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Home My WebLink AboutPermit Electrical 2010-4-16 " Electrical Permit Application . r_ .','," _' I D,..,.., '_,~! , . D , " 225 Fifth Streett Springfield, ~R 97477tPH(S41)726-3753+FAX(541)726-3689 ~ DEPARTMENT USE ONLY Pennitno.: ~ 'i}-Lj12 10 Date: This permit is issued uuder OAR 918-309-0000. Permits are noutrausferable. Permits expire if work is uot started withiu 180 days of issuauce or if work is suspended for 180 days. lOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION D Residential D Government D Commercial JOB SITE INFORMATION AND lOCATION Job site address: "2'100 D ;; r- City: State:tJ1L- Taxlot.: \ DESCRIPTION OF WORK cS132-v'IL--E f2fTr'"L?-- rrcp,--, PROPERTY OWNER Name: 'c7Je--/C /'M1/..-LC7L- '100 D .5r City: -p/= l- \) ZIP: 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). Signature: CONTRACTOR INSTAllATION Business name: Si8J9tJ$ t'=Lec.TIf:.\ Q. Address: FO '&:y( Gb> city:fLt'f'\SAtJI itlLL ZIP:'f74S""S- Phone: 0/1-1 91;). -!l-6S'O Fax9'j)- 7-'+1'0 - 0 '(;(;Z E-mail: -F"'9 fG2;J WI"" @!) IM5/U, e'O!"" CCB license no.: '15'+72... BCD license no.,,)p~3!'3 C Signing supervisor's license no.: 4o'14~ 5 Print name of signing supervisor: 6(eOer--l 6B (SlG"Z- Signature of sig':ling supervisor: .~X \'0~ rv"rJ' ~. \5:! V o..:."Q ~.~ ~~ 440.2584.J (9/08/COM) FEE SCHEDULE Number of inspections per iter? () 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 feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) f $ 81.00 $ ~( 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over t ,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps Of 1,000 volts, see services or fe<;dcrs section above Branch circuits: new, qlteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b. Fcc 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 not 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 $ APPLICANT USE (A) Enter subtotal of above fees $ 6'[ ~::. (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [AD $ 173=. (e) Technology Fee (5% of[A]) $ L{ OS TOTAL fees and surcharges (A through C): $ q'-( ~ CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00472 ISSUED: 04/16/2010 APPLIED: 04/1612010 EXPIRES: 10/16/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS:, 2400 D ST ASSESSOR'S PARCEL NO.: 1703361413300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service panel change",:,,;', f: Owner: POOLING & SERVICING AGREEMT Address: 2141 5TH AVE SAN DIEGO CA 92101 --j~..,- ,.. Contractor Type Electrical I CONTRACTOR INFORMATION ~ , , uireS 'IOU ,to Contractor N' oregO('l laW re~~ Ut\'~iration Date STEVEN GEISLER II,TlE-NIIO . dopted b'l tll i's2are set Ion _ 11/23/2010 , tile rules by In O~ a:~obtaiO c . tile telep\lOOe 009al al@cW, 'oter, tNote, 'I'W Notilicatlotot Size: celY1fI~I~&f 1e1(l}lot)ll" Ut~_Z344). Sq Ft 1 st Floor: nu~ P1\'lJtlls 1-800-33 ,Sq Ft 2nd Floor: Wate 'type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occnpant Load: Phone 541-726-0618 # of Units: Primary Occnpancy Gronp: Secondary Occnpancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION ~ f "0" lay Dist: IF 1\'1E. 'NOR\\ M01h~t:~~I,:rr~~~<\..dE.)(?IRE. \:W>J\II IS t->\01 1H\9''ilffil'i:nivl~~I!.R ,HIS? 0 FOR J1,U T'i'VjJ'1, 'iZ&tQ:\lOf,n!;e~B J1,N 0 0 N E. COMME.NC~S RIOO. REQUIRED PARKING Total: Handicapped: Compact: ~, , PUBtlC IMPROVEMENTS Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description ~ Description Type oIConstruction $ Per Sq Ft or mnltiplier Square Footage or Bid Amount Value Date Calculated 'Page I of 2 l"!'A" . '1~' " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20JO-00472 ISSUED: 04/16/2010 APPLIED: 04/16/2010 EXPIRES: 10/16/2010 VALUE: j'".,lr ,C,) J\P', , Status Iss u ed 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value,of Project Fees Paid . Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $9.72 $4.05 $81.00 4/16/10 4/16/10 4/16/10 2201000000000000367 2201000000000000367 2201000000000000367 Total Amount Paid $94.77': ,:iii 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. I Reauired Inspections ~ , Electric Service: Approval required prior t,,"utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that 1 have carefully examiued 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 Ordiuances ofthe City of Springtield aud the Laws of the Stateof Oregon pertaining to the work described berein, aud that NO OCCUPANCY will be made of any structu~e:Witho~'ipermission of the Community Services Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 further agree to ensure that all required iuspections' aj'e 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. ~~~ 1~\b-l() Owner or Contractors Signature Date Pa2e 2 of2 1.25 Fifth Street Springfield, ~regon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000367 Date: 04/16/2010 II :43:33AM Job/Journal Number COM2010-00472 COM2010-00472 COM20 I 0-00472 Paid By STEVENS ELECTRIC Item Total: , Check Number Authorization Received By Batch Number Number How Received cJc 320 I In Person Payment Total: Amount Due 81.00 9.72 4.05 $94.77 Description Perm Serv/Fdr 200 amps or less + 12% St~te Surcharge + 5% Technology Fee Payments: Type of Payment Check Amount Paid $94.77 $94.77 , ,..,;. p~..,,_. ~,. , ". . ., ~; " cReceintl Page I of I 4116/20 I 0