HomeMy WebLinkAboutPermit Electrical 2010-5-5
225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
DEPARTMENT USE ONLY
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~ ~ fegft':o.~OI 0 - 00 sf, I
Date: '5 - ') - ( U
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 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
D Residential I D Government IIl(l'Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: $70 YY1 ,*tN' !!(;f
City: c:; p~,_ /l State: 012- I ZIP:
Reference: i 703557 J Taxlo!.: / Cc:
DESCRIPTION OF WORK
E.y-.,.,;r~,,, /-soA 1::J.rJh<ml/ ~IKLrI"T.rnA
^Ju. I [,j/f' 0- -
PROPERTY OWNER
Name: I' rn ~ C:PANfI.,0'~L../J.
Address: IIJ II~"\ 0 'tf\. -S-r
Ci~<.!-..f r\L- State: ~,)IL-I ZIP:ql~\
Phone: '-V - I Fax: - -
E-mail:
Th" II' . b . d 'd'al fa 200 amps or Icss (2) $ 63 00 $
IS msta atlOn IS emg ma e on res! en!1., lor~ . T5. property .
owned by me or a member of my imll]eqia!e ~a:Wily. rru1i:ln law re ui ewvllln~ amps (2) $ 8700 $
property is not intended for sale, excIi.~rige!'Il!ase~(!t.lfe\1td~%e .
479.540(1) and 479.560(1). . hif,uHlon Center rhos I reQW1 LltlliVlf<unps (2) $126.00 $
"I OAR 952-001' e ru s l~ . .
Signature: 0090 y,,; ,- -001 ~ through )A~S or 1,000 volls, see services or feeders sectIon abovc
CONTRACTOR INSJrJIi 'n;:'~":. ,;,upres f t IIIrwOe!ltilfuits: new, alteration, extension per panel
Business name: (11),// LJI /lJ.-I . "'t!he ~.' J"v;~;a~~fiI~~ E!f?1lDnor branch circuits with purchase ofa service or feeder fcc:
Address: c2l::5., .:;;,., A ;;. "T':nler IS 1-800-332-2, 44" Eacli"b'ranch circuit $ 6,00 $
City: ktJl-,,<;V:c State: ~ I ZIP: 97L/tJtI b. Fee for branch circuits without purchase ofa service or feeder fcc:
Phone0'i1-301- ll'id-.. I Fax:9fI-'161- a->lJ7 First branch circuit (2) t $ 55.00 S~'Y
E-mail: Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not included
APPLICANT USE
NOTICe' , (A) Entcrsubtotal ofabo~
THIS PER"MIT SHAll EXPIRE IF ""iMinimum Permit Fee~
;UTHORIZED UNDER THIS PERJ, Jl~Jr2~"surcharge(12X[AD
OMMENCED OR IS ABANDONED ..l1. ology Fee (5% of[AD
ANY 180 DAY PERIOD. 'f(h AL rees and surcharges (A through C):
CCB license no.: it/9t>"V9 I BCD license no.: dD -'-/$';;c.
Signing supervisor's license no.: L.7'R79S
Print name of signing supervisor: /f. /1-"/. ,,') "., <1J4
Signature of signing supervisor: ~ Y" (/ !/ / U.
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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 additionalSOO 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 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
60 I 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: instalJation: alteration, relocation
A
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (1)
$ /
$
$
$
$ 63,00
$ 63.00
$ 63.00
$58.00
$ ~K,
~'
f,"-
$
$
$ ..81SAJ
b7~
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00569
ISSUED: 05/05/2010
APPLIED: 05/05/2010
EXPIRES: 11/05/2010
VALUE:
~ .-(
Status
Issued
. :;' ~
SITE ADDRESS: 590 MAIN ST
ASSESSOR'S PARCEL NO.: 1703353108600
'~l! '
Springfield TYPE OF WORK: Electrical Work Ollly
TYPE OF USE: Addition
Public
PROJECT DESCRIPTION: Add circuit
Owner:
Address:
CITY OF SPRINGFIELD
150 N 4TH ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Contractor
CONRICH ELECTRIC LLC
License
149509
Expiration Date
11/02/20 II
Phone
541-607-3447
BUILDING INFORMA nON ~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary COllstruction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type. of Heat:
Water Type:
'R'~.itge'Tyji~:
on \:~;~~rl~~~
. n,eq . . p ;;iCif\h
" ,,\}3,y:ljIDE'~ Q) ATlON
! ~ . '." ". Ce\\~ e
. .....",-,1.' 0010\ 0\\ e
I,. ...il.... :~~?_IlOI' . ollies \e?non
Ir, (jh\\"~ (\\a'l o'o\aln ~1~o\i\icaliO"
009Q.. .0 \ne ce(\\el. ~g~'lIll:il~'t..w!\.Rqd:
callIng \ I \ne Ole9R~~a~R1"Rqd:,.
bel 0 . I,I)U
(\ll\11 cen\el IS % of Lot Cov~rage:
Lot Size:
Sq Ft 1st Flool':
Sq Ft 211d Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
REQUIRED PARKING
Total:
Halldicapped:
Compact:
I PUBLIC IMPROVEMENTS.
Street Improvements:
Storm Sewer Available:
SpecialIllstruction:
Sidewalk Type:
DownspoutslDrains:
Description
Tvpe of Construction
$ Per-Sq' Ft
or mulilplier
.', "',.; ;;'-",t''::: ~.~~~ }:~::j~,~,,,,
.__<,.;,11.'.-0.' .. "'O~~
.. ..; " Rt. \fi\\~'> 01
VaIJ'a'tiOlfhe~c1\l t~ D U\',\DE~ 1~~~DO~t.D fO~
.,' .. ~~ OR \5 r>: .
,.., ~~~-E\1~ER\OD. Vallie Date Calculated
Notes:
Paee I of 2
Status
Issued
225 Fifth Street, Springfield, 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
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid';":'(
>,:.,'\:.iit:
I':
, ' Date Paid
$6.96,',' '.
...,....
$2.90..
$55.00
$3.00
Total Amount Paid
$67.86
Plan Reviews ~
5/5/10
5/5/10
5/5/10
5/5/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00569
ISSUED: 05/05/2010
APPLIED: 05/05/2010
EXPIRES: 11105/2010
VALUE:
Receipt Number
2201000000000000464
2201000000000000464
2201000000000000464
2201000000000000464
To Request an inspection call the 24 hour;r~cl!rding 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.
L Reouired Insoections ~
Rougb Electric: Prior to Cover
Final Electric: When all electrical work is complete,
:~:~'~i:; .. '-", . :-
By signature, 1 state and agree, that 1 have carefulWfex'amined' 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 tbe 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 conto'actors and employees who are in compliance with ORS 701.005 will be used ou 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 anhe front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
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Page 2 of2
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Date
225..Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
22010Q0000000000464
Date: 05/05/2010
11:56:0IAM
Job/Journal Number
COM20 I 0-00569
COM20 I 0-00569
COM20 I 0-00569
COM20 I 0-00569
Payments:
Type of Payment
Check
cReceinll
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
55.00
3.00
6.96
2.90
$67.86
Paid By
CONRICH ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number 'Number How Received
Amount Paid
djb
In Person
Payment Total:
$67.86
$67.86
3533
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