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Home My WebLink AboutPermit Electrical 2010-4-23 ,. Eleetrical Permit Application E'7.....,~; w' -~!" "::,':~ . - - \-~ ~Jl\Y"'9F SPRIN(;F~~_LP',. qREGON ~~ 225 Fifth Streett Springfield, OR 97477+ PH(541)726-3753t FAX(541)726-3689 DEPARTMENT USE ONLY [~ ~ ".M Pennit no.: (/01 ~ (lObO ~ Date: q~2s _/eJ This permit is issued uuder OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180 days of issuance or if work is snspendedfor 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION rn'Residential D Government D Commercial JOB SITE INFORMATION AND LOCATION Z- L / City: '3 . 12. . ZIP: Reference: Taxlot:O \. \. DESCRIPTION OF WORK ~/:::CV I 5 V! 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: ZlP:C?7t/ E-mail: CCB license no.: 917 l/ / Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ,,~~~ \J '6' 440-2584-J (9/08/COM) FEE SCHEDULE Number of inspections per item 0 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) { $ 81.00 $0/ . 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 volts (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 abovc Branch circuits: new, alteration, extension per panel 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 not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Sigt,lal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ APPLICANT USE (A) Enter subtotal of above fees $ 01- frv (Minimum Permit Fee $58.00) (B) Enter 12% surcbarge (.12 x [AD $ L J. .., b..__ (C) Technology Fee (5% of[AD $ '.0 r- / '> TOTAL fees and surcharges (A through C): $q~ 1 ov CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM20I0-00502 ISSUED: 04/23/2010 APPLIED: 04/23/2010 EXPIRES: 10/23/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 221 W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703274401100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Re-Wire Service Owner: HARDRE PAUL D Address: 221 W CENTENNIAL BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor LITE ELECTRIC SERVICE License 59748 . Expiration Date 08/01/2010 Phone 541-688-8996 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: #of Stories: Heighfof 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 INFORMATIO~ REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handieapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: ~tff!V.s!,wer Available: NSpeC'i!I'j:InstrucA~tL EXPIRE IF THE WORK THIS PERMIT S ERMIT IS NOT ,\~9!~[:RIZED UNDER THISOPONEO FOR . rnm f'~ ,ED OR IS ABAN ANY 180 DAY PER Type of Construction Sidewalk Type: D. 'fD'-~L'i(eS you to TION OW~SI")Uts rams. Utility ATTEN ' u, - ~ d by the Oregon follow rutes.,adoP\\hOSe rules are sat fortl'l ,,' ," .. Notification cent~~1 0 through OAR 952'OO~ ''".. ",,~',\n ~AR 952.001'obtain copies otthsrUlas. . . cal g tha centar. on Utility Notification Valu"a'tlon Oescri ti ar for lhe, or1a~OO'332-2344). Canlar IS . Square Footage or Bid Amount Description $ Per Sq Ft or multiplier Value Date Calculated Page I of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , ,.., '-'..- ~ , ~, "". '. :.Eotal 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 4/23/1 0 4/23/10 4/23/10 Total Amount Paid $94.77 I. Plan Reviews ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00502 ISSUED: 04/23/2010 APPLIED: 04/23/2010 EXPIRES: 10/23/2010 VALUE: Receipt Number 2201000000000000392 2201000000000000392 2201000000000000392 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. Reauired ,Insoections ~ ii, " ',1"'1 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, tbat I bave carefully examined the completed application and do hereby certify that all information hereon is trne and correct, and I furtber certify tbat 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 structnre without permission 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. 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 . l~'" ~. ; '!<"v l~"/ t.P ,. Page 2 of 2 Date City of Springfield Official Receipt Development Services Department Public Works Department 22~ F:ifth.Strcet Springfield, Oregon 97477 .541-726-3759 Phone RECEIPT #: 2201000000000000392 Date: 04/23/2010 9:54:51AM Paid By LITE ELECTRIC SERVICE Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 81.00 9.72 4.05 $94.77 Job/Journal Number COM2010-00502 COM20 I 0-00502 COM20 I 0-00502 Description Penn Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Payments: Type of Payme~t Check Amount Paid DJITI 7202 In Person Payment Total: $94.77 $94.77 .~_i,t::t,j . -'.". ,~-;:t~ t:~;:;) .' . r:'~'iJ' 'i<''''' "-:'~(. ~ , I" ~'~ ", ,,,.'" cReceintl Page I of I 4/23/20 I 0