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HomeMy WebLinkAboutPermit Electrical 2010-6-10 225 Fifth Street. Springfield, OR 97477.PH(541)726.3753.FAX(S41)726-3689 DEP.ARTMENTUSE ONLY CoW\"ZOtO-OO 750 Pemit no.: Date: /;'-(0 -/0 Electrical Permit Application ::crfy10F"SPRINGFrntii:"OREGON;;.' .' d";'~-:~~'-i';-"[f"""T:' -' '.~ ,~~,,>- ~ ",,-~ "<.-~'!;'i.(.:,)~i,R"~'i...;"'''''' ':""-.-~I..'<F' ~'$_ 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 wurk is suspended for 180 days. . ".LOCAL'GOVERNMENT APPROVAL'.;'; , <",." .< :'~" :,''''i''i~_,~;!(r;~0:n~;FV;r3\;Wt;:;:?~~E~'1.~S~R EJ>.Q IjEfWqf:.)tt?;~1~V?~~fi~~~\~Wt~,~): Zoning approval verified? DYes DNa . - - , Cost Total' Number' of.in~peciio'ns p~r,i_tein'(,) Qty. ,c',> :.','CATEGORY00FCbNSTRUCTION\,," .' . :. ,:;" .",-' ,..' ", ,.,.,", ,'"':,.-"!.' e#i'-" . cost. i_,., Residential, per unit, service included: D Residential I D Government T o Commercial 1,000 sq. ft. or less (4) f;\!i~1!:l7i:UOB)tSITE;INFORMATIONMN[jr;,IJ:OC:AtION~)~\:!tn $134.00 $ Job site address: k/l I. A.Jr :# /Ill Each additional 500 sq. ft or portion $ 25.00 $ thereof City: ,-.,0. CN~/ I Stateo1. I ZIP:9)jr/ 7 Limited energy (2) $ 32.00 $ (2,<'> Reference: tI) 70 '3 ~ s'{ 2- I Taxlot.: o2boo Each manufactured home or modular $ 63.00 $ , , '. .. . .{..:".~,' dwelling service or feeder (2) DESCRIPTION OF WORK',.,.;:',' , .1)0/..<1..... A-/'" t-~ Services or feeders: installation, alteration, relocation ./ - 200 amps or less (2) $ 81.00 $ PROPERTY OWNER 20 I to 400 amps (2) $ 95.00 $ Name: -;r;! .-r (t.' #kcC-. - 7::' -r- 401 to 600 amps (2) $158.00 $ Address:jJ(ICHT!t7- nru1 IZt:, i .:rSl.AN~ c./tZ .- 601 to 1,000 amps (2) $205.00 $ City: Sf>F'!:. I State: 0L T ZIPS 71.(77 Over 1,000 amps oAJ;;f6.itiT'ON: Ore on r ~~r, slilou tn Phone~f1If u.f",s-;:.G6'/1' I Fax: Reconnect only ( " f ~""l aao~1f~~ 0 lj1 %:Qtijl op Utility - - E-mail: Temporary servtlldi),A;Rl{jIlltf~G1"ll~tiPlt1fif ;';;i;::'. 9R~~'r This installation is being made on residential or fal1D property 200 amps or lessI(W~:. Yo~ may obt inc Piihe$UfeSb owned by me or a member of my immediate family. This 201 to 400 amps <i'U.tmb:r ~.., ,..""',, I'~c ~i" e e ~W1one property is not intended for sale, exchange, lease, or rent. OAR 401 to 600 amps (2) Center is 1 ioo W2j)lj4 . $ 479540(1) and 479.560(1). Signature: Over 600 amps or 1,000 volts, see services or feeders section above CONTRACTOR INSTALLATION Branch circuits: new, alteration, extension per panel Business name: I? 1/17'/ ~f;;'", rtcC/h~ .-C./AJ a. Fee for branch circuits with purchase of a service or feeder fee: Address: J077 CA./ //0 ? Each branch circuit $ 6.00 $ City: JZV"",N<-- I State 0"1.. 1 ZIP:'?7'i-'OZ b. Fee for branch circuits without purchase of a service or feeder fee: Phone: (~_d-~hrq'l.tJL I Fax:s<,.;I ,(.-Y-l~7rJ/ First branch circuit (2) $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: /~ '- "07 I BCD license no.: '?rVo,",C/L Miscellaneous fees: service or feeder ~ot included Signing supervisor's license no.: '( q 7"7 .L;f' A E.ach pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: /;'::./.:7 ;2. C//'i.... Each sign or outline lighting (2) $ 63.00 $ I.:: Signacure of signing superviso"<' >-- ?~ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) c:::-- --- Each additional inspection: (1) $58.00 $ ~~~ W \o\~.\'Q ':~t:~!~9*1t]$~~t~it[iit~){;:~tA~'~:LjCA~Tt~V'S.E1~;';it~ti;:,::;/.;tf~;'i;,;:;l!;;~t~::~{;;h:~': ,t V--~'i{/ (A) Enter subtotal of above fees $ 5B NOTICE: e; ,"".J (Minimum Permit Fee@j:bO) THIS PERMIT SHALL EXPIRE IF THE WORK ~ (B) Enter 12% surcharge (.12 x [A]) $ b?b AUTHORIZED UNDER THIS PERMIT IS NOT (C) Technology Fee (5% of [A]) $ z: 1Q COMMENCED DR IS ABANDONED FOR TOTAL fees and surcharges (A through C): $b78fc ANY 180 DAY PERIOD. 440-2584-1 (9108/COM) it I I! ~. I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00750 ISSUED: 06/10/2010 APPLIED: 06/10/2010 EXPIRES: 12/10/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 54] -726-3676 Fax 54]-726-3769 Inspection Line SITE ADDRESS: 806 A ST B ASSESSOR'S PARCEL NO.: 1703354202600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Burglar alarm Owner: FITCH MICHAEL J Address: 1269 ISLAND CRT SPRINGFIELD OR 97477 1.(.. .3'::f/' f . '1' ,,~ I CONTRACTOR INFORMATION I Contractor Type . Contractor License Low Voltage Electrical RUIZS CUSTOM SECURITY SYSTEMS INC ]08202 BUILDING ]NFORMA TION ~ Expiration Date 08/25/20] I Phone 54]-687,9202 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: .Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a J.,OPMENT INFORMATION I r8> €:- ~0~0<a~':~r8>~~'_D,,' 't. ~" v ~v_Qo. ,_ lYY,o,.ay .,.s. . ..q> -1$-0 ~0 O'r' -1$-0 ",~ljilheeHrees Rqd: ~~'l:>'Q"'~0;:,if ""~ 0~ ~'(faved [jrive Rqd: O.../lJ ~/lJA..'<I:-~O it0.~oI;:~:'-~ of Lot Coverage: ~. bO to..~ & A0~"'!fi'" . o '6 l': " ~ "" V', . if ~f6 CJ-,,>'" if>~. ~ PUBLIC IMPROVEMENTS t.' ~..-"-o~w>- ~ ~O.../lJ Street Improve~~~~4';:,,~ ,.t}-I$-0.. '" "Ii! ~"c.'r' ~O ~ ~ ~ Storm Sewer A vallli~....~. ,,-~t:b ~..'o ftJ~ Special Instruction: Vj 0'" ~ #/lJ CJ ~o<$ REQUIRED PARKING Frontyard Setback: Side] Setback: Side 2 Setback: Rearyard Setback: SoJar Setbacks: Total: Handicapped: Compact: .-t.!".... Tvpe of Construction ~' ~\j<(!.~" Sidewalk Type: '\~~ ,<:;, ~\j " ~ ~~ ~ Downspouts/Drain~~<i:. ~~:~ ~(S . . ~\,<;}~<:;,~ ~~<i:.~,.: . <:;,~~ ~~..:"\ '!t-~<:;)I" ~\~'fr;. ~~ ~~<:;) fo ~~ , ~ ". I ~ \~\ ,,-\j<(!. R,<i:.\:) ~'Y",<(!. Valu~'tion Des~ription I 'r-'0'\"~S~ \:)~ ~~ 'O~ Square FootageCl ~o.I, \ V I or Bid Amount ~ a ue " Notes: .J,.... Description $ Per Sq Ft Or multiplier Date Calculated }b'-?i ..r~.;\ ''''1'' Paee] of2 If-'Sd i'4""~ l~' ~ .J:~r;~ . 'Jr,' ....~.~; 1 \ 1, It:-., ,( j, ..j.... J -" "', ""e Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Une '.' Total Val~e of Project I Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Low Voltage - Commercial Indus Amount Paid $6.96 $2.90 $58.00 'liA" $67.86';'> "Lt '~,," .' "-..' , , ' Total Amount Paid 'l'j. I Plan Reviews ~ Date Paid 6/10/10 6/10/10 6/10/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00750 ISSUED: 06/10/2010 APPLIED: 06/10/2010 EXPIRES: 12/10/2010 VALUE: Receipt Number 2201000000000000679 2201000000000000679 2201000000000000679 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. Reauired Insnections I " Low Voltage: Prior to cover. 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 r 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.!y,ho.~re i,n5ompliilnce with ORS 701.005 will be used on this project. I fnrther agree to ensure that all required inspectio'ris'are'req't'ested at the' proper time, that each address is readable from the street, that the permit card is located at the front o.t,ii:~ prop~rty, and the approved set of plans will remain on the site at all times during construction. "1~-'-.:" ,.,. "" Owner or Contractors Signature , . !,1I! ~. ~I'~-~' " .' Pa2e 2 01'2 Date 225 Fifth Street Springfield, 'Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000679 Date: 06/10/2010 2:18:30PM Job/Journal Number COM20 I 0-00750 COM20 I 0-00750 COM20 I 0-00750 Payments: Type of Payment CreditCard cReceiotl Description Low Voltage - Commercial Indus + 12% State Surcharge + 5% Technology Fee Paid By TED RUIZ Amount Due 58.00 6.96 2.90 $67.86 ,. lIem Total: Check Number Authorization Received By Batch Number Number How Received DJB 006334 In Person Payment Total: Amount Paid $67.86 $67.86 . ,~,. :;10,' ..i ~. '. > '~.' ;::1, l " Page I of I '" . ' p" 6/1 0/20 I 0