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Home My WebLink AboutPermit Electrical 2010-1-13 Electrical Permit Application ~i ' t 225 Fifth,StreeU Springfield, OR 97477. PH(541)726-3753+ FAX(541)726-3689 ~f~;OE~}(RiMENJitfm(SNISY. 1':~e:~t:-o:'~\D~tN)&P I Date: \-\~-\D I 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. ~~!EG-O:~~G,~V;E:Bf.!MI;Nif~~~~~'W~~~ Zoning approval verified? 0 Yes 0 No _~'j},,~~8ifiLE;GP'!i\f1f~.l;;If!:<;$I\I$E~!!!~1l1!'Q.riI~~~1 I Residential, per unit, service included: I , D Residential " ,l D Government LD Commercial 11,000 sq, ft, or less (4) I I~~~l~j?~ :1 ~~~;;':~.~::~ ~'~~ ~ ! ~J~'~S;GgiF;'.mI!:lN~Q.~W&l_R~~~~$\l dwelling service or feeder (2) I ""\f"; I""J ~ (,'l..t) \~ 1.1'\ Services nr feeders: instal/ation, alteration, relocation $ I ~~~~B~~~~ij~~rw~_14~~1l1 I ~:~ ::~oo:;: ;:~ : ::::: $ I Name:l,(m(1\0.~<)\X\\\ ?6l\\\~X--- I 40] to 600 afups(2) $158.00 $ I I Address:~' ~ ~eex- ' I I 601 to 1,000 amps (2) $205,00 $ I ,I City:I.l.r'\y\(\G'_ l,~ State: OtL.1 ZIP;c\i4.1e1 I Over 1,000 amps or volts (2) $469.00 $ I 1 -, \ I I Reconnect only (2) $ 63,00 $ I Phone: - . Fax: . - . I E-mail" .I If! _ ,. I Temporary services or f~eders: installation, alteration, relocation I , This intragTtiMt~! being,!'Iade on residenlilll.ll,.famwlz;qperty I 200 amps or less (2) $ 63.00 $ I ownedliYll&ICE~M~lD.bilrlAtln~!ji!te l1i1J>i1~\ffi\!1- I 20] to 400 amps (2) $ 87,00 $ I propeI](Jm9Qi1Jm1fMJt:l'l, rffll8'~tvW",I5rNei OAR 479,54'66Mrv\'ENC'E50tiR IS ABANDONED FOR I 401 to 600 amps (2) I $126.00 $ I 1~~~"J~f)J)AYPF9IDI\ '" ~,.c_.~__...""" . II Over 600 amps or ];000 volts, see services or feeders section above II ' '~-3".~~lL9iiG;,0J~m~G31i..eJ3;~IN$JUJXrnlrJ.\1Tjt(Ini{~~~~,~W~ Branch circuits: nel1l, 'alteration, extension per panel I Business name: LH5vAl' s f}El..,..t O;-L- Mia. Fee for branch circuits with purchase ofa service or feeder fee: I I Address; J30Y- It- I I Each~: Oreqon law ~gu,rIts~,ol'ol $ I I City: fif,J/{lZf~ L I State: (Hl... I ZIP: 911.1'~51 b, Fe),lffIl~lItI~~/jlVrMlIl;DI1llgmiWtilit9'ederfee I I Phone: s-= ell:. '1Zt.-'7f?1S' I Fax: 5'1JI-7;;c.... "",'Z~-z..-I Fir~:~a~:~~;~;r~~l~ I" '" .' ~r $5t;) I I E.mail: b'i.-rti/uf.$ ,U. <2 AfSIJ, rdWI."..,. I I Ea~~gi!i~llrnI~ copie; 0\1 e~U!l.l@Db1 $ Lo I I I" I I . ""II,,, '''~ "~mer "6 . JnA lplo"'n I CCB license no,;lJ/I'Z ~I ~ BCD license no,; Zo-nJ-c.. MlSce,lkn , e s: rvle or .cre ?''f}~nfr~::~~~" I Signing supervisor's license no,; :JsS7-$" I I Each pump mlltllmt<erqlfcle. 0,332234,).$ 63,00 $ I I Print name' of signing supervisor: L..,IV..J p. ~ I Each sign or outline lighting (2) $ 63,00 $ I I Signature of sig;,ing supervisor: . P pI,. ,I Slit gnat 1 circllit Oxtr a lim,ite(d2.)ellergy panel, I $ 63 DO $ I . . ~ ~ a era lon, ore enSlOnO U ~~;;~;i~~~~~jfIQ~~~~~~;l~ (A) Enter subtotal ofabove fees .. ," r (Minimum' Permit Fee $58.00) I (B) Erite(12%'surcharge (,12 x [AD (C) Technol6gy:Fee (5%?f [AD TOTAL fees and surcharges (A throllgh C): ~~~~~~ 'tx.\o' \ ~A( ~. ~~~' ..\'0 ~.,' \pl 440.2584-1 (9108/COM) $ \.t2l.cx.: $ "1.?>'J,.. $ 3 .o..SI $\ \ .~n Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2010-000S0 ISSUED: 01/13/2010 APPLIED: 01113/2010 EXPIRES: 07/13/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6849 G ST ASSESSOR'S PARCEL NO.: 1702352200800 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Add two circuits Owner: BALLIET RONALD L & JUDY M Address: 6849 G ST ' SPRINGFIELD OR 97478 I C:ONTRACTOR INFORMATION i Contractor Type Electrical Contractor CY~NS ELECTRIC License 102316 BUILDING INFORMAT~ON. Expiration Date 10/14/2011 Phone 541-726-7895 # of Units: Primary Occupancy Group: Secondary Occupallcy Grollp: Primary Constrllction Type Secolldary COllstruction Type: # of Bedrooms: ' # of Stories: Height of Strllctllre Type of Heat:' Water Type: Range Type: Ellergy 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: II/a I DEVELOPMENT INFORMATION I REQUIRED PARKING FrolltY\~<hli<\tjirJ<: " . Overlay'Dist: Total: Side 1 Si't't/J& . E WO!jttreet Trees Rqd: ATTENTION: Oregon_~:yauto Side 2 sbHJ~Ii':ERMIT SHALL EXPIRE IF TH 'l'Ied Drive Rqd: follow Mea adopted ~t!!II~Q;,tgon Utlllty RearyaF'llisdtllOOllED UNDER THIS PERMIT IS N .'ofLot Coverage: NotillcatlonCenter. Thoset'Ul88aresetfolth Solar S(llMf1MENCED OR IS ABANDONED FOR 'In OAR 852.()OHI01 0 through OAR 852.()O1. " I - - E;' , nJT E; MAn Vnu mlW q!1taln coplell of the ruIe8 by "" I VV /'I. . U . I PUBLIC IMPROVEMENTS I O8IIlngthecenler. (Note:.mel8lepnomt . ' IIIIIIIbIr for lie Oregon Utlllty NoIIIIoaIIOn Street Improvemellts: Sid (\.,Y..TJlI>.UlOO 3a2-2344). Storm Sewer Available: Speciallllstrllction: DownspoutslDrains: ..:-:~, Notes: I Valuation Description I Description Type of Construction $ PerSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated ":",,,L :-t. ' Paee 1 of 2 ,"'.-:. '. Status Issued CITY OF ;')rKH~t..t<IELD Building/Combination Permit PERMIT NO: COM2010-00050 ISSUED: 01/13/2010 APPLIED: 01/13/2010 EXPIRES: 07/13/2010 VALUE: ' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project , Fe~s Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $7.32 $3.05 $55.00, ,." $6.00 1/13/10 1/13/10 1/13/10 1113/10 Receipt Number 2201000000000000037 2201000000000000037 2201000000000000037 2201000000000000037 Total Amount Paid $7P7 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 Reouired Tnsnection\J Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, tbat 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 tile 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 certily 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 e~ch 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. Owner or Contractors Signature Date Pa2e 2 01.2 225 Fifth Street Springfield, Oregon 97477 . 541-726-3759 Phone ..,....~~_',RA~G""F,1Si'IW>.i1i.j".,..,...:.,. ',L.",.,' ~., .' .. .. , ' , , , ...,.......'.._.......",_r._.... '. Job/Journal Number COM20 1 0-00050 COM20 1 0-00050 COM20 1 0-00050 COM20 1 0-00050 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2201000000000000037 Description Add, Alter, Extend Circ ' Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee City of Springfield 0fficial Receipt Development Services Department Public Works Department Date: 01/13/2010 Item Total: Check Number Authorization I~eceived By Batch Number Number How Received Paid By l. YNNS ELECTRIC KR 18375P Phone Payment Total: ~---~-"""'~'" ....- ~ --~- I y I ., .. CITY OF SPRINGFIELD DEVELOPMENTAL SVC.-OEPT. 2255THSTREET SPRINGFIELD,OR97477 (541)726-3791 Phone Order , :;, 1009 ",-hal,t: 7004668 ;1 I,Vi0" ,",:CodE": ~\$~[Rr,ARD '~1!IXXXXXXXX\316M ""Cd '",'r 0" ,. do. ~. ~)~; Code: 18315P , " 14: .1 [ .~:; '",[, ~ .:1 I Invoice>>: '1 .. CustcmerCopy THANt{YOU Page 1 of 1 $'1 '7 1,)1 - 2:23:26PM Amount Due 55,00 6,00 7,32 3,05 $71.37 Amount P"id $71.3 7 $71.37 1 /13/20 1 0