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Home My WebLink AboutPermit Electrical 2010-3-1 Electrical Permit Application 225 Fifth Street. Springfield, OR 9747HPH(541)726-3753HAX(541)726-3689 ... . ...., ,----".. ,'q, "DEPAihniiENT US'EONLY Permit no.: '0 ,...Q)S ( Date: cZ1 s-o/~ /0 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; ""',,' :'''L!0CAL;GOVERNMENT;'Af1F'R0YAlf!:'i\~,({!tj!,>;;~ Zoning approval verified? g-yes 0 No fJ"~f;!,;u/;'i,iCATEGOR:Y&'0F,'i'C()NSl'RUCTION%;+". .,..... Q-itOsidential 0 Government 0 Commercial ~~itOB.@:SI;[E~INF,;QRMA:tI()Ni7AN[j!'\1I0.cAi!I()N~~~';;~1'1 Job site address: /<./ L 7t- City: Reference: PROPERTY 'OWNER L r'tVl S+ Name: 'D ,^i/l..A-. Address: i 'flY, L-. City. S '",- Phone: OiL 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. .'.,CONTRACTOR INSTALl.AnON: "" Business name: ~ Address: ZIP: <i'7<vz. t6iJo "J. Ifn LX- City: Phone: :5'-tt E-mail. CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor:, 'u: - ~~~. ~ \\}~.\ ~ ~~ ':P ;~ 440-2584-) (9/OS/COM) ~ 7 ,~um~er.?Lin;p.e:~p~rit~in'()~;~.~~~r' ':. Totoil ,., cost. "". ::.,' "". ,.,','.' " .c.;r,....,. ,_! ..,i,~; ........,; ._'...... ,.)1". ,_.,'.' '- ".__ "'C Residential, per unit, service included: 1,000 sq. ft. 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) / $ 81.00 $ BI.o( 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2), $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or voits (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 20 I to 400 amps (2) $ 87.00 $ 401 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 pane! 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 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder l}-ot included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ ;~~(<,';{~~1tl~~,-;-;~';;;'!i~;+~ij.f~KWAR P,'hICANJ:+"StJ5'E%ii:i"2,'-!~"~1'~;:'~~;;;j'::'F';~1<t'.,1?", .:' ;l1",~;,,\,;;;??~~".':!;,:..'f:~,t:;~:r...\~;_ -'e"' .' ." . . .~"f;.... '. ?n::rL;:IJ>j:\;e{'hr'~:?Jt.~<,;:t' ~;;; (A) Enter subtotal of above fees $cf / <5 ~ (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ 9,7 2- (C) Technology Fee (5% of [A]) $ '7.0 TOTAL rees and surcharges (A through C): $ 9<7'- r ~ 7 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20I0-00259 ISSUED: 03/0112010 APPLIED: 03/0112010 EXPIRES: 09/0112010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1426 L ST ASSESSOR'S PARCEL NO,: 1703253305200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace service Owner: LANGE DEANNA R Address: 1426 L ST . SPRINGFIELD OR 97477 . Contractor Type Electrical I CONTRACTOR INFORMATION . Contractor License ENERGY DESIGN CO 161672 BUILDING INFORMATION ~ Expiration Date f 0/05/20 I 0 Phone 800200-2372 # of Units: Primary Occnpancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bed rooms: #.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: Occupant Load: n/a I DEVELOPMENT INFORMATION ~ REQUIRED PARKING Frontyard Sethack: Side I Sethack: Side 2 Sethack: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: I PUBLIC IMPROVEMENTS ~ n.' S\ 18.U(0)8o.\l.lnu '1~~OOO 81.\. 10\ 111110 '~am YP'€:810 081.\. OU,. 00 :;;-., ~.\\,\r :\ ')8W8 nO).. 06 UOI'\'9010\'\ Qllv;,'.1ll\9~'iJ\W\o f.,'9\l.l 6 'd'</O uI eUO\.l ~\os8i.OO \.I,O\OO-\OO-~~\.'ElO\\\'O\'l IA selO) a ~O \.IOnOl I.\l 'le\UaO lOA tjl.0110\ .\oo-~S6 ~'9l1all\A es~o. pe\dOP~~~uN3U.'4 ~O\ \lls 06e10 el.\\ uooa10 ." ci\i\OI-ee I '.'_,': Storm Se'ftt}'Ff~~!,le: Speciallnml'St~~RMIT SHALL EXPIRE IF THE WORK Notes: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDO';'" IVY PERIOD. I Valuation Description ~ Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I 01'2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line " ',Total Value of Project I Fees Paid . Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $9.72 $4.05 $81.00 3/1110 3/1110 3/1110 Total Amount Paid $94.77 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00259 ISSUED: 03/01/2010 APPLIED: 03/01/2010 EXPIRES: 09/01/2010 VALUE: Receipt Number 2201000000000000183 2201000000000000183 2201000000000000183 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 InsDedions I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that I 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 wiII 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 d:: il"r j.. Paee 2 of 2 Date City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 54]-726-3759 Phone RECE]PT #: 2201000000000000]83 Date: 03/01/2010 1:56:15PM Job/Journal Number COM20 I 0-00259 COM2010-00259 COM20 I 0-00259 Payments: Type of Payment Cash Change Description Penn Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Amount Due 81.00 9.72 4.05 $94.77 Paid By ENERGY DESIGN ENERGY DESIGN Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid njm njm I n Person In Person Payment Total: $100.00 ($5.23) $94.77 Job/Jol:lrnal Number COM20 I 0-00259 COM20 I 0-00259 COM20 I 0-00259 Payments: Type of Payment Cash Change cReceintl Description Penn Serv/Fdr 200 amps or less. + 12% State Surcharge + 5% Technology Fee Amount Due 81.00 9.72 4.05 $94.77 Paid By ENERGY DESIGN ENERGY DESIGN Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid In Person In Person Payment Total: $100.00 ($5.23) $94.77 nJm nJm .,;... 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