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Home My WebLink AboutPermit Electrical 2010-3-10 Electrical Permit Application . , 225 Fifth Street> Springfield, OR 97477 > PH(541)726-3753> FAX(541)726-3689 .it~r9',~.r~~l~~~~ Pennit no.:~\\) . l\ 0/10 3) Date: 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 if work is suspended for 180 days. ~j~..f_I1:G8~~.!?!G'05t.E~IilI\ilEI\l)J..;f~R;B.~(;)'!jt:.__" . Zoning approval verified? 0 Yes 0 No ""'-""""~~-""""'A""'E"G'~0R" r",,,,,,,,,-O NS"'R"''''''I'O' ~N""-~""= 2.~~.~_.1!k_..,:___>__\~~~..~S;.:.., ,._!.!l_LIlI~\JJ.I1.,.".~~~~ o Residential 0 Government 0 Commercial lW~.WeTSiill.E~lli!g~gMmttlQJi!!l~NQl~~i!i~!R@tili~1I1; Job s e address: E-mail: This installation is being made on residential or fann property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). I-C.- Signature of signing supervisor: 440-2584-1 (9/08/COM) Residential, per unit, service include"d: 1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) . Each manufactured home or modular dwe!ling service or feeder (2) $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) $ $ $205.00 $ $469.00 $ $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ $ 87.00 $ $126.00 S Over 600 amps or 1,000 volts, see services or feeders section above 201 to 400 amps (2) 401 to 600 amps (2) Branch circuits: new, alteration, extension per panel a. t' Clll W, Each pump or irrigation circle (2) Each sign or outline lighting (2) $ 63.00 $ $ 63.00 $ Signal circuit or a limited-energy panel, alteration, or extension (2) Each additional inspection: (1) $58.00 $ ,-~'l'" ~p.:Iii;iIDG"ANill~SE''"''l'~~l'';;;'~WA'~. ~ '"'J';......_<_""__.H.."_._:.lJj1i._I.:._.~t;:~~.!~,~~~<tt{~~ (A) Enter subtotal of above rees (Minimum Permit Fee $58.00) S 63.00 $ (B) Enter 12% surcharge (.12 x [A]) (e) Technology Fee (5% of[A]) TOTAL fees and surcharges (A through C): $ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00301 ISSUED: 03/1012010 APPLIED: 03/10/2010 EXPIRES: 09/1012010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1059 LAUREL AVE ASSESSOR'S PARCEL NO.: 1802061310200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition PROJECT DESCRIPTION: Replace 200 amp service and add five (5) additional circuits Residential Owner: SECRETARY OF HOUSING & URBAN DEVELO Address: 20829 72ND AVE S STE 150 KENT W A 98032 , . ,- . .. . I CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor LYNNS ELECTRIC License 102316 BUILDING INFORMATION ~ Expiration Date 10/14/2011 Phone 54 I -726-7895 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: S'I Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Ca"port Sq Ft Other: Occupant Load: ilIa None!: . "'.~_ Front yard Setb1iPH6 PERMIT S . ""Overlay Dist: Side I Setback:AUTHORIZED U HAll EXPIRE IF TH!'WOffJ("es Rqd: Side 2 SetbackCQM NDER THIS PERM"../S<lIYf-jo'e Rqd: Rearyard SetbAfN MENCED OR IS ABANDONEOo'O'Rr.rt'coverage: . Solar Setbacks: 180 DAY PERIOD. . ~ ." .. I DEVELOPMENT INFORMATION ~ REQUIRED PARKING ATTENTION: Oregon Uiw't\1qulres you to follow rules sdopted W4111'IiOmgoh Utility Notification Center. Th05elJlllGGlare set forth In OAR 952~01-OO10through OAR 952-001. 0090. You may oblsln copies of the rules by Street Improvements: Storm Sewer Available: Special Instruction: I PUBLICIMPR()VEMENTS rumber for the Oregon Utility Notification . Center is HOO-332-2344). Sidewalk Type: Downspouts/Drains: Notes: " "'I:! r I V aluation ~escription ~ DescriPtion Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 01'2 :'.:' If '., . ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00301 ISSUED: 03/10/2010 APPLIED: 03/10/2010 EXPIRES: 09/10/2010 VALUE: ...i, .. "'., Status Issued :,.~ ",~ 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid} Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Orc Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $13.32 3/10/10 2201000000000000218 $5.55 3/10/10 2201000000000000218 $30.00 3/10/10 2201000000000000218 $81.00 3/10/10 2201000000000000218 Total Amount Paid $129.87 I ,P:!ll,n R~vjews ,~ 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. LReouired Insoections ~ Rough' Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that allY alld all work performed shalrbe done ill 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 allY strllcture without permission of the Community Services Divisioll, Building Safety. I further certify that only contractors and employees who are in compliance with oks 701.005 will be used on this project, I further agree to ensure that all required inspectiOl~-~T~\re r~~~e~ted at the proper time, that each address is readable from the street, that the permit card is located at the front of tlie property, and the approved set of plans will remaill 011 the site at all times during construction. . i'" '! Owner or Contractors Signature Date Paee 2 of2 ,'. . ..:;".1: 225 Fifth Street Springfield, Oregon 97477 54]-726-3759 Phone ....,~t~Q..""'~ III... ,., ...... ~....... j ; ftj . ~_. ... --- City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000218 Date: 03/10/2010 9:25:50AM Job/Journal Number COM20 I 0-0030 I COM20 I 0-0030 I COM2010-00301 COM2010-00301 Payments: Type of Payment CreditCard cReceintl Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By L YNNS ELECTRIC Received By Check Number Batch Number KR CrTY OF SPRINGFIF.lD DEVELOPMENTAL SVC, DEPT, 225 5TH STREET SPRINGFIELD,OR97/1n (5'11)726-3791 Phone Order (19 lilt: 7Gl1'16b8 'W ~de : ICARD lXXXXXi5316M ;Odl: Code: 66267P InvoiteU: , Cu!>Lw<t. Co,",,- THANK YOU , . " Page 1 of 1 . ~ 09:/1 r " $12: \1 ,J Item Total: Authorization Number How Received Amount Due 81.00 30.00 13.32 5.55 $129.87 Amount Paid 66267P Phone Payment Total: $129.87 $129.87 , \ 3/1'0/20] 0