HomeMy WebLinkAboutPermit Electrical 2010-9-15
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Electrical Permit Application
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:CITY;'OF SPRINGFIELD>':'OREGON'~:.
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225 Fifth Street. Springfield, OR 97477tPH(54t)726-3753tFAX(54t)726-3689
DEPARTMENT 'USE ONLY
Permitno:<~IO - 30 S- tit:; Jl'7l(
Date: OJ II ')
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issnance or if work is suspended for 180 days.
LOCAL'.'GOVERNMENTAP,PROVACd
Zoning approval veri fied? 0 Yes 0 No
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o Residential 0 Government 0 Commercial
~"jf%r;J.OB}Srrr:=;INFORMATIONi1ANJjIJ~OCAtION~\i,?,if;!
Job site address: ',5 3'3
City: <; ?F<-IJ)
Reference: \ 1-
DESCR.
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Name:
Address:
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).
ZIP: <7'? rt ?
Signature:
~.""'n-.
BCD license no.:e~Slo
Signing supervisor's license no.: S"Y/Q7 S
Print name of signing supervisor: T ~
Signature of signing supervisor:
.J - 6:ro.p
440-2584-J (9108/COM)
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. . . '., , Cost Total
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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 ocfeeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) { $ 81.00 $71
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 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) c.: -li-6:r.elF -$ " ~
201 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 pane!
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I.. $ 6.00 $]1.,:;
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder ~ot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign oroutline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
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(A) Enter subtotal of above fees $
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $ /'1 E:L
(e) Technology Fee (5% of [A]) $ - 5-
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TOTAL fees and surcharges (A through C): $ Is/.. 5"'1
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CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2010-00305
www.cLspringfield.or.us
IVR Number: 811134711979
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci.springfield.or.us
PROJECT STATUS: Issued
ISSUED: 9/15/.10
:: ,I
APPLIED: 9/15/10
EXPIRES: 3/14/2011
VALUE: $0.00
SITE ADDRESS: 33358TH
ASSESOR'S PARCEL NO:
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Springfield
1702343200100
PROJECT DESCRIPTION:
Adding electrical for athletic storage building" see COM2009-01174 for related record and
inspections
OWNER:
ADDRESS:
SPRINGFIELD SCHOOL DISTRICT 19
525 MILL ST
SPRINGFIELD OR 97477
Phone Number:
CONTRACTOR INFORMATION I
Contractor Type
.ct?ntract..or Name
Sp'RINTER ELECTRIC INC
Lie Type
CCB
Lie Exp
02120/2011
BUILDING INFORMATION I
# of Units:
o
# of Stories:
I Height 0.' Structure:
Type o.f;~eat::_.;.;_.~."
Wat"rJype:."'~,,:,' ',' ., .
:.::U: '~'" 11',.,1, ~ I~
Range,Type:i; !)..
~~;L,t~: '; .... ,r,
# of Bedrooms:
Hazmat:' ~.
Sprinkled Building:
Fire Alarms:
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal! Development Code:
Plumbing Specialty Code Ed.ilia":
Residential Specialty Code Edition:
Structl:'r.~t.:Sp~ci~~~ f:.~~~ ~~ition:
I doll'". ',' ",1 ' .
1';~'::li"'~:::;'."::; SIte InfQfhlataon
Energy Path:
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
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Springfield Building Permit
9/15/2010 1:58:43PM
Lie No
174458
Phone
541.743-1213
~
Lot Size:
Sq Ft 15t Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Occup"ifCYJ~!!agi'egon law re .
loHow rules adopted b t qlllres you to:
Notiiication Center Th y he/Oregon Utility
in OAR 952-001-00'10 those ruhes are set forth,
0090 y, . roug OAR 952-001_
calitngO~~~~~t~~~I(~~fei:et~~ft~~: r~~s by
numbercfor the Oregon Utility Notihcat~en'
enter IS 1-800-332_2344)..
Nonc~ . .
THI .;
AUT~~~~~~ JHALL EXPIRE IF THE WORK
COMMENCED O~DER THIS PERMIT IS NOT
ANY 180 DAY PER:6t.BANDONEO FOR
Page 1 of 3
Co
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225 Fifth St
Springfield,OR 97477
Phone: 541-726.3753
Inspection Phone: 541.726.3769
Fax: 541.726.3676
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CITY OF SPRINGFIELD
Building I Commercial Permit
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www.cLspringfield.or.us
PERMIT NO:.,81'{-SPR20)O-00305
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IVR Number: 811134711979
permitcenter@ci,springfield.or.us
PROJECT STATUS: Issued
ISSUED: 9/15/10
APPLIED: 9/15/10
EXPIRES: 3/14/2011
VALUE: $0.00
SITE ADDRESS: 33358TH
ASSESOR'S PARCEL NO:
SCOPE:
WORK INVOLVED:
:.t ";f.PE.oF STRUCTURE:
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Adding electrical for ath.I.~t!c. s,torage,lbuilding. see COM2009-01174 for related record and
"'e"'",r).", .,
inspections '.It,>" .",1,
Springfield
1702343200100
PROJECT DESCRIPTION:
DEVELOPMENT INFORMA liON ~
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of lot Coverage:
Highest point on structure to
north properly line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
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PUBLIC IMPROVEMENTS ~
, '.
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
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Sidewalk Type:
Downspout/Drains:
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.~~;:?Valu'ation Description ~
Description
Tvpe of Construction
Unit Amount Unit Tvee
Unit Cost
Value
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DescriDtion
Service~OO amps or less
Branch circuits with service or feeder each circuit
State of Oregon Surcharge (12% of applicable fees)
!echnology fee (5% o! permit total)
Total Amount Paid
, Amount Paid
$81.00
$3?,Q9. :'
Date Paid
09/15/2010
09/15/2010
09/15/2010
09/15/2010
ReceiDt #
374313
374313
374313
374313
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".," $136.89
Springfield Building Permit
". 9115/2010\1';1J58:43PM
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Page 2 of 3
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
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CITY OF 'SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2010-00305
IVR'Nu;nber: 811134711979
perm itcenter@ci.springfield.or.us
PROJECT STATUS: Issued
ISSUED: 9/15/10 ~::' " EXPIRES: 3/14/2011
APPLIED: 9f.151.10;.{.:' 'VALUE: $0.00
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SITE ADDRESS: 33358TH
ASSES OR'S PARCEL NO:
Springfield
1702343200100
~, ."\:;
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Adding electrical for athletic storage building- see COM2009.01174 for related record and
inspections
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Department Received Due Date Comolete ~.~ Result Reviewer Comments
Application Acceptance 09/15/2010 09/15/2010 09/15/2010~ . ~0ver. the'Co'unter' Chris Carpenter
Initial Review 09/15/2010 09/15/2010 09/15/201'6", Over,the Counter Chris Carpenter Over the counter permit
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Electrical Review 09/15/2010 09/15/2010 09/15/~01o.~: !'!9j,R~...q~.ired Chris Carpenter Over the counter permit
Mechanical Review 09/15/2010 09/15/2010 09/15/20).6; Not Required Chris Carpenter Over the counter permit
Plumbing Review 09/15/2010 09/15/2010 09/15/2010 Not Required Chris Carpenter Over the counter permit
Planning Review 09/15/2010 09/15/2010 09/15/2010 Not Required Chris Carpenter Over the counter permit
Fire Review 09/15/2010 09/15/2010 09/15/2010 Not Required Chris Carpenter Over the counter permit
Public Works Review 09/15/2010 09/15/2010 09/15/2010 Not Required Chris Carpenter Ov~r the counter permit
Energy Code Review 09/15/2010 09/15/2010 09/15/2010 Npt Required Chris Carpenter Over the counter permit
Traffic Review 09/15/2010 09/15/2010 09/15/2010 Not Required Chris Carpenter Over the counter permit
Structural Review 09/15/2010 09/15/2010 09/15/2010 Not ~equired Chris Carpenter . Over the counter permit
Pennit Issuance 09/15/2010 09/15/2010 09/15/2010 Issued Chris Carpenter
INSPECTIONS REQUIRED. ~
Inspections I~~,,,; il : '..,)j, -;:"
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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 any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or 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 apRroved set of plans will remain on the site at all times during
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Owner or Contractor Signature 1~''1 Date
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Springfield Building Permit
9/15/2010 1:58:43PM
Page 30f3
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www.ci.springfield.or.us
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TRANSACTION RECEIPT
811-SPR2010-00305
333 58TH ST
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
541~726-3753
permilce nter@ci.springfield.or.us
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224-00000.426102
224-00000-426102
821-00000-215004
100-00000-425605
TOTAL DUE:
tp-'A-y'M' 'ENT TYPE"'-""PAY OR'.'" . CASHIER' CCARPENTER "C'O'M-M'-EN- TS", .,.. 'f,7 ----:try'..''''" ,. -
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Services 200 amps ?r less
Branch circuits with service or feeder each circuit
DATE: 09/15/2010
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. $81.00
$36.00
$14.04
$585
$136.89
AMOUNt'PAID 'c'" . .
RECEIPT NO: 2010000326
RECORD NO: 81 l-SPR2010-00305
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
Credit Card
530532
mike michel
$136.89
$136.89
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