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Home My WebLink AboutPermit Electrical 2010-5-4 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 DEPARTMENT USE ONLY ....... CO<N\ ZOIO -00 SS, PenTIlt no.: Eiecfrical Permit Application . ." "'."" -, ",... ~'" . J. 3: '~. _""'M. '<f"; "_" ~.::.A'';C''V CITY OF SPRINGFIELD; OREGON;~ . -... 1 ' ~. . _ '. DateS- L( -I r--- This permit is issued under OAR 918-309-0000. Permits are nonlransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ~ " '. . 'L:OCAl:: GOVERtIIMENPAI'.PROVAl';.,'c.... c';01iY,;"! ~ .F.o..,;f't;:(~f:~~1i~kt~..::jhFEE...SCH E__D.Ut;E[*r:.~~.~~;;i:0}:if:;1o~'~~~:~W Zoning approval verified? DYes DNo . N u ~ ~er ~Iinspe~ti~?~ pr~itei.;\)' ,;.1 Q~y, Cost Total j"'ea:, cost. I ::'..,~- .' .:CATEGORY,OI' ;CONSTRUCTION';~: .' .. '. . .. Residential, per unit, service included: o Residential I 0 Government 'i-Q'Commereial ~t~E:ldOB;\SITE;:INFORMATIONrMD~iLO.CATrION'i!'~>?~{i! 1,000 sq. ft. or less (4) $134.00 $ Job site adclress770 ~q(\o"'" ~)~ ",,',f3'- \)S? { Each additional 500 sq. ft. or portion $ 25.00 $ thereof City: ~r.>1 " 'i\ ,,~', e\d-- I State: ~~ ZIP: Limited energy (2) $ 32.00 $ Reference: /7Di 22 <:: l/ I Taxlot.:02S'DC> Each manufactured home or modular $ 63.00 $ .,. " DESCRIPTION: OF .wORK";";';'~"""1Y;;';;"" dwelling serVice or feeder (2) c.l-.a I\"'~ ~ c.:;;N Oe.. ;-,-e.(.. Services. or feeders: installation, alteration, relocation WC,,'.l" \\~~~"o... " : (<:j.A I'l-- 200 amps or less (2) $ 81.00 $ 'PROP ;!:tTY OWNER 20 I to 400 amps (2) $ 95.00 $ Name: ~'^- ~~ ~"'t~+ (cJ"Lu 40 I to 600 amps (2) $158.00 $ Address: Zo c> 1-I,4.t.lTrW4lcr -Aver 5t:- t't-Ic( 60 I to 1,000 amps (2) $205.00 $ City: ~L-f:-><A. I State: oL- ZIP:77JO ( Over 1,000 amps or volts (2) ---" $469.00 $ Phone: - - I Fax: - - Reconnect only (2) $ 63.00 $ E-mail: Temporary services nr ~~ Wlstallation, alteration, relocation This installation is being made on residential or fann pro#lllryEN I ot :zQrQQ legon UtII1tV_ $ 63.00 $ owned by me or a member of my immediate family. Thi'40lloW ru ~ r,; 4fliI~~ ~ .:.;.. $ 87.00 $ property is not intended for sale, exchange, lease, or ren~atl 479.540(1) and 479.560(1). \nOARll! i___GhAnI\eIlbf $126.00 $ Signature: 0090. Yo ~ ~ ~ices or feeders section above . ; CONTRACTOR INSTAllATION ,,'~ f 'lIi'lI'(lIIegaJlt ation, extension per panel . Business name: c:::.'tl-D\e~ i1.-t'\ l:Y){f c.'\ iCl nter...-fl>1 Dlauc1rclrcults w~ih purchase ofa service or feeder fee: Address:S 362'--' Co~..., < ...",.,._\"" Q. ~ Each branch circuit T $ 6.00 $ City: C.f~<v-e\" I State(:)~ ZIP:q 1l"J2~ b. Fee for branch circuits without purchase of a service or feeder fee: Phon~If/-2Z.~ -7"lZ? I Fax: - - First branch circuit (2) $ 55.00 $SS- E-mail: Each additional branch circuit I $ 6.00 $b CCB license no.:/ W.z. 74 I BCD license no.:C44t Miscellaneous fees: service or feeder ~ot included Signing supervisor's license no.: <"2.~? <:: . Each pump or irrigation circle (2) $ 63.00 $ Print name of sign ing supervisor: '/'\an (; ('Over Each sign or outline lighting (2) $ 63.00 $ S' f" . ~ ~--- Signal circuit or a limited-energy panel, $ 63.00 Ignature 0 stgnmg superVIsor: 7?" -"''-;;'- alteration, or extension (2) $ , Each additional inspection: (1) $58.00 $ ~ ~ /i;~~e:5~g:~~~~i~~~~~"~elHc,i{NT:0fJSEt.i:i,:: .\.'.~g~~;~:~~:,- "\~;t,,: ; NOT\CE: .' (A) Entti: ~llf'fl\!weR\{ . $ b( THIS PERMIT -'" r ~OT.. ~.~. AUTHORIZED o:tl0RrA])" $ 7~Z ~cS<~ COMMENCE o ogy Fee (5%0f[A]) $ :?f5.S~ ANY 180 M A fees and surcharges (A through C): $ 7/ 77 w. 440-2584-J (9/08/COM) CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00559 ISSUED: 05/04/2010 APPLIED: 05/04/2010 EXPIRES: ] 1/04/20]0 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 770 HARLOW RD APT 118 ASSESSOR'S PARCEL NO.: 1703223402800 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Addlalter 2 circuits ":. TYPE OF USE: Alteration Residential Owner: SUN RETIREMENT CORPORA TlON' Address: 200 HAWTHORNE AVE SE A-140 SALEM OR 97301 I CONTRACTOR INFORMATlO~ Contractor Type Electrical Contractor License COMPLETE ELECTRICAL INSTALLATION 184274 BUILDING INFORMATION ~ # of Uuits: # of Stories: Primary Occupancy Group: Height of Structure Second",)' Occupancy Group: Type of Heat: Primary Construction Type VB Water Type: Secondary Construction Type: \ w requirE!!"fll!llI1I;ope: # of Bedrooms: ATTENTION: orego; b~ the oredlmij\;l~th: follow r~les adopteThose rules allPSlIIIfrmtlluilding: nla . nter. . In OAR 952-001-Obtaln INFORMATION 0090. You may 0 (N te' e ' calling the center. o. iI' ~N t\1lcaU~ Front yard Setbackilumber for the oreg~~ ~.,~ . .erlayDlst: , Side I Setback: Center Is 1-8~ # treet Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special I nstruction: Expiration Date 10/14/2010 Phone 541-225-7827 Lot Size: Sq Ft I st Floor: Sq Fl 2nd Floor: Sq Fl Basement: Sq Ft GaragelCarport Sq Ft Other: Occupanl Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Notes: '" .-.' ,.. Description Slluare Footage or Bid Amount LuL . L.'\, ", '3~..;.."~ ,'~~',~ ;;.._:< , " Page I of 2 ", .~-~, i'" , Value Dale Calculated . ^t .....,~' .', CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00559 ISSUED: 05/04/2010 APPLIED: 05/0412010 EXPIRES: 11/04/2010 VALUE: '. ;;.t, '~ir:' ',... , '':'" 'i, Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne.of Pr~ject . I Fees Paid ~ Fee Description + 12% State Snrcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amonnt Paid. Date Paid 'Receipt Nnmber $7.32 $3.05 $55.00 $6.00 ~ '\ ., 5/4/10 5/4/10 5/4/10 5/4/10 2201000000000000455 2201000000000000455 2201000000000000455 2201000000000000455 !; '7;'" Total Amonnt Paid $71.37 I Plan Reviews I 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. . . Reouired Insoections . Rongh Electric: Prior to Cover Final Electric: When all electrical work is complete. By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is true ~lIld 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..,~ithout permission of the Community Services Division, Building Safety. I further certify that only contractors and employees'Yho are'in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspectio~~. are requested at the proper time, that each address is readable from the slreet, that the permit card is located at the front lifthe pro'p'ei'ty, and the approved set of plans will remain on the site at all times during construction. ~-. , Owner or Contractors Signature Dale ,~. ." ."',, ,;'; Pa2e 2 012 225,Fiftb-Street Springfield, Oregon 97477 541-726-3759 Phone S_,P"]:Q"~_,n~,, '., Wr!. . , ~.. '.. ...... ow -; , " '" .__."._...._..,'_.~-.. " - City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000455 Date: 05/04/2010 9:21:2IAM Job/Journal Number COM20 1 0-00559 COM20 I 0-00559 COM20 I 0-00559 COM20 I 0-00559 Payments: Type of Payment CreditCard cReceintl Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology, Fee Paid By CMPLTE ELCTRCL INSTLTNS Re5eli~ed ~}' '~(n Y""". J, , Check Number Batch Number '. .It' .1.'..;, I"~ ,....~, -.. ~~ . ,-.". ',djh -~'"~.:,> -c")1'J Page I of I Item Total: Authorization Number How Received '032035 In Person Payment Total: Amount Due 55.00 6.00 7.32 3.05 $71.37 Amount Paid $71.37 $71.37 5/4/20 I 0