-rent. OAR
479.5t'OUJI:tl!Jln9.560(1). ' ,1401 to 600 amps (2) I $126.00 $
SignailifilS PERMIT SHAll EXPIRE IF THE WORK . lOver 600 amps or 1,000 volts, see services or feeders section above
I~-:fi.~'-"i 1::.r::::E=~~~~~i I
I City":)l;~/lJIf.:iI:latJ. I State:?'/( I ZIP: Q79"? JI b. FeefoOOM)1 !tIuw1h'1~l!ItaIlflwplll'6t1l's'r~e!FI:fV: I
I Phon{SI.f/~7~/Ztf>p3fl FaxS'II-747, 7/5'1' I Firstbra,!~H 1M cemer. IN ~e:.t ~t~!IWlope
E-mail: JJ/-;A-bJ~A@t7atK/lt.f.l1l-t- I Each addilto::al, ;3.~"u, :.1,,1 1 j ~b~t'i\m
I CCB license no.: f~"16 I BCD license n.o.~& ,j7c- I Miscellaneous fees: service or feeder not included
I Signing supervisor's license no.: ~9'1-S .1 I Each pump orirrigahon circle (2) 1$63.00 I $
I Print name of signing supervisor:~Y .&~.Q~ .l.J~l Each sign or outline lighting (2) $ 63.00 $
I S. f" . /'.A /' ./ 111 I Signat circuit or a limited-energy panel; I I
Ignature 0 SIgning superV1s0r~~ ~ / I alteration, or extension (2) $ 63.00 $
. /" I Each additional inspection: (I) I I $S8.00 I $ I
rl~oP 1_~~.<<aBl!lc~NttiOSE~~1
'_\.\t(- \\' "v~ I (A) Entersubtotalofabovefees -I
"r-..~~ ~~\.J W~Q (Minimum Permit Fee $58.00) $&'J,_
~ r-.:\. \0 ~& I (B) Enter 12% surcharge (.12 x [A]) $7.5'~ I
'\V ~\,,-l.b~ I (C)TechnologyFee(S%of[A]) $3./51
, ~ ~ I TOTAL fees and surcharges (A through C): $73,7/ I
44O-2584-J (9/08/COM)
,
Status . Issued . , ,. .'
.,'r.", "'. .,~, ..,
225 Fifth Street, Springfield;OR\: ~\;.
541-726-3753 Phone"" -
541-726-3676 Fax
541-726-3769 Inspection Line . '...,
.j
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01572
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
......
-. ~ '~.~ .
SITE ADDRESS: ;; 4475 DAISY ST SPACE 86
ASSESSOR'S PARCELNO.: 1702323406500
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PROJECT DESCRIPTiON: '.Eletrical Service Replacement
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
Owner: COUNTRY MANOR LTD PTRSHP
Address: 7007, SW C,ARDn,.AI,-SJE 185
PORTLAND OR '97224
,1 ,:
Contractor Type
Electrical
I CONTRACTOR INFORMATION I
Contract!lr
LR BRABHAM
License
8699
Expiration Date
12/18/2010
Phone
541-747-6638
'; I 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 INFORMA TI~fmON: Oregon law re!J!l!r~s you to
J TICE: . , '. foll.ow ~le8 adopted Bff"W~~l1iI9'G
Frontyard Setb~R~: PERMIT SHALL EXPIRE IF T~P..6~ist: Notification Center. 'fhtl3G.W1es are set forth
S~de 1 Setback: ( ORIZED UNDER THIS PERMrtlS.-HOfr,,:es Rqd: In OAR 952-o01.0010tW&\\\ilB.9m~52-o01.
Side 2 Setback: ~;H, '. . IS ABANDONEDIf.Oilt D,r!ve Rqd: 0090. Voumayobtaln PQI1I~!Iar.l~e rules by
Rearyard Setbacli:1MENCED OR, " % of LofCoverage: calling the center. (Nofe.. llie tel~pho~e
Solar Setbacks: NY 180 DAY PERIOD.' nu~bef for the. Oregon Utility Notification
Center IS 1-800-332-2344).
I PUBLIC IMPROVEMENTS I
Street Improvements:::
Storm Sewer Available:
Special Instruction:
\
Sidewalk Type:
Downspoutsmrains:
Notes:
"I V~luation Descriotion I
.. .1... .. ~
. .
Description ,Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
. .
-, I'.
Page I of 2
Status Issued ')
""'0
225 Fifth Street"Springfi~\d,OR\;pJti::'e ' '
541-726-3753 Phone;., :,:,;J: ., :',;~.;,...t" ."
541-726-3676 Fax' ..
541-726-3769Inspection.Line
: .!:.' ~""".>
Fee Description:.,. "', ,,,
+ 12% State Surcharge':
. ,"' . -. " ~
+ 5% Technology Fee '
Manufactured Home Service
Total Amount Paid
i,~:' . ,-;~~:
~ ;
,;,.'
~ .
, ~,"
'Total Value. of Project
Fee~ ~~i~ .
Amount Paid
$7.56
$3.15
$63.00
"$73.71
Date Paid
I Plan Reviews I
CITY OF :'lrKll~GFIELD
Building/Combination Permit
PERMIT NO: COM2009-01572
ISSUED: 10/27/2009
APPLIED: 10/2712009
EXPIRES: 04/27/2010
VALUE:
10/27/09
10/27/09
10/27/09
Receipt Number
3200900000000000733
3200900000000000733
3200900000000000733
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. "
-: :r
~eouire'" Insnections I
MH Service:":Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefnlly 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
tbat NO OCCUPANCY will be made ofany 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 he used on this projecl.
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 ofthe property, and the approved set of plans will remain on the site at all
times during construction.. .
Owner or Contractors Signature
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Page 2 of2
Date
City of Springfield Official Receipt
Development Services Department
Public Works Department
"
RECEIPT,#:\'
3200900000000000733
.,
Date: 10/27/2009
II :20:50AM
Job/Journal ~ u~ber:~:>: (:, ~-~s~~ip,t~~~(;:.i;'<~.~)A~ii~:~-::,:" .~: '::': "
COM2009-015n' -';:<,\:Mlintifa~iill6dHorrie Service
,':"-,;"",-,.,,.",.'. '.:.
COM2009-0 1572:',/'/\+'5% Technology Fee
COM2009-01~72 ''fi''<.t+:'12oyo State Surcharge
,: .~: ' ',' -'.~;:.;<r~'~~;:;::"::f".,~{,?(, "'~'. . ,,::;:';), :~~( :~ .
Payments:
Type of Paymenl
Check
",.'
Item Total:
(;heck Number Authorization
Received By Batch Number 'Number How Received
KR 38287 By Mail
Payment Total:
Amount Due
63.00
3.15
7.56
$73,71
Paid By
Amount Paid
$73.71
$73.71
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Page I of 1
10/27/2009
cReceint 1