HomeMy WebLinkAboutPermit Electrical 2010-3-22
, F,:lectrical Permit A
225 Fifth Streett Springfield, OR 97477. PH(541)726-3753.FAX(541)726.3689
pennitno.:c.;O r
c8/22/IO
Date:
This permitlis issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissu~nce or if work is suspended for 180 days.
Signature:
Business na~e: n~0l]~~!{f,hil!~h~~
AddressPO ho',c, ~q- ~
City W y:. J.t'r' Yv;1 f State n d ZlP(,j 74 W1
Phone: '1.. - ) T!l). I Fax: 7 LJL,'. JD Lj"'7 First branch circuit (2) $ 55.00
E-mail: f V... Y-I/l1 '(oS(J. " ./ Tel On/'hf. ()r. 7 Each additional branch circuit $ 6.00
CCB license :no.:/.~(p 4'+ l,o I BCD Jicens'e no.: ':l 0.. LJ \.). ~ Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: '-f - r.1 J S Each pump or irrigation circle (2) $ 63.00
Print name of signing superviso~ J 0 S V /Cl ~V VY-( 'lEach sign or outline lighting (2) $ 63.00
Signature of signing superviso . \ \f .,iI b'''A A A I Signal circuit or a limited~energy panel, $ 63.00
)Y\. J W'I ,\ L IV\! alteration, or extension (2)
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Zoning approval verified? 0 Yes 0 No
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o Residential I 0 Government I 0 Commercial
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Job site addrb h:-SS::> \JJJ.L'&>> 7<,5 !
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Address: \ \ i? _ \ \ C -sz6 0, C f'{ t rl--I' dr \ L
Ciq(~W rz..( \ 1 LV State:C f\ I ZIP:<::j$O-Z.0
Phone:
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).
Fax:
440.2584.) (9/08/COM)
Residential, per unit, service included:
1,000 sq. ti. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
60 I to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00
$ 95.00
$158.00
$205.00
$469.00
/ $ 63.00
$
$
$
$
$
$13,
0-0
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
20 I to 400 amps (2)
40 I to 600 amps (2)
$ 63.00 $
$ 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 ofa service or feeder fee:
Each branch circuit
$ 6.00" $
b. Fec for branch circuits without purchase ofa service or feeder fee:
$
$
$
$
$
Each additional inspection: (I) $58.00 $
-
(A) Enter subtotal of above fees
(Minimum Permit Fec $58.00)
(8) Entc" 12% surcharge (.12 x [AD
(C) Technology Fee (5% of [AD
TOTAL fees and surcharges (A through C):
$ &3
$ '1.s~
$ 3,J
$ 7:5.
(
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00349
ISSUED: 03/23/2010
APPLIED: 03/22/2010
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: 5335 DAISY ST
ASSESSOR'S PARCEL NO.: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Reconnect- #57
Owner: SANTIAGO ESTATES ASSOCIATES LLC
Address: 112il GOLD COUNTRY DR STE 100 ,,:, " .
GOLD RIVER CA 95670 '
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC
License
136446
Expiration Date
0812012011
Phone
541-747-2724
BUILDING INFORMATION_
# of Units:
Primary Occupa~cy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Consiruction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
, Range Type:'
, Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION ~
Front yard Setba~k:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Pa~ed Drive Rqd:
..y~,of Lot Coverage:
, ....~.
REQUIRED PARKING
Total:
Handicapped:
Compact:
..
I PUBLIC IMPROVEMENTS ,
A'TTENT1olf.~\'iohYJaVi requires you,to
follow rulese.>1ilij!ijGtm>J.\lil,Qregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center.. (Note:.t.he telepho~e
Center is 1-800-332-2344).
luation Descri
Street Improvements:
,
Storm Sewer Av~ilable:
Special Instruction:
Notes:
THIS PERMll ~NDER 1\-115 PERM!
AU1\-10Rl2EO OR IS ABANDONED
rnMMENCED ,," $ Per Sq F(
DesCriJltidny 180 ;r""ep\IltllUlStructioli It' I'
AN \Jf\1 or mu 'p ler
. '
" Square Footage
or Bid Amount
Value
Date Calcnlated
Page I of2
;.,,;
, i" ~ :':
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00349
ISSUED: 03/23/2010
APPLIED:, 03/22/2010
EXPIRES: 09/23/2010
VALUE:
Status
IssJed
~~"f\
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid,
Date Paid
Receipt Number
$7.56
$3.15
$63.00
3/23/10
3/23/10
3/23/10
2201000000000000270
2201000000000000270
2201000000000000270
Total Amount Paid
$73.71
Plan Reviews I
,_":",,'~' ..: .Ai.. ;..>,,',
",
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 ReQuired InsDections I
Electric Service: Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefully'examined th'e 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.
i'.
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Owner or Contractors Signature
Date
,~, ".
,,,,,
"
Pa2e 2 of 2
225 Fifth Street
Springfield,'Qregon 97477
541-726~3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000270
Date: 03/23/2010
8:07:14AM
Job/Journal Number
COM20 1 0-00349
COM20] 0-00349
COM20 I 0-00349
Paymenls:
Type of Payment
Cred itCard
cReceintl
Description
Service Reconnect
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
BURRELL BROS
ELECT/JASON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
63.00
7.56
3.15
$73.71
Amount Paid
nJITI
005690 In Person
$7371
Payment Total:
$73.71
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