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Home My WebLink AboutPermit Electrical 2010-3-4 r <;"/0- Z. 7& ..PAINO........ iiii ZON ~ INITIA"S ~ DATE IlliIJI' SOURCE ~~ - , .... ".. CITY OF SPRINGFIELD, OREGON . ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CoM '2e' J4;?- - .2>e- '2--:rt:. 1. 'WCATIONOFlNsii,-i.4TION,- . -, 1/17 's~()fl1.' 14th LE\~ DESCRIPTION: JOBDE~ t')~~\ NEW c.i~c.ultS -roR ~,t-I'IE.e. Permits are non~transferable and expire irwork is not started witbin ISO days of issuance or if work is SuspeDded for 180 days. 2. : c:ONTRACT~Rf!"$TA~.~.~TI()1'{Ol'!..LY~ Electrical Contractor BH m €..\ Ed Ri C. Address PO &x ~!;;1 y City fLl6 eJl)f.. Phone SIfI-6ffb-DQOS Supervisor License Number /5 6 S S' Expiration Date I D - I - / D \ Constr. Contr. Number J ~ l..f DD 5 '- Expiration Date 9-/9 S~sE Owners Name J AVUld 'B I ;55 Address II '7 $e,Ut-h. ,l\. +-h City 5pRlfUc;t1e1d Phone 5'1I.n6-'t~/5 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~ ()..~o.... ~ry~ Inspection Re~: 726-3769 ~ ~~ ~~ - ..--.. ~ /q.-/ U:r , o.'1te 3. . COMPLETE FEE SCHEDULE BELOW A. ' New Residential- Single or Mnlti-Family per dwelling nnit. l__ ___ _____ __ ___ _.. _ _ ____', Service Inclnded 1000 sq. ft. or le<ll Each addition," 500 sq. ft. or portion thereof Each Manufacl'd Home or Modular Dwelling Service or Feeder $121.00 '} , $ 22.00 $57.00 ---------c- -. -- ~ B. ; Se.rvices or Feeci~t~ - Installatiol!, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 100~~ps Over 1000 AmpsIV olts Reconnect Only $ 73.00 $ 86.00 $143.0&- $186.00 $426.00 $ 57.00 c. ~.!~"!p_?rary ~Se!,,_ices ?_r~eed_e~~ __ Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 57.00 $ 79.00 $114.00 - Over.600 Amps or 1000 V 01-';< see "B'~above.. . D. Branch Circuits .. New Alteratio~ Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Penn it _? $ 50.00 $ 5.00 $~.sSO JJ~J8>JL E. : Miscellaneous (Service/feeder not included) -Each Installation L.__ _ _ ,._ _ ",__ _0_ ~_.____ ____"___~_ _______. Pump or irrigation $ 57.00 Sign/Outline Lighting $ 57.00 Limited EnergylResidential $ 29.00 Limited Energy/Commercial $ 52.00 Minimnm Electric Permillnspection Fee is $52.00 + Snrcharges - .. '" .. __.n - . -8 4. . SUBTOTAL OF ABOVE .' , 12% Stale Surcharge 10% Administrative Fee 5% Technology Fee TOT ALsha;"d Drive(T:YBuil~ng Fonns/Electrical Permit Ji~g5'~ p 225 Fifth Street Springfi\ild, Oregon 97477 541-726-3759 Phone ~R~qPIE~~. :.. Wii:., . City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000195 11:19:59AM Date: 03/04/2010 Job/Journal Number COM20 I 0-00276 COM20 I 0-00276 COM20 I 0-00276 COM20 1 0-00276 Payments: Type of Payment CredilCard cRcceintl Description Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add + ] 2% State Surcharge + 5% Technology Fee Paid By CARTER R MATZEN , ",,,," ,", Amount Due 55.00 1800 8.76 3.65 $85.41 Item Total: Check Number Authorization Received By Batc.h Number Number How Received Amount Paid KLK 080186 In Person Payment Total: $85.41 $85.41 KLK 1:-- i' Page 1 of 1 3/4/2010 1- , r CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00276 ISSUED: 03/04/2010 APPLIED: 03/04/2010 EXPIRES: 09/04/2010 VALUE: Status Issued 225 Fifth Street, Springficld, OR 541-726-3753 Phonc 541-726-3676 Fax' 541-726-3769 Inspection Line SITE ADDRESS: 117 S 14TH ST ASSESSOR'S PARCEL NO.: 1703363204401 Springfield TYPE OF WORK: Electrical Work Only ,~,{: ,.. . ",. ~~~ , TYPE OF USE: Commercial PROJECT DESCRIPTION: Add. Electrical Circuits,.for Stage Owner: CROMBIE DOUGLAS G Address: 33328 HOWE LN CRESWELL OR 97426 Owner: ATKINSON PATRICIA L C Address: 33328 HOWE LN CRESWELL OR 97426 Owner: CROMBIE JACQUELYN A Address: 33328 HOWE LN CRESWELL OR 97426 Owner: RITTENBACH LEROY Address: 33328 HOWE LN CRESWELL OR 97426 Owner: GILLHAM MARIAN Address: 33328 HOWE LN CRESWELL OR 97426 Owner: DUNHAM ANN Address: 33328 HOWE LN CRESWELL OR 97426 '" ATTENTION: Oregon'law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtaln copies 01 the rutes by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). ',':. ;, I CONTRACTOR INFORMA TION ~ Contractor Type Contractor License Expiration Date Phone ":. ~~~. '-~'; ~~~'r "."-. NOT\e!: ;RElf'THEWORl< " lHIS PERMIT SM~.l\. ~S PERMtf IS NOT, ,: AU1HORIZEO UNO: ABANOONEO fOR,,";; COMMENCEO OR , ," . ANY 180 OAY PERIOO. . '.~ t '0' ",', #''''.'' Paec 1 01'3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Descriotion Tvpe of Construction Fee Descriotion + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid ,'. BUILDING INFORMA nON ~ A2 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled. Building: VB CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20IO-00276 ISSUED: 03/04/2010 APPLIED: 03/04/2010 EXPIRES: 09/04/2010 VALUE: No Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I I Valuation Description ~ $ Per Sq Ft Square Footage or multiplier' '; !," or'Bid Amount :1 ;1" u . . . Total Value of Project ~ Amount Paid Date Paid $8.76 $3.65 $55.00 $]8.00 3/4/10 3/4/]0 3/4/]0 3/4/10 $85.41 Pa2e 2 of 3 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Value Date Calculated Receipt Number 2201000000000000195 2201000000000000]95 2201000000000000195 220]000000000000195 Status Issued ;rft:t " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00276 ISSUED: 03/04/2010 APPLIED: 03/04/2010 EXPIRES: 09/04/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Plan Reviews ~ 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 Reouired Insoections ~ Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. ,',:;t ' By signature, 1 state and agree, that 1 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 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 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 Date ;"j'} .~~\: ., ,\.. ;( Page 3of3