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Home My WebLink AboutPermit Electrical 2009-12-11 (4) I ~.i\'< :\'<, '~:'!'ti~bCAL:\GOVERNMENt~h~~~PR:OVAI.B'~~~~~i':~.i~~~r1'II~~':1Ftfq?!~~~~~1:J~~f!tF.EE:lsCHE"D.Ol!lEk~~1Y~W~~~\~~~1 1 Zoning approval verified? . 0 Ves, 0 No I LNu"!~er'?f!~spe~iio'ri~p'e~,if~"';;'().:,~".IQh.1 :~f6~!'\1 ,Total:'1 Ir":ldi"i\\,i,:\ir:~.CJ.l.TEGOR'/\~OFc;~CONSTRUCTION~;~'~"\~i;",<:,1 ,','". .,',' "'.de...,,, ,", ,.c."..., ,hea." , , cost." 1 .-..<" 'I I' I I Residential, per unit, service included: 1~~~~~~rrE~INF~R~Ar~;~~AN[j!jl~C~;~~~~~~~~~111 [1,000 sq ft, or less (4) . I I Each additional 500 sq. ft. or portion $ Job site address: thereof $ 25,00 City: 1-{9C6 Uf\l:, \.j' 1 State: () c.., [ZIP: q tLf7?J 1 I Limited energy (2) $ 32.00 $ lr,~e~:;~~ce: 1.~o.D~?c:~~~N>0F'W~;~:~~:~;~;1ty~;:.;:11 ~~~~I~:nS~~~~~r~~ re~~~r (~)odular $ 63,00 $ 10 ~0. ' 17('; (K.. . . /,1 _ ~ ~" ',,"' '. b, :;., - "'1 I Services or feeders: installation, alteration, relocation ....f"rcf'{r:: L)\[y.AtioL.. u'f q "'-6 rN... +,c/W" 1M eEl"" 1 I I 200 amps or less (2) Z $ 81.00 $ I . . ' :PROP.ERTV.oWNER ',,' I I 201 to 400 amps (2) $ 95,00 $ 1 Name: C' Ni"U'10 Wt,D/;f'S I 401 to 600 amps (2) $158,00 $ I Address: LI80 <::, Df\lS- c:; <;,T ArrEfllTrON~ . 601 to 1,000 amps (2) $205,00 $ 1 City: ~1j)iF(f;UJi' State: Of., 1 ztib~~~d~~~!llll!lll9lRi';>MO!J~f{ $469,00 $ Phone:~<{I-It1i. Iq ~7 I Fax: . In OM 952-Dn. ~tlrRIRJAA,'lf~r.g~QJJon Util;~y $ 63,00 $ . ~- - -v jUo.1h_ '-~ "I.fl.. .. rn 6 7 ~{MdC" ~ A. y", I' .' CC v'\ U., YOU may ot ~~)""."",gWi'~J:\'/:f~~..euth<: installation, alteration, relocation .. ''-1' >-<,0, eEl/lIng t~ :'21l~~l€llt -V"VlJ). This installation is being made on residential or faJlIIl/!!$~" ce lte r, '=' '1 ~1~ru1es-"r $ 63.00 $ owned by me 0: a member of my immediate family. ThIs r the O~l\OiJoo;i!fi&il~phone - $ 87,00 $ property IS not mtended for sale, exchange, lease, or rent. BRftter II ,"'LJP" ' j' !;;;.L~l;a!lO 479.540(1) and 479.S~\(I). .0 !..a~_~tL} n $126,00 $ Signature: Ck~_ ~ lOver 600 amps or 1;000 volts, see services or feeders section above I . :',,:, '::tCONTRACi\;0R'INSTA~lATION: :.: .1 1 Branch circuits: new, alleration, eXlension per panel I Business name: ~ [.,;' AI t::rIl. I I a. Fee for branch circuits with purchase ofa service or feeder fee: Address: / I 1 Each branch circuit 1 I $ 6,00 1 $ City: I State: ~ ZIP: I b. Fee for branch circuits without purchase of a service or feeder fee: 1 Phone: I ~ - 1 First branch circuil (2) I $ 55,00 $ I E.mail: /' I 1 Each additional branch circuit $ 6,00 $ I CCB license no.: /' I BCD license no,: I I Miscellaneous fees: service or feeder :'0/ included I Signing supervisor's~nse no.: 1 I Each pump or irrigation circle (2) $ 63.00 j Print name of signi~g supervisor: I I Each sign or outline lighting (2) $ 63.00 I Signature of signing supervisor: NOTICE: 1"l's'igrial:'cirCuit or a limited,energy panel, $ 63,00 $ THIS PERMIT ::iHALL t!\t'ltit I "fff~W1'Rr.ten,S1on (2) AUTHORIZED UNDER THIS PEb,trt,;~t~~~:t:;~~ction~:~).. . .,L.~~8~~,~,"_, ~ ,~". II COMMENCED OR IS ABANDOIIE!:"'~0Q,",~,.:M<=,'~~AF!eI1lCANTJ:!USE'ii.~;,,':;>l;,~~:j\;:.:ri1;i,",:-;." ANY 180 DAY n:IflGY (A) Enter suototal ofabovefees 1~2. ~'V,..(1 (Minimum Permit Fee $58.00) $ \t\ .\\9 'l/\ 1 (B) Enter 12% surcharge (.12 x [A]) $ I'l'...f 1C'(A)~ 1 (C) Technology Fee (5% of[AJ) $ &,"'0 ~ 'D\ 1 TOTAL fees and surcharges (A through C): $ I p" ~<f IJ;.\ Electrical Permit Application - }, oil. " 225 Fifth Street. Springfield, OR 97477tPH(S41)726.37S3tFAX(S41)726.3689 l~f:\D~f~~T~ENfG~'E ofol,i:y:..:,,cl I P~~:::;ZCO ., - 017 &i I I Date: /2.-(/-0; I 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. $134.00 440.2584.} (9/08/COM) $ I I I 1 I 1 /64- I 1 I I I I 1 1 I 1 I 1 1 I I I I 1 1 I $ $ Status Issued 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 541-726-3676 Fax 54],726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01768 ISSUED: 12/11/2009 APPLIED: 12/11/2009 EXPIRES: 06/1 1/2010 VALUE: SITE ADDRESS: 4205 DAISY ST ASSESSOR'S PARCEL NO.: 1702323305300 Springfield TYPE OF WORK: Electrical Work Only ATTENTr fol/ow rut ON: Oreb~~nRACTOR INFORMATION' NotifiCatio:~ adOPt~a by th - ,.OJ "S you to XA~~o~~::' Those r~,~egon Utility License -~~V.tIU mall ^".!~ throuflh nAa:,e~~et forth nu~;;: ~noe center.-'_"lNm4>~_1ATlON I r the Or ! Iblb' . . Center Is egon~t' ~I .1?hone f -a<lO :stg~ation R-3 -e, 11f Strnctnre Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: PROJECT DESCRIPTION: Replace service and feeder Owner: . HODGES CAROL YN A Address: PO BOX 390 SPRINGFIELD OR 97477 Contractor Type Electrical # of Units: Primary Occupancy Gronp: Secondary Occupancy Gronp: Primary Construction Type Secondary Constrnction Type: # of Bedrooms: VB TYPE OF USE: Repair Residential Phone Nnmber: 54]-606-1977 Expiration Date Phone n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive I{qd: % of Lot Coverage: NOT/CE- I PUBLIC IMPROVEMENTS I Street ImprovementsrHIS PER' .f1/1TH MIT SHALL ',' .' Storm Sewer Available, ORIZED EXPIR ''''':''', Speciallnstruelion:COMMENCE UNDER THIS E IF THE WOR ANy 18 D OR IS PERMIT I K Notes:. 0 DAY PERIOD:BANDONED FO~ NOT , Description I Valuation Descri9tion I $ Per Sq Ft Square Footage or multiplier.... ." or Bid Amount Type of Construction Paee] of2 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01768 ISSUED: 12/11/2009 APPLIED: 12/11/2009 EXPIRES: 06/11/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% Slate Surcharge + 50/0 Technology Fce Perm ServlFdr 200 amps or less Ainount Paid Date Paid Receipt Number $19.44 $8.10 $162.00 12/11/09 12/11/09 12/11/09 2200900000000001374 2200900000000001374 2200900000000001374 Total Amount Paid $189,54 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 R~nui"ed Insnections I Electric Service: Approval required prior to utility company energizing service. By signatnre, [ 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 c,ertify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the La,,, of the State of Oregon pertaining to.the work described herein, and that 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 arc in compliance with ORS 701.005 will be used on this project. I further agree to ensure thnt 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 01" plans will remain on the site at all times during construction. I, ^ \\ "- ( .0vf.\ /'- ~ '\- ~ I r ~ 1\- Owner or €ontractors Signature \j /J.-- (/-09 Date Pa2e 2 012 . ',' 225 Fifth Street Springfi.cld, Oregon 97477 541-726-3759 Phone Job/Journ:ll Number COM2009-0 1768 COM2009-0 1768 COM2009-0 1768 I'ayments: Type of Pllymcnt Check cRcceint 1 .. :~I~.'!~..B+!)~~' , ~..'. ,~: '.:"..'.... IlAlr ",' ta:"Iij- -,: City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 22009000000000013 74 Date: 12/11/2009 Description Perm Scrv/fdr 200 amps or less + 5% Technology fee + 12% State Surcharge Paid By CA HODGES Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1164 In Person Payment Total: Page I of I ] :28:25PM Amount Due 162.00 8,10 19.44 $189.54 Amount Paid $189.54 $189.54 12/11/2009