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Home My WebLink AboutPermit Electrical 2010-3-3 ;:r. , 225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 ,::yr<';:<\:;{">;:~<"'iJ'~;' ;';' /,L,"i,i~i<;:;j,i~,,;":i:-,: ' ~Ac[)E:RAR,TMENTdUSE;PNLY:T? -,J;."""".:"<,O'__,,,-,," ".".... . '_..;...+5Z".",,',,""i;.~,,>;~ ,,_,--, -', COW' ZO { 0 - 00 Z73 Permit no.: Date: :, -3 - ( 0 Electrical Permit Application 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'ifwork is suspended for 180 days. 'c." -.,',.:.,,'LOC::Al.:,<30VERNMENl'APPROVAb ..' ii." :. , '.. ",FEE 'SCHEDuLE' .. . . );.i.,) , .,. Zoning approval verified? DYes DNo ! . .'. ,".. . i.' " 'Cost) i'Total ))"7;.;!-:,) \CATE<30RY,OECONSJiRl:JCJiION ". T :i,) "".' 0,~ ~'TJ)~r'ofins'pect!t:t~,sperite~~k),i~,.. 9ty,t .. i ,,'ea~ 'J:~>; ';!2tcost: Residential, per unit, service included: D Residential I 0 Government I 'i! Commercial ':''';.:jOS'SITEINFORMAJiION ANO-'il.:OCATlON. '. '.. . 1,000 sq. ft. or less (4) - $134.00 $ Job site address: Intersection of 28th @ McKenzie Hwy 15 Each additional 500 sq. ft. or portion $ 25.00 $ thereof I State: I ZIP~ , City: Springfield OR 97477 Limited energy (2) $ 32.00 $ Subdivision: RoW- rttAi=- $oj&-" "at no.: Each manufactured home or modular $ $. I:t,.' '.~;.;.,1;:.".JDESCRIRl'ION OF.i~W0RK:" ',-i!. dwelling service or feeder (2) 63.00 Modify existing traffic signal Services. aT feeders: installation, alteration, relocation ..jO\o* lo495 i 200 amps or less (2) $ 81.00 $ ~ ;'>i"";' 201 to 400 amps (2) $ 95.00 $ Name: ODOT . JOf1oW rU. 'u 1III~~al)lps(2) $158.00 $ Address: 3 S~ CAP ( ,0 L ST Nq;,':!.ITI~at;o ~~ ' '/mPPte [~u/res ,,~. $205.00 $ City: sil'Lt:-w1 I State: atL I ZlP:OtiJOtum-o 'Ii::lh.yt;f/g(}JJI Utif:::. $469.00 $ Phone: - - I Fax: - - Calling th "~ VlQtJrpm!!t6l?1t!fflOA~e,,~~ttOrth $ 63.00 $ E-mail: I '~'''lJer for th ~ ~i' ~ 1Alt;e,rtfiJJ9rl1tallation, 'alteration, relocation This installation is being made on residential or farm property vtln ar itrfg~Ufi1 ~'tj~e/~f:?hone"' $ 63.00 $ owned by me or a member of my immediate family. This 201 to - ~i?G441"'''''atloll $ 87.00 $ property is not intended for sale, exchange, lease, or. rent. OAR 479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $ Signature: Oy~~ 600 amps or 1,000 volts, see services or feeders section above, t,. i";CONTRACTORI NSl'A Ll.:AJiION' '::'~'~f Wi:~;;:~:~ .....;:,. Branch circuits: new, alteration, extension per panel Business name: EC Company a. Fee for branch circuits with purchase of a service or feeder fee: Address: PO Box 925 Each branch circuit $ 6.00 $ City: Albany I State: OR ZIP: 97321 .. ~, Fee for branch circuits without purchase of a service or feeder fee: I Fax:54'l.-926-4268 .. Phone: 54 'l. - 92 6 -4 2 6 6 First branch circui~ (2) l $ 55.00 $ 55.00 E-mail: davidom@e-c-co, com NOTlr.r:. Each'additional branch circuit $ 6.00 $ I BCD license nbHI~ ""~~C ~ ..,- -Miscellaneous-fee~_;,.~.w~vf.ce or feeder not included CCB license no.:4 9737 Signing supervisor's license no.: 3257 S AUTHOR/7,::n .. H, IldacliX\'<m f" il!i""'ion circie (2) $ 63.00 $ Print name of signing supervisor: William ':tRJ5!MfNCFn f1 ~~ Ct;1c!ijjG cp . ~!'g'l!l' . $ 63.00 $ Signature of signing sl\1ferv;j~;:-OO ~ d 8,Q DAY P FU ~ti\D@~ittm-~t\!HY panel, ' $ 63.00 $ OO~ration. or ex s ) Each additional inspection: (1) $58.00 $ , . ....p...,... ";.iT:::;:' .,'- -'..T..........;. ..' ;;APPLICANTUSE:.cy..:....t...,...y~....., .... ~iJ~ (A) Enter subtotal of above fees $ 58.00 ~\Q (Minimum Permit Fee S58.00) , 0/ (B) Enter 12% surcharge (.12 x [AD $ 6.96 0J~ ra0 (C) TechnologyFee (5% of[AD $ 2.90 ~ TOTAL fees and surcharges (A through C): $ 67.86 \ ~i<< ~ 440-2584-) (9IOB/COM) ,-'< Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00273 ISSUED: 03/03/2010 APPLIED: 03/03/2010 EXPIRES: 09/03/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 28th/Main - McKenzie Hwy ASSESSOR'S PARCEL NO.: ROW-TRAFC-SIG TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Public PROJECT DESCRIPTION: Modify existing traffic signal Contractor Type Electrical ODOT 355 CAPITOL ST NE SALEM OR 97301 to \aW 1t:yv"I!l'"' ~n~t\\lW t,TiEtmotl: ~'ffi.~~~R:~I!~RJlIl~TlON ~ 1QIIOW r~\e9 ~ntel,. 05 Ol'p. 95 -UIJ Con~oViollt\on C 01-0010 t\110U,g\1 01 the (Liles ~Ycense EC ql'Q ~-O e: obtain COP\~s e tele\J\10~~ 737 caliing\\1e ATlON !lumbel 101 \el is 1-6 Cen # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Phone Number: 503-726-2552 Owner: Address: Expiration Date 0111512012 Phone 541-926-4266 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft I st Floor: . Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION ~ REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: O"erlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: . ;':. Compact: N ol'~1!':'t Coverage: If lHE WORK S PERMIT S,",,II,tt EXPIRE T IS NOT MOONED fO ,11'5;:'- _., :_,,:._~,;.,.~_'_t\.: .:/", 'Side\~alkType: Downspouts/Drains: Street Improvements: Storm Sewer Available: Speci"llnstruction: ;-';;:'':'.' ;-~.. f" Notes: I Valuation Description ~ Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e 1 of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees Paid-l Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid $6.96 $2.90 $55.00 $3.00 Total Amount Paid $67.86 I Plan Reviews ~ Date Paid 3/3/10 3/3/10 3/3/10 3/3/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00273 ISSUED: 03/03/2010 APPLIED: 03/03/2010 EXPIRES: 09/03/2010 VALUE: Receipt Nnmber 2201000000000000191 2201000000000000191 2201000000000000191 2201000000000000191 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..".',....... Reouired Insoections I " ' Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 1 further certify that any and all work performed shall be done in accordance witb 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 Commnnity Services Division, Bnilding Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 further 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 " -:\~;, Paee 2 of2 Date ~:'. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ":""...j:q'!!RIlL..,l)~'..... ..1. lilt. , ....~... .c z~; ..-,-..^...- ."0",..-. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000191 Date: 03/03/2010 2:55:14PM Paid By EC COMPANY ALBANY Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 55.00 3.00 6.96 2.90 $67.86 Job/Journal Number COM20 I 0-00273 COM20 I 0-00273 COM20 1 0-00273 COM20 1 0-00273 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment Check Amount Paid djb 4091 In Person Payment Total: $67.86 $67.86 'i~' t.".,. " " " ;~~~\ ~1' ,( l i:f ~ l' !,~' , '<...,i. cReceintl Page 1 of I 3/3/2010