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Home My WebLink AboutPermit Electrical 2010-1-15 Electrical Pe,rmit A plicatio.D 225 Fifth Street+Springfield,.OR 97477,+ PH(541)726~37S3. FAX(541)726-3689 IWJ;iI,,~~R;tQtEi~NiLyl.' ;W;_*h,.,~,~0b7__ .. ~:fu!!1iW,;r;w;yJi;1 I Permit no;: C' J 0 - ,lQ 9. - I Date: \-'\5-10 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180 days oHssnance or if work is suspended for 180 days. ~if1llJ!iJ!o:eJl:Il!l!3'O)lER.N!VlENiI'lilJl:eeR.0.\lJl:~1 li~;;~~;g~~l'olile.~N~mR.Ueiliro~~~J J..e1Residential . lD Government . J 0 Commercial' T_'1rJOaISIi)lEII"ll;aR.M~mIONrJl:NQ!I!OCJ%i11IONI!IllilliIiI I Job site address: 1f<f7'i l)li /5 JI St. 1 .1 City:SjJ.-f/IY6Afl /) 1 Stat~:OX , 1 ZIP:C}!LfY 1 Reference~51lTetf fi 8 I Taxlot.: . I c 4li,ffJ-"'ES"RIPilil"N"O' .~FW"R'_ffi"_4""_"'''' E . ~ .:mr~~IJ, .~; ",I j \J." !?'J; '.r_ "Q, ,.~~f4llj~Jl0'5%tm#l I a II. .~VI(!C' /EtPltfCG/lJcwr- 1 1 'fl,D'2.. ~?.:~. '0 t,QS LX.) 1 __.1lIlIll'Il:!ROeERT4Yl'aW"lER~ 1 Name: C~/{jJi-I<,/ m/fIllt7/f 1_J--.C- I I Address:'fLI75I)/I/51/ S-t: #: '1/ 1 1 City;.J7Jf2//f/6ReLfl I State:ty~ r ZIP: ?}JtI2i 1 Phoner'll-7tf1' .$t17'f I Fax: -.- , I E-mail: - I Temporary services or'feeders: installation. alteration, relocation [ This installation is being made on residential or fann property 200 amps or less (2) , $ 63.00 I $ I owned by me or a member of my immediate family. This 201 to 400 amps (2) I 1 property is not intended for sale, exchange, lease, or rent. OAR $ 67.00 $ 479.540(1) and 479.560(1), , 401 to 600.mps (2) $126,00 $ 1 . Signature: ,>;,~:~>;," Over 600 amps or 1,000 volts, see services or feeders section above [ _MtiJlljl_mAA:emO~IINSili . * Branch cir~OzeCJflllS'llVf,I~\~1tD 1 Busi~llleii\E~I'T;(S~ ' I a, Fee forfllMM~_~~~!\1 ~~l'!&=~ 1 Addr ^" - '" hutilioatlon Oelltef. TIt II art' : ..., l1=)'1, FOR . 1 Each b'iWYI\~'CIk~M01.oo101h Up GAR!' 2lDDn- -' "'-ICity;~I~ tate:' '; I'ZIP:"'7?-7".7;t"lbFeefo~_~:,;;;;...pIa&~Ie8ll;\I, , 1 Phonl'W\- , .'~ Fax:5'"st/ -7t/7' 7/S/f I. Fi"tbran~me~::\~~'t;. 1 E-mal]: bIJ/lUtD~fCl)&tt)(jl.df:;Jll2f- I I EachadctllMl,'Wdh'fell'I91.:o~T$ [ CCB license no,: J~ qqV. f BCD license no.:dd',..f'?cll Miscellaneous fees: service or feeder, not included., I Signings\lpci-Visor'sIicen~eno,: .lf9Lft/s' 1 I Eacbpump or irrigation circle (2) , I $ 63,00 1 $ ,I pnntnanieO[Signin,gSupervisor&AA1I/' A/l~jl?/lft.~ I EaChSignOrOUtline,lighti~g(2) , ",.1 $ 63.00 $ I Stgnatureofslgmngsupervisor:. ./ / .A / / ' I Slgnal,Clrcul~orah!lllted-energypanel'l $ 63:0'0 $ . .:?rA...I~ 7~ 1 alteranon"or,extenslOn(2) / > ;:../ Each additional inspection: (1) ,.,--.~ ,~~.\Q ,~ ~~ ~Q \'" .~. ~~ ,~ 440.2584.J (9/08/COM) , ~-:. ~, '.I~i<'. ",>Sf"., 'Ill! . 'I&T.i5'ta, IB.I ~}2,; .(i':j;J[~ !lt1[cii~(;g [. Residential,.per unit, service included: [ 11,000sq,ft,orless(4) 1 $134,00 $ I I EaCh. additional 500 sq, ft, or portion I I tbereof , ,$ 25,00 $ I Limited energy (2) 1 $ 32,00 $ 1 I. Each manufac.tured home or,modulirr I / /'2--:-- dwelling service or feeder (2) $ 63,00 $ (,tV , I Services or 'feeders: instal/ation, alter~tion, relocation , I 200 amps orless (2) I, I $ 81.00 201 to 400,amps (2) 1$ 95.00 401 to 600 amps (2) $158.00 601 to 1,000 amps (2) $205,00 Over 1,000 amps or volts (2) I $469,00 Reconnect only (2) 1 $ 63,00 $ $ $ $ $ $ $58.00 I (A) Ent~~'subtotal of above fees (Minimu~: ~ermit Fee'SS8.00) , I (B) Enter 12%' surcharge (,12 x [AD 1 (C) Technology Fee (5% of[AD I TOTAL fees aud surcharges (A through,C): - $ 61. -- , $7,% $ .-3. If) I: $73.7/1 ':~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMITNO: COM2010-00062 ISSUED: 01/1512010 APPLIED: 01/1512010 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 68 ASSESSOR'S PARCEL NO,: 1702323406500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Mobile Home Service r~placement Owner: ROGERS DOROTHY E Address: 4475 DAISY ST #68 SPRINGFIELD OR 97478 'I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor LR BRABHAM License 8699 BUILDING INFORMATION I Expiration Date 12/18/2010 Phone 541-747-6638 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy 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: n/a I DE~ELOPMENT INFORMATION I , RE!)U1RED PARKING Front yard Setback: ",'"c;,,',' ,.. Overlay Dist: Total: Side I'Setback: i\\t. \NOR\{# Street Trees Rqd: Handicapped: Sid~~et: \.. e~?\Rr. \f ~ \S ~Oi Paved Drive Rqd: ' . Ore on ~~,YOU.to Rea m~ W"'t~~ S\'l~~Q 1\'1\S ?r.R\IJ\\ "OR % of Lot Coverage: Amm:ON. dopfed by th8 Oregon,Utlli\y Sola S'etb:i.c~:z.eO UNO<-" NoONeO r follow ru eU Th 8ri11esaresetforttl "I1HU' - if \~ t>.BI\ M"lIfjr-a110~Ce~,..,~w_i1110ADQI;~.oq1. CO~.~MENUO~Y ?ER\OO. I PUBLIC IMPROVEMENTS" ~~ ~;;:~ obtain caples 01 the rules by ". 'ioN 180 ' '"'''''', .0 '1 (Note: the telephone Street Improvements: .. C:~~::~~gon Utili\y Notil\Callon Storm Sewer Available: n ""'Do'tifftllPUl'ItIi~2.2344). Special Instruction: :: I ';,':1, Notes: I. .. I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage' or Bid A'/lIount Value Date Calculated .., ,'::r Page 1 of2 Status Issued CITY OF SPRINGFIELD " Building/Combination Permit PERMIT NO: COM2010-00062 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% State Surcharge + 5% Technology Fee Manufactured Home Service Amount Paid Date Paid Receipt Number $7.56 $3.15 $63.00 1/15/10 1/15/10 1/15/10 1201000000000000050 1201000000000000050 1201000000000000050 Total Amount Paid $73.7I 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 ,~,e()uired Insn~ctions I MH 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 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 berein, 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 in~pections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of tbe 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 Job/Journal Number COM20 I 0-00062 COM20 I 0-00062 COM20 I 0-00062 Payments: Type of Payment Check t;Receioll RECEIPT #: Description Manufactured Home Service + 12% State Surcharge + 5% Technology Fee Paid By LR BRABHAM 8,,~~~~!~~.'.'_.,'.,"...: WE".' -'at,' , - . , , . .', ,-",,' -_..'-'-...'..""..-', '. ~ ' City of Springfield Official Receipt Development Services Department Public Works Department 1201000000000000050 Date: 01/15/2010 Item Total: Check Number Authorization Received By Batch Number Number How Received KR 38519 By Mail Payment Total: Page 1 of 1 ~ 10:56:49AM Amount Due 63,00 7,56 3,15 $73.71 Amount Paid $73,71 $73.71 1/15/2010