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Home My WebLink AboutPermit Electrical 2010-1-4 225 Fifth St,eettSp,ingfield, OR 97477tPH(541)726-3753tFAX(541)726-3689 I..W'"'....,...""'.'.'."......'" "",."""" .,".,.;,. ~i';;:.DERARTMENt.USE. ONLY.;' ""__.0'0 ,~ '-,.:',-::l'.\. ..... _." '. ..' ; ,"" ".,,, .c. !, -. 1'~fo~(O- 000(0 I Date: / -'I - I 0 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 suspeuded for 180 days. . . I ;\':+~;.;'V~:~- "'<";JL;Td'CAl.:tG0VE_RNIViE:NT';~I?RROYAlBf,~tft5f$;t~it~:t~~ \~~\~lt;i~li;~~~~~tr~i!:?1~;~1fEl:ttS-C.f.lEJjJJl!!E~0~~t?~;~~mw;~lf~~~ii~ ii;~:~;:;;~i:~:;'~~;~~~'~~;'JOI7)'C~N~~RUCJIO~';;;;;t;,:""';", i 1;'~~T-~~~,o~j~~P~;tl~~i:p,~J~~;;~; (2.~.:.19!y.:1 ,:, ~~~f.-!:;I.:"l~~~~...: il~~,~~i~'JrE~HN~~R~A~~;N;;AN[j~~~c~mt;~;;i~~ilEi i ~~~~::tl;I':'~:s:n(:; service Included: . $134.00 $ (.?C(I . I. I? - " . i -'- .. .. I I Each additional 500 sq. ft. or portion $ 25.00 $ Job Slte address: / --.:J 7 rr $~~ L:> . thereof I City: 5oY'>,.,,,.f~,JJ I State: 1fJiZ., I ZIP: q I I Limited energy (2) $ 32.00 $ I Referen~~.:I?~~~I:I~NI:QF~lwJ;~~,:~;~~~~~~i I ~~~~I~~nS~~~~~r~~ Pe~~:r (~)odular $ 63.00 $ I ;;;~, I....J - rJ/ I Services or feeders: installation, alteration, relocation T'tt:!..1.ifJVt'...). ~d 11c.ur S~"..-VI '<-J . I I 200 amps or less (2) $ 81.00 $ : Name:~n hPR:~:WNER::: ..1 : ~~: :: :~~ :::: ;~; ~1::::: ~ I Address: ,/JO ~ 57 77f sh--e~-t- I I 601 to 1,000 amps (2) $205.00 $ I City: 5 hn t;.I/ I State 'ilK I ZIP:97'1713 I lOver 1,000 amps or volts (2) $469.00 $ I Phone.!;;I-ll"l-aJS9 I FaxS'l/-~"-lbo~ I Reconnec~~1\ctJlI~~, $ 63.00 $ I E-mail: ~..eQlW..allallOn.allerallan.relacal.an This Installation is being made on residentIal or farm pr~ ~~_~~A ~.oo,1. $ 63.00 $ owned by me or a member of my Immedtate family Th'N!l:'i.t\~ .of..l)01&~ ot",."VI $ property is not Intended for sale, exchange, lease, or ren~ ~ ~1I v .... teI.,~~ $ 87.00 479.540(i) and 479.560(1). --4-- _ ,(OJrl8\l_'-i~e('Y.e $126.00 $ Signature --;: \ ~ .. Y"'Y'.. _ ~ \ __ ceU\J\G \\\. ~ \Jt , see services or feeders section above I .. .~;:C.ON:rRACTOR: INSTALLATlOW. ' ~ ~ \, ItS: new. alleratlOn. extensIOn per panel I Business name: -I a. Fee for branch CIrcUIts with purchase of a servIce or feeder fee I Address: I I Each branch circuit I I $ 6.00 I $ I City: I ~te:. I ZIP: lb. Fee for branch circuits without purchase of a ~ervice or feeder fee: I I Phone: lo.! 0 1 Fax: I First branch circuit (2) $ 55.00 $ I . JI I I E~mail: \r Each additional branch circuit $ 6.00 $ CCB license no.: D I BCD license no.: I Miscellaneous fees: service or feed~r not included I I Signing supervisor's license no.: I Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signing supervisor: I Each sign or outline lighting (2) $ 63.00 $ I I Signature of signing supervisor: I Signarcircuit or a limited-energy panel, $ 63.00 $ I alteration, ~or extension (2) I Each additional inspection: (1) $58.00 I $ I :i'At;f?:t\~J.~~it~ll:?~,l?S;;}i';(':Y!A"-'-D 6i1[I"C"'A'---:;'N"'T:- "ir,U": -Su"'E' '1"'';~~'";''';>2t72!r.:;t,c1:(~;;'i;':.~ji~'>J l;;;; . '. .:-:_.~~'.~c;_~:,,::.,;..: .l'fi.~~i;'i^$l.'r:1~;:::;,i':~/;~;xH!;:E?:;, '- r;,J;L:: _ __. ,,'f,,'t __ _ *fuf'!::.i~'.it"-';;r~J~\!~f..'Slf:;9i:;;id.'~;\~ ~~~I~EE~MIT SHAll EXP;~E' ;;';; l~d~~~~t::~i~f:e~O;;:'~~) $ \ 3 L( AUTHORIZED UNDER THIS PERMI ~!t~12~.surCharge (.12 x [A]). $ /6 ~ COMMENCED OR IS ABANDONEDI~Bj\echnOIOgyFee(5%0f[A]) $ b7....1 ANY 180 DAY PERIOD. ..1 TOTAL fees and surcharges (A through C): $ I ~f-"J 1B ,- - ~~o y.fr;; I JC)Q/ . ~ ~'" ~ 440-2584-) (9/08/COM) Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00010 . ISSUED: 01/04/2010 APPLIED: Oi/04/2010 EXPIRES: 07/04/2010 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1827 H ST ASSESSOR'S PARCEL NO.: 1703362110500 Springtield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair PROJECT DESCRIPTION: .Rewire house and repair plumbing and mechanical Residential Owner: . DON HORTON Address: 780 S 57TH ST SPRINGFIELD OR 97478 Phone Number: 541-517-3059 I CONTRACTOR INFORMATION I Contractor Type Electrical Mecbanical Plumbing Contractor OWNER OWNER OWNER -.,."' License 'Expiration .Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Co.nstructioll Type Secondary Construction Type: # of Bedrooms: . .... . ....RIII~Wl'nlII~'1tY "TTEN'WIiIn: ~'I ~'.ir.1 .., . \ folloW rules aool' ~ .~. 'll8lUles are 1 J{ptilicatlon ~~f ~tou~h OAR 95~: ~ "\i\' OAR 952-uu.'!;1tl' C!lie\'6~'i9I the r 0090, You lTlBy~~t mte: the te!~.e"~ VB calling \he"'fhl! 'I . UtilItY Ngul-- number fo~YI 4344). Ce~~,Jfy atb: Sprinkled Building: n/a Lot Size: Sq Ft I st Floor: Sq Fl 2nd .Floor: Sq Ft Basement: .Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION, I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: P;ved Drive Rqd: % of Lot Cover.age: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC I:WPROVEMENTS I. . "H -'}.:':';'.'--"S' . .', ".".;'''.''.'.''.:'..'Side1Zalk Type: NOTICE: T SH"'LL EXPIRE IF THE ~~sP~uts/Drains: THIS PERM\ THIS PERMIT IS ,i. . AUTHORIZED UNDE: ABANDONED fOR:;;'~L:, . COMMENCED OR ".,.:...., . ANY 1 BO DAY PERIOD. . Notes: Paee I of 3 Status ",!'. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00010 ISSUED: 01/04/2010 APPLIED: 01104/2010 EXPIRES: 07/04/2010 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspeetion ~ine I V aluatio~ D~~~riptio~ I Deserintion Tvne of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project FPI,' P~i.IU Fee Descrintion + 12% State Surcharge + 5% Technology Fee 1st Appliance Fixture Residence Wiring 1000 Sq Ft Vent Fan Amount Paid Date Paid Receipt Number $40.32 $16.80 $79.00 $114.00 $134.00 $9.00 1/4/10 1/4/10 1/4/10 1/4/10 1/4/10 1/4/10 1201000000000000002 1201000000000000002 1201000000000000002 1201000000000000002 1201000000000000002 1201000000000000002 Total Amount Paid $393.12 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. UeouirecUnsnecdons I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When aU plumbing work is complete. Rough Meebanical: Prior to Cover .,-, Final Mechanical: When aU mechanical work is complete. Rough Electric: Prior to Cover Electric Service: .Approval required prior to utility company energizing service. Final Electric: When aU electrical work is complete. Paee 2 of 3 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: COM2010-00010 ISSUED: 01/04/2010 APPLIED: 01104/2010 EXPIRES: 07/0412010 VALUE: 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. 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 times during construction. I -1t~ --:-. \ ~ ......- ------- Owner'or Contractors Signature , ~.~, '.. "" -. Paee 3 of 3 , '/t! I/o Date 225 Fifth Street . .' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 1 0-000 I 0 COM20 I 0-000 I 0 COM20 1 0-000 I 0 COM2010-00010 COM20 I 0-000 I 0 COM20 I 0-000 1 0 Payments: Type of Payment Check , cRecejntl RECEIPT #: Description Fixture , I st Appliance Vent Fan Residence Wiring 1000 Sq Ft + 12% State Surcharge + 5% Technology Fee Paid By DMH ENTERPRISES G:~~~f;l~l,~<<?J ";~ '" h "'~'. ~.. (... ~...}.1 __w..,.--- City of Springfield Official Receipt Development SerVices Department Public Works Department 1201000000000000002 Date: 01/04/2010 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1306 In Person Payment Total: . , ...: ., Page 1 of 1 2:50:59PM Amount Due 114.00 79.00 9.00 134.00 40.32 16.80 $393.12 Amount Paid $393.12 $393.12 1/4/20 I 0