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Home My WebLink AboutPermit Electrical 2010-4-29 .~~ 225 Fifth Street+Springfield, OR 97477+PH(541)726-37S3+ FAX(541)726-3689 " DEPARTMENT USE ONLY , Permit no.: (!//t) - S;;)7 ~" ;J;Cl--/O Date: 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 C'ONSTRUCTION ZIP:97 '-17 Taxlot.:O OF WORK Name: PROPERTY OWNER (: City: Phone:5~ 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 f19.560(l). /J Signature: (Co ~ r c7H.~.~'~ CONTRACTOR INSTALLATION Business name: N~ Address: City: Phone: E-mail: Sign' g"Sllpervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: .~ ~#~'t ~,D f>...?9~-rv ~ '\ 440-2584-J (9/08/COM) FEE S'CHEDULE Number of inspections per ite~ 0 Qty. Cost Total ea. cost Residential, per unit, service included: 1,000 sq. n. or \ess (4) $134.00 $ Each additional 5.00 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufaclured home or modular $ $ dwelling service or feeder (2) 63.00 Services or feeders: installation, alteration, relocation 200 amps or less (2) I $ 81.00 $;-1. 0-- 20110400 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 fceder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or fceder 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) ]:ach additional inspection: (I) $58.00 $ APPLICANT USE '(A) Enter subtotal of above fees $lfj. rV (Minimum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) $ ~/r, /- (C) Technology Fee (5.% of[A]) $ 4..()i TOTAL fees and surcharges (A through C): $'14f- "7 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00527 ISSUED: 04/29/2010 APPLIED: 04/29/2010 EXPIRES: 10/29/2010 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 346 24TH ST ASSESSOR'S PARCEL NO.: 1703361408900 Springlield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: 200 AMP Panel Owner: PORATH ROBIN SUE Address: 346 N 24TH ST SPRINGFIELD OR 97477 iLl." 'J" I .. , .~ , ;l I CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I NOTICE: -"- # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy,Group: Primary Construction Type Secondary Construction Type: '# of Bedrooms: nla Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: "110 ,... AUTHO (1), ,Hl'iI'FO ON, COMMENCED I IS PERMIT IS NOT ANY 180 DAY ~~I~~\f)ONED FOR 1I,!:tJwut.Trees Rqd: Paved Drive Rqd: "~. '~f Lot Coverage: . REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS ~ , Sidewalk Type: ATTENTION: Oregon law reqUlre~ you to follow rules adopted by the OregorDowilJPouts/Drains: Notification Center. Those, rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by in the center. Note: the telephone Notes: " V alu/i:lilo\erD~s Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of2 r";' jt:l;: ",.l ')'\0'1' ,I I 11 ~ h i! -.,:~I! . . " , ,. . ~ ., Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line i', Total Value of Project .I . Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid $9.72 $4.05 $81.00 Total Amount Paid $94.77 ,," Plan Re\;iews ~ ,;;.",' Date Paid 4/29/10 4/29/10 4/29/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00527 ISSUED: 04/29/2010 APPLIED: 04/29/2010 EXPIRES: 10/29/2010 VALUE: Receipt Number 3201000000000000171 3201000000000000171 3201000000000000171 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 Insoec~ Electric Service: Approval required prior to uti'Iity" com1p'a'ny energizing service. 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 sh'all' 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 of the 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. '.'~''''''''';<':''''''''~ ~", -TT"l -'."~;\;' !Z&~ 5/ pO~:~r" '. ., Owner or Contractors Signature "",.' Page 2 of 2 cf /;;29// , o Date 225 Fifth Street Spdngfi~ld, Oregon 97477 541-726-3759 Phone 8~ ..,"!<!".'."_.LO ii........ "i... Iri.r' -.el'... , , ., ,,- c. ~ .~_....-:c " -""",,,,,,-,,""-"~".-~ ..- City of Springfield Official Receipt Development Services Department Pnblic Works Department RECEIPT #: 3201000000000000171 Datc: 04/29/2010 IO:38:20AM Job/Journal Number COM20 I 0-00527 COM20 I 0-00527 COM20 I 0-00527 Payments: Type of Payment Cash Change Oescription Penn Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Paid By ROBIN SUE PORATH ROBIN SUE PORTH Amount Due 81.00 9,72 4,05 $94.77 Item Total: Check Number AuthorizlItion Received By Batch Number Number How Received nJm njm Amount Paid In Person In Person Payment Total: $95,00 ($0,23) $94.77 Job/Journal Number COM20 I 0-00527 COM20 I 0-00527 COM2010-00527 Payments: Type of Payment Cash Change , cReceintl Description Penn Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Paid By ROBIN SUE PORATH ROBIN SUE PORTH ", , " Received By njm njm , , , Page 1 of I ,~ .~" (Sheck Number Batch Number ; , " Item Total: Authorization Number How Received Amount Due 81.00 9,72 4,05 $94.77 Amount Paid In Person In Person Payment Total: $95.00 ($0.23) $94.77 4/29/20 I 0