HomeMy WebLinkAboutPermit Electrical 2010-6-21
Permit no.( J8 - :r1 f'
'\jt 225 Fifth Street+Springfield, OR 974F+PHY;41)726.3753+FAX(541)72 3689 1., / .
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This permit is issued under OAR 918-309-0000. Perml s t: n~~ sferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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) I $ 81.00 $J1;,1J:!
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
ZIP: Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation. alteration, relocation
Name:
Address:
City:
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member afmy immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor
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440-2584-1 (9/08/COM)
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
$ 63.00 $
$ 87.00 $
$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
b. Fee for branch circuits without purchase of a 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)
Each additional inspection: (I)
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [AD
(e) Technology Fee(5% of [AD
TOTAL fees and surcharges (A through C):
Status
Issued
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: COM2010-00794
ISSUED: 06/21/2010
APPLIED: 06/21/2010
EXPIRES: 12/21/2010
VALUE:
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SITE ADDRESS: 500 S 48TH ST
ASSESSOR'S PARCEL NO.: 1702324407300
SPRINGFIETYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION:
Owner:
Address:
Contractor Type
Electrical
TYPE OF USE: New
Commercial
200 amp Service and 2 branch Circnits
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THIS PERMIT SHALL EXPIRE IF THE WOR
AUTHORIZED UNDER THIS PERMIT IS NOT.
':',:\""l~'lrm nR IS ABANDONED FOR,- "
ANY 180 o/tcf~IW?&TOR INFORMATION I
License
8699
BUILDING INFORMATION ~
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, #'ofSto'i'ies:
,. Height of.Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Contractor
LR BRABHAM
Phone
541-747-6638
# 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:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
DescriPtion
Expiration Date
12/18/2010
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
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_IOLVELOPMENT INFORMA T10[}
A'J"TIiftI'Ieu. ~".lIUII ..... reqUires you to
follow nllea adopted by the Oregon Utility
Notification Cd1lt&l'!"l'~6= iullll/ are set faIth
In OAR 952-oo'f~O~"'AR 952-001.
0090. You m8ylDbUtlft'lt~/Wl)f the rules by
calling the caIIt8l'L~N6lr.N'telephone
nUmber for the Oregon Utility Notification
PUBLIC IMPROVEMENTS
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
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I Valu~t;~~ Description ~
$ Pel' Sq Ft
01' multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Page 101'2
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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"'TotafValue of Project
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~Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Eo Add
Perm ServfFdr 200 amps or less
Amount Paid
$11.16
$4.65
$12.00
$81.00
Total Amount Paid
$108.81
I. Plan Revie~s I
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Date Paid
6/21/10
6/21/10
6/21/10
,6/21/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00794
ISSUED: 06/21/2010
APPLIED: 06/2112010
EXPIRES: 12/21/2010
VALUE:
Receipt Number
3201000000000000317
3201000000000000317
3201000000000000317
3201000000000000317
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.
ReQ.ii.ired;IrisDect~
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Ufor Electrical Ground: Install ground rod ai""iooting and call for inspection in conjuction with footing and/or
foundation inspection.
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
D nderground Electric: Prior to cover
By signature, 1 state and agree, that 1 have carefully,examinedthe.completed application and do hereby certify that all
information hereon is true and correct, and 1 furtheri~ertify thaf'lDY and all work performed shall be done in accordallce with
the Ordinances of the City of Springfield and thet~ws 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 alld employees who are in compliance with ORS 701.005 will be used 011 this project.
I further agree to ellsllre that all required illspections 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.
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Paee 2 of 2
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Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000000000000317
Date: 06/21/2010
II :28:09AM
Job/Journal Number
COM20 1 0-00794
COM20.l 0-00794
COM20 1 0-00794
COM20 10-00794
Payments:
Type of Payment
Check
cReceintl
Description
Penn ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
LR BRABHAM, INC
Amount Due
81.00
12.00
11.161
4.65
$108.81
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Item Total:
Check Number Authorization
Received By Batch Number . Number How Received
KLK 38849 KLK In Person
Payment Total:
Amount Paid
$108.81
$108.81
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