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Home My WebLink AboutPermit Electrical 2009-12-4 Electrical Permit Application 225 Fifth Street. Springfield. OR 97477+PH(541)726-3753+ FAX(541)726-3689 1~~S~E~15TRIi~NfO~E ON,lY:.':).'1 I ' /YIJ r /\J~I Penmt no,: l '1 .xr:.,,'5 j ~ ,..,f I " Cit \~\Y , Date: / J-/ tYi/ 0 Y \Y. 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 ":ork is suspended for 180 days. ' 1'~:jlEOCAl::.G09ERNMENT'rAf1RB.o.vAl5f~cit!}Y;'i~'ii~);'!\'\1 !~~~;\;;l'.Gi"~~Wi\jli,\?Jt1!Fi~EE1SCHED.l:JlJE~Jw~~jljg1\;J:l}.~"'!Il!\~,,~~1 I Zoning approval verified? ",0 YesDNo . ,I 1~~.ull!~er'?:ci~';~~il~;~{:~~r,'if~g(';-:~,fIQt~t'.:~~~!':.rl-';il~~'/ l,i},~:,~,,,,,~,,;;,1CATEGORY,i,{OFlCONSTRUCmION';'ir':,:.'& "':';';1 I" ,>0,_ ,." .._"., .",r"""" ". . j..: , , ,.... '.,...,,,,,. ,. '.. ...",~'M~Ij;fj;,:",::v. -., .-' -'.' "" ,L,",',.. , ,,' ",-", . - ..;::'~';".;" "r';>. ".'~-' Residential, per unit, service included: o Residential I 0 Government I 0 Commercial I I r,1IN~f;(!'joBwSlmE:jINFORM~:rION0'AN[;jlllSOCMION~,jj,','-*,:\:jl 1,000 sq, ft, or less (4) 1-"""":',., ,I.. "'2~.2.::":' C"'5' 7". .,",..;".'.'1 I Eachadditional500sq,f1.orportion Job site address: /. ~, ' thereof I City C)"tJjl..J,iQi le!d I State: (ftZ<... I ZI~: '17"-1771 I Limited energy (2) I Referen'ce: \~-ao.A I Taxlou'\ElZ> I Each manufactured home or modular I":""" bESC~li'T10N:'0F'.vvORKl\!f.4N!h.;gi:\o'i~~":(,,,,'t'l dwelling service or feeder (2) I /~ I"'~ I I' I : Name, ~p :;JPEt?7/N:~;))'1 I Addres~ OZ-l2.. <;: C sT:' I I CitySJI?l?1 ;V'fl- /E/d I State:Of/L I ZIP:tf'1tiI7 1 I Phon/ I Fax: ' ' I I E-mail: This installation is being made on residential or fann property owned by me or a member of my immediate family, This property is not intended for sale, eXCh~nge, lea e, or rent. OAR 479540(1) an 9560(1); If-... / I ,,:; -'-., ~ J Slgn re: '-/J1~ N" -:/~ I "jCbNTRAC;rORINSTJl.t;t.ATION: ,: I Business name: I Address: City: ' I State: ' I Fax: I ZIP: Phone: I E-mail: I CCB license no,: I BCD license no,: I Signing supervisor's license no.: I Print name of signing s~pervisor: I Signature of signing supervisor: ~~ '~~ ~ 2>'1.~ .. '1QD 440,2584,) (9/08/COM), \t2...:\.(:A. $134,00 $ $ 25,00 $ $ 32,00 $ $ 63,00 $ Services or feeders: installation, alteration, relocation I 200 amps or less (2) $ B1,OO $ I 201 to 400 amps (2) $ 95,00 $ I 40 i to 600 amps (2) $158,00 $ I 601 to 1,000 amps (2) $205,00 $ lOver 1,000 amps or volts (2) $469,00 $ I Reconnect o~ly (2) $ 63,00 $ I Temporary services or feeders: installation, alteration, relocation I 200 amps or less (2) $ 63,00 $ J I 201 to 400 amps (2) $ B7.00 $ I 401 to 600 amps (2) $126,00 $ lOver 600 amps or 1,000 volts, see services or feeders section above I Branch circuits: new, alteration, extension per panel I a. Fee for branch circuits with purchase ofa se'rvice or feeder fee: I I Each branch circuit I $ 6.00 I $ I b. Fee for branch circuits without purchase ofa service or feeder fee: I First branch circuit (2) $ 55,00 I $ !. j Each additional branch circuit $ 6.00 I $ I .1 Miscellaneous fees: service or feeder not included I Each pump or irrigation circle (2) $ 63.00 I Each sign or outline lighting (2) $ 63,00 I Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) I I I I I I 1 I I I I I I Each additional inspection: (I) $58,00 '$ I li~~r~t~r~t?4ti~~~~'R.~iHC(N't{~'uJ:fE11.i#~~4~iA\;~~i1.:~Jt;~~~H;I\ $ $ (A) Enter subtotal of above fees (Minimum Permi.t Fee $58.00) I (B) Enter 12% surcharge (12 x [A]) I (e) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through C): $ 03. '5V $ :3, ~s- $ 7,<$-(0 $ 1..5.17/ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-0N3i f1 ISSUED: 12/04/200if' .'\~~l9 I APPLIED: 12/04/2009 'J EXPIRES: 06/04/2010 {).1 VALUE: 225 Fifth Street, Springfield. OR 541-726-3753 Phone 541-726-3676 Fax 541,726-3769 Inspection Line SITE ADDRESS: 2725 C ST ASSESSOR'S PARCEL NO,: 1703361421800 Springfield TYPE OF WORK: ElectdcaI Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Owner: T1RRILL DONALD H Address: PO BOX \034 ROGUE RIVER OR 97537 Contractor Type Electrical Contractor OWNER ICONTRACT?R INFORMATION I License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occnpancy 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 I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOP~ENTlNFORMATlON I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I ^""I'!N'fIONlimr*liuml~wequire$ you, to ~Iiow rules~d.c>e!ed by the Oregon Utility otilication ~I'itl!r.~mltls:are set forth : OAR 952-{)01-o01~ thro~gh OAR 952-001- 0090 You may obtall1 copies of the rules by Notes: ; IOTlCE: oaliing the center. (Note: the tele~ho~e rHI." D[::0"'7,-' -u:Dt'..rf'" 1hl\ Oreaon Utility Noblicalion AUTHORIZ".' UIII'ILL tXPIRE IF 11'W. . I Center 18 1.auU~"-~I' , COMMEN ED UNDER THIS PERMI ",~,~Q{N\ion Descriotion , CEO OR IS A I ,IM"I " , . ~N,Y 180 OIlV DIOC!jA",BANO,ONED F@~:r Sq Ft Square Footage Description, 'Tv/le,of I.lUllst. uctlon' I ' I' ' B'd A . or mu tip lef or I mount, , / Street Improvements: Storm Sewer Available: Special Instruction: Value Date Calculated Page 1 01'2 Status Issued CITY OF SPRIN(Jl'lELD ' Building/Combination Permit PERMIT NO: COM2009-01}(1 /-V"\ ISSUED:' 12/04/2009, \ VI APPLIED: 12/04/2009 EXPIRES: 06/04/2010 VALUE: 225 Fifth Street. Springlield, OR 541-726-3753 Phone 541-726,3676 Fax 541-726-3769 Inspection Line , Total Value of Projecl Fe~s Pai'J I Fee Description + 12% State Surcharge +,5% Technology Fee Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $7.56 $3.15 $63.00 12/4/09 12/4/09 12/4/09 3200900000000000790 3200900000000000790 3200900000000000790 Total Amount Paid $73,71 I Plan Reviews I c'" 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 Re{Juir~rll?snectillns ~ Temporary Electric: Approval required prior 10'Utility Company energizing pole, 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 1 fnrther certify that any and all work performed shall be done in accordance with Ihe Ordinances of the City of Springfield and Ihe Laws ofthe State of Oregon pertaining to the work described berein. and that NO OCCUPANCY will be made of any structnre without permission of the Community Services Division. Building Safety. I further cerlify Ihal only contractors and employees who are in compliance wilh 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 tbe 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 t::O;;t=I)I~ ~ ~ De-c Otj Owner or Contractors Signature Date Pa!!e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Numb COM2009-0 173 COM2009-01 I COM2009- 731 Payments: Type of Payment Check ~~0\ cReceintl ",:~~>I'~~'s:!~'_"A: I.~.,'II~ '.'.... h:, '\ , . , 1IfL' .' , , -- ...." 'W'""",,-,,,,,W'" --.-. RECEIPT #: 3200900000000000790 Description Temp Power 200 amps or less + 5% Technology Fee + 12% State Surcharge Paid By DONALD H TIRRRILL City of Springfield Official Receipt Development Services Department Public Works Department Date: 12/04/2009 Item Total: Check Number Authorization Batch Number Number How Received , Received By NJM Page I of I 3003 In Person Payment Total: 12,40: ISPM Amount Due 63,00 3,15 7.56 $73.71 Amount Paid $73. 71 $73.71 12/4/2009