HomeMy WebLinkAboutPermit Electrical 2009-11-4
225 Fifth Streett Springfield. OR 97477tPH{S41)726-37S3tFAX(541)726-3689
'~'JDERARTMENm:uSE!oNj3:Y,~llt'l
ii~ 1:::::e:;:'~;;J~~1
I Date. /I It-I/o 5 I
/
,.,.
This permit is issued under OAR 918-309~OOOO. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
1~1,,~l!OC~L~.GOYERNMENT::fAP.I?R0V~~~1 ~~~I;EE~S!ilI'lE[)UUE~I1~~~'
I Zoning approval verified? 0 Yes 0 No I ir~~Ylft~~.I~IIr~rlllt~~1
1~~.CATEGORY'!!01;{CONSTRUCJ10N~~}]:lM1
I I Residential, per unit, service included:
~~~~~~ITEi?IN~~~;;~;~ND~~~C~;:~r~~) 11,000 sq. ft. or less (4)
I Job site address; ~ ~~ 7 ,v.,yt1-. 3'1'''''''' 1 I ~~~0"tditional500 sq. ft. or portion
I City: ~I:.....f,'i/~ ] State~ I zIP:97'7?~ I Limited energy (2)
. ~eferen~e: '\ l\ a't. V'\ Il:, t I TaxIOt.O\ \NI\ 1 Each manufactured home or modular
~'E'~\1;\DE$CRIP,;TION,~OF,lWORK~.~~1 dwelling service or feeder (2)
/J' I I Services or feeders: installation, a/terJtion, relocation
..i.q,.~ ."",.., JC;.v'" I"JYCvr T -(-oJ
I fU-,-./ Dvc-r-k:>" /k~r?v'-<..o I I 200 amps or less (2) $81,00 $
1~~~;:~P'E:'~O=~j~: : ~~: ::~~::::~: :1::~~ :
I Address: j'-f(i,7 3'1+1,., I !601tol,000amps(2) $205,00 $ I
I City: SPho I State:~ I ZIP:'1'?4'1') 1 I Over 1,000 amps or volts (2) $469,00 $ I
I Phone: I Fax: I I Reconnect only (2) $ 63.00 1 $ I
E~mail: I I Temporary services or feeders: installation, alteration, relocation I
This installation is being made on residential or farm property I 200 amps or less (2) I $ 63,00 $ 1
owned by me or a member of my immediate family. This 1 201 to 400 amps (2) 1 $ 87.00 $ I
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). 1 401 to 600 amps (2) 1 1 $126,00 $ I
Signature: lOver 600 amps or 1,000 volts, see services or feeders section above I
~~!lZ_C()NTMc;roR~INSTAI1l!A.n0N~~~: I Branch circuits: new, alteration, <x/ension per panei I
Business name: ~ I'~I-C l.I~r~n.,'(. I a. Fee for branch circuits ~ith purchase ofa service or feeder fee: I
I Address; Po Rl'lx -?Ifoo I Each branch circuit 1 $ 6,00,1 $ 1
1 City: ~111!c I State: iJy I ZIP. 97Y~Y I I b. Fee for branch circuits without purchase ofa service or feeder fee: 1
I Phone:5Y~7~6-/Y7/ I Fax:SY"L7S"/-G;.o~ j I First branch circuit (2) It I $ 55,001 $55 1
I E-mail: ""h A) ~..(__/It'<J<<JW(. . """" I 1 Each additional branch circuit I $ 6.00 $ 1
I CCB license no,: /fcY$" 77 I BCD license no.: G91 I 1 Miscellaneous fees: service or feeder not inciuded I
I Signing supervisor's license no.: 30.;l..3S' I 1 Each pump or irrigation circle (2) I I $ 63,00 $ J
1 Print name of signing supervisor; o.w.'d ~V'4!'./~'" I I Each sign or outline lighting (2) $ 63.00 $ I
I Signature of signing supervisor: //.--,,~. -,,' L- I I' Signal circuitora limited-energy panel, I I $ 63.00 $
.".-, -.- .. - alteration, or extension (2) .
I Each additional inspection: (I) 1 1 $58,00 1 $
1__~~eRI1ICANt.-!iU$E~~"
I (A) Enter subtotat of above fees
(Minimum Permit Fee $58,00) $ '5~
I (B) Enter 12% surcharge (.12 x [AD $ ~Cf( (? I
I (e) Technology Fee (6% of[AD $ i LH>' I
I TOTAL fees and surcharges (A through C): ~
(/7.giP
$134,00
$
$ 25.00
$
$ 32,00
$
$ 63,00
$
.~~~
~ "S)'
~~/
~--:J~'I('
~~
440-2584-J (9/0SlCOM)
. ", ,~" ", '.;. . .". d",' . ./
SITEADDRESS: ':2467 34TH S1"
ASSESSOR'S PARCEL' NO,: 1702193101109
. ' .. ,ArF' . TYPE OF USE:
PROJECT DESCRIPTION: 1 ~.~r~~itforl?j~l~vP~.hR~:'I: ~jr~~on law requires you to
, .. .' '. ',':',;i/;:". ,:- r" "f' .u'"" aao.",.,o by the Oreaon Utl'/I'ty
,...,..__..... -\.II"'. .lr....,.,...,.... r>_.. _. ...
Owner: MCIN6()gRA~ iri\\iARn~(CO'NNiE001:0010 thr~~~'h~:~e9~~.~O~:~
Address: 2467 N 34TH ST. '.' u9U" You may obtain copies of the rules b
. SP'VNGFIELD OR 97477 n7,~~! ~~: t:e_nt;:r, (Note: the telephone Y
. -. -. - :;J"'" .....ultty l'llUlIlIOitlOn
- I c6~~~etrntiN1il6~MWFION I
.:~i~~'}
.,1
'.r,: -
Status
Issued
225 Fiflh Slreet, Springfield, OR,,:;':-.;
;:~:~i~:;~;~ ~~;~~fS!~~,;'}VH.~f.';~~f(t: ,I;.
541-726-3769 Inspe~ii~nLin~ ..,
';;;!..; !; .~
~.: '..
,.
CITY V1< ~PRlNGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01613
ISSUED: 11/04/2009
APPLIED: 11/04/2009
EXPIRES: 05/04/2010
VALUE:
, Springfield TYPE OF WORK: Electrical Work Only
Residential
Contractor Type
Eleclrical
Contractor " .
, CAMP CREEK ELECTRIC LLC,.
License
164877
Expiration Date
06/09/2011
Phone
541-746-1471
~.:- ~'~l'';':-'it'~ ~~: ........'1':
~: .,1' . ' '
. "
# of Units: ~,' l..~~: .1. ,:;'
;:t.." "',..
Primary Occupancy Group:,'
Secondary Occupancy Group:
Primary Conslruclion Type
Secondary Conslruction Type:
# of Bedrooms:
,.
"
,
.. ~",,;,
~: . 'ii(,~l~',
.:;...~~
, . , _'ic;,;;tl~"
'!':~ .....:Jti{
. '
~ 'i .
,~. " ,t;::"" '\
~!': ~'. 3'
',.
, '
~ ,"
l . "',.~
',~ ;:
Frontyard Setback:
Side 1 Selback:
Side 2 Selback:
Rearyard Selback:
1
Solar Selbacks: ", '
. ').i
--0;("'-".
,::1 ..:~;~l'
,~ .;i \
Street Improve~e-;tt~:" ,~..': l,~ '\:>i
. r '~-'\ _i, "'l, ,
Slorm Sewer Available:, . ': .;, ,;;"
,~' .,.
Special Instruclion: '
Notes:
.1
.J
. :i.-:tlr:,..
.,,:.-
Description
';.\ :' 1(\,'; ", ~ ~""'. i I .1,
,
", i ~ ,: \ . ~. i
,~;. .~; I .
iJl ' l' , ~ , ;'
, Tvpe of <;:onslruction
, .
:~~ ,:ft
..
.1:
I BUILDING INFORMATION I
# of Slories: Lol Size:
NOTlc~eighl ofSlructure Sq FI Is1 Floor:
THIS PE ..: EXPIRE IF THE WORK Sq FI 2nd Floor:
. IS NOT Sq Ft Basement:
A,WTHORki~ fl THIS PERMIT . Sq Ft Garage/Carport
COMMENGle~Ralfi:ABANDONEO FOR Sq Ft Other:
ANY 180!jjWpIp~\fiID!ling. n/a Occupant Load:
I .DEV~LOPME~T INFORMATION I
REQUIRED PARKING
'.J
Overlay Dist:
# Slreet Trees Rqd:
Paved Drive Rqd:
% of LolCoverage:
Total:
Handicapped:
Compact:
I PU~LIC IMPROVEMENTS I
Sidewalk Type:
Downspouts/Drains:
,)
I Valuation Descriution I
$ Per Sq,Ft
or mulliplier
Square Foolage
or Bid Amount
Value
Date Calculated
o
>
Paee I of 2
p
"
,...i. .~
Status Is~f~,~i::";;;c.:<{\.;~4'~~ii.~:' \:
:m Fifth Streei;CSpriiigfield;.OR::;~:t'-
" . ,'" I. . . "
541-726-3753 Phonei' ;
. 541-726-3676 F~x> \:'" .
.' 541-726-3769 lIi~pection.Une":" :'2. ,'i
./' .\t. .~, ,;.,. .,. I,
';'" -r
..
,,",
\~t" nl~~~'h\
; Fee DescriPtio~;~'~,::~.~~,At-;.:.;~~-~ ,"
+ 12% Slale Su'rcharge} .
+ 5% Techuology, Fee .
Add, Alter, Exlend Circ
Minimum/Adjuslmenl Eleclrical
" :~.h::
Tolal Amounl Paid '.i~ ';;.
~;., i!;." ,::''47.... ..'- . 'l
, "
J ~ . .
j~ . jji~. i,. ~.
,. . 1~\ ,
. .,f.. . '\ ,,~ '
I ~,'~;; '1~1' . ~-'
,
"
.~! ~~
"
'_J> Total Value of Projecl
Fers Paid I
. Amount Paid
Date Paid
11/4/09
11/4/09
11/4/09
11/4/09
CITY OF SPRINlil<lELD
Building/Combination Permit
PERMIT NO: COM2009-0I613
ISSUED: 11/04/2009
APPLIED: 11/04/2009
EXPIRES: 05/04/2010
VALUE:
Receipl Number
2200900000000001255
2200900000000001255
2200900000000001255
2200900000000001255
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
..:.:.',1" ',,:'.:'~"",!, ..:'" ..:::i\2: ;.~ :
work day -", " ~,,',,", ".,'" .., ":" "
, . 1.: ~i'. ~. .' . "
~ 'f j .
'-1' \, "
;ki~dr. ~~.L,...
,
_I.... ,..,
"
$6.96
$2.90
$55.00
() $3.00
$67.86
I Plan Reviews ,
I R~(lIJired I~s[lections I
Rough Electric: Prior 10 Cover
Final Eleclric: When all electrical work is complele.
. ')
By signalure, I ~Iate;and agree, Ilia"! have carefully examined the completed application and do bereby certify that all
information her~o~ fs'true and correct, and I further certify that any and all work performed shall ~e done in accordance with
Ihe Ordinances '~f th'e City of Springfield and Ihe Laws of tbe Slate of Oregon perlaining 10 Ihe work described berein, and
that NO OCCU?AN,CY,will be made of any slruclure witboul permission of Ihe Community Services Division, Building Safety.
I furlher cerlify'thal only contraclors and employees who are in compliance with ORS 701.005 will be used on this projecl,
I furlher agree 10 ensure Ibal all required inspeclions are requested al the proper time, tbat each address is readable from Ibe
slreet, Ibal Ihe permil card is localed al tbe front of tbe property, and Ihe approved sel of plans will remain on Ibe site al all
times during construction.
"
..
- / ~,'i .
C7~'0;~
/ ...l ..,'
Owner or Conlraclo'rs Signalure
/i ..i, ~i;'~'~,:~ ,:-1. .
:~:-~.~,:-!I' .;b, .
I, . .,:0' . i:;~~ ;";0 ,:.;
" ,.
'F ~ t ,]~,-~~:!
~ ' .
..
.i~ {~;\"
,~ i
~.. "1}'; r {.
"
Page 2 of2
// k/09'
Dale / ( .
225 Fifth Street
Springfield, Oregon 97~77,._.
541"-726-3759 Phnne."::-,'
.~ ~.';.
.,~,..:';;~' .
.~. .~
..>, t
,) ~:~~~~p...cIJ!~',",,''''.!'i'. ".
il '
.' -~~:
'.,,:, ,
,_.' '.,
_n',. ,','. ,..< .."' ~
City of Springfield Official Receipt
Development Services Department
Public Works Department
.,
".;;" ::,;,t~i;~;J1lli(;~I.kT#:
2200900000000001255
Date: 11104/2009
8:26:32AM
Job/Journal Number
COM2009-01613
COM2009-01613
C0M2009-01613
COM2009-01613
,.
. Qescription .' , ..
. Add, Alter, Extend Circ
Minimuny Api.",~\ment Electrical
,;,:.. ::+,5~,Te.clinologyFee"
.:..il.~..t.. "',;r:,>_ ".~.")~;:\~ ..... ,,",
. -:~(\,t':ii:.12% Stille.su~chirrge
"'~(':'; ~., '':'''..' .' ;;
Item Total:
Lheck Number Authorization
Received By Batch Number Number How Received
Amount Due
55.00
3.00
2.90
6.96
$67,86
~~~io~n~:~~fin';:'~': .M~~:~~'d~;~;~~t:. :'.~;:::ii;f.Xi::::; ~+"._ ,','-
Amount Paid
CreditCard
CAMP CR ELECFY.'".
, ''''
cjc
543702 In Person
Paymenl Total:
$67.86
$67.86
..
: +:,~: ';~:hifi,;::,,;~~~~'!~~i~~:!.t
,
'. ,
. ; 1'" ~ .'j~,:: i.".' .
~ :;...
....,. ....
.
()
.~-
. 1-.1:'1'':(1',.
~ ~. 'c- .,~r...
. -;~""';;~:'~f~_"'-':#~'4r:.~
..,1.,
" .
~,;, '..... '. .'
~ '!i' ~~'
.. I.
tit-I. ""l't'..
0,
, .-
~;:":<'i;~;~~-~,,;.H,"%~il :.:
~ .). ,~;d.\e'F~ '~4':' : .::~:\ .
~ . ~
()
i
-I ...
.!t'! Ii
,
\ ~:'..'
>-
,',
,,{ "
o
".' .
~' ~ -.f'
;
..,.. '-;~~~~.
;'1 "
~r ." i .
"
I" ..
u
'; :""'.
;' 'i -"
t' l.
,
i
lr i "
.'
l:";:-':ns: ;
...:;:;.,...:!t+:. ..
'.
.
"
."'Ii "
cReceintl
u
Page 1 of I
11/4/2009
" . .'~
...;.:,j"". .