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Home My WebLink AboutPermit Electrical 2011-7-5 . Electrical Permit Application - 225 F;[.h S'reettSpringficld, OR 97471+PH(541)726-3753'FAX(541)726-3689 DEPARTMENT USE ONLY Permit no.: 5'/ {- ((.,~ 0 Date: 7 5" I ( 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? DYes D No CATEGORY OF CONSTRUCTION o Residential 0 Government Commercial JOB SITE INFORMATION AND LOCATION' S,;, /(it, 5/- 012.. ZIP: '( 7 I; 7 1 '70) 3c.CXi Taxlot.:.?l'Ji30 DESCRIPTION,Of; WORK' L~ ,1-- Q I:~e c.. I. VI Job site address: :2 O.J- City: )', r' p,,-, /J. Reference: ~fP""T~ ,"PROPERTY'OWNER Name: S u /3 Address: 'J- ZIP: C; 7977 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: CONTRACTOR INSTALLATION Phone:~ - .7- E-mail: A.......6e/Je_.r.c..t v"" CCB license no,:/:'>-Y Signing supervisor's license no.: Print name of signing supervisor: ~,:"""" So(......... Signature of signing supervisor: ~... f?- ~'v\)'? \ }f 440-2584-J (9/08/COM) FEE SCHEDULE Nunlber of inspectionsper'iteDl' () Qty. Cost Total ea. cost Residential, per unit, service included: 1,000 sq, ft, or less (4) $134,00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof L' , . o<,uu . ,) 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 Of 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, I $ 63,00 $& '5 alteration, or extension (2) Each additional inspection: (I) $58,00 $ 1'; " j; 0,' A"PPLlCANT USE (A) Enter subtotal of above fees $~) (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ - ?~ (C) Technology Fee (5% of[A]) $~ J,JS TOTAL rees and surcharges (A through C): $ / "7 x/' ?7'" ( " CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01660 IVR Number: 811161209802 www.cLspringfield.or.us PROJECT STA TUS: STATUS DATE: Issued 07/05/2011 ISSUED: APPLIED: 07/05/2011 07/05/2011 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield,or.us EXPIRES: VALUE: 12/31/2011 $0.00 SITE ADDRESS: 202 S 18TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703360000500 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Low voltage cabling Phone Number: OWNER: ADDRESS: CITY OF SPRINGFIELD 202 S 18TH ST SPRINGFIELD OR 97477 Contractor Type Low Voltage Electric Contractor Name NATIONAL NETWORK SERVICES OF OREGON INC Lie Type CCB CONTRACTOR INFORMATION ~ Lie Exp 02/10/2013 Lie No 154300 Phone 541-726-9209 # of Units: BUilDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: 'Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Site Infonnation Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 7/5/2011 9:02:25AM Lot Size: Sq Ft 15t Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 2011 ATTENTION: Oregon law requires you to foHow 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 n1lmhpr fnr tho Or9....gli I U.:l:./.j' "._,'" . .' ~ ~enter is 1-800-33'2:2344i:"v~"v" I I .~ o. ...Jt;;;.. S FERMIT SHALL EXPIRE IF THE WORK ;THORIZED UNDER THIS PERMIT IS NOT OMfl/iENCED OR IS ABANDONED FOR ,NY 180 DAY PERIOD. Page 1 of 3 . S~~~NG;I.EL~. ~~ ~.OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01660 IVR Number: 811161209802 225 Fifth Sl Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/05/2011 ISSUED: APPLIED: 07/05/2011 07/05/2011 EXPIRES: VALUE: 12/31/2011 $0,00 SITE ADDRESS: 202 S 18TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703360000500 SCOPE: Electrical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Low voltage cabling 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 I Descriotion T voa of Construction Unit Amount Unit Tvee Unit Cost Value FEES PAID ~ DescriDtion Sla~e of Oregon Surcharge (12% of ~pplicable fees) Data I Telecommunications T,:~h6~lo,9Lf:e (!,o,(~i P!~i; t~t;i)--------' Total Amount Paid Amount Paid Date Paid Recio! # $7.56 07/05/2011 2011001863 $63.00 07/05/2011 2011001863 - $3:-15 -------'07/05/2011--- -- ----- - 201i00i863- $73.71 Springfield Building Permit 7/5f2011 9:02:25AM Page 2 of 3 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01660 IVR Number: 811161209802 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/05/2011 07/05/2011 Issued 07/05/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753- Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us EXPIRES: VALUE: 12/31/2011 $0.00 SITE ADDRESS: 202 S 18TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703360000500 SCOPE: EleclricalOnly WORK INVOLVED: Alleralion TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Low voltage cabling Plan Review ~ DeDartment Permit Issuance Received Due Date Comoleted Result 07/05/2011 07/05/2011 07/05/2011 Issued Reviewer Chris Carpenter Com"m'ents: :...;"" Initial Review 07/05/2011 07/05/2011 07/05/2011 Over the Counter Comments: Over the counter permit [bPplicalion P":cepl~iic~c;\' ,:, 97/05/2011/;07/0~!29j,_1;:' 07/05/201'1' - [.."'......." ".-._,..~.,cr" y_)\>i>"'j%_I....'I,~:i -;;."';"''')'':''~,&",",- <r.....~, _ ;""';t'.'.~t-",.,,;;;~_,,,^,,,,,. - ~~:~~-~ - ft", ~ Over theCounteir:- '!..~;~:~<~ {: . INSPECTIONS REQUIRED ~ Inspections 4550 Limited Energy 4999 Final Electrical Final Electric: When all electrical work is complete. Chris Carpenter ~, : '''- 'qt5ti~i.Bf~rP'.e~t~_r ,":.:.....JC.:'.....:. :'." -E':%;'bfTCt'ry-,:~~ _.-.:,~::_ 1 ,,",,' 7' 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. ~.---'~ Owner or Contractor Signature 7/ if /; Date Springfield Building Permit 7/5/2011 9:02:25AM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth Sf Springfield,OR 97477 541-726.3753 www.ci.springfield.or.us 811-SPR2011-01660 202 S 18TH ST permitcenter@ci.springfield.or.us RECEIPT NO: 2011001863 RECORD NO: 811-SPR2011-01660 DATE: 07/05/2011 lDESCRumON'" '~e. - ;-O<-"';ff!"",e~"%'l ',"""'1:.> i ~1.\CCQI.iNT:C.6DE- """" .'AMOUNT.DUE -I Data !Telecommunications 224-00000-426102 63.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 7.56 Technology fee (5% of permit total) 100-00000-425605 3.15 TOTAL DUE: 73.71 Ll'~ VIIiIENT; 'f'YPE,.'..:.PAV:6R'" '!-':C~SHIER::tCARP~TER,fLC;;.911i1I1i1ENtS*i,_~_ e', ~AMOUNT PAID. .. Credit Card NATIONAL NETWORK SERVICES $73.71 070308 OF OREGON INC TOTAL PAID: $73.71