The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2010-1-15 225 Fifth Street. Springfield, OR 97477+PH(54I)726-3753HAX(541)726-3689 IlrilDEp.'ARmMEN1;TUsE10NI1~\I~1 ~ 1:::::'.rm:~;t""~~~~P:il I Date: \-\S-\o I Electrical Permit A . 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. l~z'~0'~n'""'n"g:;'~a'p';p'L:r'Oo'vCaAlvL!e~rlGfi'e0dY?ERNM,EDNiliyrieAs'~~Rl:lVAD,L""N~O'~:l!111 1'~=-'~=!IIISCHEo'UI~~illlI~~I-'II:T';;"~I'~ L~~er~.l'f:lti~nspeetion's~perditem,'(t) Q"i. e.,.o.s.t ',' '_"Q.,t.!l",~,; "",~r,:_ '. ~,eal" ." co.sJ.l!i'! 1~~CATEG0Ry.rl:lF~C,l:lNSTRClC;nl:lN~1 I Residential, per nni4 service included: ~;~~;~I1iEIIN~~Ra;;:;;AN~.~~C~m;~~'~ 11,000 sq, 1\, or less (4) I Job site address: W7 S [),q I5V 5 mEET I I ~~~~:fditioual 500 sq, 1\, or portion I CitY:~J!/AYpF/Et" I State:M I ZIP: q7~1J1 Lirnited energy (2) I I Refere~c~: .M19t!(;: b 3 I Taxlot.: I Each manufactured home or modular II ~)I.~?:;~~~R~;~~~;~=~.II :::::: :::::e:::::/~::ion, alleralion. relo:al;:~oo if~~~R0P'ER~ill0WNER~.j : ~:~ ::::00::: ;~~ : : ::::: I : I Name: ('a{t!~p m;9J1/~K I-tf~ I 401 to 600 amps (2) I $t58.00 $ I Address'/L/75lYlf611 st. #ql 601 to 1,000 amps (2) I $205,00 $ I CitySjJIfIAl6HlFt.~ I State:O/\, I ZIP:t17tf7J' I Over 1,000 amps or volts (2) I $469.00 I $ I Phone3'll-7tJ7- 197'1- I Fax: .~ I I Reconnect only (2) I $ 63,00 $ I E-mail: ....IITemporarySerViCesorfeeders:installation.alteration.re/ocation Th" II' 'b' d 'd' I ' ' I 200 amps or less (2) I IS msta atlOn 15 emg ma e on reSl entIa or larm property . -.. owned by me or a member of my immediate family. This 201 to 400 amps (2) \tftI property,is not intended for sale, exchange. lease, or rent. OAR 479.540(1) and 479.560(1), $134.00 I I $ I $Gj. (/(.1 I I I I $ $ $ 25.00 $ 32,00 44O-2584-J (9/08/COM) I ~.e I ~I I Business name': L.A? I5K/tf1I?IH1t'.JAIC- . I a,Fed _ .h~' -, ee: I Address: fd' aJ~g- '1: "~'~-t;',,,.r,"~ _ I Each b~_\t\9 m I $ I 'CitY'-1f&'IM. 6iP/&Zlrtsfilt.e:-~\\t., '77' 'I b,Fecfor~~Mlp\rc seof~sm;c.c~cederfce: I' Phon::if.(~47', ~, ~~ .' 7/51 I I Fi"t branch circuit (2) , II $ 55,00 I $ I E-~'W:~~ . ~jS-rU I Each additional branch circuit ' $ 6.00 I $ I CCg n~&~~ ,<<:; ~'\YiT~e~se no,: c1tJ ,jJ?c... Miscellaneous fees: service or feeder not included I Sign~~~.;~~~49~7'-t . , I EachPUn.'por.i~gationcircle(2) I I $ 63.00 I $ I Printnr1}\",o'(~\ln~~supervisor:L/9If'~Y dA"~#J?J V,f.1 I Each Stgn or outlme lightmg (2) $ 63.00 $ I Signatu;~~ofsigningsupervisor' ./' ~ /'/ i#1 Signal,circuit~Tali~ited~energypanel, I I $'63,00 I $ , M."" ' . ,. - , ~ alteratIon; or extensIon (2)- / / I Ench ndditional inspection: (I) I, I $58.00 I $ I _n~ ~1~~P.P.I!Il:::AN;riuSE__1Mm1 ^r.Q-i--:>,:'~ """'D I (A) Eutersubtotalofabovefees I 6.'~ d() I :', jA ~ :;. . - ('/ . ~ (Minimum Permit Fee $58.00) $ V. ~ ' ~\.'l;\~ I (B)EnterI2%surcharge(.I2x[AJ) I $ '(,5b I ~ ,~<l./ I (C) Technology Fee (5%0f[AJ) I $ 3./5 I ~? 1 m""'"::-:'.....~..(^"~'"q' 1 " 73.7/1 ~if Signature: 1l:'\"lit"'lIlc.()NTRAC;rORlilNS1'A~l!'AmlC)N_ ,:.i: Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00061 ISSUED: 01115/2010 APPLIED: 01115/2010 EXPIRES: 07/15/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection,Line SITE ADDRESS: 4475 DAISY ST SPACE 63 ASSESSOR'S PARCEL NO.: 1702323406500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Mohile Home Service replacement Owner: PONCE BARTOLO CHAVEZ Address: 4475 DAISY ST SPACE 063 SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor LR BRABHAM License 8699 ~UlLDlNG INFORMATION I Expiration Date 12/18/2010 Phone 541-747-6638 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: ~~~ Occnpa~Ot\~~ V" :r~.J't. \ r DEVELOPMENT INFORMATION J". O,~~.o~~~~~ , ~~~~;'''~~~~t~ot~~,.J\t~ING ""d~c.'~erlaY Dist: .. ~$)'lI t\J Ot\ Ce JP\O I\I~' e ~ ,,;/:>'''' reet Trees Rqd: 'IOo'$.~~?,JP\ f!i>~ ~ '.1\'1. ~ ,,;;i' A~~ ~dDnve Rqd: ~ ol'S'- -(()I) "'''~~et. e~&l\l !i:..~'\~\~'roOf",otCoverage: \~. ~\'r15 ",eO\~ , <f~ 9~~~~ ~()~ ", ~~~e' ~~\e' '" .' , \rv~' ~ ~~~~~~ '\~;\$)'i'PIJBLIC IMPROVEMENTS" ., Street Imp~~1tie~~~X:.'$ ~ ~ \~ ~('\ , Sidewalk Type: \A\S Q..\'" \) ~ o..\()'v' Storm sewerJo.\('t\~~~~c,~ ;:l, ~X:.'" Downsponts/Drains: Special Instrnc'fl{/~~~ ~ 'i:)'t- C; ;:l. \'Cl Notcs: \>-~ # of Units: Primary Occnpancy Group: Secondary Occnpancy Gronp: Primary Constrnction Type Secondary Constrnction Type: # of Bedrooms: # of Stories: Height'of strnctnre Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Bnilding: , n/a Front yard Setback: Side 1 Sethack: Side 2 Setback: Rearyard Setback: Solar Sethacks: ", '1:;\;1i: I V~lu~tion Description I, .' ' Description ,Type of Constrnction $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Valne ,Date Calcnlated Paee I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00061 ISSUED; 01/15/2010 APPLIED: 01/15/2010 EXPIRES: 07/15/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726.3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,.Total Value of Project ": .. ,Fees Paid I Fee Description + 12% Stale Surcharge + 5% Technology Fee Manufactured Home Service Amount Paid Date Paid $7.56 $3.15 " $63.00 1//5/10 1/15/10 , 1/15/10 Receipt Nnmher 1201000000000000049 1201000000000000049 1201000000000000049 Tutal Amount Paid $73.71 I 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. I ~e(lu~red Insnections I ,!",' .l' MH Service: Approval required prior to utiliiJ;'comill,ny energizing service. :;,' -'. , By signature, 1 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 fnrther 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, Owner or Contractors Signature Date , H Pa!!e 2 of 2 8.:r.:,~EU>_~." '.,... ,;. ,.' '....; Iii-' , ""',"', " " " " ~ ,,' , " -, ~ - ..~.. '_',,',,"C''-~ ,,^ ,- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM20 1 0-00061 COM20 1 0-00061 COM20] 0-00061 Payments: Type of Payment Check cReccintl City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000049 Date: 01/1512010 1O:30:42AM Description Manufactured Home Service + 12% State Surcharge + 5% Technology Fee Amount Due 63,00 7,56 3,15 $73,71 Poid By LR BRABHAM . Item Total: Check Number Authorization .Received By Batch Number Number How Received Amount Paid KR ByMail Payment Total: $73,71 , $73.71 38518 / ',' .. , " , Page I of I 1/15/2010