HomeMy WebLinkAboutPermit Electrical 2010-5-12
225 Fifth Street. Springfield, OR 97477 tPH(541)726-3753t FAX(541)726-3689
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'.. tiE~A~TMENtUSE ONLY.
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Pennit no.:
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Date: 5; 1;1 /0
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.
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PROPERTY OWNER'
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Name:
Address:
City:
Phone:
F-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).
ZIP: p '17
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440.2584-.1 (9/08/COM)
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,Number' oHnspecil_o'nspe,r.,item{) .,,,.~': Qty.
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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) I $ 32.00 $
. Each manufactured home or modular $ $
dwelling service or feeder (2) 63.00
Services or feeders: installation, alteration, relocation'
200 amps Dr Jess (2) $ 81.00 $
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 Dr less (2) $ 63.00 $
20 I to 400 amps (2) $ 87.00 $
40 I 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 pane!
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 $
Signal circuit or a limited-energy panel, I $ 63.00 $6)90
alteration, or extension (2)
Each additional inspectinn: (I) $58.00 $
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(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00) $
(B) Enter 12% surcharge (.12 x [AD $ 7"(,.
(C) Technology Fee (6% of [AD $ 1()
TOTAL fees and surcharges (A through C): $ 73'Z!--
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00594
ISSUED: 05/12/2010
APPLIED: 05/1212010
EXPIRES: 11/1212010
VALUE:
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Status
Issued
225 Fifth Street, Springfield, OR
541-726:3753 Phone
541-726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 223 A ST
ASSESSOR'S PARCEL NO.: 1703353203000
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Low voltage for CCTysecnrity ,..
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" . __ "'nM reQUire "I'll-
ENT\UN Vlv~-'- n Oregoll ~l..1 ,
CITY.OF SPRIIll.GFIELD AT IT rui..s ~dopled bY t r~les are set lort"
250 NORTH A s'f 10\ ow . - Center. Those OAR 952-001-
SPRINGFIELD OR 97477 Notilic;,a~~~_001_001othrOugh olthelulesbY
In OAr> obtain caples \ hone
SPRINGFIELD UTILITY B~D, YoU may nter (Note: the ~~ ~~ca\ion
250 NORTH A ST calling the ce 'e on Utility ,,0 II
SPRINGFIELD OR 97477 number lor the,O~_~oO_332-2344).
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. ICON'-fRACTOR INFORMATION ~
Owner:
Address:
Owner:
Address:
Contractor Type
Electrical
Contractor . .P......... License
GLOBAL SECURITY & COMMUNICATION ]69705
I BUILDING INFORMATION I
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Constrnction Type
Secondary Constrnction Type:
# of Bedrooms:
# of Stories:
NOi\CE: . He;g~~~~f 1HE \NO~~
'THIS PERMli1S'\i {)€Fy~~is PERM\1 \S N
/l.U'THOR\"ZEO~el~llti\lANOONEO fOR
COMMENCE6~mI~l!1.h:
/l.NY '\ 80 D~pl-lnKied Bnilding n/a
I DEVELOPMENT INFORMATlO~
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of ~~~,;?,verage:
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I PUBr:ICIMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Commercial
Expiration Date
10/10/2010
Phone
541-461-9657
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occnpant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downsponts/Drains:
Notes:
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
.
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
Total Amount Paid
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Valu1tl'on Descri
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
Fees Paid ~
Amount Paid '
$7.56
$3.15
$63.00
$73.71
Date Paid
5/12/10
5/12/10
5/12/10
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Plan Reviews ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00594
ISSUED: 05/12/2010
APPLIED: 05/12/2010
EXPIRES: 11/12/2010
VALUE:
Value
Date Calculated
Receipt Number
2201000000000000488
2201000000000000488
2201000000000000488
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To Request an inspection call the 24 hour r~t~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.
Reouired Insoections ~
Low V ollage: Prior to cover.
Final Electric: When all electrical work is complete.
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 strncture withont permission of the Commnnity 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 constru' n.
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Page 2 of 2
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Date
225 Fifth Street
S'pringfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000488
Date: 05/12/2010
. II :55:44AM
Job/Journal Number
COM20 1 0-00594
COM20 I 0-00594
COM20 I 0-00594
Description
Low Voltage - Commercial Indus '.:
+ 12% State Surcharge 10. ,n
.:iit!:.
+ 5% Technology Fee ~',
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Amount Due
63.00
7.56
3.15
$73.71
Item Total:
Payments:
Type of Payment
CreditCard
cReceintl
Paid By
ANTHONY J GOMEZ
Check Number Authorization
Received By Batch Number Number How Received
cjc 312155 In Person
Payment Total:
Amount Paid
$73.71
$73.71
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