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Home My WebLink AboutPermit Electrical 2009-12-28 225 Fifth Stree" Springfield, OR 97477. PH(541)726-3753' FAX(54 1)726-3689 I'i; 6EE~inMENT U~EONLY I I Pennitno:. 0<1-- c?/o~7 I I Dale: /d-j;Jr:jo ~ I Electrical 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. I, ...~.I..!OCAL:<>OVERNMENT...APPROVAL'+; :>T,'.'I 1!,:\,:,,'i;+:,,~~:~t,,~il~?;'l!i;f'EE'!iSC8EbOI!jE~)i!'i~i,i;;\1i*,g'0;i1~1"?'\'~~11i I Zoning approval verified? 0 Yes 0 No I I ,NUni~erqfins~etiionsp~rii~;'hr,)IQ1j..1 ,S6~! "/ .Total' '.Ui,.:.'.'cATEGOR.Y.!()!i'iCONSTRUCTIONi,\" ., I' ,', ,.. '. ...'"..',,,,..,,, :..'" ,',. '.' ea. . cost 1~~t&~j~.&~t~~rt:E:;'N~~RfJ~~7;Nt'~NO~~~C~:~N;~~~~"y:11 ~~~~::ti:I,:,el:S:n(:; service included: $134.00 $ I' \ L 7.. c:. C:'" M I, ~ . / 'h\'.A ' 'I I Each additional 500 sq, ft, or portion $' 25,00 $ Job sIte address: 'JJ'J v"Mll'lta D Vt71 ' thereof . I City: -SpYly\<'rfi -e l~ I State. OiL I ZIP: t?lNlll I Limited energy (2) I Reference: _ _ ." ,,_ _ J_T~X,_ lot.: ,I I Each ~anufa~tured home or modular , , 'DESCRIPTION OF WORK ",',' .'Ci',,,.',,. "')'1 dwellmg seTVIce or feeder (2) .IAf) VI wde" .e k. c.trnftl 'n.vt . I I Services or feeders: installotian, alteration, relocation r fil I I 200 amps or less (2) $ 81.00 $ I PROPERTY OWNER '1 I 201 to 400 amps (2) $ 95.00 $ I Name: 'DICIlV\M ~,~ I I 40] to 600 amps (2) $158.00 $ [AddresS)' t~:'5 C-e",-!(;r\nir11 J3,lvP'i I I 601 to 1,000 amps (2) $205,00 $ City: 6bn 1')'1 n' ((vi I State: (]~ I ZIP: P/7'-1:-Z 7 II Over 1,000 amps or volts (2) $469.00 $ Phone:<;)-11. 'N~ 1P'i (P'1 I Fax: I I Reconnect only (2) $ 63.00 $ I E-mail: ~PlA.6to\L:t~AII~~o+wttl\;I~c:..M--1II.TempOrarYSerViCesorfeeders:installation.alteration.relocation This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family, This 1.201 to 400 amps (2) $ 87,00 $ property is not in ded for sale, exchange, lease, or rent, OAR 479.540(1) and 4 9560(1), ...A ' I 401 to 600 amps (2) $126.00 $ Signature: _ I'C" ~ lOver 600 amp's or 1,000 volts, see seryices or feeders section above : CONTRACTOR' INSTALLATION, ' ,I I Branch circuits: new, a/teration, extension per panel Business name: I I a. Fee for branch circuits with purchaseofa service.or feeder fee: I Address: "- ~ I I Each branch circuit I $ 6.00 I $ I City: __________ I State: ~ I I b. Fee for branch circuits without purchase of a service or feeder fee: Phone: ~><:-----. I I First branch circuit (2) $ 55,00 $ E.mail: / ~ I I Each additional branch circuit $, 6.00 $ r CCB license no.: ~ I BCD license ~ I ! Miscellaneous fees: service or feeder ':lot included SigningjJlfJefVGo~'s license no.: '" I. 1 Each'pump or irrigation circle (2) . $ 63.00 Print name of signing supervisor. I I Each sign or outline lighting (2) $ 63.00 Signature of signing supe, rvisor: I I Signal circuit. or a limited-energy panel, $ 63.00 $ alteration, or extension (2) I Each,a}\~J!ip.l)!'1 inspection: (]) I $58.00 $ r,j~:;i#~if7~~~~~~v~~~~~~f1~~~r~;W:?J'B~:i~';;':T\; l/ (Mirii;(,lu\tUW/,J;WJ~~8.001HIS PERMIT I) NaT 8/ ,f '1111/,nilrr\l("lr-n f)n I'"' "n" ~1,",f"\J\lr-~ rr n -- I ........,....,-...,.'v...lJ v I U /U...../\j\II.)UlllL..LJ .. I ./ f I (B) gm,ef If&'r,s~\9~\~,eC<d~{A]) $ -0.0 \ I (C)Technol~gyF~;(5%-~i[Ajj' $ ? 7Iz.. ,I TOTAL fees and surcharges (A through C): $ qL-l. 7V I $ 32.00 $ $ 63.00 $ ~JV I I I I I I I I I $ $ \'v\J~~{f-- ~Va ~ ~ 440-2584-J (9/08/COM) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01837 ISSUED: 12/25/2009 APPLIED: 12/28/2009 EXPIRES: 06/25/2010 VALUE: SITE ADDRESS: 1335 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703253310500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Electrical upgrade Storm~S~)i~l.J;'-vailahle: ATTENTION~I'l're'dB~'\l*P(~res you to spec,i~,I,~')JrR~tion: , follow rules adopted by the Oregon Utility ,IUlI10R MIT SHALL Notification Center. Those rules are set forth N~tO'0~ IZED UND EXPIRE IF in OAR 952-Q01-0010through OAR 952-001- A,,,, V/ENrc" _ ER 1/.11(' __ THF IAI".~. . nnM V~" mOil "hIe I'] {;opies ofthe rules by '., I fiO DAV pvn /S ABAND' J.:tflV//T IS II'~;' call1lg the center. (Note: the telephone , ERIOD. ONED FOR ~aluation DescriDtiolhjJlr for the Oregon Utility Notification . Center is 1-800-332-2344). $ Per Sq Ft Square Footage or multiplier or Bid Amount Owner: BRINTON LIVING TRUST Address: 1335 CENTENNIAL BLVD SPRINGFIELD OR 97477 Contractor Type Electrical Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupanc)' Group: Primary Construction T)'pe Secondar)' Coustruction Type: # of Bedrooms: Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Description Type of Construction I CONTRACTOR INFORMATIO~ I License Expiration Date Phone BUILDING INFORMATION I # of Stories: Height of Structure T)'pe of Heat: Water Type: Rauge T)'pe: Encrg)' Path: Sprinkled Building: u/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 REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLlCIMPROVEMENTS I Sidewalk T)'pe: Value Date Calculated Pa2e I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01837 ISSUED: 12/25/2009 APPLIED: 12/28/2009 EXPIRES: 06/25/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project F ees P~i~ .1 Fee Description + 12% State Snrcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amonnt Paid Date Paid Receipt Nnmber $9.72 $4.05 $81.00 12/28/09 12/28/09 12/28/09, 2200900000000001431 2200900000000001431 2200900000000001431 Total Amonrit Paid $94.77 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 Reo "-,'d hlsnections ~ Ilul ..1 ..1 1111 III Electric K~V~.!'{t~wired prior to utility company energizing service. 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 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. 1 furtber certify 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 requested at the proper time, that each address is readable from tbe 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 times during c~=1{ ,~ \ viM! 01 Owner or Contractors Signature Date Page 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1837 COM2009-0 1837 COM2009-01837 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000001431 Date: 12/28/2009 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge Paid By DIANA K LEE Item Total: Check Number Authorization Recei~cd By Batch Number Number How Received nJm 049242 In Person Payment Total: \.II\1 , &;~.; 'r.- Page I of I 1O:56:54AM Amount.Due 81.00 4,05 9,72 $94.77 Amount Paid $94.77 $94,77 12/28/2009