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Home My WebLink AboutPermit Electrical 2011-5-11 225 Fifth Streett Springfield, OR 97477 < PH(541)726-3753. FAX(541)726-3689 'OEPARTMENTUSE ONLY ; ,"'->.' . 511 - )b:J Date: c; 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. .- , :' "',cE0C~L:G0VERNMENT"Ap'pR:OVAIS!;\'~"':;;'t'i"'V' Zoning approval verified? 0 Yes 0 No ';~):\'ii'/d.cATEGORYi&'Of,;;CONSTRUCTION!'$":'';b' . " D Residential D Government Commercial ~~~iilOB'iSITE1,INFQRMAT'IONI'AND!iG0CA;'(;10Ni(!(l!!\',,;;-;i~ '2-0 "7D 3>7 f2-. ZIP: q-; <""- .," Name: Address : w ZIP: City: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, Or rent. OAR 479.540(1) and 479.560(1). . I'C- 4t'VD City: Phon E-mail: CCB license no.: ~'17 'f Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440.2584-J (9/08/COM) (J.J /C- #:- 7 't<1 I liF<~?i;~~~~~t,tj~J!-W~;$~f1FEE;1.~'-CH E[j_U~EfC1!~if1~i}~?~~~~~ <.N ~~,~~!, ?r;~~,_~p~~t~?r?"~ .~,~r.}t~.~:'-(-)\ ~,Jq!r'.' Cost" "\: Total ._{:'~ea:::' ._': . cost. Resid~ntial. per unit, se~vice 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: installation, 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: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 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 l $ 6.00 I $ 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 not 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: (1) $58.00 $ :tl~1'r_~l~~1~Iftt.lwiAR'J?,uIC'AN1!~lJ,s.'E~~"t~~~*%;ffiffi~j'~;i;;;:~~:: (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $"'Y1 (B) Enter 12% surcharge (.12 x [A]) $ <]1) 2- (e) Technology Fee (5% of[A]) $ l{.OS TOTAL fees and surcharges (A through C): $ 9 'i 72- . , . S~~~N,G::'E,_,~ ~~~ ~.O.REGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00800 IVR Number: 811167690685 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.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: 204 30TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702310005200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100A service for QWEST repeater OWNER: ADDRESS: GOODWILL IND OF LANE COUNTY 855'SENECA RD EUGENE OR 97402 Phone Number: CONTRACTOR INFORMATION' ' Contractor Type Electrical Contractor Contractor Name TONY KOTH Lie No 59748 Lie Exp 05/19/2012 Phone 541-688-8996 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 2011 ~ Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit Sf11/2011 2:22:21PM Page 1 of 3 S!.~INGF.IE~LD .. :,h_ ~ OREGON 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-SPR2011-00800 IVR Number: 811167690685 permitcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 05/11/2011 05/11/2011 EXPIRES: VALUE: 11/06/2011 $0.00 05/11/2011 SITE ADDRESS: 204 30TH sT, Springfield, OR 97478 AssEsOR's PARCEL NO: 1702310005200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: sideyard Setback: Rearyard Setback: Solar Setback: 1 DOA service for QWEST repeater DEVELOPMENT INFORMATION ~ 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 Tvpe Unit Cost Value FEES PAID ~ Description State E!. Oreg~,Surcharge (12% of applicable fees) ~ervic~~OO ~~E~._~es~~~ Technolo~y fee (5% of permit to~al) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94.17 Date Paid 05/11/2011 05/11/2011 05/11/2011 ReciDt # 2011000924 2011000924 -..-...........-...,,-...,,-.......-.- 2011000924 Springfield Building Permit 5/11/2011 2:22:21PM Page 2 of 3 SPRINGFIELD ~;; ~_it!;b ,- '* OREGON CITY OF SPRINGFIELD 225 Fifth 5t 5pringfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMITNO: 811-SPR2011-00800 IVR Number: 811167690685 permitcenter@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: 204 30TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702310005200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100A service for QWEST repeater Plan Review -~ Department Application Acceptance Received 05/11/2011 Due Date 05/11/2011 Comoleted 05/11/2011 Result Over the Counter Reviewer Chris Carpenter Electrical Review 05/11/2011 05/11/2011 05/11/2011 Not Required Chris Carpenter Comments: Over the counter permit lnit!~J',R~v1eY':.' c,4~-~ ': '\r<--':Q~iFF211 J._,,~Q?JliJ(?;9H:-;rq,5(t1/J~;1~.,<. . Q'geflthe'~ou0ter,,~;;, :-,-~::-C~hns_carRenter;::~:z,,:~ :~ CO~lllments:"'- 6v~r~the;co~ht~[l~f;nif~:~;i:~~~~_~'>O-~;~:;,;X~t;Yl~:~~~.., "~~tf~1~f0- '~:'i:;:-:{~;:: P~. "~.~': , ~ ,,~4 ' ','1- ',",. ;:;f: ~.,:] 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. 5' -I! -I! Owner or Contract r Date Springfield Building Permit 5/11/2011 2:22:21 PM Page 3 of3 . . www.ci.springfield.or.us TRANSACTION RECEIPT 811-5PR2011-00800 204 30TH 5T CITY OF SPRINGFIELD 225 Fifth 8t Sprlngfleld,OR 97477 541-726-3753 permitcenter@cLspringfield.or.u$ RECEIPT NO: 2011000924 RECORD NO: 811-SPR2011-00800 DATE: 05/11/2011 lDESCRIP..TI0NY" t.:;:",!'" "-~,;~-',:.~''''.;g-i='~i-'" ,po,;,: t' ,,: ACC0UNT~C0DE';;:' ." " ":.S.~'::'AI\I10i.JN:tDUE~;""'-,:::....j' Services 200 amps or less 224-00(~OO-426102 81.00 Slale of Oregon Surcharge (12% ,?!~pplicable fee~L 821-00000-215004 9.72 Technology fee (5% of permit total) 100-00000-425605 4.05 TOTAL DUE: 94.77 ~l YMEijJTh:WPE~;:t~ff5F?Ay6f{1trcA~H1E'R:~ccltRPEN~TER"'_""~:+F>~~!.~C'oNfN!~NT~";~'!:flf:~~.f~.-~-''':-;::i~S;$j~~- < ~~AMOLJ~"(PAID7~- ,;. " -. 7"-'7]'j Check Lite Elect. TONY KOTH 94.77 7499 TOTAL PAID: 94.77