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Home My WebLink AboutPermit Electrical 2010-2-16 I I I 200 amps or less (2) $ 81,00 $ 'it /- I 201 to 400 amps (2) $ 95,00 $ I 401 to 600 amps (2) $158,00 $ I I 601 to '1,000 amps (2) $205,00 $ I I ZIP'''' 7'1771 lOver] ,000 amps or volts (2) ,"O~ \/011 to $469,00 $ 1 1_,1 ,R~conJl~ct 6\ilyri21~:~';~;6regon L tilitY $ 63,00 $1 I '" ',', '''''v~- -, ,~~r",.m IOftIl I I Temp'orilJ:.,~ffrvj~~Stfetlde79:~S1~7-"f.!M'f1/teratlon, reloca(lOn ,'~ : ~ga~m8\ IOOlC)thrO~i~~ ~i~~~ ~~ ~~~ $ 63,00 $ I I~ O~ )?(}(()Q14OOl1lnllB~~[e~the tei~~t ~ $ 87,00 $ I ;~~;nji;o~~~gon Utility NU~'IC I $126,00 $ I n ver ~(\ltQJ:i8r \~v~'~~~Vlces or feeders sectIOn above I I I I EJ~ctrical Permit Application 225 F;[th Streett Springfield, OR 97477. PH(541)726-3753' FAX(541)726-3689 I)j :f\';' "'i'E'bCAL::GOVERNMENT\fApP~ROYAt::4Z';i'~f~',ni'),;;!d I Zoning approval verified? ' 0 Yes 0 No I 1;'i,,11,'fl;~iif,;#{CATEGORY;i;Of'\;CONSTRUCTIONi1~\'~';:';;i;-,,';I,:;I 10 Residential' ~vemment I 0 Commercial " 1 1~4~jJ:>El.R$ITE(;jJNF;ORMATIOrilWAN[ji\!UO,C'Aflil,ON~~~I;.((lil I Job site address: .2 CfY.. 5:. I Y7.L <;.tf?F..D I I City: C; f? Fl> I State: D fZ. I ZIP I I Reference: \ 7033 b~---, I Taxlot.:OO~ccJ:, I:' "-:'-":"'DESC'R'IP'T' 'ION:O'F'WO R'K"",;,,,-:,:,,.,,"t,iY-,~.N,j:,;",7";1 , .' . " '" '. ',. ' ;""" _. ' "'",.t',.:};.:;:I:"';:;,; !::~': ',.' jfl)fAl~/' ,.J""';> p'_< ~ >--' I-, (/4dEL I ~,PROBERT.y,OWJilER.;-:: ' I Name Ct-f'1 0+ S P F.I:::> I Address: 54tdZZ,<;; s-f'- ,..t- I City: Sf/FI:::. I State:t/L 1 Phone:5c{'( 7zb- 37).3 I Fax: I E-mail: This mstallation IS bemg made on residential or farm property owned by me or a member of my Immediate family, This property IS not mtended for sale, exchange, lease, or rent OAR 479,540(1) and 479,560(1), IZ:;:':':D~~~Ffi'~~'NfUs'EpNly;,:, " 1<;~:ifof(O -00,z05' I Date: z/ 6/0 1,000 sq, ft, or less (4) I Each additional 500 sq. ft or portion thereof \ Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) $134,00 $ $ $ 25,00 $ 32,00 $ $ 63.00 $ Services or feeders: installation, alter/uion, relocation Signature: I, ' ''-'"'';,',;'';:FCONTRAClOR'INSTALLATlON:, ,'I I Branch circuits: new, alteration, extension per panel Business name: ~~;C) ~ ,,t:?;C I I a. Fee for branch circuits'with purchas'e ofa service or feeder fee: Address: PtP q.,,)( ':':>0 'I V I I Each branch circuit I I $ 6,00 I $ I City: ~ to I 5tato;2.. I ZIP: I I b. Fee for branch circuits without purchase ofa service or feeder fee: I Phone: 9s?~OD:;!+Fax: I I First branch circuit (2) 1,$ 55,00 $ E-mail: I I Each additional branch circuit I $ 6.00 $ CCB license no.://h 3;::;29 I BCD license no.: I I Miscellaneous fees: service or feede"'",not:jriCiJ'ded Signing supervisor's license no,: 30/7 S I Print name of signing supervisor: ~<9c)C':S tho(',..J~1 I Signature of signing supervisor: A'7i.ot:A~1 -t~' I ~&~O qjl/' ~~0 fj ,~Q( ~~ 440-2584-J (9/08/COM) ~ or irrigation CirCI'i~ If';}\~ 'jND~,o, ,I $ :tillS ~RM\II&\~~ PERl ~\T'~ }'t~!oo; I $ ~r~:~~~'i_~1 ~n..~'l~rgo~ $ 1'}..1~"f8W'0M1.9~I.lIr!'(I) . ,$58,00 $ 1~~3~~f~{t~1i~~~ARi?:GicgN!f:!~~:8s,I;]~~Rf~&#~~~~~l~fR~l~{2 (A) Enter subtotal ,of above fees (Minimum Permit Fee $58.00) ,I (B) Enter 12%surcharge(,12x [A]) I (C) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through C): $'i5r $ '77Z $ 'fC> 1~ $ 7,0/77_':- -- CITY OF SPRINtJl'lELD , Building/Combination Permit , , " 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Une PERMIT NO: COM2010-00208 ISSUED: 02/16/2010 APPLIED: 02/16/2010 EXPIRES: 08/16/2010 VALUE: Status Issued SITE ADDRESS: 298 S 18TH ST ASSESSOR'S PARCEL NO.: 1703360000500 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: 125amp sub panel TYPE OF USE: New Public I PUBLIC IMPROVEMENTS I 1C.'l'lO?~ :,'., ' \~i'd~:t)\\.~.t\01 ~01\Ct~ ~ ~~f>.\.\. ~\fl'?~~~~ain;: "i\-\\S ?~~~t.U \)\'\tl~~ ~'Of>.\'\\)~~ ~:~t\'\~~ ~~?\OU. r !,'\1 ~ <00 I Valuation Descrintio~ I . H:;" I' Owner: CITY OF SPRINGFIELD Address: 202 S 18TH ST ATTN SPRINGFIELD UTILITY BRD SPRINGFIELD OR 97477 ,- I CONTRACTOR INFORMATION 1 Contractor Type Electrical Contractor THORNTON ELECTRIC INC License 116329 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I. BUILDING INFORMATION I , IpW requires YOU,t,D ,'~,T.NT\()N: O#'ff-S'tol"f,l,k Oregon Utility j'"" -y, \\JlcsacJCII~iJ$P~f'S'I~IlU'Yit set forth !,;ot:jiGa~i~n Cenl!'xpe ~?'o'/.Nl OAR 952-00'- in OAR 802-001 wdmlf~Bl\is of the rules by 0090, you may m.:e telephone caliing the ce~Jr bl''\!Jinity NotifioatlOl\ number for thl!5 h, ' ~). nla r.Anter I 1 I DEVELOPMENT INFORMATION I' Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: . ...' , QVerlayDist: " # Street Trees Rqd:' ,- \ Pa~ed Dri~e Rqd: '% of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction , " Pa2e I of 2 ,7: ~' Expiration Date 08/21/2010 Phone 541-686-4151 Lot Siz~: SqFt 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupaut Load: 'REQiJIRED PARKING Total: Handicapped: Compact: .":-i;W' Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 12% State Surcharge + 5% Technology Fee Perm ServlFdr 200 amps or less Amount Paid $9.72 $4.05 $81.00 Total Amount Paid $94.77 -' " ..:' ;<. Total Value of Project Fet's Paid I I I.. Date Paid ........', .. ....t' I Plan Reviews , 2/16/10 2/16110 2/16/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: ~OM2010-00208 ISSUED: 02/16/2010 APPLIED: 02/16/2010 EXPIRES: 08/16/2010 VALUE: Receipt Number 1201000000000000139 1201000000000000139 1201000000000000139 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 ,Reou,ired Insnections I Electric Service: Approval required pr'ior 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 1 further certify that any and all work performed shall be done in accordance with Ihe Ordinances 'of the City of Springfield and Ihe 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 further agree to ensure that all required inspections ~re 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 Pa2e 2 01'2 Date 225 Fifth Street r?_ - Sptmgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 1 0-00208 COM20 I 0-00208 COM20 1 0-00208 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: City of Springfield Official'ReJeipt Development Services Department Public Works Department 1201000000000000139 Date: 02/16/2010 Description Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Paid By ROCKLIN THORNTON Item Total: Check Number Authorization Received By Batch Number Number How. Received djb 05516a In Person Payment Total: ; ~ j ,,' Page 1 of 1 10:06: 12AM' Amount Due 81.00 9,72 4,05 $94.77 Amount Paid $94,77 $94.77 2/16/2010