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HomeMy WebLinkAboutPermit Electrical 2009-12-18 225 Fifth Street. Springfield, OR 97477. PH(541)726-375H FAX(541)726-3689 ,.\ . b~r~,RnjjENt U~EONL y '" I Pennitno C q~ \Bl \ I I Date \fd'\6.cp\ I Electrje,al Permit Application 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. 1-' " '.' : LOCAL: GOIIER/IIME/IIT' AF:'F'.ROVAU'~i':'i'j:"I' 1,";':'i!H,A{':1\<13;;~?\':'!i~!:!:(SOHEbl.JuJE~:'H!2,ii,1\\?,}'!(,"i'i"%,Ji'i~~m ~ g pp D D No I,Num..b,fr;'firsp~~iio~i.p~r.it~~(;lQiy.I" ,~~~~,'I~~WI 1::::si:e~;~~~~~~i~~~~~~~~:n~~RUr~O;:~merci~l':i I Residential, per unit, service included: I 1il!%~mrfl?;(bB.j;SIJiE';INfQRMA;r;lbllll"A/IIJj}iLj!()CA."tION..~!.iK",f,:1 11,000 sq. ft. or less (4) $134.00 $ I I JOb~' addn:ss. \ -:\.'\ ~0JvG,_ . I I ~:e~~:ritional 500 sq ft or portion $ 25.00 $ I City. K\\ 'il..X\~tate:U'f---1 ZI~\'\--r-hl I Limited energy (2) $ 32.00 $ I Reference. n~:~~~~OFWJ;~xl~tC.~)T~i I ~~~~I~:"s~~~~~~~fe~~:r(~)odular $ 63.00 $ 'j) -'-- I I Services-or feeders: installation, alteration, relocation r-e.Pa,'v 5;;',-- ./l'c.-e., A4J T - ( \ f\r~u\JZ-- '\4-'1- "\ I I 200 amps or less (2) $ 81.00 $ I -PROPERTY OWNE~ I I 20t to 400 amps (2) $95.00 $ 'f:;t Name: _').\ \\"; '?(}~\l M"'.)\-t I 1 401 to 600 amps (2) $158.00 $ Address:~.6.: ~~ --,~ _ I I 601 to 1,000 amps (2) $205.00 $ City: ~c;L- 1 State: 0\'--1 ZIP: \J( f\ Tl[ lOver 1,000 amps or volts (2) $469.00 $ I Phone: _ _ . I Fax: -. _ I I Reconnect only (2) I $ 63.00 $ 6; ~'I . I E-mail: I I Temporary services or feeders: installation. alteration, relocation This installation is being made on residential or fann property I 200 amps or less (2) I $ 63.00 $ owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479.560(1). 1 40t to 600 amps (2) I $126.00 $ Signature: lOver 600 amps or 1,000 yoJts, see services or feeders section above I :CONTRACrOR INST ALLATIONI I Branch circuits: new, al'era,j~n. ex!~~~ioi!'.er pane:!.. I Business name: Aut- r /~ c.-f-,.; L. .:i:.... I a. Fee for branch circuits with purchase of a service pf feeder. fee: I Address: )"/70 f1) 2$ -n., )-1. I Each branch circuit 1 I $16.00 I $ I I City: f/.".k/,~II I State: DI2 I ZIP: 7-7</771 I bFeeforbran:hCjrCurnO~r.o/llJ'~'Wf~1W.~ee I . I Phone:JfiI -ly7- 2-l..I) I FaxS/I -7ii.- 0 ~ L '1 I I First brancror~I'iW'\1.lll!!\ adopted PYtll"C!i1r~~=~~:rb I E-mail: I I Each addjt~fioll!ilillli~ter. 1 OS8 \ ~bAA~ 2$001- . I CCB license no.:", L- (1 L I BCD license no.: 20 _ 5s<:.1 I MisceltaneoJl1i9.'1. , tfmPie:stoftherulesDY I I V,. /IN t9 R I~:;n I Signing supervisor's license no.:. .<)D j, i. 5 I Each pump or i_I\,-~Jrt~r.,..o ." . I printnameOfSlgningSUpervisor'~~~ C Jlf'f/eJ,e71 1 EaChSignOroull~i~:'~~" ~" . $ I Signature of signing supervisor:~ ..{ ~,_ n /~ P--=-I I Signal circuit or a limitePenergy panel, $ 63.00 $ / V ?'::::~/.J..D/ _' alteration. or extension (2) ~~D\ ~~, ~!~~~~;;7"@Of:.i~:;~;~~J; \\: ~<:y NOTIC:~M\T S\1f\.LL EXPIRE If T~{ ~~~~ .1 (B) Enter 12% surcharge (.12 x [AD $-1 .~\W ~ THIS ~R\ZED UNDER THIS PERM FOR. .1 (C) Technology Fee (5% of [AD $ <~_ ~.V') \S- ~~~MENCED OR IS f\.BANDONED. I TOTAL fees and surcharges (A through C): $l-J ~ II ANY 180 Df\.Y!ER\OD. .: j\ "i'\ ~(\o,.t\.k" '^~ 440-2584-) (9108/C04{\:1'0W ~ ~~ \.'J\,^ ,~, ~~t)tI ~ O\0MJ \J\O-.. \~~\\J,\ Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01811 ISSUED: 12/16/2009 I APPLIED: 12/1812009 EXPIRES: 06/1612010 VALUE: 225 Fifth Stl'eet,:Spri,iglield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 444 MAIN ST ASSESSOR'S PARCEL NO.: 1703353107700 Springfield TYPE OF WORK: Electricat Work Onty TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Repair Service Mast Owner: DUGGERJACKL ). .<.M.""~"(\(\RXCL~ "'~\\t'\. Address: 420MAIN ST 0\ ,VVJ V' . ~V SPRINGFIELD OR 97477 I CONTRACTO~INFORMATlON I Contractor Type Electrical Contractor ALERT ELECTRIC INC License 12772 Expiration Date OS/22/2011 Phone 541-747-2213 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Eifergy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: I Compact: I I I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: . DownspoutslDrains: Notes: I V aluation De~criDtion , Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 CITY OF SPRINGFIELD Building/Combinati.on Permit Status Issued , PERMIT NO: COM2009-01811 ISSUED: 12/16/2009 APPLIED: 12/1812009 EXPIRES: 06/16/2010 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% State Surcharge + 5% Technology Fee Service Reconnect. Amount Paid' , Date Paid Receipt Number $7.56 $3.15 $63.00 12/18/09 12118/09 12/18/09 2200900000000001405 2200900000000001405 2200900000000001405 Total Amount Paid $73.71 I 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 Re(llJir~\1 Insnections' Electric Service: Approval required prior to utility company energizing service. By signaturc, 1 state and agree, that I have carefulty examined Ihe completed application and do hereby certify that alt information hereon is true and correct, and I further certify that any and all work performed shall be.done in accordance with the Ordinances of the Cily of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wilt be made of any structnre without permission of the Community Services Division, Bnilding Safety. 1 further certify'that onty contractors and employees who are.in compliance with ORS 701.005 will he nsed on this project. 1 fnrther agree to ensure that alt required inspections are reqnested at the proper time, that each address is readable from the street, thaI 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~struction. Owner or Contractors Signature Date Paee 20f2 225 Fifth Street Sprin"gfiefd,'Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1811 COM2009-0 181 t COM2009-0 1811 Payments: Type of Payment CreditCard cKcceintl RECEIPT #: Description Service Reconnect + 5% Technology Fee + 12% State Surcharge Paid By GREG HATLEGERG 'i;f~i City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000001405 Date: 12/18/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received lIh 18489 18489 In Person Payment Total: Page I of 1 2:38:40PM Amount Due 63.00 3.15 7.56 $73.71 Amount Paid $73.71 $73.71 12118/2009