HomeMy WebLinkAboutPermit Miscellaneous 2009-2-10
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00192
ISSUED: 02/1012009
APPLIED: 02/1012009
EXPIRES: 08/10/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspe~tion Line
SITE ADDRESS: 4750 FRANKLIN BLVD SPACE EI4 EUGENE TYPE OF WORK:
ASSESSOR'S PARCEL NO.: 1803031103500
TYPE OF USE:
PROJECT DESCRIPTION: Replace MH main bfeakerm
Owner:
Address:
KLEMAN KENNETH J
6208 CAMINO DE COROZAL
TUCSON AZ 85704 ,,:. ::';'hll. .~
III ~:~R ~/(1/)"~j:~~~i~CTOR.INFORMA nON.
0090 5::;'0 ' ' , '
o 'You 01'00' I/)ose'~ Ureg ~ YOu 1
ContJ-a~tQrlh InCly Ob(IO Ihrou r~/es ClreO/) Ulili/License
WILL'fAM- ~'{!;;p.:')f(Jii/~ OOPi,,~ OAR o~?t fOrt~1351 '
L-e/)te,"-is'f 'BuiLDING:iNFOIWA:flroN I
, . , . 1f11 J I'
Jvu_3 '.cy No ""'fOne oJ'
#324';).,. //"0"1'
OT~"'T\~: y 10/)
Height o(Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
04/28/20 I 0
Phone
541-501-5650
Contractor Type
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooins:
'.
Lot Size:
Sq Ft 1st Floor,
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq F) GaragelCarport
Sq Ft Other:
Occupant Load:
nla
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
l'
'l"HvU liCE: I DEVELOPMENT INFORMATION'
" ISPE "
AUTH RMIT SH '
Co ORIZED UN AL~f1~e f'
AN~l~~NCED OR ~%RiI~~~~ i"!L/fiqiWORK
DAY P"'R fI!ll~1 I rJS NOT
c:, 10D."!. 0 <fl'fJrr
REQUIRED PARKING
Total:
Handicapped:
Compact:
I P~BLlC l~~ROVEMENTS ,
Street Improvements: '
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Notes:
Downspo;v:~
'(.~
I V ~Iuati~~ D.escdp,tion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Sqnare Footage
or Bid Amonnt
Value
Date Calcnlated
Page I of 2
Status
Iss u ed
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2009-00192
ISSUED: 02/10/2009
APPLIED: 02/10/2009
EXPIRES: 08/10/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
F.~~~ Pa!d ,
Fee Description
+ 12 % State Surcharge
+ 5% Technology Fee
Minimum/Adjnstment Electrical
Amount Paid
Date Paid
Receipt Number
$6.96
$2.90
$58.00
2/10/09
2/10/09
2/10/09
1200900000000000089
1200900000000000089
1200900000000000089
Total Amount Paid
$67.86
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. ~i11 be made the same working day, inspections requested after 7:00 a.m. win be made the following
work day.
I RCf!uired Insl]cctions.
Rongh Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signatnre, I state and agree, that I have carefnlly 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 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 plan~ will remain on the site at all
times during construction.
Owner.or Co~tractors Signature
Date
Page 2 of 2
Electrical Permit Application
" e B
~iji:t'i!i,;y.f';;:>-'\r~c-.0"-';h~'Ym'4'i]1ill'" '.' "",~~~i.'0U{J~1
~1f ,DEp'ARTMENlj,USEiONI~.y,; ;[it
",jfl""r~~:'/0~'~;;""t:>~h')"'[<<"":1:;;<';"'~,""-~~1E't!:{:;g:i~J:l":5"'''
- .. .. -
I
I
(0""'2.01:>9- 00 } 92.-
Permit no.:
Z-/ohoo 7
I I
225 Filth Streett Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
Date:
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issu~nce or if work is suspended for 180 days.
1~1!()~G~!-il.Gb:v.EBNMENifilt.lliP.P.RbV~!-~~
I Zoning approval verified? 0 Yes 0 No '
'~~~l!ii'lj;;A",E<30RY~bF.!I:::::C:>NS5ERl!l.omIQN~~4liIli';;l\)$
1 I Residential, per unit, service included:
o Residential 0 Government I 0 Commercial
:~:';:E:'~;"~.~~~~r1!;~~ i ~~::::;:, .~''" ;':::
1=~~~~~,~~bN(O~Wb~~~~1,~~ I J~~~I~~S~~~~:~~ fe~~~r (~)odular . $ 63.00 $
1 &ti /ICE yVI1+ vVlAuv ~f2cA.-L.~ 1 Services or feeders: installation. alteration. relocation
~ 1 200 amps or less (2) $ 81.00 $
'J"l':'o~4i'l'iEio'Sji!~,BRO'riER"':V"'li"O'W'NERi"l"l;i;'!!fii1"i'!.'jjl,{i('iit..",fii.i 1201 to 400 amps (2). $ 95.00 $
~iL *4'~"'~,~-,"_",~_,_'l-. ., ... ,_Id. ......_.".'_IJi..fL.... ,_ _... c..._ _.._c.xti,:,;.""".;(.r'-.'!Thli?&iUh'Z::r"'!.,0's.-.,,,hl'i.;l ,
Name: iht( LLew1 Ad. 1 J. ~I to 600 amps (2) $158.00 $
1 Address: hZOF CAvv\IND 'Dc L~~~,~0-b~2~~1,000ampS(2) $205.00 $ _
1 City: I '-^ c.5 oAr' 12.1 State: .Jl--1- J, L!t'\'O~1:;l -l ~ S ~o'(%'\;Ooo amps or volts (2) $469.00 $
/ I '-f~" .Q, . \...,1 .I}.. _ (tg, YN
1 Phone: _ _ I RaX':O~'::;oQW~'::ose IV;':: O~". "'1~'l1ect only (2) $ 63.00 $
_t"'~.~ 0.\...\' ," l(\" J ~( \\V
I E-mail: f\ \ ' ~ ~u\~.... Ce\"\\e'. '\ () \'(\\ v. .~eS 0' ~\01 a'f-,i)~.I~ar;(Y"y services or feeders: installatiOn, alteratiOn, relocatiOn
. \\n . "'('\ \ nO or-nO \",,0 \y <r
This installation is bemg made l;o"es'ide.i:!tijl!"6T ~"{!I1\~'O~df' '~\' ~)'IJ 1:/ amps or less (2) 1 $ 63.00 $
owned bJ: me 0: a member ofmy~l!)irFediak~ falb).lY,\U'his ()\\ \l\\: """r'2\il to 400 amps (2) 1 $ $
property IS not IDtended for sale,\exc.\1iill~ \."l!5e!'6~("en$.~~'" 87.00
479.540(1) and 479.560(1). ()" ~\\\d~ \01 \.'t\ 'IS \-'0 I 401 to 600 amps (2) 1 $126.00 1 $
c :oel \el
SIgnature: {\U\\' Ce{\ Over 600 amps or 1,000 volts, see services or feeders section above
~~c~o'Nm~Cm0RIINSmP.:I!IlAml~N~~~Sfi~l; Branch circuits: new, alteration. extension per panel
Business name: O~i l ( "5 :;2 r..J... c 7" (" f A C I I a. Fee for branch circuits with purchase of a service or feeder fee:
Address: !l17,- 0 (? .-t,ar - '-'- I [) y- 1 I Each branch circuit j , I $ 6.00 I $
I City:. 5",t /A [ State: 0 r 1 ZIP: 11 Yo 21 1 b, FeeforbranChcircuit:.'1.~~If:'''l4fj}~,l~~Yaserviceorfeederfee:
1 Phone: :; - ~.; So / 5 uhFax: S -'If -'7</?/J~\MlC, t:, First-y'~~l\c~R~~9M\I \S ~U, 1 $ 55.00 $
1 E-mail: ~~\Sl ?~h1i'hW.\i'9~~wffil:.t\) f\)\\ 1 1 $ 6.00 $
I CCB license no.: -:J (3 s ( 1 BCD license no.: JO f Y itl.I.Jl~qlll\~!Wm\'3e~\)fe~7c; or feeder not included
I Signing supervisor's license n~ ;}!j) .~a .Jlr.. COI^~ 1~~~\il?J,l.\\;lttion circle (2) $ 63.00
1 Print name of signing supervisor: 17 I' f ( ;R... 'v. f>,N {, ~ch sign or outline lighting (2) $ 63.00
I Signatureofsigningsupervisor~ '11/1 11/1 '1 /J I Signal.circuitorali~ited-energypanel, I $ 63.00 $
- . ; ~vLJ/ ~'r q _i/l-- alteratIOn, or extensIOn (2)
f I. Each additional inspection: (I) 1 1 $58.00 $
1~~jKp,.FilliQ'At{tiasE_~~
I (A) Enter subtotal of abovefees ..... '" ,.. $ ~-
(Minimum Permit Fee $58.00) ) 0
1 (B) Enter 12%surcharge(.12x [A]) $ b 7b 1
I (e) Technology Fee (5% of [A]) $ '2 po 1
I TOTAL fees and surcharges (A through C): ' $ 67 810 ~
1~~""""'~~_'iiL.",.;$!"'-' "'..'."".' .'" "'''.lfmii{'1g'__.c;,;,'
~.,,$j'ij~~~'?l:r_IiE;E:~_S,\':HE[)_tJl!E:i'if'.,):~2Wf~ll
1~"",j\",{"'W\~;j!~'''!;~'''l1!I,'li%",.w'~li'''''''!<I0rI'€Ost~I~Tofal~''
.',Number: of,lhs ectlOos, er,:ltem:: ti 'j, t ~ "'-. "."..~_1~ ."~-~"- . .
~'1ijt'f.z,~'fk1M:_&~ffi!A~~~1_i!,~~~'t~:\~'k~i1;,~ 2.Jg &~,~.~~~ ~.~,QsjS
440-2584-) (9/08/COM)
1
1
I
1
I
1
I,
1
$
$
...: " .
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00 192
COM2009-00 192
COM2009-00In
Payments:
Type of Payment
Check
cReceilltJ
Item Total:
Check Number Authorization
Paid By Received By Batch Number Number How Received
CONSTRUCTION UNLIMITED djb 2655 In Person
INC
RECEIPT #:
1200900000000000089
Description
Minimum! Adjustment Electrical
+ 5%Technology Fee
+ 12% State Surcharge
Page I of I
City of Springfield Official Receipt
Development Services Department
Public Works Department,
Date: 02!I0/2009
11:03:44AM
Amount Due
58,00
,2,90
6,96
$67.86
Amount Paid
$67.86
Payment Total:
$67.86
2/10/2009