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HomeMy WebLinkAboutPermit Electrical 2010-11-19 225 Fifth Streett Springfield, OR 97477. PH(541 )726.3753. FAX(541 )726-3689 c' ... " ' ;c " '.,~- '-.. ..,),",'" -.-~ '" DEPARTMENT, USE ONLY . '" ' "," ,,'" . i,~ ~>'~""7'\~'\ '..' ",d,~~' ,:,..>,,\.,... ,. .... " pennitno.:~\D . Date: \ \ . \ C\ . D This permit is issued under OAR 9t8~309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issu.ance or if work is suspended for t 80 days. ~.;,';~~i!:i;"~;;tOCAl!:,,'GOVERNMENT?;ApRROVAt;,i;~~":" cc:T'.... Zoning approval verified? DYes D No ~'~!il';'i'II,\'~}!'~CATEGORYiiOF,V,CONSTRUCTfON<.;".';'l' ':C:/ D Residential I D Government I ~ Commercial ;~;;'~'~JOB,SITE;INFORMATION;AND'lOCATION , 1.000 sq. ft. or less (4) ,,('\ =.' 1 Each additional 500 sq. ft. or portion $ Joh site address: 'YJr I I~ 't~n~ thercof $ 25.00 City: 5-1-'"" \ r 111. State: ~ ZIP: C .'4!f11 Limited energy (2) $ 32.00 $ Suhdivisio;Y \., \1~2.1.W Lot no.~n ~\q. Eaeh manufactured home or modular $ 63.00 ".';;'.\.'t!:;..,....":I....'"".".."...DESCRIPT.ION.cO".WORK"'.""'........,.....'.',..'.'..'. "".'.'" dwellIng service or feeder (2) $ "~, ,:._l~i.~. ~~""6.~".-."'t"'>'" . "" . .,~ r,li\I, . ~. "" ,', ..\';,1.)'."... ...\t' ,"'(~ },,, >".".;:,: \ I, (J-\) n r -;l \ ~.r.rllJ l..ln-<' l 't') 't\ ft \)/rl.~rvieesorfeeders:inslallation.alleralian.relacalian ;~'iiJ\J,~":;;~:~MflI?RORERT,C'O\lll~E~~'\~~'i1~f:~3'\j~;'r.::f:r; ~:~ ~;::oo::;: ;:; I ~ : ::::: ~~ Name: ~""'\ 0 f'\o l(",(\--O l-10""'1 '\~ 401 to 600 amps (2) $158.00 $ Address: '60 t-h -nr r-t" t I "") ::--., 601 to 1,000 amps (2) $205.00 $ City..L'\..... 0 tI'i Stat~j )l] ZIP,c~ T 1\ Over 1.000 amps or volts (2) $469.00 $ Phone: '" ~ I Fax: _ _ . I' Reconnect only (2) $ 63.00 $ E-mail: -- Temporary services or feeders: installation, alteration, relocation 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). '. Signature: r::'('\\i~i,!,i~j)'CONTRACTOR:,INST ALIlATION~:",~:t;,,~i;;';.' \,,,, Business name: f\ 0 1 t'\ /1 \,.., 1 , s: J , /IT;... ,,;. , Address: (JD .Ad -!J ~3 City: F, I /J d /YfO I StateN ZlpQ7t.J 0 :;L Phone~l/7 -b~ (,,-;::;::11"'\1 Fax;~q I hf?:nJ..... E-mail;../l1i#..);1A..........JoJ/JI.Th ;..... . CCB license no.: 51() l?8 BCD license nodJ-I{/c:;/' Signing supervisor's license no.: ,::;~ ::J S .... Print name of signing supervisolli.. J;, ."'.:h ~ 1/11 ,. Signature of signing supervisor: _'I ~ 7 {/ ',/ NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PE~IS NO COMMENCED OR IS ABANDO~ -. .~ ANY 180 DAY PERIOD.. . \.~ ~( 440-2584-) (9/08/COM) II" .,'.'. )";A::f~;.FEE.SCHEDI1LE ,r~'ill;(c ~ "'~;;;;-; ;A~<C';' ,\,!::; ,,,,!,\,,,.,,,~, ,_~' .,~"'- (,,;.; ~'";"', " ~,,; 'Number,.ofinspecti(;tis i>erltem (_) Qty,; ,. "'," '~i'-':i"""', .,~ 3':\~'," "'." -'" ,~' ::' . . .,,:.. -- ;~;, -.e' ": --..;;, Cnst ea. Tntal cost Residential, per unit, service included: $134.00 $ 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, alteratiOfi, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit J2j'~ $ 6.00 Vi b. Fee for branch circuits without purchase of a service or feeder fee: First branch cir~uit (2) Each additional branch circuit $ 55.00 $ $ 6.00 $ Miscellaneous fees: servic.e or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) . $ 6~~>9-q n < , .. l' r" ill rrf Signal c}~~ft bi11Ijrl1ii~a~nlerro' p'an~i,t ,; 0 'C1r1'63100t~'h litM~~h alteratidn~~br,'exteiisiofi (QpOplClO uy ,~>J' t f > . , _, .-:>I"o.c::o ' t-1r.-+'r!r"1Wln v----e-!Llt:1 lllU '- ....- -. I,hr Ench :ida!!.i~nal~~l,,~~,~~n;,mn thrn lOh ()Af~5_8J!0.~C$I- ~i~."'.;"t''iiJ.)~'i'!*J,';'v'''''''':C:;;A'-RDi'''''''A'''N''o'''U'SE' '<'l'tlieWule.s;"'Y.....T:.<.. ~__"<\it"~,'fff!{,, (\ ".,.",,... .'.r,,_,",~~..,'_. 'J,;'" "~h,l.,_",~,_,A.'\,...,,,..,,."'~~.,~\~...-,-.!%~:,- (A) Enter~M~(9t'1l @nb(j~e'fCes. (Note: the te 3pn~ol.,,, \2. oJ''' (Minim~!\!JI~i.rmijFce..$58:00)'g0I1 U\IlIty Nc Lifle, , ').J . . ~~... .-."n f"lQII , I.'prn~r It> t-<lUU-'-''-'~ - A,-A (B) Enter t2%surch'arge (12 x [All $.' (C) Technology Pee (5% of [All $ .Inrp.(d) TOTAL rees and surcharges (A lhrnugh C): ~ -, ~~ C>"\ - -.. ~\t)J\ tw~.cV TRANSACTION RECEIPT 811-SPR2010-00257 2800 GATEWAY ST www.ci.springfield.or.us CITY OF SPRINGFIELD 225 Fifth 5t Springfield, OR 97477 541-726-3753 permitcenter@ci.springfield.OLUS RECORD NO: 811-SPR201Q-00257 DATE: 11/17/2010 , .. ....:h-." lid ."", . .. 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'::,~'.: / 224-00000-425602 $18,616.75 611-00000-426604 $10.00 719-00000-426604 $492.55 719-00000-426604 $94.28 444-00000-426607 $11.59 445-00000-448025 $682.79 444-00000-448024 $52.21 447-00000-448027 $7,231.78 446-00000-448026 $1,984.24 443-00000-448025 $578.60 442-00000-448024 $1,185.46 224-00000-425603 $209.00 224-00000-426102 $803.00 224-00000-425603 $76.00 224-00000-425603 $76.00 224-00000-425602 $222.00 224-00000-425604 $1,929.75 224-00000-425602 $0.75 224-00000-425603 $19.00 224-00000-425603 $114.00 224-00000-425603 $38.00 224-00000-425603 $133.00 224-00000-425603 $57.00 224-00000-425603 $19.00 224-00000-426102 $2,022.00 224-00000-426102 $380.00 224-00000-426102 $810.00 224-00000-425603 $76.00 100-00000-425605 $1,228.78 821-00000-215004 $2,949.06 224-00000-425602 $228.00 224-00000-426605 $22.80 100-00000-425605 $11.40 TOTAL DUE: $42,364.79 lPA YiviEN'j;D'j5E!'~:: PA\':OR '::I:!i'!C'ASH'ER'CCARPEN'rE~',lcdlVilVigiitrsJ:,;i4IIF}':I:'11l!:.111"."111' I' l' ;'AIVi0UNT:j5AiQ'!~'I,ITI'?:' .. ", "I RECEIPT NO: 2010000853 IIIlESCRIPTION Buildin9 Permit Fee SDC: Administrative Fee - MWMC Regional Wastewater SDC SDC: Total Transportation Administration Fee SDC: Total Sewer Administration Fee - SDC: Compliance Cost - MWMC Regional Wastewater SDC SDC: Improvement Cost - MWMC Regional Wastewater SDC SDC: Reimbursement Cost - MWMC Regional Wastewater SDC SDC: Improvement - Transportation SDC SDC: Reimbursement - Transportation SDC SDC: Improvement Cost - Local Wastewater SDC: Reimbursement Cost - Local Wastewater Water heater Electrical Plan Review Storm Sewer Storm Sewer - Each additional 100 feet or portion of Miscellaneous copies Mechanical Permit fee (based on value of work) First copy Hose bibb Water closet Urinal Sink/basin/lavatory Floor drain/floor sink/hub Drinking fountain Branch circuits with service or feeder each circuit ., '37 Services 201 to 400 amps 11 Services 200 amps or less to . Fixture Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) Deferred Submittal Admin fee (10% of applicable fees) Technology fee (5% of penmit total) Check HOWARD S WRIGHT CONSTRUCTORS LIMITED HSWC petty cash case-freeman Check 677 " $42,102.59 $262.20 $42,364.79