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Home My WebLink AboutPermit Electrical 2009-12-29 225 .;ifth Streett Springfield, OR 97477tPH(541)726-3753tFAX(54I)726-3689 ':^0Z,',>','"""," cii>:'!:i5,,,,,,h~"":_.i." ,":,'" '-::'>~~;"'_.. ,"">':"""'''-':-4'''''':-P~':"":'1 "t"d!:;OEPARTMENfuSE ONty"t,ij' --ANA-~~ "". . -~. .~_~.,.u ., '='" , ~-.~~t;.~~ ~-:OI6i\,1 I Date)Z- 2?-~7 I Electrical Permit Application . D 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. p iJfi3E.t",~lOCAI.JGO.vERNMENT}APPROVAL',j:"i"f'f,':,'ll1 'FEE'SCHEOUlE' ",j .' '-j 1 Zoning approval verified? 0 Yes 0 No I ['Nn,-rUbe," r:Of,iil~p,le~tio'ns' P;',I, J',:';i:);,2.."IQtrl;,;'C,' ?~t' [.t,',leootsatl , I:lJ'~;;".,CA'TEGORY.fOF,j.C()NSTRUCJ'ION;.:iif':;J.;<.~J,i>:'1 (,"',"" ,.","",." . . ",ea. ., i~~~~~~I:~ITEJIN~~R~;~7;~:~NO~l~c~;~;~rd:l I 1 ~:::::tJ:I.:~:s:~:; servIce inclUded:, $134.00 $ j I J b' dd .., ~/ 'I 1 Each additional 500 sq, ft. or portion I $ 25.00 $ I o SIte a ress: ~ J D A-II...,.., A V"L- thereof I City:.f P/!~ I State: t00L I ZIP: 9?!/n Limited energy (2) I $ 32.00 $ I i'~~;;f~~:~jji~f~~~~;;NOFW~~~~~~:X&~~~ I J~~~I~:"s~~i~~r~~ re~d:r (~)odular [ I $ 63.00 $ I I M el.e ~ M 'oJM. ) 1000 ~ Ile.:I-!~~.J I I Services or feeders: ins/alla/ion, ai/era/ion, reloca/ion 1 , . I ". I I 200 amps or less (2) I / $ 81.00 , <!.t.,/" PAlL r-...,"'", .-..., 1""'~1"Jr~~~"',"'0r",c:PRO~ERT,Y.;[OWNER'!'l,'~,J,,_~j~i':'I(i::~ I 201 to 400 amps (2) $ 95.00 ,$ I Name: .00"'- W1.......... 9<14-. ...... - I 1 401 to 600 amps (2) I $158,00 I $ I Address: '2.. s-t A-tI ~ ~_ON: Orellon law mltu t 601 to 1.000 amps (2) I 1 $205.00 $ I City: !; P f-Id/ INootr~tV.;)ly tllfiOrl ' ~3fr.~ps or volts (2) I I $469.00 1 $ I Phone:$'"4/-'7t(l-"Z"74n-i'952~t:OO:'Ot'08ertil~JrWi4l1)(2) I 1$63.001 $ _I I E.mail: &0......I.J.M<>V.~.!>>~~.~:~r.~9ii~Jervicesorfeeders:InslallaI10n.alleraI10n.relocolion J This installa,ion is being made l}II,{, . :lP~rp,r~/lIote::lhlllt ~ ~css (2) I $ 63.00 $ J ownedbY~. amem er fnYg5IYTI . ~tllIiiipMgomilltL'N .. '11;'~amps(2) I $ j property I ~t tend sa e, exc Jar,r"SIl. ~. , :.:xl 87.00 $ 479.540( ) an 479.5 .; : .2; . }l01 to 60iJ amps (2) $126.00 $ I ,~gna:ure: . ,.' t/" _ ..', I I Over 6~0 'mps or 1,000 volts, see services or feeders seclion above I 1~.;.,~j!f'~:''''':_C0NTRACTOR~.INST~L:~~}ION,.::.:.:~~~~;~,-.,cf,1 I Branch circuits: new, ai/era/lOn, ex/ensionperpanel I l.susiness name: :[)OVl UA. I!1-Y ~ 'j I a. Fee for branch circuits with purchase of a service or feeder fee: I I Address: '2.. <;(:; rll #" A..l/-f-. I 1 Each branch circuit '. I I $ 6,00 I $ ~ City: ~Pl-.(d/ - I State: d- I ZIP:9?v77I I b.Feeforbranchcircuitswithoutpurchaseofaserviceor~eederfee: I PhoneG"'u-l- .,i I Ze>?<6 ,[ Fax: I 1 First branch circuit (2) .1 I $ 55,00 I $ I E.mail: cb--a.t;J.IMe..;fJI.-..;~C......l...st;lVn<1.1 Each addition,l branch circuit ' I $ 6.00 $ r CCS license no.: I SCD license no.: . 1 I ~'liscellaneous fees: service or feeder no" included I Signing supervisor's license no.: I I Each pump or irrigation circle (2) $ 63.00 I Print name of signing supervisor: I I Each sign or outline lighting (2) I $ 63.00 f Signature of signing supervisor: J I Signal, cir,cuit or a li~ited-energy paneL I $ 63.00 $ alteration. or extensIOn (2) NOTICE: ""'\;'t:i'';F'',liti'~'ddi'ion~lin~p~c'i",n:~)1 ,I $58.001 $ THIS PERMIT SHALL EXPIRE IF TI- FiWQRK0~ii!1\i~~",AF'~l!ICAN:t:liUSlt:"i,,;:~~"':t," 'j AUTHORIZED UNDER THIS PERMnIHPWifs,~~tolalOfabovefees I $ B ( I COMMENCED OR IS AB~ONED rnfi",~..;;m,;Permlt Fee 558.00) ANY 180 DAY j'E~IOD.a - '.' ,qJ),Enler 12% surcharge (12 x [A]) I $ '17l. 1 WI" ()' I (C) Technology Fcc (5% of [A]) I $ ~O) I '~~~ I TOTAL fees arid surcharges (A through C): I $ 9'f!Zj ~~ $~( I 1 ~' ~ $ $ 440.2584.j (9/08/COM) U I i' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I62I ISSUED: 11/05/2009 APPLIED: 11/05/2009 EXPIRES: 05/05/2010 VALUE: _~~AI:N~~Is:IL:.D) ., ' . ., li' .~ , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetinn Line SITE ADDRESS: 256 ALLEN AVE ASSESSOR'S PARCEL NO.: 1703233303800 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Relocate service entrance TYPE OF USE: Alteration Residential Owner: MARTIN DONALD L & C A Address: 256 ALLEN AVE SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION . License 'Expiration Date Phone Contractor Type Electrical Contractor OWNER I BUILDING INFORMATION' , 0 n Iaw;res you to # of Units: ATTENTION: rego 0 ~~I'l'Utility Primary Occupancy GrofQllOw rule8ltl~opte~~~ hi\l'~M~f}ttIlJle Secondary Occupancy CNotiPcatlon Cen:10thro )()~f#OOI:l'001- Primary Construction J1n>GAR 952~~ taln COp ~lSrtJltlJroles by Secondary Construetion~: You maY:r (Notd!-~Il11"~O~e # of Bedrooms: calling ~: Or~9on I.ltnll~lIliilbatiOn numb8rC:~t8~ Ia 1-800"*<ll84l\iLBuilding: n/a I DE~ELOPMENT INFORMATION' Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 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: Com pac': I PUBLIC IMPROVEMENTS I ... ".;,.,:,,,:;.,,,, M01ICE: EXP'Rti~emI!'WOOK THIS PERMIT SH/I,LL THIS ~1\~p<llit~1.ins: AUTHORIZED UND~: /l,BANDONED FOR . COMMENCED OR ANY 180DAY PERIOD. Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Pa~e I 01'2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01621 ISSUED: 11/05/2009 APPLIED: 11/05/2009 EXPIRES: 05/05/2010 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541,726-3769 Inspection Line Total Value of Project Fe~s P3id I Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $9.72 $4.05 $81.00 $9.72 $4.05 $81.00 11/5/09 11/5/09 1115/09 12/29/09 12/29/09 12/29/09 2200900000000001261 2200900000000001261 2200900000000001261 2200900000000001439 2200900000000001439 2200900000000001439 Total Amount Paid $189.54 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. . ~elll/irfrl I,~snections I Electric Service: Approval required 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 an)' and all work performed shall be dOlle in accordance with the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to 'he work described herein, and that NO OCCUP ANCY 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 iuspeetions are requested at the proper time, that each address is readable from the s'reet, 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 7Eril:;~ I Z - 2 ~-t7'1 Owner or Contractors Signat~re Date Paee 2 of 2 225 Fifth Street ,. . . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009.0 1621 COM2009,0 1621 COM2009.0 1621 Payments: Type of Payment Check cRcccintl RECEIPT #: 8P.~~~~.~'.EL__'?: . .1,........ .~, . : .'.' , -.. City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000001439 Date: 12/29/2009 Description Penn Serv/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge PlIid By CHARLOTTE MARTIN Item Total: Check Number Authorization Received By Blitch Number Number How Received djb 4564 In Person Payment Total: Page I of 1 I :53:25PM Amount Due 81.00 4,05 9,72 $94.77 Amount Paid $94,77 $94.77 12/29/2009