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Home My WebLink AboutPermit Electrical 2009-12-18 Electrical Permit Application "f. . 225 Fifth Street. Springfield, OR 97477.PH(~41)726-3753+FAJ((541)726-3689 IP bEP~iri-MENTUSEONLY' I Pe~it no. f!- q -; 1& q j I I Date: (2.. /1 6 /0 '5 , This permit is issued under OAR 918-309-0000. Permits are uontransferable. Permits expire if work is noi started within 180! days of issuance or if work is _suspended for 180 days. 1"" ., "LOCAV'<30VERNMENTA~PR,0VAl'i'k{:':]<;":1 1 Zoning approval verified? DYes.. D No ',i">:'CATEGORV/OF,CONSTRlJCTfoN":,, .' illi~1l~~~~~~~llTE!:IN~~R~A~7:N;;AN~};~;'c~;7;~~~~;;r;;.,;1 1 Job site address: 155 ~Ol..'-' e>> 1 I City: SoI.:'oJ",'I:\\L\() I State: ~L I ZIP: QZ<jD<1 1 1 Referen~e: \r;o?,'t1..0) 1 Taxlot(1?~ 1 Ii .... . . DESCRIPTION QFWORK':..' ""i "I 1 hti' A\~ Gu",l"t[' I 1 1 I / . PROpERTY OWNER . '. . I I Name: ~~ ~\C.\",\~<C~ S.u-')~~l'( I I Address: (,{""Fo tv- </2-. I 1 City: {jJ. 1 State&.- I ZIPrN'I1 1 1 Phone~,~(-7cfr(-("7> 1 Fax:5<1r 1iff- (;37'1- 1 1 E-mail: I This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479.560(1). Signature: I : CONTRACtOR INSTALLATION I Business name:S S~ i+ II I Address: 1 City: I Phone: 1 E-mail: I CCB license no.: I BCD license no.: 1 Signing supervisor's liCense no.: /0,73 pJ I Print name of sighing supervisor'---~"'hLi $411.4.C {',AJ'" I Signature of signing supervisor: A State: 1 Fax: 1 ZIP: ,~ \~~_OC\ ~'&.~ \~ 440-2584-J (9/08/COM) l;r:7;::,:~;~:~:'l/~::~~~if,it;,;~~1_:Yi~r~~~T::'~E~tSC. HE_[j.LJI3E1!{!l??i<;i,r{?;;,i~~~;;y~~ji~~?>1r~A~~,?H I.NUIl1,~~L;;finspe~iiunX~~.r)i~~'()..IQiy.I.. c;,~~1'1~~W .1 I Residential, per unit, service included: I 11,000 sq. ft. or less (4) $134.00 $ I I Each additional 500 sq. ft. or portion $ 25.00 $ thereof ~ I Limited energy (2) , $ P:/fo $ >0 I Each manufactured' home or modular I dwelling service or feeder (2) $ 63.00 $ r Services or feeders: installation, alteration, relocation I I 200 amps or less (2) $ 81.00 $ I 1 201 to 400 amps (2) $ 95.00 $ I 1 401 to 600 amps (2) $158,00 $ I 60 I to 1,000 amps (2) $205.00 $ 1 Over 1,000 amps or volts (2) $469.00 $ '1 I Reconnect only (2) $ 63.00 $ I I Temporary services or feeders: installation, alteration. relocation I 1 200 amps or less (2) $ 63.00 $ I I 201 to 400 amps (2) $87.00 $ I 1 401 to 600 amps (2) $126.00 1 $ 1 lOver 600 amps or 1,000 volts, see services or feeders section above I I Branch circuits: new, alteration, extension per panel 1 I I a. Fee for branch circuits with purchase of a service or feeder fee: I / I . Each branch circuit I $ 6.00 I $ I I b. Fee for branch circuits without purchase of a serVice or feeder fee: I I First branch circuit (2) I $ 55.00 I $ I I I Each additional branch circuit I $ 6.00 $ I I I Miscellaneous fees; service or feeder f!ot included I r Each pump or irrigation circle (2) $63.00 1 Each sign or ouUine lighting (2) $ 63.00 ! Signal circuit or a limited-energy panel, I $ 63.00 $ I alteration, or extension (2) . 1 Eachadditional inspection: (1) 1 $58.00 $ t!:r~~l:~:,~i~~~~~7~~~'?J~~~i:~'~.e'L:jCA'NT,)}j)SEY:i:(tt'G~j_;;z4(;Ei!;;ti~),'i;_:;(i,~_: h I $ $ (A) Enter subtotal of above fees (Minimum Permi.t Fee $58.00) .1 (B) Enter 12% surcharge (.12 x [AD I (C) Technology. Fee (5% of [AD I TOTAL fees and surcharges (A through C): $')f $ fo "I c. $ :;J-'(~ $671!'yl CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-0I693 ISSUED: 12/01/2009 I APPLIED: 11124/2009 I EXPIRES: 06/0812010 VALUE: $ 500.00 \. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 755 HAR,-"OW RD ASSESSOR'S PARCEL NO.: 1703220003000 Springfield TYPE OF WORK: School PROJECT DESCRIPTION: TYPE OF USE: ....,..'-...~. Partition wall .-....-,... Owner: Address: SPRINGFIELD SCHOOL DISTRICT 19 525,MILL ST to SPRINGFIELD OR 97477 ON' Oregon law requires YOUUt'lltV .."t"'TI:t..f'Tl. . t.-- t"\ro.nnn 1 follow rules aaol)l"'~, ~'ffi!Ii' - I .~prftsettonn 'f! fcl~'C:'J' DJmQlUCJN I Nolllca I 1I''''J U 'l ,II ,U:UjJ. JJ . in OAR 95:<,-u1 ,- " .~ co ies oftne rUII:l~ Contract<OO90. You may obtai Nofe' the tele*"€!~lIse OWNER calling Ihe cenler. ( n UtililY Notification . ~....... f""trp{'O ;\ nU'lllJo'r,I<<iflLIJlMi*,,~tJkMATfoN I 1 I Contractor Type General # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: ., .'._ E Height of Structure~b.:"W-I-~""""""~'1 . ......~.;s... .-:'........ .-.,.~-, Type of Heat: W~ter Type: Range Type: Energy Path: NOTICE: Sprinkle~,~n~~'1!~h\-\E WOl'lr~ THIS ~~DEvE20iM~NT4INI1(!)RMNn~N", AUTHl" ..~-'- - ABANuudtL f J. COMMENCED OR IS . DAfl"'rl~W.lSt: ANY 180 ls't~~~t T~ees Rqd: Paved Drive Rqd: % of Lot Coverage: Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPIWVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descdption I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction ;. J .~ \.. Pa2e I 01'3 Alteration Pnblic Expiration Date Phone 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: Handicapped: Compact: Sidewalk Type: Downspoutsillrains: Valne Date Calculated Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-0I693 ISSUED: 12/01/2009 I APPLIED: 11/24/2009 I EXPIRES: 06/08/2010 VALUE: $ 500.00 225 Fifth Street, Springfield, OR 54] -726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Bid Amount Use Bid Amount $1.00 500.00 $500.00 $500.00 11124/2009 Total Value of Project F',JWt f'WU Fee Description + 12% State Surcharge + 5"/', Technology Fee Building Permit Plan Review CommllndlPublic + 12% State Surcharge + 5% Technology Fee Low Voltage - Commercial Indus . Amouut Paid Date Paid $6.96 $2.90 . $58.00 $37.70 $6.96 $2.90 $58.00 , 12/1109 12/1109 12/1109 12/1109 ]2/18/09 ]2/18/09 12/18/09 Receipt Number ]200900000000001289 ]200900000000001289 ]200900000000001289 1200900000000001289 ]200900000000001347 1200900000000001347 1200900000000001347 . Total Amouut Paid $173.42 Plan Reviews I Initial Review ] 1/25/2009 11/25/2009 APP LLH Structural Review II 12512009 11130/2009 APP CJC As noted on plans. 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. ~Rp:llllirprl \g~npl'tio"i.l , Framillg;Jnspection: Prior to cover and after all rough ill inspections have been approved. Wall Insulation: Prior to cover. Drywall: Prior to taping. Filial Bu!ldillg: After all required inspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover Final Ele.clric: When all electrical work is complete. Pa!!e 2 of 3 By signature, [ state and agree, that [ have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and [ further certify that any and all work performed shall 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 structure withont permission of the Community Services Division, Buitding Safety. [ further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. [ 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 ihe property, and the approved set of plans will remain on the site at all times during constructi7u. ~,L' n'L AI j' J JJo.r-- I '--' ... Owner anti'actors ~ignature .. .--// _ Se~JN'Gl;lliILO:, .1 Status Issued 225 Fifth Street, Springfield, OR 54 [-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ., ; Paee 3 00 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01693 ISSUED: 12/01/2009 ' APPLIED: 11/2412009 EXPIRES: 06/0812010 VALUE: $ 500.00 t</If/oc; ( Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Jour",ll Number COM2009-0 1693 COM2009-0 1693 COM2009-0 1693 Payments: Type of Payment Cash Change ,Job/Journal Number COM2009-0 t693 COM2009-0 1693 COM2009-0 1693 RECEIPT #: 1200900000000001347 , Date: 12/1812009 Description Low Voltage - Commercial tndus + 5% Technology Fee + 12% State Surcharge Paid By JOHN SERACENO Item Total: Check Number Authorization Received By Batch Number Number How Received cJc In Person In Person Payment Totat: Descril}tion Low Voltage - Commercial Indus + 5% Technology Fee + 12% State Surcharge Payments: Type of Payment . Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Cash Change cReceintl JOHN SERACENO cjc In Person In Person Payment Total: ". ,. 'r ,. Page 1 of 1 IO:54:39AM Amount Due 58.00 2.90 6.96 $67.86 Amount Paid $70.00 ($2.14) $67.86 Amount Due 58.00 2.90 6.96 $67.86 Amount Paid $70.00 ($2.14) $67.86 12/18/2009