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Home My WebLink AboutPermit Electrical 2011-8-16 .- . .'''. Electrical Permit Application ~ - '"' ,,_ I< "" ."';.' '. " f ',":-" "'; ~_.* ':, '" ~ '"" '" ~ h It ,:Ql1\~L ()F)S'p~~~G1l:~E~D, 'gR~(ij.~~~.::; 225 Fifth Streett Springfield, OR 97477tPH(S41)726-3753. FAX(S41)726-J689 , DEPART~ENTU~E,~NLY 9PAINOPIELD 0:::::11 ~~"-:zJ Permit no.: (;( ( 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 APPROVA8, Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION o Residential 0 Government 0 Commercial ,....JOB. SITE'.INFORMATION.AND.;LOCATION (] City: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member afmy immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: Business name: E-mail: CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: -' '. FEE SCHEDULE 'f>~ , " ,,1~ -, Cost. Total ~~I"b~r:)of inspcctioniper; item,() Qty. ea.1, -: ~ 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: installation. alteration, relocation 200 amps or less (2) L $ 81.00 $ ,r( 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 I 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 I $ 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 addilioDll1 inspection: (I) $58.00 $ - '" " APPLICANt'lJSE ,'.; ,,;'i,<', (A) Enter sublotal of above fees 6/ (Minimum Permit Fee $58.00) $ (B) Enter 12% surcharge (.12 x [A]) $ 'F-=- (C)Technology Fee (5% of[A]) $ 40S TOTAL fees and surcharges (A through C): $ '1'i~ ~ 'VJ \w\ 5~~' JnJ <;,\\(. ~~ CD ~\bjjd-~ ~ ~\\eO~ \CO\ 'D~ St ~\~ .. www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01947 IVR Number: 811156482512 Issued 08/16/2011 ISSUED: APPLIED: 08/16/2011 08/16/2011 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci.springfield.or.us EXPIRES: VALUE: 02/11/2012 $0.00 SITE ADDRESS: 1001 35TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702312100100 PROJECT DESCRIPTION: SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial , Service for Qwest Phone Number: OWNER: ADDRESS: , , &UNDANCE LUMBER CO PO BOX 109 SPRINGFIELD OR 97477 Contractor Type Electrical Contractor # of Units: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Contractor Name TONY KOTH CONTRACTOR INFORMATION ~ Lic Type CCB BUILDING INFORMA TION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No 59748 lie Exp 05/19/2012 Phone 541-688-8996 o 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: 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: . AI I "-" II'_,~: uregon law requires you to 20j,10w ruies adopted by the Oregon Utility Notification Center, Those rules are set forfh 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). Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report R~quired: Springfield Building Permit Site Information 8/16/2011 '11:56:11AM ~ " I-"'~',:' NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of 3 .. SPRIN..G.F.IEL~D, .- ..~ . "~''7... OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01947 IVR Number: 811156482512 225 Fifth St 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 0811612011 ISSUED: APPLIED: 0811612011 0811612011 EXPIRES: VALUE: 0211112012 $0.00 SITE ADDRESS: 1001 35TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702312100100 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Service for Owest Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMA T'ION I 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 I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvee of Construction Unit Amount Unit Tvee Unit Cost Value FEES PAID ~ Description State of Oregon Surcharge (12% of applicable fees) ~~~vic~s 200 amps or less Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.72 """-~~-"_._'-'._-~ $81.00 ---_._--- $4,05 $94.77 Date Pa id 08/16/2011 08/16/2011 --,_._.......,.,._- 08/16/2011 Recio! # 2011002249 2011002249 ,-_.._--- 2011002249 Springfield Building Permit 8/16J2011 11:56:11AM Page 2 of 3 -. SP~..'N. G FIEL~ .~ . ~ ,i!M. ~>l' ,~ "......~.. OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01947 IVR Number: 811156482512 www.ci.springfield.or.us 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: 08/16/2011 08/16/2011 Issued 08/16/2011 ISSUED: APPLIED: EXPIRES: VALUE: 02/11/2012 $0.00 SITE ADDRESS: 1001 35TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702312100100 SCOPE: Electrical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Service for Owest Plan Review ~ DeDartment Application Acceptance Received 08/16/2011 ~ Over the Counter Due Date 08/16/2011 Comoleted 08/16/2011 Reviewer Chris Carpenter Electrical Review Comments: Over the counter permit l(nitiar'R~vr~w..~-,/,:,:-.e,. ~'-o87f672611:.. '08/:16/2i:l~;1;', b~!,.16/2011<-. . - Over;the:Counter-' -;,;",,8hris G,arpente~("'':'O'>~;'M'i: \,'<.~... ,).:,,'-~1 t~~~f&~~t:~~~~ii?un~~r_~:r~E~:;.:"~,j~C~~.~~'i'~~.1L. ~~_",Z:~'.~~~__j~,~' _~~!~,.,~. ~~:-. .~~~__,~_~~. ~__~~;~~:L.:~r:~!~'J 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. ~ I~-*-- Owner or Contract6r Signature U --9-/6-// Date Springfield Building Permit 8/16/2011 11:56:11AM Page 3 of3 Sr~~::l.~ ~ ~'OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541.726-3753 www.cLspringfield.or.us 811-SPR2011-01947 1001 35TH ST permitcenler@cLspringfiefd,or,us RECEIPT NO: 2011002249 RECORD NO: 811-SPR2011-01947 DATE: 08/16/2011 " .. >>J:k:i';'..;JI.:.>:' ": ::..--.J..AC;COUNLCODE, _~_2:.~~~____,,"'1VI0UNJ~DUEL...;SJ':c_JI 224-00000-426102 81.00 --.------.----- -- -.---.- 821-00000-215004 9.72 -_.- .----,..- 100-00000-425605 4.05 TOTAL DUE: 94.77 '..f hCOMMENf~.t;;:,:..':j:-"..",...... . ~. 'AMOUNT-F'AID,~ .... __,n 94.77 j tDESCRfl?~TI6N:i,,-,,-,~.::,'~ ";sr ___~ervices 200.~m~.::r:..'~~___ State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) PAYMENTT;YRE ' Check 7574 P~ygB'-' tCASHiERfCCARPENTEI3.:J: TONY KOTH 1 Lite Elect TOTAL PAID: 94.77