HomeMy WebLinkAboutPermit Electrical 2010-6-7
225 F;fth Street. Springfield, OR 97477tPH(541)7i6-3753' FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.:
{E/o ~ ()07/
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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 issuance or if work is suspended for 180 days.
LOC~L:.(30VERNMENT APPROVAL> ."
Zoning approval verified? 0 Ves 0 No
.CATEGORY.'OF ':CONSTRUCTION'.
IN Residential 0 Government 0 Commercial
~;;ji&;':J.()BSSITE:.INF()RI\IIA TIPi'll ANO::GO.CATION:.:';
Job site address: "62
City:
Reference:
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Name
V7
City:
Phone:
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 479.560(1).
Signature:
. Co.NTRACTOR INSTALLATION
Business name:
. Address:
City:
Phone:
E-mail:
Print name of signing supervisor:
Signature of signing supervisor:
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440.2584-J (9/08/COM)
i .,~ t : ?',):~~'~:,:r~;::~~;;?i:}~;~;FEE'~'SCH E_OU Pl;f..:;t!~~i~:;r:~(~:r?i~~::~~~;~!i~qr~:
.N:umber" of inspectio'nsp~r ite_m.(,) '. Cost Total
Qty. ..
. . . - ," '. . . ~ " , ea. : cost
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 $ $
dwelling service or feeder (2) 63.00
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
40 J 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: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
20 I 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 panei
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit I $ 6.00 I $
~. Fee for branch circuits without purchase of a service or feeder fee:
First bra~ch circuit (2) I $ 55.00 $ CJ,
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder I}ot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a Iimited~energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
f~~~~~~~~~,~~Yl)gifA~~t~~:,:ARej:;fcJ(NtDJJ'$En~:,:~<.': ;-,:;~ '. .
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00) $ ( L:;" ,....
(B) Enter 12% surcharge (.12 x [AD . $ <?
(C) Technology Fee (5% of [AD $ ? .
,
TOTAL fees and surcharges (A through C): $ (,.,7_ ~.
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C;~
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00719
ISSUED: 06/04/2010
APPLIED: 06/04/2010
EXPIRES: 12/04/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS:, 562 M ST
ASSESSOR'S PARCEL NO.: 1703263400404
SPRINGFIETYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace water line
Owner: STEWART SANDRA
Address: 562 M ST
SPRINGFIELD OR 97477
j~'1 ;- '" t
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Plumbing
Contractor License
LIVEWIRE ELECTRIC INC 56697
BERNARD PETERSEN INC 93126
BUILDING INFORMATION ~
Expiration Date
05/16/2012
08123/20 11
Phone
54] -344-4928
54]-343-9339
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
# of Stories:
H~ight of Structure
Type of Heat:
.. -, \Vater Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION ~
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overla1; I?.ist:" Total:
'#StreetTrees Rqd: Handicapped:
'Paved Drive Rqd: Compact:
, ,%'ofLot Coverag1.1TENTION: Oregon law requires you.t,o
follow rules adopted by the Oregon ~~~~h
PUBLIC IMPROVEM 952-001-00'10 through OAR 952'-00b1-
, ~ copies of the ru as y
0090" You _~ ~e: the telephone
calling the ce ' I tt"~ Notification
number f~tlilaJ~l'Itl. )
,: ' Center 10 1-800-332- 344 ,
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOTICE:
Not~ms PERMIT SHALL EXPIRE IF THE WORK, . , '
AUTHORIZED UNDER THIS PERMIT IS NOT -j,
COMMENCED OR IS ABANDONED FOR ','
ANY 180 DAY PERIOD.
,
Page 1 01'3
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00719
ISSUED: 06/04/2010
APPLIED: 06/04/2010
EXPIRES: 12/04/2010
VALUE:
j'I..~..., . .' ,e,
!: ~!
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726,3769 Inspection Line
I Valuation DescriDtion ,
Description
Tvpe of Construction
$ Pei- Sq Ft
or multiplier
Sqnare Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Water Line - 1st 100'
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
. .-".~",..,
Amount Pai,t,;'
,,-, ~,: ,.,
$9.12;"' "
$3.80!i: "
$76.00
$6.96
$2.90
$55.00
$3.00
, Date Paid
6/4/10
6/4/10
6/4110
617110
617110
617110
617110
Receipt Number
2201000000000000632
2201000000000000632
2201000000000000632
2201000000000000645
2201000000000000645
2201000000000000645
2201000000000000645
Total Amount Paid
$156.78
I ria n Reviews ~-
. '.' .,.;~ " : ,
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.
l.Jle~,,:;,~~:.~e~';'"~i_~,nections I
i,1
Water Line: Prior to filling trench and incl~d~~,g r'equired testing.
Final Plumbing: When all plumbing work is"c~~plete.
Final Electric: When all electrical work is complete.
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Paee 2 of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,," 1,1'"''''
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00719
ISSUED: 06/04/2010
APPLIED: 06/04/2010
EXPIRES: 12/0412010
VALUE:
By signature, 1 state and agree, that 1 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 witb
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 fnrther 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.
Owner or Contract s
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Paee3 of 3
6-1-;12
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000645.
9:56:54AM
Date: 06/07/2010
Job/Journal Number
COM20 I 0-00719
COM2010-00719
COM20 I 0-00719
COM2010-00719
Payments:
Type of Payment
CreditCard
cRcccint 1
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
55.00
3.00
6.96
2.90
$67.86
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
L1VEWIRE ELECTRIC
Amount Paid
nJm
641990 In Person
Payment Total:
$67.86
$67.86
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Page I of!"
6/7/2010