HomeMy WebLinkAboutPermit Electrical 2010-5-27
Electrical Permit Application
~tiTy OF SPRJNGFIELD, OREGON
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225 Fifth Streett Springfield, OR 97477tPH(541)726-3753t FAX(541)726-3689
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Date:
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuan~e or if work is suspended for ]80 days.
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Zoning approval verified? 0 Yes 0 No
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o Residential I 0 Government I 0 Commercial
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Phone: _ _ Fax: _ _ -'t7
E-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).
Signature:
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Address:.fJ h () ~ 100 7
City:W'4 -/rV:/I'O State:Orf zIP'1IL/<i'l
Phone)l. "17 iY- Fax: i-l..J.l.J. 104'7
E-mail: hVVy~I7..)YOsr.I.IlTf..fr~Onll.nf .(C'I?'
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Signing supervisor's license no,:
Print name of signing superviso~
Signature of signing supervi~ I
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440.2584-) (9108/COM)
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 feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 61.00 $
201 to 400 amps (2) $ 95.00 $
40 I '0 600 amps (2) $156.00 $
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 fceders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 67.00 $
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 panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
I $ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited.energy panel,
alteration, or extension (2)
$ 63.00 $
$ 63.00 $
$ 63.00 $
Each additional inspection: (I) $58.00
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(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(8) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of(A])
TOTAL rees and surcharges (A through C):
$x/.'lSV
$ q .1-. '-
$ q,()
$'14.'111
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: COM2010.00684
ISSUED: OS/27/2010
APPLIED: OS/27/2010
EXPIRES: 11/27/2010
VALUE:
Status
Issued
SITE ADDRESS: 5335 DAISY ST 143
ASSESSOR'S PARCEL NO.: 1702330001300
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: 200 Amp Service
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Owner:
Address:
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SANTIAGO ESTATES ASSOCIATES~LC
11211 GOLD COUNTRY DR STE 100;):
GOLD RIVER CA 95670
Contractor Type
Electrical
I CONTRACTOR INFORMATION ~
Contractor License
BURRELL BROS ENTERPRISES INC 136446
BUILDING INFORMATION ~
Expiration Date ,Phone
08/2012011 541-747-2724
# of Units:
Primary Occnpancy Gronp:
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:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ilt Other:
Occupant Load:
n/a
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION ~
):i.,' , "0:'1"" : ' REQUIRED PARKING
, ;~~~r1ay\:;ii~:" . NTlOI>I: Oregon law r~~~~b~~i;~y
'''~:Sireet Trees Rqdf.r; rules adopted by the h~\\'Wf~ith
Paved Drive Rqd: ~tmcation Center. Those rUn em~!72-001'
% of Lot covera~ OAR 952.001.001 ~ t~~Ui~S 01 the rules by
0090. Vou may obtain oie: the te'eph~ne
O egon II
PUBLIC IMPROVEMEN ber lor the. ~ 800-332-2344).
Center IS -
:sioewalk Type:
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Street Improvements:
Storm Sewer Available:
Special Instruction:
Downspouts/Drains:
Notes:
NOTICE: ,,J:
THIS PERMIT SHALL EXpiRE IF tHE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED I 0/"\ WV"L '
ANY 180 DAY P - Maluation Descri tion
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
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Status
Issued
225 Fifth Street, Springfield, OR
541.726.3753 Phone
541.726.3676 Fax
541-726.3769 Inspection Line
:; Total Value of Project
LFees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Total Amount Paid
$9.72
$4.05
$81:00
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$94.77:;:,". ".';':;:iI::.'
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Date Paid
5/27/10
5/27/10
5/27/10
,d,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00684
ISSUED: OS/27/2010
APPLIED: OS/27/2010
EXPIRES: II/27/2010
VALUE:
Receipt Number
3201000000000000246
3201000000000000246
3201000000000000246
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 after7:00 a.m. will be made the following
work day.
Reouired Insoectioris ~
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Electric Service: Approval required prio':-io'ii;iility company 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 1 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 of the Community Services Division, Building Safety.
1 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 inspecti~~~t~~~eTe.qu.~s~ed at, ~~e proper time,.that each address is readable from the
street, that the permit card is located at the front of.t~:e:pr6pel:ty, and the approved set of plans will remain on the site at all
times during construction. .::.:..""::~'~ ~=:1
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Owner or Contractors Signature
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Page 2 of2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000000000000246
7:45:00AM
Date: OS/27/2010
Job/Journal Number
COM20 1 0-00684
COM20 1 0-00684
COM20 1 0-00684
Payments:
Type of Payment
Cred itCard
cReceinll
Description
I
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
. JOSH BURRELL
Amount Due
81.00
9.72
4.05
$94.77
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
njm
045430 In Person
Payment Total:
$94.77
$94.77
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5/27/2010