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Home My WebLink AboutPermit Electrical 2011-5-4 Electrical Permit Application ,'<-i1t", 0; .:. '/'~'"'~ ;!t."''''' . ~';:"1" -..~J!..':a.."_'~~~": ( 'CITY OF'SPRIN<:1FIELD 'URE'GON;' : ,.. '.".- . ~ _... f'- .;~" -,,-j;,._""<1 . .r---. "::".I-~-:;i': :' T. ~:...:.~~. 225 mtb Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 Date: 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] 80 days. , EOC~VGOVERNMENT'Ap'PROVAI3"':;-! Zoning approval verified? DYes D No :. . \;'C~TEGORy.~(jF .:CONSTRUCTION~:~"'.' D Residential D Government ommercial G'..;~iB:J,OB,;SI1iEi:INFORNiATIONFAND5LO_CATrION{,~?,:i&fi; Job site address: '2- r;, I r. City: p-f). /L. ZIP: Reference: DESCRIPTION, OF WORK' '""",;':"":,:1~,'':/'': ~t/~ ~T w'~ 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: Signature: . CONTRACTOR INSTALLATION c- E-mail: CCB license no,: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: om 440-2584-J (9/08/COM) '\';\?3~';1rfi::1~~'\Gt;,~1i'~~(i~:'.;'f';'FE1~;~',SCR E_[j.IliIEEr~,W~~~r:tit,;~~~~i.~:~tl1 , . ,'. ',' Cost Total iNuf!lber' oqnspectioris p~r.ite,m (). '. , Qty. "';'.'~~~~~' cost L. ,,'-:'" .', _,' '.': "'. _ ",'0' ',- I'.' ~_ :';::, ' '.' " 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: instalJation, alteration, relocation 200 amps or less (2) $ 81.00 $ 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: instalJation, alteration, relocation 200 amps or less (2) $~ $9-.1af.- 20 I 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 panel 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 feeder fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit $ 6,00 $ Miscellaneous fees: service or feeder f}ot included Each pump or irrigation circle (2) $ 63,00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58,00 $ :E~~d~M$~fJfJt~'~~f:i;t{'Af?~,llic~Nt:rOS'E\'.;,,;:~/~~'tl~;;;jk:~1:~"~::: .,~,~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ (B) Enter 12% surcharge (.12 x [A]) $ cr. 7--:J..- (C) Technology Fee (5% of[A]) $ 't.@S TOTAL fees and surcharges (A through C): $7~r1 .;- ,......., sp. RIHGFIE~ ~.!.U ~_ ~. . ,~ ,!P.... ;"~t",,,' ~.J.7 '" 'ly'h .. ).. OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00745 IVR Number: 811190719016 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspeclion Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield,or.us PROJECT STATUS: STATUS DATE: Issued 05/04/2011 ISSUED: APPLIED: 05/04/2011 05/04/2011 EXPIRES: VALUE: 10/31/2011 $0.00 SITE ADDRESS: 265 51ST ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702333202200 PROJECT DESCRIPTION: SCOPE: Right of Way Permit WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Placement in public right.ot.way: 100 Amp Service tor Quest Communications OWNER: ADDRESS: OSTRANDER JAMES L 265 N 51ST ST SPRINGFIELD OR 97478 Phone Number: Contractor Type # of Units: Occupancy Group Occupancy Comments # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Contractor Name TONY KOTH CONTRACTOR INFORMATION I Lic Type CCB BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No 59748 Lic Exp OS/19f2012 Phone 541-688~8996 o U Utility 100 amp service for Quest Electrical Specialty Co~e Edition: Springfield Fire Code Edition: M~chanical Specialty Code Edition: Municjpall Development Code; Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lot Size: Sq Ft 1 stFloor: Sq Ft2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: 2008 o Site Information Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: NOnCE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY'PERIOD. Springfield Building Permit 5/4f2011 9:50:11AM ~ ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obfain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Page 1 of 3 ~..... SPR.IN..G FIEL;iJ ."~ .....' (.~ . c::,,_,>, \ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00745 IVR Number: 811190719016 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 05/04/2011 ISSUED: APPLIED: 05/04/2011 05/04/2011 EXPIRES: VALUE: 10/31/2011 $0.00 SITE ADDRESS: 265 51ST ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702333202200 SCOPE: Right of Way Permit WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Placement in public right-of.way: 100 Amp Service for Quest Communications DEVELOPMENT INFORMATION ~ 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 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 ~ Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Description State of Oregon Surcharge (12% of applicable fees) ~ervices 200 amps or less Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94.77 Date Paid 05/04/2011 05/04/2011 05/04/2011 Recipt # 201.1000869 2011000669 2011000669 Springfield Building Permit 5/4/2011 9:50:11AM Page 2 of 3 .. - CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00745 IVR Number: 811190719016 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/04/2011 ISSUED: APPLIED: 05/04/2011 05/04/2011 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield,or.us EXPIRES: VALUE: 10/31/2011 $0.00 SITE ADDRESS: 265 51ST ST, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702333202200 SCOPE: Right of Way Permit WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Plan Review Placement in pUblic right-at-way: 100 Amp Service for Quest Communications ~ Deoartment Application Acceptance Received 05/04/2011 Due Date 05/04/2011 Comoleted 05/04/2011 Result Over the Counter Reviewer Kip Kaufman ElectrIcal Review 05/04/2011 05/04/2011 05/04/2011 Not Required Kip Kaufman Comments: Over the counter permit IlriiliatRevieW: ,Yt. '." ..':;"O~IO'!i20\k05/04l2g1r;;;05104/?O,1t:~i:OxeI)re:Co\!J5t""'~-<::,,_ .:Kip;Kaufll]ar;- ,',"' ,: '" lc?,~m:eh.ts:~'::9i.~~,tt~l~ i?~~~er:pe;:mJi:"r;~1_; t~~~~' Cr)',L':~~;:~;l;;,~\ .~ ~m~~~:3;1g~~": -'~ ~~~;!~~'~ ~j~'.:,~t~ ^~~:.~:~~ -f~:;;.~';' " I INSPECTIONS REQUIRED ~ 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' 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 loc~ted at the front of the property, and the approved set of plans will remain on the site at all times during construction. I ) Inspections 4225 Service or Feeder 01~ :;--"cf-I/ Owner or Date Springfield Building Permit 5f4/2011 9:50:11AM Page 3 of 3 SPR...I~..~.FIE..L~ ~L\' :.,fn~ ",:"._0... OREGON TRANSACTION RECEIPT .- CITY OF SPRINGFIELD 225 Fifth 5t Springfield.OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00745 265 51 ST ST permitcenler@cLspringfield.or.us RECEIPT NO: 2011000869 RECORD NO: 811-SPR2011-00745 DATE: 05/04/2011 lDES.cRIe.TION\:lZ~;.. .~~:'"."",?; ",;.&:~"~"J\,:: iW'!":~:.&:~;6;CC0UNf(c.obE';d;.i,.&::"'1i..,'. AMO.UNJtD.I.JE.. '1 Services 200 amps or less 224-00000-426102 81.00 Stale of Oregon Surcharge (12% of applicabl~.!ees) 821-00000-215004 9.72 Technology fee (5% of permit total) 100-00000-425605 4.05 TOTAL DUE: 94.77 1::EJ.\"IVI~~:LTY~~~;::;2:;R&o~tt<i;.ItiffiR:'KKAUfM~!'!i.". ;;....: .~"'COMM~NIs. {,{~: Check Lite Electric Service ck#7481 also covers 7481 #811-SPR2011-746 "~~;~';7":~2~,,~~M'~~A~MQl)~!:pAID~ "~'~~:2:~ 94.77 TOTAL PAID: 94.77