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Home My WebLink AboutPermit Electrical 2010-4-7 Electrical Permit Application I ~<ID[1~m~<ID~ 225 Fiftb Strer:ttSpringfield, OR 97477.PH(S41)726~375J.FAX(54t)726-3689 DEPARTMENT USE ONLY I~. ~ ow Pennit no.LIO / 6Co Date: )0-- This permit is issued uuder 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION D Government D Commercial JOB SITE INFORMATION AND LOCATION This installation is being made on residential or farm property owned by me or a member afmy immediate family. This property is not int~J1:ded for sale, exchange, lease, or rent. OAR 479.540(1) and 41Q.560(I). Signature: CONTRACTOR INSTALLATION Business name: - Address: City: CCB Signing supervisor's license no.: Print name of signing supervisor:r"'Y'\L Signature of signing supervisor: .~~~ 'Y~~ \})'V'V~ ~~~ ~ 440-2584-) (9!08/COM) FEE SCHEDULE Number of inspections per item () Qty. Cost Total ea. cost 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 fceder (2) Services or feeders: installation, alJeration, relocation 200 amps or less (2) ; $ 81.00 $ -II) 20 I 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 volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary scn-ices or feeders: instal/alion, 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 I,OOO 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 I $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First hranch circuit (2) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a Iimited.energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ APPLICANT USE (A) Enter subtotal of above fees $ cl5 -0 (~nimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of[A]) $ .~ TOTAL fees and surcharges (A through C): $ LfI.L./ -;- I I 7 , '; CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00369 ISSUED: 03/26/2010 APPLIED: 03/26/2010 EXPIRES: 09/26/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2155 LAURA ST ASSESSOR'S PARCEL NO.: 1703271101800 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: New service and one feeder for residence. Owner: VINCENT DONALD R & ISABELLE Address: PO BOX 1443 SPRINGFIELD OR 97477 I CON'rRA0T0R INFORMA TlON . Contractor Type Electrical Contractor License GMD ELECTRIC INC 162191 BUILDING INFORMATION I Expiration Date 11/1912010 Phone 541-726-8601 # 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 Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENTlNFORMATlON I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: ..... ....' . Storm Sewer Available: ,. . "Speciallnstruction: .;. Notes: NOTICE: THIS PERMIT SHAll flU I HOUNDER THIS PER~,lIl_f'JnT ~ 0WV1ENCED OR IS ABANDONE/:l.Utit'alion Description I ""^n nlJ.,Y PERIOD ,.' '. $ Per Sq Ft .' Square Footage DescriptIOn Type of ConstructIOn I ' I' B'd A or mu tip lef Of I mount .. , . _. I I I. 1:;> a I PUBLIC-IMPROVEMENTS ~OllOW rules adopted by the Oregon Utility , otifi~liA\Ja~iR\;l;~:Those rules are set forth In OAFnJS:2-051:Ml 0 through OAR 952-001- 0090.~~Q)Opies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notificallon Center is 1-800-332-2344). Street Improvements: Value Date Calculated Pa2e I of 2 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,,,.ll:~': ',)ii' .. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00369 ISSUED: 03/26/2010 APPLIED: 03/26/2010 EXPIRES: 09/26/2010 VALUE: Status Issued . ,...~. ';P"'/ J:'-,'''.; . .' Total Value of Project LFees Paid A Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amonnt Paid Date Paid Receipt Number $9.72 3/26/10 1201000000000000263 $4.05 3/26/10 1201000000000000263 $81.00 3/26/10 1201000000000000263 $9.72 4/8/10 2201000000000000336 $4.05 4/8/10 2201000000000000336 $81.00 4/8/10 2201000000000000336 Total Amount Paid $189.54 Ipi-~nRe;'iews 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. I Reouired InsDections I Electric Service: Approval reqnired prior to ntility company energizing service. 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 will be made of any strnctnre withont permission of the Community Services Division, Bnilding Safety. I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed 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 'it,~': :~~.; l' .',~~l;c'" Ii, .,,,,". Owner or Contractors Signatnre Date Pa2e 2 01"2 225 Fifth Street Springfield, Oregon 97477 54]-726-3759 Phone ii~ City of Springfield Official Receipt Development Services Department Public Works Department RECE]PT #: 220]000000000000336 Date: 04/08/20]0 I:S4:32PM Job/Journal Number COM20 I 0-00369 COM20 I 0-00369 COM20 I 0-00369 Description Penn Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment CreditCard Paid By Item Total: Check Number Authorization Recei\.'ed By Batch Number Number How Received Amount Due 81.00 9.72 4.05 $94.77 Amount Paid GMD ELECTRIC/SUE GOWINS NJM 024595 Phone Payment Total: $94.77 $94.77 "- ~"I,;?~" "J. . ~.f:.t -..... ,Ki\'~ :~~\ 'l" '. ~ '.d , '~r .' .';\ ;"1 ; cRcceintl Page I of I 4/8/2010 GT\1D Electric Inc. We D" illite Belle, Way PO Box 72206 Eugene, OR 97401 Phone: 541-741-7369 Fax: 541-988-1800 I:mall: amdtlllamdelectric.com CCB: 162191 FAX COVER SHEET TO: Nancy Machado City of Springfield FROM: Mike Gowins FAX: 541 726-3689 PAGES: 2 RE: Elec Permit # COM2010-00369 2155 Laura Street DATE: 04/07/10 Hi: We need to add onto our current permit - neglected to add a feeder. So sorry for any inconvenience. Thanks so much. Sue@ 1d WdB1:~0 010c L0 .~d~ 00B1BB61vS: .ON X~~ J[~lJ3l3 aW8: WO~~