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Home My WebLink AboutPermit Electrical 2010-2-5 225 Fifth Stre". Springfield, OR 97477. PII(54I)726-3753+ FAX(54I)726-3689 .......NOF11!I.D I DEPARTMENT U~E ONLY" ~ ~ I Cb./-IAz-o(()-c>:O/Stf I __ PermIt no.: , I Date: ~ S;;;O , This permit is issued under OAR 918-309-0000. PermitS are uoutransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Electrical Permit Application or ...D~ . _ ,. - ~ ~ r, 'cr:tY,()l:;~'PJl.!NlG'F!EtD,()RE}GON .. . . '~-' - , . / LOCAL GOVERNMENT APPROVAL FEE SCHEDULE I Zoning approval verified? DYes: DNo I Number ofiuspections per itemr() IQly./ 'Cost / CATEGORY OF CONSTRUCTION ea. \ Residential, per unit, service included: I DrResidential I 0 Government I 0 Commercial , JOB SITE INFORMATION AND LOCATION . I 1,000 sq. ft. or less (4) $134.00 $ I Job site address: \5\"::> C S-\Te0-t- I ~'::';~'1ditional500Sq, ft. or portion $ 25.00 $ I I City:~Y1~dd I State: IlR I zIpq14/l I Limited energy (2) $ 32.00 $ I I R,' e, ference: /7b:S:3 bz ~ I Tax lot.: 0 'i ?c:::cr, I Each manufactured home or modular $ 63.00 $ I It.:':~ "'() f\~E?SCR:T~O~ ~\ ~ ~ORK ' '''':'''', dwelling service or feedcr (2) ~ ~ \ , ") _-.....:...~ A '" \-X...- I Services or feeders: installation, alteration, relocation I I I I 200 amps or less (2) $ 81.00 $ 8\.GC \ 1(~1 PROPERTY OWNER'j"~1 I 20t to 400 amps (2) $ 95.00 $ I I Name: 5"'1 y\ h, r },~~ I I 401 to 600 amps (2) $158.00 $ I I Address:\,S\S C ~-tx-~ I 1601 to I,OgOamps(2) $205.00 $ I I City:~h r:-a-\?\e 1<5. I Statez~ I ZIPC\IL\il lOver 1,000 amps or volts (2) $469.00 $ I I-Phone: -54~:z,?;\, 12><1 \ I Fax: I Reconnect only(2) I $ 63.00 I $ I E-mail: D,-.jn,e5Sb 6:) ,Vj~OO, <:.o~ I Tempo'aryservices~rfeeders:installatio..alteratio..relocation This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ owned bJ: me or a Il,lember of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ property IS not intended for sale, exchange, lease, or rent. OAR 479.540(1 and 479.560~ ~' I 401 to 600 amps (2) $126.00 $ Signature. .~:>o lOver 600 amps or 1,000 volts, see services or fceders section above I'", " CONTRACTOR INSTALLATION 1-\ T-ir=Mfir;~., I Branch Ci'.CU. its: new, alteratio..' eXtension per panel I . ,'~ fall -'I'C,ev'm". Busmess ~~e: \,. ,ow rUies .bdl l~t';f,Sec~~~r!ia$lhi~iV'o'r}tP,J>urchase ofa service or feeder fee: I Address: i~~'~'~a;,'3!} 9Jnt~r. ~~~~h~lWi\ln Utility I I $ 6.00 I $ I ' I I -"~'vull"",," ~"'l~~r" City: S1,ate: Z~O. You m.., ,- -:,::,,~"f~~ usi$G~.t purchase ofa service or feeder fec: I, Phone: I f,"~ FaX: ,,=~n2 the C. ,~ :~~EI \it lpl~iitsttDles b',; I $ 55.00 $ I E-mail: I I" / c;~'~~f <yre@aJ:tltJitJi . !'I&c~it I $ 6.00 $ I CCB license no.: fir/ I BCD license no.: I8I'MWa1llaP-as~; semmr feeder no~ induded I Signing supervisor's lic~e no.: I Each pump or irrigation circle (2) i $ 63;00 I Print n:une of signing supervisor: I Each sign or outline lighting (2) $ 63.00 I Signature of signing supervisor: I signal. circUit or-3 li!llited-energy panel, $ 63.00 alteratIOn, or extension (2) I Each additional inspection: (I) NOTICE- I APPLICANT USE THIS PERMIT (A) Enter subtotal of above fees . AUTHORIZED tHALL ExPIRE IF . (Miuimum Permit Fee $58.00) f~~MENCED O~~ER THIS PERMr::~ I ~ter 12% surcharge (Iix [A]) ~1~PERIg ABANDONED FO~~. rechnology Fee (5% of [A]) ~ ,D. '1 TOTAL rees and surcharges (A through C): ~.B'~ ,'. ~~o- ~ ,""/ Total I cost '\ $ $ $ $58.00 I $ $ 8\,00 $ Cj7Z $ I{cK $rtf 2L1 440-2584-) (9108/COM) _~"~RI..,QFiIlU.Q t . -\ 225 Fifth Street, Springfield, OR. 541-726-3753 Phone" 541-726-3676 Fax 541-726-3769 Inspection Line , CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00154 ISSUED: 02/05/2010 APPLIED: 02/05/2010 EXPIRES: 08/05/2010 VALUE: Status Issued SITE ADDRESS: 1515 C ST ASSESSOR'S PARCEL NO.: 1703362309700 Springficld TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residentiat PROJECT DESCRtPTION: 200amp service Owner: EICHENGREEN BRYN C Address: 1515 C ST SPRINGFIELD OR 97477 Phone Number: 541-337-7391 Contractor Type Electrical Contractor OWNER I CONTRACTOR INFORMATION I' License Expiration Date Phone - BUILDING INFORMATION I , , # of Units: # of Stories: . Primary Occupancy Group: R-3 Height of Structure Secondary. Occupancy Group: Typc of Hcat: Primary Construction Type VB Water Type: Secondary Constrnction Type: Ra!l~1;jdlW\O # of Bedrooms: e on laW ItllMm~~i\'I !\TtENiIOl'\: 01 ~ed bY \11Q;~\Il!lfddi(ll:l.1lThg ."'''f adoI' 'n ..a <"fes -i nn<. ~~~\li'~ation ~~~~~o~#~10~fiil\iiIlORMA TION 1 In OAR 952:..a" ob\aln \}.,,J: ;"e telepnu,.rJ 090 '(ou... " 'No\e. "'~'o.a\iOn o '. \l1e cen\el. \ IJ1\IiW 1st: calling Olegon numbedol the. 1_800.3tSt ees Rqd: Centel \S Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupanl Load: n/a \ Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: ~ Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I NOTICE: :'. Sidewalk Type:hi""":"'" iTHIS PERMIT SHJilrr'C',(IDIRE'rwarMf WORK 'AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR " ANY 180 DAY PERIOD." " Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page I 01'2 CITY OF ~YKl1~\.Jl'lJ!.LD Status Issued Building/Combination Permit PERMIT NO: COM2010-00154 ISSUED: 02/05/2010 APPLIED: 02/05/2010 EXPIRES: 08/05/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , ;1..... . .;. , . , Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Numher $9.72 $4.05 $81.00 2/5/10 2/5/1 0 2/5/10 2201000000000000109 2201000000000000109 2201000000000000109 Total Amount Paid $94.77 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. 1.'!''4I '.1 Reouired Insnections I Electric 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 herein, and that NO OCCUPANCY will bc made of any strncture without permission of the Communiiy Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will De used on this project. I fnrther agree to ensnre 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 timeSdnringconst~~ ./ . OS-'t=*'/~ 20"10 = '--' - ontractors Signature ~ Date .._t ofJ: r~' 1 Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00 154 COM20 I 0-00 154 COM20 I 0-00 154 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2201000000000000109 Description Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Paid By . BRYN EICHENGREEN Check Number Received By' Batch Number djb . . '~'Il ";-",- Page I of I City of Springfield Official Receipt Development Services Department Public Works Department Date: 02/05/2010 10:37:25AM Item Total: Authorization Number How Received Amount Due 81.00 9,72 4.05 $94.77 Amount Paid 101108 tn Person Payment Total: $94.77 $94.77 2/5/20 I 0