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Home My WebLink AboutPermit Electrical 2010-3-23 Electrical Permit Application ~.<:..: ,< :1.9!..y,;QF'SP.RINGFIELD, OREGON . 225 Fiftb Street+Springfield, OR 97477+PH(541)726-3753+ FAX(541)726-3689 fi~E~ Permit no.: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuan~e or if work is suspended for 180 days. ~ ~"\ .~(\O ArrENTI~ N: oregoA'l\l-AA'~\1ou to fo~V" \ rules ade \I...J.e O~~'ttility'fi :-.. Center. ~ es are selforlh 2-00~ \) 0010 throllg" AR 952-001-0090. a o~lT copies of the les by calling the cen er (Noie; ~ telephone number for the Oregon Utility Notification Cent~~dll1~P~2€l/3)14). Date: 1$~IllE:l::I.t!l.. .. a11l'i ~9stli! Residential, per unit, service included: 1.000 sq. ft. or less (4) $134.00 ~~jjlJ!!O_G.~~$j~!igBl~MENml\,~~~I;iCilM;6;).;'~~lt~ Zoning approval verified? DYes D No ~1"~W:CAmE$J:>Rlf'.qIi,ii!(;::<DN$lFRl!J~]ICilN~tl~i'i%i D Residential D Government 0 Commercial ";J~i1f);t:JOB'iSI[EtlINF,,0RMMION.~f/f,.N[\~.l![0C;6;ml.O.Nili!fili'l\~i Job site address: \'b \n ~ ~ V n 1Y City: State; ZIP: Subdivision; l,o'?,'15:Z>:S Lot no.t y;;.:;:z[)( ~lJJ~J;~!1!lo.E;a~gl~iJj(J)N1t0~W:<DR~f~~ ^ l \h '\l\ V'l\a "n . ~ \ \ \...'-\\L (' () f"DV("(1 Services or feeders: installation, alteralion, relocation ~l~~~~~~J~1\~~E~1N~ 200 amps or less (2) Name: t'rJ~ I: OQ A C"'ll.{)\~J. J. Address:\D \ Q ~, ..... V 0 ~" City: '\!. '" I'" eel State! )(.L ZIR':' l't I Phone: -\. -:"\- \ i\ll fl,l Fax: - - E-mail: This installation is being made on residential or farm 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). Signature: ~.'eij;SR:>lql'S;r~,q,p"'1'!I"'Nliit'i"""'~'-4 .",.ll._>ThI~~ _ J.n "'~"LS'..;,..lfSCL~~ttJ;~T;(ttLr;i'w:r0.w Business name: II y y~ I ~ r {).5 . Address:,(J ( h rH '1Jt?J 7- City:W(J'~"rv;l/f State:(jyf zIP'11L/<jv. Phone: ll~ '1 .., ). y. Fax:/-4. 4 10 4 '7 E-mail;hvvyVr/:brasr;.nf1t1rtMnh.ni .(l n Each additional branch circuit eeB license no.: J~ I '111 It BCD Iice'Rle no.:~D ...1fLl;J Miscellaneous fees: service or feeder not included Signing supervisor's license no.: L....4 -r:l .:). _ Each pump or irrigation circle (2) $ 63.00 $ Print name of signing superviso~ ()' h II fI f:::') V y r t) Jil'.<h sign or outline lighting (2) $ 63.00 $ Signature of signing supervis -~ I II . ,J"A',. t l"S;grGtClfcuit or a hmned-energy panel, $ $ SJ.r: I AlA r"\ I A 1/\ I " . "alteration, or extensIOn (2) 63.00 V V.-V /1111 V V, '<:; v.. 'n \../ r v '~..: r.E~h1~dditionlll inspection: (I) $58.00 $ \j-'""~":',~ ~ ~. '(~... -".. .<:~ .... F.:'. C> (A) Enter subtotal of-above fees t ( 3~C .~() -~JA (I}.'"/,t:::. $ (Minimum)..~~r~t.F..~c;,~5~..!t~) )" .. (B) Enter t2%;rrcbrrgsi{.~2;tj:~:]) $ - .S.o (e) Technology Fee (50/0'91'.1A])., $ ~. \ c ') TOTAL fees and surcharges:(~ through C): $ rr~. 7 ~~<V to~~ Each additional 500 sq. ft. or portion thereof $ 25.00 Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $ 32.00 $ 63.00 $ 81.00 20 t to 400 amps (2) 40 I to 600 amps (2) 601 to 1,000 amps (2) Over 1.000 amps or volts (2) Reconnect only (2) $ 95.00 $158.00 $205.00 $469.00 L $ 63.00 Temporary services or feeders: instaltation, alteration, relocation-- 200 amps or less (2) $ 63.00 20t to 400 amps (2) 401 to 600 amps (2) $ 87.00 $126.00 Over 600 amps or 1,000 volts, see,services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 b. Fee for branch circuits without purchase of a service or feeder fee: $ First branch circuit (2) $ 55.00 $ 6.00 $ $ $ $ $ $ $ $ $ ${ 1"lr:J.. $ $ $ $ $ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00352 ISSUED: 03/23/2010 APPLIED: 03/23/2010 EXPIRES: 09/23/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1310 MARKET ST ASSESSOR'S PARCEL NO.: 1703253308300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: overhead to underground service lateral Owner: Address: GOURLEY STUART E & JANIE D 1310 MARKET ST SPRINGFIELD OR 97477 Phone Number: 541-744-1047 I CONTRACTOR INFORM A nON I Contractor Type Electrical Contractor License BURRELL BROS ENTERPRISES INC 136446 BUILDING INFORMA nON ~ Expiration Date 08/20/2011 Phone 541-747-2724 # of Units: Primary Occnp.ncy Group: Secondary Occupancy Group: Primary Construction Type Secondary Constrnction 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: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occup.nt Load: n/a [ DEVELOPMENT INFORMATION ~ Frontyard Setback: Side I Setback: Side 2 Setb.ck: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: It, ,. (:-, Valuation Description ~ Description Type of Constrnction $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Valne Date Calcnlated Page I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20]0-00352 ISSUED: 03/23/2010 APPLIED: 03/23/20]0 EXPIRES: 09/23/20]0 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,> ;..1 Total Valne of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Service Reconnect Amouut Paid $7.56 $3.15 $63.00 Date Paid , 3/23/10 3/2311 0 3123/10 Receipt Number 2201000000000000272 2201000000000000272 2201000000000000272 Total Amount Paid $73.71 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. _~.':. . ". , l",.Reouired ]nsDect~ Electric Service: Approval required prior to utility company energizing service. By siguature, I state and agree, that I have carefully examiued the completed application and do hereby certify that all information hereon is true and correct, aud 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 Oregou 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 ouly 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 -tji:~ " ';~), S-.' ....~ ';' Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone liiii City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000272 3:00:59PM Date: 03/23/2010 Job/Journal Number COM2010-00352 COM20 1 0-00352 COM20 I 0-00352 Payments: Type of Payment CredilCard cReccintl Description Service Reconnect + 12% State Surcharge + 5% Technology Fee Paid By JASON BURRELL Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 63.00 7.56 3.15 $73.71 Amount Paid IIh vs3928 Phone Payment Total: $73.7] $73.71 v53928 Pa.ge I of] 3/23/20] 0 03/23110 TUE 15: 22 FAX 5417263689 CITY OF SPRINGFIELD @J001 ********************* ... TX REPORT ... ********************* TRANSMISSION OK TX/RX NO CONNECTION TEL CONNECTION ID ST, TIME USAGE T PGS, SENT RESULT 1816 03/23 15:21 01'05 2 OK 95417441047 Electrical Permit Application . EGON 225 Firth SI",r.Sprlngfield, OR 97477.PH(54I)726-3753. FAX(541)726-3689 ~ Date: , , This permit is issued under OAR 918-309-0000. Permits are nontransferable, Permits expire if work is not started within 180 days of issuon~e or if work is suspended for 180 days. . , ! , I "0::[ii;;jf;:FJ'Ji~P,$'.<<I;t~J;j~;/;i;ffi'MgNt~BP.~~A~~1S:~1ttM!\*i,' Zoning approval verified? 0 Yes 0 No ,','.'.".",,' ......"----..,,.... """''''''''''''''''''''''''''''',,,,,"''I,il'''--';;,,.,, .."...."i.""';(."...,... :;:i:~~i0i},~t~:{\;,':~;;::;";qA:'m~_.g~~'~t~&~~Jii'};!~~';:~K-8,,;,,~~J~,.I~.~)tk\r-.g;6(i':~}~:;;~f{;il;~~Y o Residential 0 Government I 0 Commercial "."'.''''i';J,lEiB,,Slm8:Nti.lW~l'>.fA\]Ij:C!jihi*~,r:ir:(g~wt\lll'ji~i:,;i;;j,'/::i~ Job site address: \~ \n ~ ~ "" V 0 tr City: State: ZIP: ~:t~~~~ili:~?~~r[~~ ":';':,'~:~5.~,;~f~e~l\W~i!;R~:ia')~JJ:;ktfu\i:I~,gm~.~\it':!1ii9jf Name: l'rJ~ (00..J ~n~"l'J. ^ Addres~: \:6 \ 0 ~ """ ~ ~ 0 l' City: '-'- ... .....\rJ.. State)U ZII'1. \7f ,- Phone: -\ -1.",\, ~'1 ,\,1 Fax: - . . E-mail: This installation is being made on residential or farm property owned by me or a member of my immcdiate family. This property is not intended for sale, exchange, lease, or rent. OAR 479,540(1) and 479.560(1). Signature: .. '''Y;~;,Lil',,;~\'J&~~~ifl;. ~~~ili1!l"'~I" w" ,~;~r ifu!f~,~j '~.~;;::;;-~;~~~. ..." "nl~' ", Address:, fJ I h /) t ~ ,,()J 7- Ciry:W r J- --Irv;Jh' Stare:(jyf ZIP':'! /1./"/" Phone: 1 +- 'J. 7 '- y. I Fax: -1.l U J.O ~ 7 E-mail:Jt)vvy-.,17 n45f'/{ M6nh'n"l.[ ,., CC13lieense no.: I"::' , ,II BCD licen eno.:rlt~ -'4-U' t":~_;__ ______._.'.. .. ~ 1_ _ , , ". !,'l:','V ';:~ Residential, per unit, service ind~.dc:d; 1.000 sq. fl. oeles, (4) I Each additional 500 sq. ft. or portion I thereof I Limited energy (2) ! Each manuta.cturcd home or modular i dwelling service or feeder (2) I $ 63.00 $ Services or feedt.fs: installation, altera4on, re 'ocmion 200 amps or less (2) I $ 81.00 $ 201 to 400 alnps (2) $ 95.00 $ 401 to 600IDllPS (2) I $156.00 $ 601 101,000 amp, (2) I $205.00 $ Ov<r 1,000 amps or volts (2) I $469.00 $ Reconnect only (2)' L I $ 63,00 $1 rJ -:J.. " Tc:mpora.-y .!5(!rvices Dr fceders: instCllldtion. lJ leralian, relocallon- 200 omps or less (2) I $ 63.00 $ 20110400 amp' (2) $ 87.00 $ 40110600 amps (2) I I $126.00 $ Over 600 amps or 1,000 volts. see servic~s or fe?ders sec.tion above Braneh cir<:uits: new, alteration, e.xle~i~n per bane/ a. Fcc: for braneh circuits with p~rchase olrn scr~ice Of feeder fee::: Each brllnch circuit I II $ 6.00 $ b. Fee for branch circuits without purch~ of If. ~c:rvice Of feeder fee; First branch circuit (2) I I $ 55.00 $ Eaeh additional branch circuit ! ! $ 6.00 $ Miscellaneuus fees: service or jeederl10tlincluckd , , : II $ 32.00 $