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Home My WebLink AboutPermit Electrical 2010-1-25 225 Fifth Street. Springfield, OR 97~77. PH(541 )726-3753. FAX(54l )126-3689 " I 'DEPARTMENT USE ONLY ~~ I~~d~~;~'o 1011 I Date: l-zs-eorO . E'e,d,rical Permit Application CITY OF SPRINGFIELD, OREGON This permit is issued nnder OAR 918-309-0000. Permits are nonfransferable, Permits expire if work is not started within 180 days ofissuance or if work is suspended for 180 days, V \S{\o>,O \'V v@..<:V V- 440-2584-J (9/08/COM) ~ 1 ' . LOCAI.::. GOVERNMENT APPROvAL I Zoning approval verified? 0 Yes D No 1 _ CATEGORY OF CONSTRUCTION I ayRe;idential I 0 Government I 0 Commercial I 1 ' JOB SITE INFORMATION AND LOCATION .1 I,OOOsq,ft,orless(4) I Job site address: ~ I a \0. 7\ \ \J ~ I C <;,-\:. 1 ~~~~;fditionaI500 sq, ft, or portion I City: ~r C \ 0 I State:Or e \, I ZIP: q(L} 'I II I Limited energy (2) I Reference: . /70J'Z- 7t.t Z. I Taxlot.:OIOo8 I I EachmanuFacturedhomeormodular 1 DESCRIP;nON, OF WORK. 'I dwelling service or feeder (2) I k \+( .~Qv\ r -e W\ C){?\ e .1 I II Services or feeders: installation, alteration, relocation I ' . I 200 amps or less (2) $ 81,00 $ I' PROPERTY OIlVNER I. 201 to 400 "!lIps (2) $ 95,00 $ I Name: Tn1(\~ A-\-k il!1':>Df) I' 401 to 600 anips (2) $158,00 $ I Address: <8 ~ 1- \JJ, ()\ u ff\ \I \ C ~+- I I 601 to 1.000 amps (2) $205,00 $ I City: <;;f'\;-)('~ I. State:(')'rR:'fflcrrii:)~'lb~Qiln ~m.J..q~<<~,W'1tS(2) I $469,00 $ I Phone: J.:)q, . 7 ;:)io -2'11"c! Fax: iollow r~leS .adopte ~ l v'\tIe~" ~~~, I $ 63,00 $ I E-mail: Notification lOemer. h~~MItA,fll;~pl!-\lM~~.\l!.reeders: mstallatiOn, alteratiOn, relocatiOn , - I t1/.~~~' This installation is being made on residentia I '" ~Obt n l'''rr'''ll'l'Iftll~li by , ' $ 63,00 $ owned by me or a member of my immediate , ~er. (~6tll:tIheJ~~' $ 87,00 $ property tS not mtended for sale, exchange, lea , fiB:, Or gc ~I '""UUI' 479,540(1) and 479,560(1), nuinber or '1 I,~ 'ilI.ilVlPS $126,00 $ Center 18 ." , , Signature: Over 600 amps or 1,000 volts, see services or feeders sectIOn above I CONTRACTOR INSJ ALLA TION " 1 I Branch circuits: new, alteration, extension per panel I Business name: L z:... F ~ \..Q Ll-i["'\ <.: 'I-~.I" a. Feef~~ ~r~~.;~.~~irc.uits with purchase ofa service or feeder fee: I Address:'1 ~rR:),~ JDI\.O ') fA-c.I€ ~ Q,d I I Each branch circuit I I $ 6,00 I $ I City: hp ~\d r State:O['~ I ZIP: '1 '1yi-81 I b, Fee for branch circuits without purchase ofa service or feedcr fee: I Phone, trLJ ~ - q33 - ;;)S~ Fax, 4a VV\..Q I I First branch circuit (2) I \ I $ 55,00 I $ '5.5' I E-mail: I I Each additional branch circuit lo $ 6,00 $ ;J L", I CCB license no,: I DSl.{,S I BCD license no,:;)n- 3R.'3 <:1 I Miscellaneous fees: service or feeder notinc/uded I I Signirig supervisor's license no,: ' 4\iL\- 6 I I Each pump or irrigalioncircle (2) $ 63,00 $ I I Print name of signing snpervisor: kf.1 (\.Q", nV('\~Vl I I Each sign or outline lighting (2) $ 63,00 $ I I Signature of signing supervisor: ~Fn r:;. -0. inJ _I I Signal,circuitorali!":!ted-energypanel, $ 63.00 $ I r.p~ \ )L,J '~\U'-""'"~ alteratton, or extenSIOn (2) I Each additional inspe~tion:'(l) $58,00 $ I I ~ I (1\) Entersubtotal of~:~'~l~~;~~~~u~~ (j l _ 1 _,I Q' I ~nm P!J",~f~~ nlll\\1 \S ~ $ -\ @:r '-~Q \'l,~!!j~WJI\!%{N~~iW~,~EUfU" ,'1 $ /0 7~ ~ 4J \J$~\-IO~~~oroil~~~"- I $ I.(sr 0' f,~~~~",geS(AthrOUghC): 1 $/06471 I\~'{ yO$ " , ---- . FEE SCHEDULE I ~~.rj.b.;r ofj'~spe~c'tions peri1em h I Qty.1 I Residential, per unit, service included: Cosf ea. $ 32,00 $ 1 Total I cost I I I I I I I I $134,00 $' $ 25,00 $ $ 63,00 $ CITY OF SPRIN(J.HJ!,LD ,Building/Combination Permit PERMIT NO: COM2010-00104 ISSUED: 01/25/2010 APPLIED: 01125/2010 EXPIRES: 07/25/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 I nspection Line SITE ADDRESS: 812 W OLYMPIC ST ASSESSOR'S PARCEL NO,: 1703274201008 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION:' Add/alter 7 circnits Owner: ATKINSON TRUDIE L Address: 812 W OL YMPIC ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION 1 Contractor Type Electrical Contractor L & E ELECTRICJNC License 105475 I BUILDING INFORMATION I' r # of Units: Primary Occnpancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: I you to A1Tbl110N: Ore ~~;ffUtiIi\y tallOW rules adopttl ~ u'i'~ are set lorth NotiII't::t.\lon Center, {l~'l'IOAR 952-001- In OAR 952-OO1-00R9 ~ to Of the rules by 0090, You may obli\\~1 lite telephone calling the centll!'IJ'\8 mi 'Mtnlficalion nla ~. ,^' 1M Clreo ~} 1\t!M _ ~..~'i~-I-;::srt'rI,,-. ~"OfrV ENT INFORMATION 1 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: . .~.r; ;." O-:erlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Residential Expiration Date 03/30/2010 Phone 541-933-2653 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I PU~LIC IMPROVEMENTS I 01\'(... SidewJl.lk \fYP'At. ~ "\01 . \ rd~n\\'I~\1 \'v \' ~~~~~~~~1 ~:~~?:~~~o~~\5"t~ :\'l\O'i\\/.\:. o? \<0 ~ ~c~oW\W\t.~Ct~, ?t.?\O~. In" nr>.'1 ,,\\~ ~- I Va,luation Descrip,tion , Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amonnf Type of Construction , Paee I of 2 '\;' I~' Valne Date Calcnlated ". ,-2.,' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20I0-00I04 ISSUED: 0112512010 APPLIED: 01125/2010 EXPIRES: 07/25/2010 VALUE: ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid J Fee Description + 12% State Snrcbarge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt N nmber $10,92 $4.55 $55,00 $36,00 1/25/10 1/25/10 1/25/10 1/25/10 ,2201000000000000068 2201000000000000068 2201000000000000068 2201000000000000068 Total Amount Paid $106,47, , I . Plan Re\;'iews 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 workday: R~,,,..ired In,sryection~ I Rough Electric: Prior to Cover Final Electric,: When all electrical work is complete, By siguature, I state and agree, that I have carefully examined tbe completed application and do hereby certify that all information hereon is trne and correct, and 1 fnrtber certify that any aud all work performed shall he done in accordance with the Ordinances of the City of Springfield and the Laws of tbe State of Oregon pertaiuiug to tbe work described herein, aud tbat NO OCCUPANCY will be made of any strnctnre without permission of the Commnnity Services Division, Building Safety. I further certify that only contractors and employees who are in compliauce with ORS 701.005 will be used on this project. I further agree to eusnre that all reqnired inspections 'are requested at tbe proper time, that each address is readable from the street, that the permit card is located at tbe 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 Paee 20f2 225 Fifth StI;eet Sprin'gfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2010-00104 COM2010-00104 COM20 1 0-00 I 04 COM20 1 0-00 1 04 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2201000000000000068 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By EDW ARD DENOUDEN Check Number Batch Number Received By djb '",: ,1. I. <, Page.! ofl City of Springfield Official Receipt Development Services Department Public Works Department Date: 01/25/2010 I :35:50PM Item Total: Authorization Number How Received Amount Due 55,00 36,00 10,92 4,55 $IU6.47 Amount Paid 05606b In Person Payment Total:' $106.47 $1 U6,47 1/25120 I 0