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Home My WebLink AboutPermit Electrical 2010-4-28 n . :. Electrical Permit Application 225 Fifth Street+Springfield, OR 97477+PH(S41)726-J753+FAX(541)726--3689 DEPARTMENT USE ONLY CO","" "Z.:l' c) '00 52 Permit no.: " 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 ISO'days. lOCAL GOVERNMENT APPROVAL Zoning approval verified? DYes D No CATEGORY OF CONSTRUCTION o Residential Commercial o Government ZIP:t:!7fj77 sJfU G' E-mail: This installation is being made on residential or limn property owned by me or a member of my immediate famiJy" This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR INSTALLATION Business name: AOT Security Address: 2815 S W 153 rd Ii r City: 97006 Beaverton Phone: 503 -4 6 9 -7 2 06 E-mail: spate@adt.com CCB license no.: 59944 CD license no.: 26 -20 9 C L E 389LEA Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor" Ken Kraus 220 uires yOU \0 '\11 , \~~: oregjJ~,I~W req e on Utili\y /{ 51 r t IS a I- ~TW,\ ~fus aOo~~~~~e set torth 't'o\(~w tl@~ nter. ThOse AR 952-001 L-/t; {,o,<- S'11',eW:Ml'ca~~~1~~ttherU\esb fi ...{~ In ~~R ~ou may obtain ~~fe~~h~ te\ephO~e ~ ~ ~'( -. 00 caliing the cen~~~cion Utility NOtit~~n t\~~\\ numberlorthe, 1.800-332-2344)/);..a '0 . center IS ~. 0#0,(' ~ ~ V" ..}-A 440-2584-J(9/08/COM) J~.fA,l /!J .f'7/g' /(,9</ 7J'0~ J.eet' c~ ~ J; 7/f .2.~9f/ 11$ 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, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I (0 400 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 $ 201 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 panel a Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit I $ 6.00 I $ 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 cjrcle (2) $ 63,00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, I $ 63.00 $ '-1 alteration, or extension (2) Each additional inspection: (1) $58.00 $ APPLICANT USE . (A) Enter subtolal of above fees $ 63.00 ~ (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [Al) $ 7.56 (C) Technology Fee (5% af[A]) $ 3.15 TOTAL fees aud surcharges (A through C): $ 73.71 . :";'M.+~~~~~ ~?:~1';:i;%..!!,. NOTICE. ,rjij THIS PERMIT SHALL EXPIRE IF THE WORK 4: AUTHORIZED UNDER THIS PERMIT IS NOT Dj, COMMENCED OR IS ABANDONED FOR AY:1;r~' ANY 180 0 ^V PERIOD .;, ".,..~)",.".S1;;1':;fj' 1"\1 . .,i"~';p.."';bl'C,,-..,,,.Flil,.,,::,',t....',,,,-.:"."'- ; ~',:,\;s"\ 'd,~,,<.' ".,.~," '..~ :~.~'";:,:-:. . ."" Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1406 Mohawk Blvd ASSESSOR'S PARCEL NO.: 1703253310004 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00526 ISSUED: 04/28/2010 APPLIED: 04/28/2010 EXPIRES: 10/28/2010 VALUE: Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Low volt for alarm system Owner: JAMES M BROWN REVOCABLE TRUST Address: 1406 MOHAWK BLVD 175 SPRINGFIELD OR 97477 TYPE OF USE: New Commercial I CONTRACTOR INFORMATION ~ Contractor Type Low Voltage Electrical Contractor ADT SECURITY SERVICES INC BUILDING INFORMATION ~ # of Units: Primary Occnpancy 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: I DEVELOPMENT INFORMATION ~ Frontyard Set hack: Side 1 Sethack: Side 2 Sethack: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: ATTENTION 0 J PU~LJC IMI!ROVE~ :. r J -T---:'-' follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001. 0090. You may obtain copies ofthe rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Notes: I Valuation Description ~ Description' $ PerSqFt . or multiplier Square Footage or Bid Amount Type of Construction Pa~e 1 ofl License 59944 Expiration Date 05/07/2011 Phone 541-736-4973 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: NOTICE' . . "",;;t'ji;i;',j,'iMff;i/i,'ii,il:c-, , THIS PERMIT SHAll EXPIRE IF THE WOR AUTHORIZED UNDER THIS PERMIT IS NO COM ANY 180 DAY PERIOD. Value Date Calculated -~~'~ CITY OF SPRINGFIELD ., .. 11 'C:'>--~;_. - "'. Building/Combination Permit . ;:.. ',.'" ___. _ _ _~~"_H~",,_~" -""~_".li Status Iss u ed PERMIT NO: COM2010-00526 225 Fifth Street, Springfield, OR ISSUED: 04/28/2010 541-726-3753 Phone APPLIED: 04/28/2010 541-726-3676 Fax EXPIRES: 10/28/2010 541-726-3769 Inspection Line VALUE: Total Value of Project LFees Paid.l Fee Description Amonnt Paid Date Paid Receipt Numher + 12% State Surcharge $7.56 4/28/10 2201000000000000424 + 5% Technology Fee $3.15 , 4/28/10 2201000000000000424 Traffic Signal - Panel $63.00 4/28/10 2201000000000000424 Total Amount Paid $73.71 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 Reouired Insnections ~ Low V ollage: Prior to cover. By signature, I 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 structure without permission ofthe 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. Owner or Contractors Signature Date Paee 2 of2 _.~ 225. Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000424 Date: 04/28/2010 3: 11 :43PM Job/Journal Number COM2010-00526 COM20 1 0-00526 COM20 1 0-00526 Payments: Type of Payment Check cReceintl Description Traffic Signal - Panel + 12% State Surcharge + 5% Technology Fee Paid By ADT Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 63.00 7.56 3.15 $73.71 Amount Paid DJB 3242523 In Person Payment Total: $73.71 $73.71 : l. ~ Page 1 of 1 4/28/2010