The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2010-6-17 225 Fifth Street. Springfield, OR 97477tPH(541)726-3753.FAX(541)726-3689 DEPARTMENT USE ONL V Permit no.:C--l1?- ~rg) 6- 1.- ~ Date: -J8 Electr.ical Permit Application -(:iTY'OF~S'PRlNGFiELDC~ORE'GON:> .: "_~"".~~~p-,.+.,.,, ,"' ~.~fJlor '0.1 .~1r;<"'e!.J";'_ ..::~. ...~-,\".,=;--".\;: This permit is issued under OAR 918-309-0000. P.ermits are nontransferahle. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. " . LOCAL: GOVERNMENT AP,PROYAl', + ";. '''. .'j' .'{ 'i:';;;",';:t?J}'~2;~~};';:~.o/~th::~t~;?~I5E:~E';S(;H E.D_UtjE{;:';;l':E~'(~!~}ZIf~~J~_i'J:::tj~~~~t~_~:; . .. Zoning approval verified? D Ves DNo . ,',' . . ..",..... Cost Total Number ofinspeCtio'ris per.item'(). .. QlY. ;""ea; cost. ,c, ':,":CATEGORVXOFCONSTRUCTIONU,.i.. , . ,;", ":", ",,' '.;...:_..."'(. .-'" ",1--, ..'...._ I D Government I D Commercial Residential, per unit, service included: D Residential 1,000 sq. ft. or less (4) ~;g~~j.JOEl:"SITEUNFc5RMA,.I()Nt:AND~:(lOCATIOI'l'!ii:;-!-;iiit:.' $134.00 $ Job site address: 75~ I-iAe.LoN f?DPrD Each additional 500 sq. ft. or portion $ 25.00 $ thereof City: ~) N:rf!GLf) I State: De- I Zlp:17477 Limited energy (2) $ 32.00 $ Reference: I Taxlot.: Each manufactured home or modular $ 63.00 $ DESCRIPTION OF WORK"'" '""",;'",,., ~ dwelling service or feeder (2) ADD 2- ~ '~e.4(""'"5 \ N :r: i) F F!-DOJV\ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ . PROPERTV OWNER . '. 201 to 400 amps (2) $ 95.00 $ Name: "5r>eJ ^-b ftt;l-J) f<.:f5Ll G ~Wt. S' 401 to 600 amps (2) $158.00 $ Address: 626 fi/lIGI- sr 601 to J ,ODD amps (2) $205.00 $ City: sfb ,.J.fit3...-j) I State: O(L I zIP:q-;Cf!i Over 1,000 amps or volts.(2) $469.00 $ Phone61/-1#&?'s75 I Fax: Reconnect only (2) $ 63.00 $ - - E-mail:. Temporary services or feeders: installation, alteration, relocation This installation 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) 479.540(1) and 479.560(1). $126.00 $ Signature: Over 600 amps or 1,000 volts, see services or feeders section above .C.ONTRACrOR INSTALLATION Branch circuits: new, alteration, extension per pane! Business name: ~ r.f:,/ief) ~ DJ<5Je.Jc:J a. Fee for branch circuits with purchase of a service or feeder fee: Address: 57-5 /VilLI..- <0;7 Each branch circuit $ 6.00 $ City: -Spl2.,r--bViGl.-D I State: 012. I ZIP. 974T7 b. Fee for branch circuits without purchase of a service or feeder fee: Phone: - - I Fax: - - First branch circuit (2) $ 55.00 $ E-mail: ) Each additional branch circuit $ 6.00 $ CCB license no.: I BCD license no.: Miscellaneous fees: service or feeder ~ot included Signing supervisor's license no.: //)73 IJS Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor:. ~L., ~, .,r .> Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor' ^ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) / ~ ~ Each additional inspection: (l) $58.00 $ ,iW;,'::',::A*~~~~~~tIJ~'sWtt~::,~:CAReLICj(Nr:t!0ilJ$_:El::j;:,tr'L~fi.:;:;ti~l~Z:,~/;:i'!~K~~':j,:-:' ~~ (A) Enter subtotal of above fees $'~8 6 D (Minimum Permit Fee $58.00) :S / \9' ~o/ (B) Enter 12% surcharge (.12 x [AD $ ~Ji( , ~. (C) Technology Fee (5% of [AD $ ;J<f' ~ TOTAL fees and surcharges (A through C): $ ;;, 7-rf /- j/ 440-2584.J (9108/COM) r--.i 'vd:..,,"l"~"''';'''~;"'' ~".,."",.,,i ". . .., I CITY OF SPRINGFIELD lItiir', '" I ! L Building/Combination Permit II ." ~~ '.',,,11" ....,... "w~i,.".... . ."" ", .." ..<".. Status Issued PERMIT NO: COM20IO-00785 225 Fifth Street, Springfield, OR ISSUED: 06/17/2010 541-726-3753 Phone APPLIED: 06/17/2010 541-726-3676 Fax EXPIRES: 12/1712010 541-726-3769 Inspection Line VALUE: $ 2,500.00 SITE ADDRESS: ' 755 HARLOW RD Springtield TYPE OF WORK: School ASSESSOR'S PARCEL NO.: 1703220003000 TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Remodel of Existing Space- IDF Room Owner: .. " '. SPRINGFIELD SCHOOL DISTRICT 19 Address: 525 MILL ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General OWNER Electrical OWNER I BUILDING INFORMATION ~ # of Units: # of Stories: Lot Size: Primary Occnpancy Group: E Height of Structure Sq Ft I st Floor: Secondary Occupancy Group: Type of Heat: Sq Ft 2nd Floor: Primary Construction Type VB Water Type: Sq Ft Basement: Secondary Construction Type: Range Type: Sq Ft Garage/Carport # of Bedrooms: Energy Path: Sq Ft Other: Sprinkled Buildiug! No Occupant Load: I DEVELOPMENT INFORMATION I .._-- -- ..~~-.'. ., REQUIRED PARKING ,., ,.". Frontyard Setback: ' Oyerlay Dist: Total:' Side I Setback: # Street Trees Rqd: Handicapped: Side 2 Setback: Paved Drive Rqd: Compact: Rearyard Setback: % of Lot Coverage: Solar Setbacks: ATTENTION Orpf1nn l'::lIH ~I"\"'" I:~",~ , I PUBLIC IMPROVE~~j'~.~les adopted by the cirego~ Utility Street Improvements: . In Ce~ter. Those rules are set forth In OAR 952-00SI<l~'o)'~I~lil(~P';iI OAR 952-001- Storm Sewer Available: 0090. You ma'DobWJn~('n!-O rof.~ I b , calling th or 11 litslDralIls: e ru es y Special Instruction: '. e cen er. ( ote: the telephone . "ill , humber for the Oregon Utility Notification i'lOTlCE:. . , . Center IS 1-800-332-2344). Note'!' HIS PERMIT SHALL EXPIRE IF THE WORK:,.. ., .. \UTHORIZED UNDER THIS PERMIT IS NOT " . ~OMMENCED OR IS ABANDONED FOR .\NY 180 DAY PERIOD. . . .. .0> Pa2e, I of.3 ~''::L'" "".~'~. .<n- ,.._<. ~.N..\iiI , {~..\.-:r "...;0.., '_.' i:-,:,: "I' CITY OF SPRINGFIELD Building/Combination Permit . :>~ ~' )t Status Issued PERMIT NO: COM20IO-00785 ISSUED: 06/1712010 APPLIED: 06/1712010 EXPIRES: 12/17/2010 VALUE: $ 2,500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amuuut 2,500.00 Value Date Calculated Descriotion Total Value of Project $2,500.00 $2,500.00 06/17/2010 ~ Fee Description + 12% State Surcharge + 5% Technology Fee Building Permit + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend C1rc Minimum/Adjustment Electrical Amount Paia'::" '". .'-.'. ..-. .- .' """'''' .,.~ ~. Date Paid Receipt Number $8.13'''; $3.39" $67.75 $6.96 $2.90 $55.00 $3.00 . "~I, 6/17/10 6/17110 6/17/10 6/21110 6121/10 6/21110 6/21/10 1201000000000000722 1201000000000000722 1201000000000000722 1201000000000000738 1201000000000000738 1201000000000000738 1201000000000000738 Total Amount Paid $147.13 Structural Review 0611712010 . di ";"~, . I ., '06/i7/2010 I Plan Reviews ~ DON KLK 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. lJ~~.~:~:~re~ ~;~.~~c.~io_ns , " ,.(~ Framing Inspection: Prior to cover and aft~r,ap rough in inspections have been approved. Drywall: Prior to taping. Fiual Building: After all required iuspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. . '. :,-~I>-t. t '.~': ' 1 ',;,. . ; Paee 2 of3 .;'~ ' ..,( CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00785 ISSUED: 06/17/2010 APPLIED: 06/17/20]0 EXPIRES: ] 2/17/20] 0 VALUE: $ 2,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ." }':;Mi.: . f::l:;:, "~ft\~'~. II. :(:1:, ::i! ",):, ': By signature, I state and agree, that 1 have carefully examined the completed application and do herehy certify that all information hereon is true and correct, and 1 further certify that any and all work performed shall he 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 inspections are reques!ed,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. '. " . ',: bu-rrQ ,\~(VeJ)~ ;.:, Owner or Contractors Signature 0> I yl(/U / I Date <"," .i,_I! .J', - ~~,~, . :,;-:: ' ,~';,.~j,,-,'" "": !~:I,;'~! 'h; . ',","': 'i- ~ . ,i-;,!.h-\ ' :,,;' J' .~ it r :: f .. ~ f Paee 3 ~f 3 225 Fifth Street Springfield,'Otegon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000738 2:12:3IPM Date: 06/21/2010 Job/Journal Number COM20 I 0-00785 COM2010-00785 COM20 I 0-00785 COM2010-00785 Payments: Type of Payment Check cReceintl Description Add, Alter, Extend Circ '. Minimum/Adjustment Electrical <.':'" + 12% State Surcharge . ,,).'\;\ + 5% Technology Fee .... ~ Paid By SPRINGFIELD SCHOOL DISTRICT Amount Out' 55.00 3.00 6.96 2.90 $67.86 - . '''''''''''' ~"...' Item Total: Check Number Authorization Received By Batch Number Number How Received njm 90412 In Person Amount Paid $67.86 Payment Total: $67.86 t. ....l".,jO;::,1 .,;- .' ,> .,"-' '-~"". ,..' :~;>': ~: 1 .." . ~.. , '. "" ....~,. "'-' '. ',l! Page I of I 6/21/20 I 0