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Home My WebLink AboutPermit Electrical 2011-7-28 .) . Electrical Permit Application ~ 225 Fifth StreettSP.ringfield, OR 97477+PH(541)726.3753+FAX(541)726-3689 ;':~~'Yi:+YV.:<' ..~'.. .~-. {"''i''.w:Y';<,4)/<~~-_:\:-:r.: y""OEPARTMENTUSE ONtY~~R,.. ,,:0.\1-" "s/'k,,::..;,'. --:'>t>:'>;~0:0"0;;"--.;; Permit no.: 51/-'0 ('6(( Z 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 180 days. . :~':'.LOCAL. GOVERNMENT..APPROVAl:.... .:.j.~ Zoning approval verified? DYes D No . CATEGORY..OF.CONSTRUCTION:' mmercial ilL City: Phone: E-mail: This installation is being made on residential or fann 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). Fax:. E-mail: CCB license no.: _ Print name of signing supervisor: Signature of signing supervisor: ATTENTION: Oregon law re Ires 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). rJi 0.. ~\ <\'<< ~.~ 440'2584-) (9/08/COM) '.' ::..-,; ."',FEE-SCI:lEDULE < ;'-'..; <; < '- Cost: . Total ':. . ..... '. .'. .~.' .>" . .,. . ',': ',: "..~.,.. :' :' 'F!.nn~~r'ofins~:~~tioDS 'p,er itemo(~j~ Qty, ~F:;'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 Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling .service or feeder (2) Services or feeders: instal/ation, alteration, relocation 200 amps or less (2) I $ 81.00 $ <;:;;-1 201 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 $ 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, 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 $ Eacl~sign or outlioe lighting (;D~ .r 'T\ E 'J'J $'~3.00 $ ~ C ~siisn~ \ir\~~t~~~ll!lWJr~~t~w. ~ \S IN~ ~3 00 $ r' ,<!!1t!,raWp,o eAA\~~( \'0 _ r'" . 'I~ . "'))U\~~ $ 1\\ I-",a,~ au I 0 s!l!:e~'ll'.".(1 $58.00 C - ::-.1"'\ l\L''i \..' .,~ ", p \\~) IEnter.sublo I of above rees $ f?:/ (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ 'in ,. -(C) Techoology Fee (5% of[A]) $ lfb, ~ JrOT AL fees and sureharges (A through C); $ 91/.77 , [ -. SPRI NGFI..EL?iJ .~j .,~ ;;e;'~".-' .," _""-ref,, XC';: .~ OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01842 IVR Number: 811103946117 www.ci.springfield.or.us 225 Fifth 51 5prin9field,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726.3676 perrnitce nter@ci.springfield,or,us PROJECT STATUS: STATUS DATE: Issued 07/28/2011 ISSUED: APPLIED: 07/28/2011 07/28/2011 EXPIRES: VALUE: 01/23/2012 $0.00 SITE ADDRESS: 3890 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702314101600 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Owest power pedestal100amp service Phone Number: OWNER: ADDRESS: MCKENZIE VALLEY DEVELOPMENT LLC 525 HARLOW RD SPRINGFIELD OR 97477 Contractor Type Electrical Contractor Contractor Name TONY KQTH CONTRACTOR INFORMATION I Lie Type CCB BUILDING INFORMA nON I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Units: 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: lic No 59748 Phone 541.688.8996 lic Exp 05/19/2012 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 Site Information I Engineered Fill: Fill Volume: Flood Hazard tf'lt . Land Hazar<;~e~~NTION: Oregon law reqUires you to Retaining vr.t~i':~W rules adopted by the Oregon Uti/'t Soils Repolh~iw~~[n Center. Those rules are set fo'r~ 0090 Yi 2-001-0010 through OAR 952-001_ ca'iingO~~~~~~~~I(~~fei.et~~ftteh'eeprhules by number fo th 0 . one C r e. regon Utility Notification :. enter IS 1-800-332-2344). ....,'...r [~OTICE: . . 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 7/28/2011 1:13:05PM Page 1 of 3 SrR.1N.G.. F..IELD~.. .;.. ':.:.: ~., .~m"OREGOH CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-01842 IVR Number: 811103946117 permitcenler@ci.springfield.OLUS PROJECT STATUS: STATUS DATE: 155 ued 07/28/2011 ISSUED: APPLIED: 07/28/2011 07/28/2011 EXPIRES: VALUE: 01/23/2012 $0.00 SITE ADDRESS: 3890 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702314101600 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: awes! power pedestal100amp service 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 ~ Descrietion Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ DescriDtion State of Oiegon Surcharge (12% of applicable fees) ~ervice~?9E.. amps ~L!?sS Technology fee (5% ?f permit total) Total Amount Paid Amount Paid $9.72 $81.00 $4.05 $94.77 Date Paid 07/28/2011 07/28/2011 07/28/2011 Reciot # 2011002133 2011002133 --.- 2011002133 Springfield Building Permit 7f28f2011 1:13:05PM Page2of3 SP~:l~~:n~ .~>~ . E'0\.c OREGON www.ci.sprlngfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01842 IVR Number: 811103946117 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 permitce nter@ci.springfleld,or,us PROJECT STATUS: STATUS DATE: Issued 07/28/2011 ISSUED: APPLIED: 07/28/2011 07/28/2011 EXPIRES: VALUE: 01/23/2012 $0.00 SITE ADDRESS: 3890 MAIN ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702314101600 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: \ Owest power pedestal100amp service Plan Review i Deoartment Permit Issuance Received Due Date 07/28/2011 07/28/2011 Comoleted 07/28/2011 Result Issued Reviewer David Bowlsby ~,~~~,~!&~l,.~~giew :i~~~~~JPents: Initial Review 07/28/2011 07/28/2011 07/28/2011 Over the Counter David Bowlsby Comments: Over the counter permit !APPlication'Acceptance' '-,"., 0712812011': '07/28/201'1." 07/28/201,1 Over the 'Counter. ;.' ,. ;P)'vid BowlSby' ", ;, .w: " r,~.~:~M~~;'.~~~.~.~>._,;;_':_~~:~o '~f;,:,:{"~ ..' ::~~~:;J~l:/.:,~,~ k,<",~"~"~~:._~".,:~1,- "", '~.:~:)~~,; _Z~~:r~"~ '.1] INSPECTIONS REQUIRED ~ Inspections 4220 Electrical Service Electric Service: Approval required prior to utility company energizing service. 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 Oate Springfield Building Permit 7/26/2011 1 :13:05PM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726v3753 www.ci.springfield.or.us 811-SPR2011-01842 3890 MAIN ST permitcenter@ci.springfield.or.us RECEIPT NO: 2011002133 EDESCRI~:J710'N::'\',~Z:~,~~:', c~;i~~~~?:*:~+'i,t+4Fqz;",; -...Hf~ Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) j,. :PAYMENT,rYPE("'t' Check 7556 ,-- 1-, -"..--~."t;i0<7Z';' ....'.,"'.. "",' ,_~ ",,- '<""":'7':'1..:.,-'" "~... ~.. ::' :-':.,," '.. "-'. " ~'. '-',- ':.: ... .",:"" 'PA YO.Rl: 'F.CASHIER:;DBOVibSBY/~?i;;"'~:"~,,, ". .J~.QNlM,J;.NT~L~~ lite electric service RECORD NO: 811-SPR2011.01842 DATE: 07/28/2011 J'~J;;:";).~r,'r ." '. 'ACCOUNfrtCODE,'-, '-~, J:(,;;!'AivlQUNJ~b.lJE; ;,Y ,"- "4 224-00000-426102 81.00 821-00000-215004 9,72 100-00000-425605 4.05 __ .. ____n __ TOTAL DUE: 94.77 L,j , , . ".':...e-MOUNT;I'AI[)*t;':~ ,.; "'''..'''1 94.77 TOTAL PAID: 94.77