HomeMy WebLinkAboutPermit Electrical 2008-9-9
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225 FlFTH STREET . SPRlNGFlELD~ OR 97477 . PII:(541)726-3753 . FAX:'(541)726~3689
ELEC!,rll(::AL'l?ERMrT 1JJf-,LICATION "",( /, ",
City Job Number ",I,(',~,""\b'"\\.' 'i' ,Date
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1. iTiLOCATIONOEINSTALE'ATION.'i",!,:', ' " 3. COlHPLETE,FEE-SCIiEDULE BELOW"Cf"t:"f,!J:PI\f(i;{i,\1;f\:if
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LEG~y~~I9.,NN\'. :,')." r'r:L \ r+--v,..c....... A.'~}e';nl~Si,~~ptiar"-'SingI<o~ "!ulti-J<)",riiI); per d~eJli~g.,~nl!i~j
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" Each additional 500 sq, n, or
portion fuere~f "
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200'Amps o,r l~ss ' , . $ 70,00
201An)ps to 400 {unps, $ 83,00
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40,1 Anips to 6,00 Amps $138,00
60,1 Amps to 1000 Amps $180,00
Over 1000 ~psIVolts $413,00 ~ ')
Re~onnect OI)ly , ' \ $ 55,00 t&._. ~
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Supervisor Lic~qseNui:nber --:. "j( l_~ '-- ' c. " [~1l1~:)r:-l;p':l?~~~~~p~for'Xccde\s..i ',~,.:~rl:~<;;'l';f~Jt~~~~t.'~J'{~~~f~~~~::.&~~~~
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ExpirationDat~, /,0, _)/ -' i 0 ; t' ' Ins,~~lIation, ~lteration:'or Relocation
.:}" '; :. I .. ,),I,!."' 200Am~sorl~ss 1.1~,,1 $55.00
Constr,iContr, Number', <i,'~ 12/i " 201 ~~p~'io 400 Aihps $ 76,00
", '" 491 '{unps to 6poAmPS $110,00
ExpirationDat~" ,,' 4; 2:'+-/0 '!",' ' Ov,ci66d,~ps' ~r lboo,' Volts see "E"a. hove,
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Signature'or'S~PerviSirig Electrician ,':::,!1 D.' tP:'f~1~~,fi:~~.r~~r~~~M~~~!~~~~~~~~;i~Jtil~f~{gf~ff.~!%:~f&~~~~~~~~~~~~fll~U :.:
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The installation, isbei!.!8,marle on property i own which LimiteciEnergy/Comme;~ial '.-- , $ 50,00
is notintended for ~ltb~~I~s~So,rpetg,e~nblyaWthreeqoUrelrgeSon~~tilltI!P,I'b;'~irtm1,,' ,,', ','ct] '.,'~.~,'~~f.,~,~~;,~"~c,',c.~:;$,'~~_".,'~,i~.,,.,:,"",~ urctsha?\eS 00
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Owners Signature: ot/flcatlon Center" Those rules are sei forth,tetT1uiREKMI,j"SI-f "".",t+':Cjii,,;!.::::~;r,,1C,\;';;j .
, , ~n 0AF-l952-001-00JQ throuq~ OAR 952-0dfi.'Y'/Slltl:lfM<liWe, ALL EXPIRE IF ~ .~
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Inspcction~c'lucst: 726-'3769;l'.',t-, ""cf, TOTAL,,;',"" -YL.O- \
Shared Drive(f:YBuilding FonnslElcctrical Pennil Application }:..08.doc
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Permits arc nori-~sferable and expire if~ork is
not started within 180 days of issuance or if.work is.
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Electrical ContractOr
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Address 7" i.t-{ r;)'(,)l~',
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City Sf2bA::1~~ p I('r, Phone
'5 L/, ./410 41,.,S/o
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DATE
$117,00
$ 21.00
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Each Manufact'd Home or
Modular Dwelling Se;"i';e or
Feeder ' .
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$55,00
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 495 RIVERVIEW BLVD
ASSESSOR'S PARCEL NO.: 1703341403100
PROJECT DESCRIPTION: Reconnect Service
Owner:, STOBAUGH DANNY W & ILONA E
Address: 495 RTVERVIEW BLVD
SPRINGFIELD OR 97477
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01371
ISSUED: 03/09/2008
APPLIED: 09/09/2008
EXPIRES: 09/09/2008
VALUE:
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
I CONTRACTOR INFORMATION'
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
BUILDING INFORMATION I
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
License
nla
I DEVELOPMENT INFORMATION'
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROV~MENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descr.iution I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of 2
Residential
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occnpant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
Value
Date Calcnlated
Status
Issued
225 Fifth Street, Springlield, OR
54,1-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 100/0 Administrative Fce
+ 12% State Snrcharge
+ 5% Tecbnology Fee
Service Reconnect
Amount Paid
$5,70
$6.84
$2.85
$57.00
Total Amount Paid
$72.39
Total Valne of Project
Fees/p~i~ ,
Date Paid
I Plan Reviews I
919/08
919108
919/08
919/08
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01371
ISSUED: 03/09/2008
APPLIED: 09/09/2008
EXPIRES: 09/09/2008
VALUE:
Receipt Number
2200800000000001362
2200800000000001362
2200800000000001362
2200800000000001362
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I Reouired Tnsnee/ions'
, ,
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 of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any strllcture without permissioil 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 Contractors Signature
Paee 2 of 2
Date
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0137!
COM2008-0137I
COM2008-0] 371
COM2008-01371
Payments:
Type of Payment
CreditCard
cRcceintl
ii~.
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200800000000001362
Date: 09/09/2008
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
JEFFREY GUCKINBERG
,
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Page I of I
Jlh
00541d Phone
Payment Total:
2:02:03PM
Amount Due
57.00
2,85
6.84
5,70
$72.39
Amount Paid
$72.39
$72.39
919/2008