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Home My WebLink AboutPermit Electrical 2011-5-11 Electrical Permit Application 225 Fifth Street. Springfield, OR 97477tPH(541)726-375HFAX(541)726-3689 "OEPARTMENTUSE ONLY ~':'. 3 t - <5f~ 781--1 Penmt no.: Date: 5 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. , "110CAL ;'GQVERNMENT ':MF!ROVA",j,'::t~.~':~":\"': Zoning approval verified? 0 Yes 0 No :;";''';':''.h\,dCATEGORY:!iOf,;:CONSl'RUCTION[';t' .'. o Residential 0 Government 0 Commercial ~-t~*Jf0U_OBXSIJ'E(;INI;ORMA;(IONI!ANJj~G'O.c-AJiION~yl!i1i.t1'; Job site address: is? 03 N 1/-/ IV ..sl. City: ? j) - State: rJ It-. Reference: I 'O~ Taxlot '. ..' 'DESCRIPTION QF WORK'iH,i\i+.:'j;;' We51 ! 00 1/-14 f> 'l!W (:?7L q}f) /J'S f71"1--- 'PROPERTY QWNER . Name: c:- Address: City: ZIP: 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). Signature: ZIP~ {,I If 0 E-mail: CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~. 6~~ ~~ 440-2584-) (9/08/COM) ~7~~}:/fJ~~:_K~0~~%tkip:~~f,t'::r~F,'I:E;{IS-CH ~O..o ~E;{~0~l1r~f.}~}f}1~~~' ., -.,' .~-, , . ,"" ..y' '-"',_'f i,',' .~,'.,,'.' .. . COSt'" Total , ,~u~ber orinspectio_n:s,p~r ite.in'O",-~;. Qty. ~"'" ,,__' , ~.." ,..-;.' :-,~,' ,-' ,,:~ -';:, .' ;;i '/ '" t -': ( . ',;:. ~'1'.. '. . :;'._ J"~ea.,,-"".:I ;'- -'CQSt.' '. Residential, per unit, service included: ],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 $ $ dwelling service or feeder (2) 63.00 . Services or feeders: installation, alteration, relocation 200 amps or less (2) I $ 81.00 $ ~l e: c- 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to ] ,000 amps (2) $205.00 $ Over ],000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 2.00 amps or less (2) $ 63.00 $ 20] to 400 amps (2) $ 87.00 $ 40] to 600.amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, altera/ion, extension per panei 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/Yo! 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 $ ';'~:f)jil?Y~-%,*~~f1~!~~f~l4;i!ARPlfic~Nt:~;;{lf~fE~~'i~,"'''-iZ~Ii;;"';Yi:J,';X~ :~.~~,:.'~'.;~c :~'.\{;,"'L "j,!>>,:.' _IS,!";.h"",'!:/~""\ "~;~~ _ .. ,,',')':,",-', '", /h _~\'D~v.::.,~'","!;--:.J4.bf,~~'!~~'f:';'1:,... c':? (A) Enter subtotal of above fees ;>? j 90- (Minimum Permit Fee $58.00) $ (B) Enter 12% surcharge (.]2 x [A]) $ <1,7:; (C) Technology Fee (5% of [A]) $ 4. ~:; TOTAL fees and surcharges (A through C): $ Cftf '-::J l' f ., www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00799 IVR Number: 811184629802 Issued 05/11/2011 ISSUED: APPLIED: 05/11/2011 05/11/2011 225 Fifth St Springfield.OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci.springfield.or.us EXPIRES: VALUE: 11/06/2011 $0.00 SITE ADDRESS: 5303 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702333107303 SCOPE: ElectdcalOniy WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100 amp Service for Owest Phone Number: OWNER: ADDRESS: ARM CHAIR HOLDING CO LLC 38533 JASPER LOWELL RD FALL CREEK OR 97438 Contractor Type # of Units: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: CONTRACTOR INFORMATION I' Contractor Name TONY KOTH Lie Type CCB BUILDING INFORMATION 1 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No 59748 Lie Exp 05f19/2012 Phone 541-688-8996 o Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal J Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit Site Information NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT ' COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I ,....... 5/11/2011 2:19:30PM 1 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Page 1 of 3 f :. CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.$pringfield.or.u$ Building 1 Commercial Permit PERMIT NO: 811-SPR2011-00799 IVR Number: 811184629802 perm itcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/11/2011 ISSUED: APPLIED: 05/11/2011 05/11/2011 EXPIRES: VALUE: 11/06/2011 $0.00 SITE ADDRESS: 5303 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702333107303 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 100 amp Service for Qwest DEVELOPMENT INFORMA TION ~ 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: DownspoutfDrains: Va luation-Descri ption ~ Description Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID . Description State of Oregon S~rcharge (12% of applicable fees) ~.::r\lices 3.~O amps ~r_less TeChnology fee (5% of permit total) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94.77 Date Pa id 05/11/2011 05/11/2011 05/11/2011 ReciDt # 2011000923 2011000923 2011000923 Springfield Building Permit 5/11f2011 2:19:30PM Page 2 of3 i ~ CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00799 IVRNumber: 811184629802 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 05/11/2011 05/11/2011 Issued 05/11/2011 SITE ADDRESS: 5303 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702333107303 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: 11/06/2011 $0.00 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100 amp Service for Owest Plan Review ~ Deoartment Application Acceptance Received 05/11/2011 Result Over the Counter Due Date 05/11/2011 ComDleted 05/11/2011 Reviewer Kip Kaufman Electrical Review 05/11/2011 Comments: Over the counter permit Initial'Revie,,",. '" c ,"1'l'"., .05/W201'1' i:OS/,t1I20Y1 t.' OS/.11/201'1,W" Overihe'Counler-:, ,.,~.,dKip.Kaufmilii-~ ., "'",_~: ". -~i~:iA~.''''~ .~ INSPECTIONS REQUIRED ~ Inspections 4225 Service or Feeder 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. )'-((-/( Date Springfield Building Permit 511112011 2:19:30PM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541.726-3753 www.ci.springfield.or.us 811.SPR2011.00799 5303 MAIN ST permitcenter@cLspringfield.or.us RECEIPT NO: 2011000923 RECORD NO: 811-SPR2011-00799 DATE: 05/11/2011 ~DESC RIP.J"lON',;, ",-'::!::"'. '.c". ~: '("n".c::::~:'f,n;:'"ll:f?,' ; *~J?CC()UNJ~CODE~ ,.~.,.:},;;:;':~ff:;'.in '.A.lVIo.l.JNJj:>:OE" Services 200 or less 224-00000-426102 81.00 State of Oregon Surcharge (12% of applicable fees) ._~~~..:215004 9.72 Technology fee (5% of permit total) 100-00000-425605 4.05 TOTAL DUE: 94.77 {1 L:p)>.y]lJf~::rJYPE2;~)>'Y:&"'\~~siiiff<:RKAUFMAN_~S~~~l\'LiJls~IS~~~;;'tfdH.: ,.'. ,'5eii; i!,-MP.l!NTp~I().5:::S::' " --.') Check Lite Electric ck #7499 (see 511-800) 94.77 7499 TOTAL PAID: 94.77