HomeMy WebLinkAboutPermit Correspondence 2009-12-7
DEVELOPMENT SERVICES
225 FIFTH STREET
SPRINGFIELD, OR 97477
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Electrical Permit Application
CITY OF SPRINGFIELD, OREGON
225 Fifth Str.et.Springfield, OR 97471 tPH(541)726-375J tFAX(541)726-3689
I DEPARTMENT USE ONLY .
Wf~I"M,,~(lq;~;r
I Date: 1;)/ (Y-f / () Y l ~
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 LOCAL' GOVERNMENT APPROVAL
I Zoning approval verified? DYes D No
I CATEGORY OF CONSTRUCTION
I 0 Residential I 0 Government lO Commercial
I:,,'f> JOB SITE I~FORMA!)ON AND 2CATION,-,",l'
Job site address: 21.2..:J C' 5/,
City: S,p!lJM) Ile Id I State: cr~. I ZIP: '17~ 77
Refererice: \fb~ftotA 1 Taxlod.~
DESd~IPTION OF WORK "
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PROPE~TY OWNER ._ , 1
Name:. --p:!J../ j) /cJ f/ 7 / ~ R./ / / I
Address: OLl2. ~ ~ s/: I
I ZIP:v'7tJI7 1
I
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City:S,,?!? I ""'I r- x/cf
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Phone:
E-mail:
I State:O/Lt..
1 Fax:
. .
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, exchan~", or rent. OAR
479,540(1)~,560(1); '^ / Ie/, A/l1 '-' ~ /
Sign~ L..-C1'1"u<z:r N' '/ L./VJ'f.//!
Welcome to Springfield, Oregon
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www.ci.springfie1d.or.us
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440-2584-) (9/08/COM) \1..~.cA
,,"<:';;'~!ft' FEE SCHEDULE
Number of inspections per item () .IQty.1
Residential, per unit, service included:
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Cost Total
\ ea. cost
1.000 sq, ft, or less (4)
Each additional 500 sq, ft, or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134,00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: instal/ation. alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
60 I to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
I Temporary services or feeders: installation. alteration, relocation
I 200 amps or less (2) $ 63.00 $ /
1 201 to 400 amps (2) $ 87.00 $
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 of a service or feeder fee:
I Each branch circuit 1 I $ 6.00 I $
I b. Fee for branch circuits without purchase of a service or feeder fee:
I First branch circuit (2) $ 55.00 $
I Each additional branch circuit $ 6.00 $
I 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 Each additional inspectinn: (I) $58,00 $
V,.i~;.t~:r~.~:,;Ar;W APPLICANT'USE,. ;~{.
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
,I (B) Enter 12% surcharge (,12 x [A])
I (C) Technology Fee (5% of[A])
1 TOTAL fees and surcharges (A through q:
$ (,3. '5U
$ 3"IS
$ 7.c,,(a
$ '/3.17/
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COMi009-Mi t'1
ISSUED: 12/041200iJ- '~\~\.9 I
APPLIED: 12/04/2009
EXPIRES: 06/0412010 ().-' '
VALUE:
225 Fifth Street, Springlield,.OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2725 CST
ASSESSOR'S PARCEL NO.: 1703361421800
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New,
Residential
PROJECT DES<;:R1PTlON:
Owner: TlRRJLL DONALD H
Address: PO BOX 134
ROGUE RIVER OR 97537
I C?NT~CTOR 1NFORl\IATlON I
Contractor Type
Electrical
Contractor
OWNER
License
Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
. Secondary Occupancy Group:
Primary Coostruction 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 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lol Coverage:
REQUIRED PARKING
, Total:
Handicapped:
Compact:
1 PU~L1C IMPROVEMENTS I
A'ffEN'fIONlil!l!-etilln'F~~!equire: youto
~li6w rUle~do~ed by the or~gun Utility
,. t'f' t' n n\Y. nnu<WDml9S.are set forth
tlo I Ica 10 lll'. rrrr=<:< 001
In OAR 952-O01-O01~ throu.gh OAR 952- -
0090. You may obtain copies of the rules by
Notes: 'iD TICE: calling the center. (Note: the lel~~ho~e
;-!.il~ P:CN"~ ~,: UI"hArlnrtllll. Orepon Utility Nobfication
AUTLICRI.;E" v, 'MLLtXf-'IRE IF TH~,W II . Center 1I1-ll0U~"-~/'
cOI~,i'VI~N"L D UNDER THIS PERMIT 'f aWiJ\ion DescriDtion ,
" , CEO OR IS ABANO- .L I .
. ~N'y 180 O/J.v Pr=D-JAn ' ,ONEO F@/WerSq Ft Square Footage.
DescrIPtIOn 'Tv/J~/)lll.loostructlOn. It' ,. ' B'd A
. . or ruu Ip lef or I mount
Street 1mproyements:
Storm Sewer Available:
Special Instruction:
Value
Date Calculated
Pa2e I of2
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Status
Issued
,CITY OF SPRINGFIELD
. Building/Combination Permit
PERMIT NO: COM2009-01731
ISSUED: 12/04/2009
APPLIED: 12/04/2009
EXPIRES: 06/04/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone'
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe.e~ Paid I
. Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Temp Power 200 amps 'or less
Arnount 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
Plan Reviews'
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 ~~,?,~ir.~d l.nsn~~tions ,.
Temporary Electric: Approval required prior to Utility Company energizing pole.
By signature,J state and agree, that I have carefully examined the completed application and do hereby certify that all
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 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 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
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Owner or Contractors Signature
Date
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