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Home My WebLink AboutPermit Electrical 2010-1-5 . Electrical Permit Application 225 Fifth Street+Springfield, OR 97477+ PH(541)726-3753+ FAX(541)726-3689 8PRINQPlIlLD I "/?EPARTMENTUSE ONi.. y '" 1IiiL:~ I Permitno,:C 10 - roC) I L I I Date: 1- 'S - 2 c> f 0 I CITY OF SPRINGFIELD, OREGON This permit is issued uuder OAR 918'309-0000. Permits are noutransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I' ,LOCAL GOVERNMENT APPROVAL f Zoning approval verified? 0 Yes 0 No CA TEGORY OF CONSTRUCTION I IDesidential I 0 Government I D Commercial I. ,JOB SITE INFORMATION AND LOCATION I Job site address: S 2 D'S 4 z....A T1 B. I City: 9Pj) , I StateO(L.:. 1 ZIP: 971.( 7 8 I Subdivision: l/oz.3Z- ~.3 I Lotno.:O')'/C>c. I ' DESCRIPTION OF WORK I MJ..I ,4..tfC;t.. ~ t:,A.rc....,...\,,; +" Services or feeders: installation, alteration, relocation 1 I 200 amps or less (2) $ 81.00 $ I ' PROPERTY OWNER 201 to 400 amps (2) $ 95,00 $ I Name: WlrtHe T~ ~a# I 401 to 600 amps (2) $158,00 $ 1 Address: 18'70 c/Mie-vL ~ At! 1.1601 to 1,000 amps (2) , $205,00 1 $ City: IM/LtI'lT,t<; 1 State:cA I ZIP: 'soJ( 1 Over 1,000 amps or volts (2) 1 $469,001 $ Phone: I Fax: 1 Reconnect only (2) 1 $ 63,00 I $ / E-mail: I_Temporary services orJeeders: in~ta/lation, alteration, relocation This installation is being made on residential or farm property t9?'i'l"1r.~Jess (2) '><;\,,:;,{, :;.$:,63,00 I, $ owned by me or a member of my immediatefamily, This ill~i1S 'lllIlPmnrt2ohH611 ':Y.D. Ill.!: I,: TU :~^~ftO,1 "$ property is not intended for sale, exchange, lease, or rent. OAR C - . ::......+-R -~O,J:R=Pc 479540(1) and 479,560(1), ;ilUT<lftJCR4@~V:~JNnffi.II:IIS Pf: ~MIl. 1$l:fQM" I. '$ Signature: 1 (j6MIlQ&<J~EtlI(l]\Ill fSl\8tB~~tp{tJRs se,c},i~fabove CONTRACTORINSTALLA TION I JU,l}!cil &Q:/iltlVnflEItIIQlihon, ex'ensio.~{!er po!!e!'):"':", Business name: r \6 H 'fY1 E \~ k, t <":D. I a. Fee for branch circuits with pwchase of a ,service or feeder fee: , - Address: t1J ~O"l( 'd-. '5 a'-\ 1 Each,branch circuit I 1 $ 6,00 1 $ City: r:W ~ I State:O(Z I ZIP: Y rp-l O~ 1 b, Fee forbranchcircuitswithoutP~chaseofaserviceorfeederfee: Phone&lI{Q~-OqDS I Fax:gH-~B{g-0050 I 1 First branch circuit (2) I $ 55,00 $ I E-mail:'E\\mt:I-e.@\-r~ ~('O QA-ot...QO""rn. 1 1 Each additional branch circuit Z $ 6.00 $ 1 CCB license no,: 191..\ OOC) I BCD license no,: t.43 Y1 1 1 Miscellaneous rees: service or feeder not included Signing supervisor's license no.: 1 C) It e '3 I I Each pump or irrigation circle (2) $ 63.00 Print pame of signing superviso;: 'Phl.L :5", KOl!. e... 1 1 Each sign or outline lighting (2) $ 63,00 Signatu, re of signing superv, is~r: /. _ j ./: -;~ ~ ~.""~ 0, I I Signal circuit or a limited.energy panel, I $ 63.00 $ . ~ ,-/,0 A v:. /-r-:-~ _ alteration, or extension a) 1 Each additional inspection: (I) I 1 $58.00 I $ ATTENTION: Oregon law requlr811 you to I APPLICANT USE follow rules adopted by the Oregon UtIlity I (A) E t bt t I f bo fi "... Notification Center. Those rules are set forth n crsu 0 a 0 a ve ccs \ \."Y. (\ In OAR 952-00'-0010 through OAR 952-GOI. (Minimum Permit Fee $58.00) ~'\) ~ 0090. You may ob1aIn copies of the rules by I (B) Enter 12% surcharge (.12 x [AD ~ ~ ~ calling the center. (Note: the telephone I (C) Technotogy Fee (5% of [AD '{ LfiV IlUIllber c':t:e Ia~~~~~~~uon I TOTAL r and surcharges (A through C): _m.~'~> ~yl'~\\)' I FEE SCHEDULE ' I Number of inspections per item ( ) I Qty.1 f Residential,- per unit, service.included: 11,000 sq, ft, or less (4) I Each additional 500 sq. ft. or portion thereof . I Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Cost ea. Total cost $134.00 $ $ 25,00 $ $ 32.00 $ 63.00 I $ $ $ $ __.,.I"",Gl1llilI,.Q, \ Status Issued CITY OF SPRIl'HJI' H.LD , Building/Combination Permit !PERMIT NO: COM2010-00012 :ISSUED: 01107/2010 ,APPLIED: 01105/2010 IEXPIRES: 07/07/2010 VALUE: I 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 520 S 42ND ST APT B ASSESSOR'S PARCEL NO.: 1702323305900 Springfield TYPE OF WORK: Electrical Work Only , TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Add/alter 3 circuits Owner: THOMPSON WAYNE D Address: 1890 CRATER LAKE AVE MILPITAS CA 95035 Contractor Type Electrical Contractor BHM ELECTRIC COMPANY I ~ONTRACTOR INFORMA 'BON .1 I License 184005 Expiration Date 09/19120 I 0 Phone 541-686-0905 BUILDING INFO~MATlON:1 # of Units: Primary Occupancy Gronp: Secondary Occupancy Group: Primary Conshnction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: ATTENTlON: Oregon law reqH'fbil!~uilding: NIIIlW runllll t1uUJJ'''u ~ NotlflcationCenter. Th FORMATION ,. In OAR 952.(IQ1-G010through OAR 952-00 . : Fruntyard Setback:0090. You may obtain COP~8 otJM.~~m- i Side I Setback: calling the cent8/'. (NOle".i ~s Rqd: ! Side 2 Setback: numIler for the Oregon Utility ~nve Rqd: Rearyard Setback: Cent8/' 111-800-332- 0 r Lot Coverage: Solar Setbacks: R2 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft'Other: Occupant Load: VB n/a REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Description Type of Construction .-",~ :,: ~.~;~{;.{~~.j;~:'::,~:"", . . NOTICE: ", ....HE. WORK ; _ . .._ ^"^' I CVDIR~ IF T : ~:: _O',.'V'" .Jr, ..- - . Mil I~ NUl ~:' I Valuation Descr.iiitib'{j)~IZED UNDER THA'NS ;~~ED FOR5~!{~' CUIVIIVlb~CED OR IS AB . ...., ;'~,:",\ $ Per Sq Ft ~q.",a'l"B'0O~!\liepERIOD. Value'" ,'; "" ~at~ 'Calculated or multiplier or Bid Amount Notes: " ~..,~, f ,:' or Paee I of 2 . ",J. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00012 ISSUED: 01/07/2010 APPLIED: 01/05/2010 EXPIRES: 07/07/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54 ]-726-3769 Inspection Line Total Valne of Project ,I Fees Paid I Fee Description + 12% State Snrcharge + 5% Technology Fee Add, Alter, Extend Orc Add, Alter, Extend Orc Ea Add Amonnt Paid Date Paid ,Receipt Nnmber $8.04 v, $3.35 $55.00 $12.00 117110 117110 117110 117110 2201000000000000006 2201000000000000006 2201000000000000006 2201000000000000006 Total Amonnt Paid $78.39 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. Re,~lUired Tnsj}ection\J Rough Electric: Prior to Cover Final Electric: Wben all electrical work is complete. By signatnre, I state and agree, that I have carefnlly ejramined the completed application and do hereby certifv that all information hereon is true and correct, and I further.'~ertify that any and all work performed shall be done in'accordance with the Ordinances of the City of Springlield 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 Commnnity Services Division, Bnilding Safety. I fnrther certify that only contractors and employees who are in compliance witb 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 ~ddress 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, Owner or Contractors Signature Date Page 2 oft 225 Fifth Street Springfield, Oregon 97477 54i-726-3759 Phone City of Springfield Official Receipt Development Services Department Puhlic Works Department Job/Journal Number COM20 I 0-000 12 COM2010-00012 COM2010-00012 COM20 I 0-000 12 Payments: Type of Payment CreditCard ~Receinll RECEIPT #: 22010000000~0000006 Date: 01107/2010 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By BHM ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received d'b , J, 319475 In Person Payment Total: , .i.!:; Page I of I 7:53:48AM Amount Due 55,00 12,00 8,04 3.35 $78,39 Amount Paid $78,39 $78.39 11712010