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Home My WebLink AboutPermit Electrical 2011-1-20 Electrical Permit Application 225 Fifth Street+Spriogfield, OR 97477.pn(541)72~3753.FAX(S4])726-3689 ~~ DEPARTMENT USE ONLY . J~ - S7'~7-9~L - Permit no.: CITY OF SPRINGFIELD, OREGON Date: L ~ 'L--{) -.l- L This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is Dot started within 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? g) Yes DNo Nu~ber of inspections per item ( ) Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Rtsideotia~ per unit, stnice included: o Residential m ~ Govemm;'- _1)!S..Commercial 1,000 sq. ft. or less (4) JOB SITE INFOR ION AND LOCATION $134.00 $ Job site address: 250 S.3?.I"~ST. Each additional 500 sq. ft. or portion $ 25.00 $ thereof City: sp",.,~ "'['=/.-" I State: a R I ZIP: Cl,(/7R Limited energy (2) $ 32.00 $ Reference: \ I trrJ~\ rY) I Taxlotf"i rv 1- '" Each manufactured home or modular DESC:::RIPTION OF WORK dwelling service or feeder (2) $ 63.00 $ I.. .., 1...4""'1"" '-'''\I'~ "R/<.A .vM 0 Rh' ,,..c- Services or feeders: installalion, alteration, relocation ~^I<. b_A ~"", ,,~. - IT 200 amps or less (2) $ 61.00 $ PROPERTY OWNER 20 I to 400 amps (2) $ 95.00 $ Name:\. ,." . '...., AI A ,,;e. \/.<<.12.0\-' ~ (?,a_ ...... ,r-r 40 I to 600 amps (2) $156.00 $ Address: Z 5 c> S.32""S~. 601 to \,000 amps (2) $205.00 $ City:SF'I2,^~ c'...,., ~ I State: 6 R. . I ZIP:<:f747P. Over 1,000 amps or volts (2) $469.00 $ Phone:c;~r?~~S~/~ 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 20 I to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 40 I 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 CONTRACTOR INSTALLATION Branch cin:uits: new, alteration, extension per panel Business name: I'J /. ^. ~n a. Fee for branch circuits with purchase of a service or feeder fee: Address: 5A,.....!!. A.5 .<<. p.,.",p( Each branch circuit $ 6.00 $ City: -[ State: I ZIP: ~ ,. b. Fee for branch circuits without purchase of a service or feeder fee: Phone:5'!1 073(,; '--( 5 '1'q I Fax: - - First branch circuit (2) \ $ 55.00 $5"S~ E-mail: Each additional branch circuit I $ 6.00 $ b5t. CCB license no.: I BCD license no.: Miscellaneous fees: service or feeder not included Signing supervisor's license no.: 4 O")":!, S Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: \c"...:. ...,PI""r ~I .D ""J:i.?..: o-ib" ( ( . Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor: /("', ...J. 1"\12. A/V. Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $56.00 $ ~~ APPLICANT USE (A) Enter subtotal of above fees $~/lJ!!. (Minimum Permit Fee S58.00) \~ (B) Enter 12% surcharge (.12 x [All $ '7~ (C) Technology Fee (5"10 of[All $ ~~ TOTAL rees and sureharges (A througb C): $ 71.3'i ~~ 440-2584-1 (9/08ICOM) . . ~SrRINGFIELD ~,'~7 ~ 'ii"'< ~-' ., c:"',','~'" OREGON www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: , CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00094 IVR Number: 811196960626 225 Fifth 5t 5pringfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us EXPIRES: VALUE: 07/19/2011 $0.00 Issued 01/20/2011 ISSUED: APPLIED: 01/20/2011 01/20/2011 SITE ADDRESS: 250 S 32ND ST, Springfield, OR 97478-6302 ASSESOR'S PARCEL NO: 1702310000502 PROJECT DESCRII'TlpN: OWNER: ADDRESS: Contractor Type # of Units: Occupancy Group Construction Type # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial 2 circuits o B Type VB NOT/CE- Electrical Specialty Code Edition: THIS PER" Springfield Fire Code Edition: A U TIJO R IZME1 IT S f-'M'JJ,a'iili!al ;SpeHtaltyJeode,Edition: I I D UN c . ~ . - NO' ',]L 'vunl\ COMMENCE l.iluJiciP\lIibD~lffiI!\ment>code' D OD -'''' nO' '0 'VU I ANY 180 DAY P ',,:SrribrngfSi?~i~!!Vqo3~Edition: EIk~ldential Specialty Code Edition: Structural Specialty Code Edition: Phone Number: lie No Lie Exp Phone WILLAMALANE PARK & RECREATION DISTRICT 250 S 32ND ST SPRINGFIELD OR 97478 fol/o t I Ol'iOJilifJ;l T.OR INFORMATION Cont~tO'fit!'lJl,iiIi~c_ Gamed b\;;~]~~ Ulres y.iJ:]ype "' UAR 95 _ ~'''~r. Ihose .",:::'c\Jon UWih ~~Jiin au may o/IW tirNG'INi1Q~~!\;JiQ~~orth 9 th ~ent ^''-''-' ofth - ~,- nUmber for ~R! St6'i's'Yote: the tie rUles by C uren0~ I','''' e ephonA entl;\ei\lhlpfu'Structurel Notifl' . ^' (j U-3302 cation Type of Heat: <eO' 344). Water Type: Range Type: Hazmat: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit Site Information 1/20/2011 11:18:13AM ~ Page 1 of 3 . . www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00094 IVR Number: 811196960626 225 Fi~h St Springfield,OR 97477 Phone: 541-726-3753 Inspection. Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE; Issued 01/20/2011 ISSUED: APPLIED: 01/20/2011 01/20/2011 EXPIRES: VALUE: 07/19/2011 $0.00 SITE ADDRESS: 250 S 32ND ST, Springfield, OR 97478-6302 ASSESOR'S PARCEL NO: 1702310000502 SCOPE: Electrical Dnly WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 2 circuits Fronlyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: 0/0 of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspoutfDrains: Valuation Description I Descriotion Tvpe of Construction Unit Amount Unit Tvee Unit Cost Value FEES PAID ~ Description Amount Paid Date Paid Recipt # State of Oregon Surcharge (12% of applicable fees) $7.32 01/20/2011 2011000133 TeZ_gYfe;(5%~total)---~-----~---$i05 --------01/2012011 ---- "2011006133- Branch circuits witho.ut.;;~;;;~;d~-1~i-~-.~.'"- $55.00M~_~----'-mii6i20~-- .___.n - -2.01-10001-33 Branch circuits without service or feeder - each additional $6.00 01/20/2011 2011000133 .-~--,~~--* Total Amount Paid $71.37 Springfield Building Permit 1f20/2011 11:18:13AM Page 2 of 3 .. .. www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00094 IVR Number: 811196960626 225 Fmh St Springfield,OR 97477 Phone: 541-726"3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 01/20/2011 01/20/2011 EXPIRES: VALUE: 07/19/2011 $0.00 01/20/2011 SITE ADDRESS: 250 S 32ND ST, Springfield, OR 97478-6302 ASSESOR'S PARCEL NO: 1702310000502 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 2 circuits Plan Review i DeDartment Permit Issuance Received Due Date ComDleted Result 01/2012011 01/20/2011 0112012011 Issued Reviewer Kip Kaufman Initial Review 01/2012011 01120/2011 01/2012011 Over the Counter Kip Kaufman Comments: Over the counter permit ~IA ," ~A""""'-'t"""-.'--';" ,.-, '0"'12""'0'-12-011""Y 0'11201'---'11''""01/20120-1~1'' .. O-''''''h:::i.,C"-- '-"'-"""';"""'''''K:''Kf''-w~'-'+?- ," ppllcatl~n cf~~_~n_ce,~.c,';~:,~_;t __"",.." ;"~_{'_~, .'*O?g~\.~~~ . ,. ,,' -.~'f:t,': _ . ~~r;t,"e;_;_9unt;;r"-"'l'. ',~-.IP?,jIU mat'!, <; ~.~ ;:_,~<;::~~;~' t~"~"r;;'i'2(~;~~' ~;":-2:fl7;;J1l~!~~~~J:flJ!);r~#~~,' ,~<., '<;~\i~?:f~~'~'}~~: ,:-~<'."'_:;~''',~~' ,,~~t;~}t'~,~~';-> -,' :' ~ ~>. ~~- '~;'~_~R~~'~:I( :_~,,_ ,A:' -~' _v ~~,:; _ ., "i,>.,~'.'j INSPECTIONS REQUIRED ~ Inspections 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 approved set of plans will remain on the site at all times during construction. . K~~z512~jl/ { /Zt? /Z-y// . I Owner or Contractor Signature Date Springfield Building Permit 1/20/201' 11:1B:13AM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00094 250 S 32ND ST permitcenter@cLspringfield,or.us RECEIPT NO: 2011000133 RECORD NO: 811-SPR2011-00094 DATE: 01/20/2011 lDESCRI~iaON i; '~'p..,;: . c"".;;;; ~:,::;;;',':';'J.1:j.J'l~':.:$f~iir;'~""Acc6uNj~co6E':::::'~';~!0#::4".,'AMOUN:tCl5uE!'", '_~' " Branch circuits without service or feeder - 1st circuit 224-QOOOOA26102 55.00 Branch circuits without service or feeder - each additional 224.00000-426102 6.00 State of Ore90n Surcharge (12% of applica~~ fees) 821-00000.215004 7.32 _.!,:chnology fee (5% of permit total) .______.__]OO.00000:~25605 3.05 TOTAL DUE: 71.37 ~l~~!$"_~UFM..A..!!,~"'j; ._.<::QMIVIENIS:'v:c .-;_~"..2LJ;~JviQU~IJ'A)Q,--.' d -'-___3 ck#85111 $71.37 LJ'1A,(M!;N.t'TYe:I;~;c:.~AydR' .; Check Willlamalane 85111 TOTAL PAID: $71.37 "\