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Home My WebLink AboutPermit Electrical 2010-6-8 " "3ZJo(,u'6 Electrical Permit Application I~<ID'~O~~~ 225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 li~ L:h f>> " , I, DEPARTMENt USE ONLY (c......zC}/o.OO '7?L( Permit no.: Date: b- <i-Ie 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 ' FEE SCHEDULE ! Zoning approval verified? DYes DNo " Cost Total Number or. i~spections per item () Qty. ea. cost CATEGORY OF CONSTRUCTION Residential, per unit, service included: o Residential I~Govemment I 0 Commercial 1,000 sq, ft. or less (4) JOB SITE INFORM TION AND LOCAl'rION $134.00 $ Job site address '1~l(9. H. . 'e.-" IfVarf wi ;]J Each additional 500 sq. ft. or portion $ 25.00 $ thereof City: .sod...,....\'t~\~ State:O~ 1m:' Limited energy (2) $ 32.00 $ Reference: T,,sJ 1.s, 1;'.<\ l.) I Taxlo!.: Each manufactured home or modular $ 63.00 $ , DESC,RIPTION OF WORK '. dwelling service or feeder (2) A..rt"........-nJ i t'~Tf; <- R~(Q( J~.,.- SITe Sen'ices or feeders: installation, alteration, relocation .q '11"1 \..I; \:'."'\($ 1Z~_ 200 amps or less (2) \ $ 81.00 $~l~ -, PROPERTY OWNER , h 201 to 400 amps (2) $ 95.00 $ Name:Orl!c.".... Oh:,-t, <>-t \-(~,,~ ",.....-1-;11':",., 401 to 600 amps (2) $158.00 $ Address:.s~ 13'h S+~H-t n,\::_ s",;t~< 601 to 1,000 amps (2) $205.00 $ City: S"hn- I State: <::l 1\ 'I ZIP: <'nJQ 1 Over 1,000 amps or volts (2) $469.00 $ Phone: ts'0.3)- C~~6_ ~6 0 <. Fax{5~ ). q~t:A<.<l ~ Reconnect only (2) $ 63.00 $ E-mail:\"e"n ...1. j~\v~-to'; (<) ildot.5t"tQ. \It' .IA ~ Temporary sen'ices or feeders: installation, alteration, relocation This installatio~is being made on residential or farm property 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 401 to 600 amps (2) $126.00 $ 479.540(1) and 479.560(1). ATTEN-, Signature: follow r Ie 51il\1p1aw~~ l>Ki',eruces or feeders section above /CONTRACTOR INSTALLATION NOlificali n . if I iYs!l!Av,o"lilf14lnntJl'lIWion per panel Business name: CI'd {"n.. c;-tl. ('\ ert l~~AR9 2- (ij.1EOO'fO"" ,eli' _iiMllilt<foollpf a service or feeder fee: Address: ,.s 'U <...~.,.. ~ $ t -(':!. r.r" S (,:. lUll n aYI9!1iI!linm:lllPiesi'ofoL ,-:." I $ 6.00 $ (,~' 'Ie m~:~~Rei~il'llct\'ase ofa service or feeder fee: City: <5 '" , I! __ State: o'R I ZIP: 'l/lfJiJI~: "r Phone: {50S )-566-56 () '" Fax:(s<>3)-.s ~'\ _<.. 'l"lSC n erliir"l.18 :l 'u OllficaUon $ 55,00 $ E-mail: 1:."..",'. \-\.~... (h~ r~ r;t~.'p.<'tr;( r".... Each additional branch{ircuit $ 6.00 $ CCB license no.: "\ \ <:: G ~ 1 BtD lic~nse no.:37-(,<.0 c. Miscellaneous fees: service or feeder not included Signing supervisor's license no.: 13 '1:l'8-.5 Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: , '''n;\~ IJ, \h......~ \t"", Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor;r ~ 0P1" o:W- Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ G t1 APPLICANT USE rvrf~} .J & (A) Enter subtotal of above fees $C::>7<P , ~~\ \~Jt JMinimum ~ t~~~.it~~~_~~8.00) 10'> NOTICE: (J;;- . ''''-'''"''''lli-,:t'''-''-.I ' . $ 10.11- THIS PERM-l~~iE:ge(I2'x.tAi) ~~~. ~ ~~ AUTHORIZ~~ (1f/,lJijilWORK $-"1';- COMMENCEr g15(AJmo~gh C): ~ tv- '-' un Iv """..uuNt:u tUN ,,',' . I{"J J- -,-,~ J' ~~R~~ ANY 180 DAY PERIOD. I 01 ?1. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00734 ISSUED: 06/08/2010 APPLIED: 06/08/2010 EXPIRES: 12/08/2010 VALUE: ': ... , :, I , ~..~ Status Issued ,,, 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ;.:..:.....,~ ..... , SITE ADDRESS: 4949 HIGH BANKS RD ASSESSOR'S PARCEL NO.: 1702280000802 Springfield TYPE OF WORK: Electrical Work Ouly PROJECT DESCRIPTION: Automated traffic recorder TYPE OF USE: New Public Owner: BRIGL RODNEY Address: 4949 HIGHBANKS RD BORN AGAIN AUTO REPAIR SPRINGFIELD OR 97478 1 CONTRACTOR INFORMA nON , Contractor Type Electrical Contractor License MORROW MEADOWS CORP 91668 'I BlJii'iiINGiNFORMA TION ~ # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Di.t:' -- # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: 1 PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Speciallustruction: Expiration Date 07/20/2011 Phone 503-399-7609 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: it;,~.,~ . ::~"I""Jf ::"1.:' ._~_,,,;:_ ':..~,-.~';.:\'"1~~;~-Dt}\\%~~p~o:utslDrains: N O~1&~:;;;,:r":'-": '; i">;~;~;f l\\~ WOB\( THiS'PERMll StlAt\. ~HIS PERtJ\ll IS NOT, AUTHORIZED UNDER DONfI) fOR <;; lliWsFA 190 Ii Notes: .', -: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction :.~ ' Page 1 of2 ',' . Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20IO-00734 ISSUED: 06/08/2010 APPLIED: 06/08/2010 EXPIRES: 12/08/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~~;~';;S' , ,j,-;,~ -, ,: . ~" ~ ,""::-,, . Total Value of Project I Fees Paid--, Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $10.44 $4.35 $6.00 $81.00 6/8/10 6/8/10 6/8/10 6/8/10 1201000000000000619 1201000000000000619 1201000000000000619 1201000000000000619 Total Amount Paid $101.79 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, insp'ecti!l~~' requ,ested after 7:00 a.m. will be made the following work day. ";'T ,..-. " . . . L-Reauired InslJections , Electric Service: Approval required prior to utility company energizing service. Rough Electric: 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 an'y and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the St.ie 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 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 construction. Owner or Contractors Signature. Date ,'1 ~' Paee 2 of 2 City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Qregon 97477 541-72(;-3759 Phone RECEIPT #: Date: 06/08/2010 10:40:03AM 1201000000000000619 Job/Journal Number COM20 1 0-00734 COM20 I 0-00734 COM20 I 0-00734 COM20 I 0-00734 Payments: Type of Payment Check Change Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Amount Due 81.00 6.00 10.44 4.35 $101.79 Paid By MORROW MEADOWS MORROW MEADOWS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb djb In Person In Person Payment Total: $102.31 ($0.52) $101.79 22498 ; >:1.' ".;', : ~ In. . Job/Journal Number COM2010-00734 COM20 1 0-00734 COM20 1 0-00734 COM20 I 0-00734 Payments: Type of Payment Check Change cReceinll ~:; ,\', .,:~ "'.. Description . Perm Serv/Fdr 200 amps or less"': ': Add, Alter, Extend Circ Ea Add .' . + 12% State Surcharge + 5% Technology Fee Amount Due 81.00 6.00 10.44 4.35 $101.79 .l',':. " Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid Paid By MORROW MEADOWS MORROW MEADOWS In Person In Person Payment Total: $102.31 ($0.52) $101.79 djb djb 22498 .,;',i',.:.... .'!'" """J' -0.(', Page 1,0'0: ~ . . j',\"/;';' ..';+ ~ :-',-' 6/8/20 I 0