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Home My WebLink AboutPermit Electrical 2009-12-22 EleCt'rical Permit Application . CITY O'F'SPRINGFIE'LD, OREGON . _. " r 225 Fiftb Street. Springfield. OR 97477.PH(54I)726-3753.FAX(541)726-3689 I. . DEPARTMENT USE ONLY -~ ~'';''J I permitno(Ia ~OI1\22- I Date: IJ./a;pj CPJ 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 J HGovernment I 0 Commercial I JOB SITE INFORMATION AND LOCATION J.ob site address: 2,5) $, 32/J/D ST City: 800 h ()flif.! Jd I State: OR I ZIP: Cj 7Lj 72' , V I Reference: J Taxlot.: I DESCRIPTION OF WORK ...E Y#J?s-'Jf)n dJ b?J,f7rn C'--J,rcu it I PROPERTY OWNER I Name: vv,'1bmt11CLnP'. 'i-hrl&t RpJlIPMtm I Address: 2W S, 32/i,/D Sf I City: SorihalkJd I State()/< I PhoneRll:RI- LJ 5l1L/ I Fax: I E-mail: This installation is being made on residential or farm property owned by me or a memberofmy 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: N/A I Address: I City: I Phone: I E-mail: I CCB license no.: I BCD license no.: I Signing supervisor's license no,: L/f)? ,<, .s I Print name of signing supervisor: J<'PfJ ne~t11 L I Signature of signing supervisor: J::;M.W~ ,,~JJ / I . '-" ~, ., I zik C/7L/73' , I State: I Fax: I ZIP: 440-2584-1 (9/08/COM) ~~ ~~O^- \~()'\ ~ ~~ ~ I FEE SCHEDULE I Number of ins pecti ODS per item () IQty.1 I Residential, per unit, senrice included: 11,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Cost ea. Total cost $134.00 $ $ $ $ 25,00 Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $ 32.00 I I I I I I I I Tempora'Y services or feeders: installation, alteration, relocation I 1 I I Over 600 amps or 1,000 volts, see services or feeders section above I 1 1 Each branch circuit 1 $ 6.00 1 $ I b. Fee for branch circuits without purchase of a service or feeder fee: I 11 , $ 55.00 I $55,[t) $ 6.00 $ $ 63.00 $ Sen'ices or feeders: instal/alion, alteration, relocation 200 amps or less (2) $ 81,00 $ $ $ $ $ $ 201 to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) $ 95.00 $158.00 $205.00 $469,00 $ 63.00 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) $ 63,00 $ 87.00 $126.00 $ $ $ Branch circuits: new, alteration, extension per panel a Fee for branch circuits with purchase of a, service or feeder fee: First branch circuit (2) Each additional branch circuit Misullaneousfees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 Each sign or outline lighting (2) $ 63.00 Signal circuit or a limited-energy paneL alteration, or extension (2) Each additional inspection: (1) $ $ $ $ $ 63.00 $58,00 APPLICANT USE (A) Enter subtotal of above fees (Minimum Penni.. Fee $S8.00) (B) Enter 12% surcharge (,12 x [A]) (C) Techuology Fee (5%0f[A]J TOTAL fees and surcharges (A through C): I $58.001 $(P/10 1 $ 2. ,ciD I $ (ol,9Jd . , :1. Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01822 ISSUED: 12/22/2009 APPLIED: 12122/2009 EXPIRES: 06/22/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 250 S 32nd St ASSESSOR'S PARCEL NO.: ]702310000502 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Extension of branch circuit Owner: Address: 28TH ST PROPERTIES LLC PO BOX-1I7 WALTERVILLE OR 97489 - , I. ~ONTRACTORINFORMATlON . Contractor Type Electrical Contractor OWNER License Expiration Date Phone . ~UILDlNG INFORMA TlON ~ # 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: . 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 REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd:. . oulWmpact: %,of Loi Coverage: n laW lequlleS ~ Utility .,. .. '.. . ". 018ClO. "Olego" Ih - lENltO'" -I d '0,/ t..e e set jor 0-1 _ _ no\nO e _ ",IAS al _ n'''_ I PUBLIC 1MPRQ-YEMiN:fS loii~ ~'~;;;~Ugh Oit~::~~s '0'1 ". 1'\ 9tl~-v~ '- ~Qp'les 0 nl phone in 0"'0 'IoU [(\a'l o'ott~'SI~e.:.'tI!]I\\il'.yr,eo\llication 009 ' cen e,. \ ~illty}' calling the ne OIP9"'" 9~tJ!\>4')\ins: pel 101 t , ~ _800-3 2- (\u[(\ centel \S Street Improvements: Storm Sewer Available: Special Instruction: Notes: _..-_11"11'". _ . ,.,...nl/ I~U I 'u_, XPIRt I' ,~, ..~,.. THIS PERMIT SHA.LL E l' '."-,'c ~I(Y\ .. I UNDER THIS pF K~'a uatlOn DescnptlOn ..' . \UTHORIZED IS ABANDONr.U run -' D ., f)' r,tT'FI\\r:F.,J'cORt t' $ Per Sq Ft Square Footage escnptlOll . 'voe.o ODS rue IOn . . . , 1811 Ol\'{ r'\:l\iULl. or mulllpher . or BId Amount Value Date Calculated Paee 1 of2 _lilieRING!lIIiII,;l:!,:""'~ ' , Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01822 ISSUED: ]2/22/2009 APPLIED: ]2/22/2009 EXPIRES: 06/22/20]0 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fees Paid I Fee Descrh,)tion + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $6.96 $2.90 $55.00 $3.00 ] 2/22/09 12/22/09 12/22/09 12/22/09 2200900000000001421 2200900000000001421 2200900000000001421 2200900000000001421 Total Amount Paid $67,86 ....; I ,flan 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. ' Reoukerlll1sol'rtions I , ..r II "1 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 I further certify that any aodall 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 structul'e without permission of the Community Services Division, Building Safety. 1 further c~rtify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 further agree to ensure that all required inspections.are r~q~ested at the proper time, that each address is readable from the street, thai the permit card is located at the front of tlie priipe'rty, and the approved set of plans will remain on the site at all times during construction. - 1'1" ft'A/]:;;;;U' ,;!fi;7ti3ti-) / Z/Z z / () C) "7 t v ~ ,/' o ner or Cont actors Signature . Date Page 2 of2 City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth_S~t;~et Springfi~id, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-01822 COM2009-0 1822 COM2009-0 1822 COM2009-0 1822 Payments: type of Payment Check cRcccintl RECEIPT #: Date: 12/22/2009 1:41:00PM 2200900000000001421 Description Add, Alter, Extend Circ . Minimum/Adjustment Electrical + 5% Technology Fee + 12% State Surcharge Amount Due 55.00 3.00 2.90 6.96 $67.86 Paid By W1LLAMALANE Item Total: Check Number Authorization Received By Batch Number Number How Received KR 80214 In Person Payment Total: $67.86 $67.86 Amount Paid e" Page I of I 12/22/2009