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Home My WebLink AboutPermit Electrical 2009-12-1 225 mth Streel+Spdngfield. OR 97477+PH(54I)726-3753+FAX(541)726-3689 I~' ';, DE'PARTMENT :USE ONLY r~,;:;""', G, F~~id I-'c ~'~ '1- 'c 17'/7 ~" &) ~ Pennlt no.: . I Date: I Z - I - 0 9 Electrical Permit Application o t 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;',': .','< ""110CJl.L;;GOVERNM ENT?AP,flR0VA8~t,~,ijf'j~7i;\~;1 IrW\:.';;Jjj-.:li~~1'1~:!l\''ft\f;:EE~SGHEJj.UlJE!t~~hi\i,*,J~\1;~I~~,~1 I Zoning approval verified? 0 Yes 0 No I 1~~~,~~r;iNhfr~~t!?'~jp'fr;.:t~~;~)~;i,{IW,1 ,.fe~~!; ,t~~Wj I f,:!:i!.i;"i:,6,;~J.C~tEGORy;,~0F..tCONSTRUCTION~;.y-:":;!>';'~;,I I Residential, per nnit, service included: I I 0 Residential I 0 Government I 0 Commercial I 1~~!J_OB}.SltE\'HNl;t)RMJl.TION~rAN[j~i!OX:ATION~Ji>i;liiil'1 1,000 sq. ft. or less (4) I $134.00 $ I I Job site address: . Silt:( .B, S/l; ,I ~~~~oaritional 500 sq, ft, or portion $ 25.00 $ I City: 5' f) /"t.. J:> , I State: Ort e I ZIP: I I Limited energy (2) $ 32.00 $ I 1,~::e~ence,:'/7~~~;;0;OF~,wd;~:~~:';;:::~~1~:~'~ I ~~~~I~:nS~~~~~~~ Pe~~;r (~)odular $ 63.00 $ I ~~ A^"e IYI e f-.er> )Jp; 5 CiI I I Services or feeders: instaffation, alteration, relocation I I I 200 amps or less (2) $ 81.00 $ I I 'PR0PER;ry,:owNER':". , I I 201 to 400 amps (2) $ 95.00 $ I : ::;r:5s: 1Z~~'rJ;jt1-p)~~~ltsl I :~: ::~~000~::Sp~2:2) ~:::::: ~ : I City:S;:~L..t+S -bl:"'W I Siate:[ket I ZIP: h <7 '3 b( lOver 1,000 amps or volts (2) $469.00 $ ~ ~ I Phone: -7f1" _ 'f ~ , q I Fax: ' _ Re.~~.'K\<~oll!l~~) I $ 63.00 $ 0..-1 . ~ rb."\- IlU'-" I E-mail: ....OfeQon\.1 I :Jt!Jlecy<a'P".:\efXKft or feeders: installation, alteration, relocation . . ... - . -1l1'(\'''' ~It ~"'~~- * . ThIS lIIstallatlon IS belllg made on reslden~ bFfilfffilJll'~ 1\1' ,SE ltJI1l0W. 85~~ '$ 63.00 $ owned by me 01' a member of my immedi4n1lfll%~Woi\I!lS:1I\ '~o\' tIC 1Ifll1 ffi~We~!tr $ 87.00 $ property IS not lIItended for sale, exchang~d4if~i~'5Jt_'1lO~~~ . cc ~,e" MiJE\\l!'v" 479.540(1) and 479.560(1), III O~ 'IoU llIa'i o'o\~\~ W \~ot\le~,Jl.,\\I?.\~ $126.00 $ Signat,ure:. ' . 009~,:\\nn \\19 C~~\~;e'llO\" ~~~~'IlVPS or 1,000 volts, see services or feeders section above I . .' . :,CONTRACTOR INSTAtlJl.Tlp1iL:Oel \01 (,.'_.... \- \O~it."anch corCUlts: new, alteration, extension per panel I u .,'f" --\,itl\ 'v' I Business name: IT ~ D > #~ a. Fee for branch circuits with purchase ofa service or feeder fee: I Address: /0 If?.. ~ ~ I I Each branch circuit I I $ 6.00 I $ I ~ity: ~______ I State: <Ic...L I ZIP: ~ 7Y"'f I I b. Fee for branch circuits without purchase ofa service or feeder fee: I Phone: 7-2.(;..-(';0':> I Fax: I I First branch circuit (2) I $ 55.00 $ I E-mail: I I Each additional branch circuit I $ 6.00 $ I CCB license no.: "~f 'S '7 "g I BCD license no.: /}..<) -t.f'7/C. I I Miscellaneous fees: service or feeder nO/included I Signing supervisor's license no.: 9'fS'..s. I I Each pump-or irrigation circle (2) $ 63.00 I Print name of signing supervisor: RI'tL- ok t3 ('DQI/f I Each sign or outline lightin{~ \NO~V. $ 63.00 I Signature of signing supervisor ~ 11. ~h un1\CF'.. ~~~\:tt,~"b,\'~U~~l\&"P , I $ 63.00 $ II 10 -....'1't If,', '. ''''''' -I ~jtO't'I>V' ~O':\ l1-11S \,\:.I" 1~UI\j\<llli\iNbl~~~~b~\M' I I $58.00 I $ &: ~ ~~~~i ~t~~~i,~~~~~{~~::~~A-NT&'USEWi'~~'f~~;'T?f~;,:~.., ~ tV ~ ,\~'i (Minimum Permit Fee $S8.00) $ t::> > ~j,; ':J'" .1 (B)EnterI2%surcharge(.t2x[A]) $ -,S"~ ~ I (C) Technology Fee (5% of[A]) $. 3/f"'I ~ I TOTAL fees and surcharges (A through C): $ 7"\J -I' r $ $ ~~~ ~:"" 440.2584-J (9/08/COM) _~ia.A, '7,,0, ~F,',,"ELD,..ufil" ..,:.l,l.l. ~" .' "~. ;1 _ , _"./ c' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRI1'OurlELD Building/Combination Permit PERMIT NO: COM2009-01717 ISSUED: 12/01/2009 APPLIED: 12/01/2009 EXPIRES: 06/01/2010 VALUE: SITE ADDRESS: 5119 B ST ASSESSOR'S PARCEL NO.: 1702333202300 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Service reconnect TYPE OF USE: Repair Residential Owner: AURORA LOAN SERVICES LLC Address: 2617 COLLEGE PARK DR SCOTTSBLUFF NE 69361 Contractor Type Electrical I CONTRACTOR INFORMATION I Contractor RALPH W BROWN # of Units: Primary Occupancy Group: Secondary Occupnncy Group: Primary Construction Type Secondary Construction Type:', # of Bedrooms: Frontynrd Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction License 63137 BUILDING INFORMATION I # of Stories: R-3 Height of Structure Type of Hent: VB W~ter Type: u\r8S ~ to ~a.u.a~.f9Q on \)tilitl . ~ON: 1""'ubVt~e 018:8 set torth t)lIoV4 ru\e~ ~~~1Jl. ~R 952.oo~ "I\-"tlt'n ' ~8 ..u..~ 'f'-t'N" it\91'~ ~~~et "',,! \l\i~~JUI!' caning :~r9.~~_.i344)' ~ ce~%\>fet Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS 1 Expiration Date 02/15/2010 Phone 541-729-1500 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicnpped: Compact: Sidewalk Type: Do,!,nsjio'ois/~ins: , -~~f'~~;~()\ . . 'l.. ~ fo.~\F. tov. -/A't\~t.:11t? ~t.~1:' 'f,-r.\~ J~^~t'O . I .,.\A\';) ~\.:. ~- ~'ii\\:{l..~I'\ 'Valua'('lt1n,~ I , 1\' -'il"lI' l'\~. 1"1..' ' x.\.... V ,v , $ Pel' Sq ffJlJ,~ ?>\) ~.re Footage - or mnltipli~'l '\ or Bid Amount Paee I of 2 Valne Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -726-3769 Inspection Line Fee Description + 12% State Surcharge + 5% Technology Fee Service Reconnect Amount Paid $7.56 $3.15 $63.00 Total Amount Paid $73.71 '".." . , Total Value of Project F~es Paid I Date Paid I Plan Review's I 12/1/09 12/1/09 12/1/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01717 ISSUED: 12/0112009 APPLIED: 12/0112009 EXPIRES: 06/01/2010 VALUE: Receipt Number 2200900000000001342 2200900000000001342 2200900000000001342 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be ~ade the same working day, inspections requested after 7:00 a.m. will be made the following work day. Reolli~e~. I,~snee~i?n,s 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 bereby certify that all information hereon is true and correct, and I further certify that any and all work performed sball 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 strueture 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 co(St:L ~ Owner or Contractors Signature , Paee 20f 2 Date 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009"0 1717 COM2009-0] 717 COM2009-0 1717 Payments: Type of Payment Check cReceintl RECEIPT #: Description Service' Reconnect + 5% Technology Fee + 12% 'State Surcharge Paid By HERITAGE ELECTRIC \ ~J:-O'-:""',_'EI.,,',',O.il": '~".,.,""""", '._,..... .. ' , -, .. .. " -' ";"::,.,," -., -,..,..... ..i;',.. :~._.., .0/' - City of Springfield Official Receipt Development Services Department Public Works Department , . 2200900000000001342 Date: 12/01/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 2088 In Person Payment Total: Page I of 1 2:53:22PM Amount Due 63.00 3.15 7.56 $73.71 Amount Paid $73.71 $73.71 I 12/1 /2009