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Home My WebLink AboutPermit Electrical 2011-6-28 225 Fifth Stmt.Springfield, OR 97477+PH(541)726-3753+FAX(54I)726-3689 ,;;.'-,;.;,.,:.',- ..,'" DEPARTMENT USE ONLY >";',.:.-. Pennit no ..$ (I -I (p I 2 II Date. This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. "1'-' ",,', o/'V) 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. CONTRAC10R INSTALLATION' '77l-I C- VlfD E-mail. CCB license no.. ><17r;s:- Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~.\ \tIt;; 440-2584-) (9/08fCOM) ~?t~i~ft~~?{WJ~,~ff~t&'~;.I~~f~:r:r;:_E'5fS'C:8 E_b.LJ (]Ef0}~t~7<<&}~~~~~<<~~r~I ;.~ u'nt~e.r",~.f;i~.~p'e.~ii'~.'ns ..p~~;'~i~;~~~'...(--r:~JQt"Y'.' .~';:~i~~:,";~ 'Totai' _' f.,-, ~), _> .: ,.,_, '"',,':C~""" ,.' -,i..tf . .,~, '. ".-., .-,_,: ,'-"'~9st' {, Residential, per unit, service included: 1,000 sq. ft. or less (4) $134.00 $ Ea~h 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. $ql~ j...- 201 to 400 amps (2) $ 95.00 $ 40 I 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 $ 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 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: (l) $58.00 $ ~II ~ (A) Enter subtotal of above fees rr-- (Minimum Permit Fee $58.00) $ (B) Enter ]2% surcharge (.12 x [AD $ 0~ (C) Technology Fee (5% of[AD $ i./~ TOTAL fees and surcharges (A through C): $ qtj?!2 .I . CITY OF SPRINGFIELD SP~.,.,I~~.. FIE~ ~,L' . ~.. ,au. ',~i ~ .,!:",~, OREGON Building I Commercial Permit PERMIT NO: 811-SPR2011-01612 IVR Number: 811101990758 www.ci.springfield.or.us 225 Fifth SI 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: APPLIED: 06/28/2011 06/28/2011 Issued 06/28/2011 EXPIRES: VALUE: 12/24/2011 $0.00 SITE ADDRESS: 3205 OREGON AVE, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702313402200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100A service for Qwest site Phone Number: OWNER: ADDRESS: GU,Y OLE & GLORIA 3205 OREGON ST . SPRINGFIELD OR 97478 CONTRACTOR INFORMATION ~ Lic Type CCB BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: AfT.ENftdN' dreg 0 I ' Water Type: ", ' n aw reqUIres YOI follow r~les adopted by the Oregon U It ge Type: ~Jotlflcat'on Center, Those rules are set ?ftrat: In_OAR 952"00H010 through OAR 952-001- 0090:, You may obtain copies of the rules b eaIllrig the Center, (Note: the tele hor. Y, , , ' ;lymber for the Oregon Ut'/'t N t'fP ,Electrical Specialty Code Edition: I I Y 0 I Icatlon Center is 1-800-332-2344). Springfield Fire Code Edition: Contractor Type Electrical Contractor Contractor Name TONY KOTH # of Units: o # of Bedrooms:. Sprinkled Building: Fire Alarms: Energy Path: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lie No 59748 Lic Exp 05119/2012 Phone 541-688-8996 Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 2011 Site Information ~ Engineered FiJI: FiIf Volume: Flood Hazard'tea< Land HJ,fY,i\sThMIT SHALL EXPIRE IF THE WORK Retainin?,';"'",I!. ~'7 0 UNDER THIS PERMIT IS NOT Soils Report Rrqui/Jl, ABANDONED FOR COMMENCED OR IS ANY 180 DAY PERIOD. ,'-.' Springfield Building Permit 6/28/2011 2:50:29PM Page 1 of 3 .. www.ci.springfield.or.U5 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01612 IVR Number: 811101990758 225 Fifth 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 06/28/2011 ISSUED: APPLIED: 06/28/2011 06/28/2011 EXPIRES: VALUE: 12/24/2011 $0.00 SITE ADDRESS: 3205 OREGON AVE, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702313402200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 100A service for awes! site 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: Downspout/Drains: Valuation Description ~ Descriotion Tvpe of Construction Unit Amount Unit Tyee Unit Cost Value FEES PAID ~ DescriDtion Amount Paid $9.72 $81.00 $4.05 $94,77 Date Paid 06/28/2011 06/28/2011 06/28/2011 ReciDt # 2011001818 2011001818 ---- 2011001818 State of Oregon Surcharge (12% of applicable fees) ~:~~ce~_3,~9 am~~ or less , ~'_,,_____ Tec~nol~~. fee (5% of permit total) Total Amount Paid Springfield Building Permit 6/28/2011 2:50:29PM Page 2 of3 www.ci.springfield.or.lJs CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01612 IVR Number: 811101990758 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci,springfield.or.lJs PROJECT STATUS: STATUS DATE: Issued 06/28/2011 ISSUED: APPLIED: 06/28/2011 06/28/2011 EXPIRES: VALUE: 12/24/2011 $0,00 SITE ADDRESS: 3205 OREGON AVE, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702313402200 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100A service for Qwest site Plan Review ~ Department Permit Issuance Received Due Date 06/28/2011 06/28/2011 Completed 06/28/2011 Result Issued Reviewer Chris Carpenter Initial Review 06/28/2011 Over the Counter Chris Carpenter 06/28/2011 06/28/2011 Comments: Over the counter permit ApglicatiohAcceptance' '"~" . <c_ \+-:",,;:'&:1';::' ,"" __~ 7 'v06/28/2011 ~96j28j20110' '''<;7>"., - , ,;:~~+*: 06/2~/2011' 1'''' _.. Oyei'the:Caunter ~ '" ~''''''' ~~x..} t ^'" :1;',' , , ....-. Chris;Ca'rpenter . :::J,o' ~)>- "7 '; ,,c', ':< ';,,' ~.,~:.: ,_,:,,:, " ""'" ~ 'TJ"" . ,.-',' , j ~;, . "" -'r 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?r /~~ / / l Owner or Contractor Signature V ~/~2/!( Oat / Springfield Building Permit 6/28/2011 2:50:29PM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 81 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01612 3205 OREGON AVE permilce nter@cLspringfield,or.us RECEIPT NO: 2011001818 !DESCRIP..TfoN. ,,, "."" " b"". .... .,;". . ___~ervices 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) PAY.OR,~ cilsi""^It"CCARPENTER TONY KOTH RECORD NO: 811-SPR2011-01612 DATE: 06/28/2011 .. ,,' ACCOUNJ2C.0DE:"._:,,c.. . 'AMOUN:(D@............:..: f- i 224-00000-426102 81.00 821-00000-215004 9.72 100-00000-425605 4.05 TOTAL DUE: 94.77 , . . COMMENTS';;;:';;;_z:~L:'-:': -'''~MOUNTI'AID. 94.77 .-1 L.P~.YM~~T1YPE. Credit Card 040784 TOTAL PAID: 94.77