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Home My WebLink AboutPermit Electrical 2011-3-31 225 F;fth Street.Spdngfield, OR 97477.PH(541)726-375HFAX(541)726-3689 DEPARTMENT USE ONLY Penn it no.: SII-5ff This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ',- ',' . 'LOCAVGOVERNMENTMP80VAt:'<;.f',';;'" Zoning approval verified? 0 Ves 0 No ,.;>, " .')CArEGORY'OF'CQNSTRUCTIONG.", ,." ,', o Residential I 0 Government I [!(c:ommercial ~~~!~;\;i,JOB.:Z,Srr:E(INFQRNiATloNiAN[)r'I!.QCATION:,i;ib~{;: Job site address: Lf"3 &; f P II-tS l( sr. City: g P)i!-If//6/t&U State: 6.1'-' I ZIP: Reference: \fl n1r~f) :.J- fJr I Taxlo\.: ') r;....r::..,{'f J) DESCRIPTION OF WORK ,,:>::i!:',. ',. Il W f?3T 100 A /L1 /~ Pt? te) e:;?'L j~ f3;J . ::~;'~i:~.:'.<~f:r.,~:~f:r~:.~~~{NA~I:i?;tr~FE:E~FSCH EJjQ8E;i~'~;!1?;\~f<(~~!t~~~~~'~}.'~~1iH;;-~ , '. -- :Nilll~berofinspectioris ~~rite~'O;i_ Qly. .~~~t 'Total cost Residential, per unit, service included: 1.000 sq, ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $134,00 $ $ 25,00 $ $ 32.00 $ $ 63.00 $ Services or feeders: installation, alteration, reLocation 200 amps or less (2) PROP~TY OWNER . 20 I to 400 amps (2) Name: Ko,UJ. [~\,1(Y.......t 401 to 600 amps (2) Address:\ d'i XI :\ ~ .ft! (\, ~p \ ,n U:tt-I" -pOI to 1.000 amps (2) City:~Ii:{'\\(m .I cfl State: ('iY T ZIPfflN\ Over 1.000 amps or volts (2) Phone: =0\- I Fax: _ _ Reconnect only (2) E-mail: Temporary services or feeders: instalfation, aLteration, reLocation I $ 81.00 $Yl $ 95.00 $ $158.00 $ $205.00 $ $469.00 $ $ 63.00 $ 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: CONTRACTOR INSTALLATION Business name: L; rE:: ~~ SC:::7u/(~ Address: Fo i30y II! 3"7 City: ~[, t::::PY State: 0/2'... I ZlP:"17ht'o PhoneS'!! - 6&fi /' (!;qq b I Fax: - - E-mail: CCB license no.: 517 'z' % I BCD license no.:?tJ --zBk? 'S .;; c; ?..5 1VN!-' 1~7H / Y- IkJd /' /J '. . , ~\\\I\ ') ~V ~ Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440-2584-J (9/08/COM) 200 amps or less (2) 20 I to 400 amps (2) 40 I 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 pane! a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeaer-fee: First branch circuit (2) Each additional branch circuit $ 55.00 $ $ 6.00 '$ Miscellaneous fees: service or feeder ':lot included Each pump or irrigation circle (2) Each sign or outline lighting (2) $ 63.00 $ $ 63,00 $ Signal circuit or a limited-energy panel, alteration, or extension (2) Each aoditional inspection: (l) $58.00 $ ;I~{t~~%j~~{~:JMYJN'~~3I~~10~tARe_OTc_~NT!:~JjsE\~%~;i:t{:-~;;~'},';:::~[(;~~:l~~/.\:!, $ 63.00 $ ,.:..,..",:" i.'.'-.';-'" (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) . (C) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through C): $TI $ {r;?:::. $Cf~ $ cr't~ ~ .. " ,:., www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00528 IVR Number: 811117997509 Issued 03/31/2011 03/31/2011 03/31/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perrnitcenter@ci.springfield.or.us EXPIRES: VALUE: 09/27/2011 $0.00 ISSUED: APPLIED: SITE ADDRESS: 4361 DAISY ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702323405500 PROJECT DESCRIPTION: SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial New 1 OOamp service pedastel Phone Number: OWNER: ADDRESS: YBARRA GREGG & SANDI 6893 SIMEON DR SPRINGFIELD OR 97478 Contractor Type Electrical Contractor # of Units: # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit o CONTRACTOR INFORMATION I Lic Type CCB BUILDING INFORMATION I ATTENTION: of~~orifW:requ\res ytlU};O follow rules adc\1J'!9!lti9~Slr~cfureg(ln Utility Notification Cen\"r]l'peroli:HealiJ1eS are seLf(jQ(jfljh . 52 001 nnlfl ilir"\Ilgh OAR 96,,- . In OAR 9 - -wa :r~'Yge'ies of tha rulll~ by 0090.. You may .m.~ge~~' the lelap\'Hl1'lll ncua~I~~r t~~ f~~IW,~~bn 'Utility Notlflclitlon Center is 1-800-332-2344), Contractor Name TONY KOTH EI~ctrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal J Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition\<.. "r Structural Speciilltv (f'~~\~C/;li.Q,~ ..nTh.ro" nlO\\-\ro' , 01HIS- PeRM /"\~';:, -lto~r\Cr ~'Ion' I\.Ul\-\OR\Ie 'R IS I\.BI\.NO \~C COMMeNCO~~ ~eR\OO. I\.NY 180 0 0 3/31/2011 12:02:32PM Lie No 59748 Lie Exp OS/19f2012 Phone 541-686-8996 Lot Size: " Sq Ft 151 Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 2008 Page 1 of3 . " CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-00528 IVR Number: 811117997509 pe rmitce nter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 03/31/2011 ISSUED: APPLIED: 03/31/2011 03/31/2011 EXPIRES: VALUE: 09/27/2011 $0,00 SITE ADDRESS: 4361 DAISY ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702323405500 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: New 100amp service pedastel DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % 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: Downspout/Drains: Valuation Description I Descriotion Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Descriotion State of ~rego~..~_ll.rcharge (12% of applicable fees) Servic~~.3.29~~ps or les~_._,__,,____ Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94,77 Date Paid Reciot # 03/31/2011 2011000592 ----03i31i2ii11-~-201:;ijoo592- 03/31/2Cii',--- 2011000592 Springfield Building Permit 3/31/2011 12:02:32PM Page 2 of3 .. . www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00528 IVR Number: 811117997509 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitce nter@ci.springfield.or,\.Is PROJECT STATUS: STATUS DATE: 155 ued 03/31/2011 ISSUED: APPLIED: 03/31/2011 03/31/2011 EXPIRES: VALUE: 09/27/2011 $0.00 SITE ADDRESS: 4361 DAISY ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702323405500 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: New 100amp service pedastel Plan Review ~ DeDartment Permit Issuance Received Due Date ComDleted Result 03/31/2011 03/31/2011 03/31/2011 Issued Reviewer Chris Carpenter Initial Review Chris Carpenter 03/31/2011 03/31/2011 03/31/2011 Over the Counter Comments: Over the counter permit f":!~----'~: . .~. . '......"'. .. ~~.~~~.~"--7.~~~"'7:.".-;'~'P'~7<"C""'-.~..~_._~~'~.=.":;'"";:r---~~-::- -:T 7-;:-~'.-' !AppJlcatlon-Acqe:ptance."""~/'- '~~:~f}p3/31/2011;#,:-:03/31/201,1,-i 'O~131/20_1 t - ,,:'AA_Over1he~ounterT>~+$~^ v:Chrls,Carpenter"I~' _ ,~_.. .' , ~: l'~ _;:~'~<\_z;:::~~~:;~{-,:J~:rt~t~,~~~:~~~;~~~~~~~ j~~~;~~;;J~~i~{~~'~~~7~'~~~~~~;~t;"~r)tt;,~_~;~~~:'~~~'Z~ ~~ ~''\ .':} .~. ~70:t,_, ;,--' ,^LJz<'~,-:,~_~~~~",--"~' - , INSPECTIONS REQUIRED ~ Inspections 4225 Service or Feeder By signature, I state and agree, that I have carefully examined the cOl!lpleted 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 constructiont}/~ ~ I ' Owner or Contractor Signature V 1-/- // Date Springfield Building Permit 3/31/2011 12:02:32PM Page 3 of 3 , TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 www.ci;springfield.or.us 811.SPR2011..()0528 4361 DAISY ST permitcenler@cl.springfield.OLUS RECEIPT NO: 2011000592 lDESCRi~'nofll~,qo"-"" Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of pen:nit total) RECORD NO: 811-SPR2011-00528 DATE: 03/31/2011 ::;:' ,:;ji"~:<~~: 0:':' '~~'0,~,y~~~~1i].r}'+,t;'~'ct:,O.fJNJic.otjE':/~c~-)~~~i~t4~-':f~~TPAMO:O N'T~bUEt"'~"%~'~ll 224-00000-426102 81.00 821-00000-215004 9.72 100-00000-425605 4.05 ._-'._' TOTAL DUE: 94.77 ~MYM~~J.;tfk~1i~:~~~ h1!I~AlQJ~jjfusHIER';,~c'cA'RPENTER~"'~~'!~\~9:QMMENl~i2~?:~if';~~?J=L ';~~:::~~,>~g,!L~1l:e~lP':-~::i:; ,:,' f '___:..:1 Check TONY KOTH Lite Elect 94.77 7456 TOTAL PAID: 94.77