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HomeMy WebLinkAboutPermit Electrical 2010-3-24 225 Fifth Street. Springfield, OR 9747HPH(541)726-375HFAX(541)726-3689 ...DEP~RTMENT USE ONLY \\). €fip ~L\. tD 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. i,'",'r",;, .!..-, Name: S\.lt'\ Address: '2,ClC> City:Sc:. Q..~ Phone: 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). zIP:Cl1 "30 Signature: Business name: Go f"'\ E-mail: CCB license no.) 2 '727 Signing supervisor's license no,; Print name of signing supervisor: V"l~ Signature of signing supervisor: ~ ~~~ ~ ,\\j'Y:. ~~.,o I~~~~ ~ ~b~~~ '(~~~X-~ . ~ CO~~ Sv'(- -<.; ~~\j . . ~,t~~\}~ ~~\j \'0 ~~ ~~ S '(~ ~X-~ \) \)'(- ~\)'V. ,\'0\ ~'0IJ'?:' ~,,~ ;:\ '(~ \>~ ~~~ ~ 'V~ ~~ .1 <0 '.\" 440-2584-J (9/08lCOM) ;;";~""";;1.h;~;';~::ry:J~~,\'/;<~~~:t{~~f1f~'I:.E-E'~~;,SCH E_DVLJef(\~%fiT&;:tfrq;J:~}k{!,;'i\;~~~~J;;t!? N~m~~r ?fiPSP~<:tilli~p~rit~~() . ~~~~ . 1~W. Residential, per unit, service included: 1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) 20 I to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) Over \,000 amps or volts (2) Reconnect only (2) $ 81.00 $ $ 95.00 $ $158.00 $ $205.00 $ $469.00 $ $ 63.00 $ Temporary services or feeders:. installation. alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to.400 amps (2) $ 87.00 $ 40 \ to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel Fee ~or branch circuits whh 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) Each additional branch circuit \ . $ 55.00 $ $ 6.00 $ Miscellaneous fees: service or feeder ~ot included Each pump or irrigation circle (2) J,-.., Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00356 ISSUED: 03/24/2010 APPLIED: 03/24/2010 EXPIRES: 09/24/2010 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 770 HARLOW RD APT 204 ASSESSOR'S PARCEL NO.: 1703223402800 Springlield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION: Remodel- AddlAlterlExtend 2 electrical Circnits Commercial Owner: Address: SUN RETIREMENT CORPORATION 200 HAWTHORNE AVE SE A-140 SALEM OR 97301 . ' ,.1;(, '" t "~.' I CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor License COMPLETE ELECTRICAL INSTALLATION 184274 BUILDING INFORMATION ~ Expiration Date 1011412010 Phone 541-225-7827 # 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: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION ~ Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: , % of Loi ~overage: , . "'~~ ..l ,:" REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I ~ aluation Description ~ Description Type of Construction $ Per Sq Ft or multiplier , Square Footage or Bid Amount Value Date Calculated " . Page I of 2 .~.' '" j,! .., CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00356 ISSUED: - 03/24/2010 APPLIED: 03/24/2010 EXPIRES: 09/24/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ," , '- Total Valne of Project I Fees Paid ~ ... Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend C;rc Ea Add Penalty Fee - BWOP Electrical Amount Paid Date Paid Receipt Nnmber $14.64 3/24/10 2201000000000000275 , $6.10 3/24/l 0 2201000000000000275 $55.00 3/24/10 2201000000000000275 $6.00 3/24/10 2201000000000000275 $61.00 3/24/10 2201000000000000275 Total Amount Paid $142.74 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. ReQuired Insoections ~ Rough Electric: Prior to Cover Final Electric: When all electrical work is 'co'mplete. 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 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 furtber agree to ensure that all required inspections ~re req~ested at tbe proper time, that each address is readable from the street, that the permit card is located at the front Of the propehy, and the approved set of plans will remain on the site at all t. d' t' " , Imes urlng cons ructlOn. , "..,;. :....,"'. ," , Owner or Contractors Signature Date Page 2 of 2 a~~!;Oiii, ~.,. City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield. Oregon 97477 541-726-3759 Phone RECEIPT #: 12:41:4IPM 2201000000000000275 Date: 03/24/2010 Job/Journal Number COM20 I 0-00356 COM20 I 0-00356 COM20 I 0-00356 COM20 1 0-00356 COM20 1 0-00356 Payments: Type of Payment Check cReceintl Description Add, Alter, Extend Circ Add, Aller, Extend Circ Ea Add. Penalty Fee - BWOP Electrical. '.'. + 12% State Surcharge + 5% Technology Fee -~,. . Amount Due 55.00 6.00 61.00 14.64 6.10 $142.74 '. Paid By RICHARD OLSON Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 1043 In Person Payment Total: $142.74 $]42.74 Amount Paid . ~ . ';,f ,'" J' . :~..r. ,.. , : . ,j ~~' Page 1 of I 3/24/20 I 0