Loading...
HomeMy WebLinkAboutPermit Electrical 2009-3-5 225 Fiflh Street. Springfield. OR 97477. PH(541)726-3753' FAX(541)726-3689 I~J(~'tD. EPA.'.R.T:M...'EfI.'.Till"". SE'.0.NlbY.".."".~1 fS1:i":~"'i;-"_;l,'.,;";,,,.'-'v'/'ii;J_,,'~;Y4~~~~~~ COw1ZaOcr-- <!:2 I Permit no.: OdO q 0 Date: '3 -$" - ZOO, I Electrical Permit Application This permit is issued under OAR 918-309-0000. Permits are nontransferable. P.ermits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. . f~I!([G~.l!IGf.)."ME@MENifi'~&fiB.Q~~~I'~l. IiEE[S~ltffiEQJ:r1!! . Z~ningappro~al..v~rified? ,_ . []Yes ... DNo. I. '!!D.~~~~~~~G)~~il:Q~I~ ,G\ '=::~I~mtz.Gi~~~~~~~i!lR~r~0~~~~~1 ~:~;~::~;=:~;=~:;:::;: ~~ ~,e ~~::;E~~~~ffilf.)~~~~~~]IEiN~~~11 ~~;;o~:i:~::II:S~O(:~ ft. or portion I :1:::::: 1 City: S \" Fb I. State: 0 IL 1 ZIP: '771( 7B 1 1 Limited energy (2) 1 $ 32.00 . $ 1~~i~~i~~l'l~fJ;VV~~~l.~~i I ~~~~l:~s~~i~:~~ ~e~~:r~~)odular I $ 63.00 $ I T~ r? C:> AlL'f I I Servic_es or feeders: installation, alteration, relocation il"'~~~IBBQ~EB~Th'({f.)WNER~I~~~W!:~J I ~~~::~Oo~:: ;:; : ::::: Name: l.A-NA }/(:)4' ~ I2DE/NJ o#' 1 1 401 to 600 amps (2) $158.00 1 Address: 723b &llrc-ltYl.. ,\'a..:t_TEivTlorvl cI601 to 1,000 amps (2) $205.00 1 City: SPFP 1 State: va-- 1 ZIR:ti;;~1;;?ft'7t' dcl;'ciJ~~(o()OrampjiP/.!~~\~P) $469.00 \..' tl ~)' II/Rr) "-....IV I Phone: _ _ 1 Fax: - - If! OAR 952:0-0" I (rR~q9.9m'H,~p~yr(2J10n Uti/it" $ 63.00 $ 1 . . ()n",,, '~O)H]fh -''''':>dfR ~ I E-mail: - -....v.. TOU may ot !~"mp"oraprJstJ~iqe~~tfeed~s: installation, alteration, relocation eal/,nn '" , '-'w~r . ... -~<:-0UJ This installation is being made on residential or fam.tpr.9"~~V the, Ite,. 2 I . ~d<fsll(e>nl1es-'.' I $ 63.00 $ b1. owned by me or a member of my immediate family. This 8'''' .e O'62OJII";4lio""p'~~)1hon -y . 8 property is not intended for sale, exchange, lease, orrent. ~'Mer i; l' - ":.:""'~.! ~;;.., . e $ 7.00 $ 479.540(1) and 479.560(1). 'l'djl~<6l)~li)~al1on. $126.00 $ 1 Signature: Ovc;r 600 amps or 1,000 volts, see services or feeders section above I lili~~G.~NmIV,\CillQBIINS!fr)!:IJ!I!'.I.l:;rn~N~"lI~~~ Branch circuits: new, alleralion, exlension per panel 1 I.Business name: S[ LA..{ r f-e<,c{;-r I 1 a. Fee for branch circuits with purchase ofa service.OI feeder fee: I I Address: 3~S'L{ ...Tr.....:"I.1H l2c1. I I EaSh branch circuit 1 1 $ 6.00 I $ 1 I City: ,<::;0(''-\ -eState: Or 1 ZIP: Q7r../7<A 1 b.Feeforbranchcircuitswithoutpurchaseofaserviceorfeederfee:.1 1 Phone: / -sq{ 7AQ-1074 1 Fax:. / 51/-. 7f./6 07).71 I First branch circuit (2) I. I $ 55.001 $ I I E-mail: N':!T!Gl". I 1 Each additional branch circuit $ 6.00 $ I I CCB license no.: 1t:,{;J,?J 51 BCD license nO.T~~~ Miscellanenus fees: servIce or feeder not Included 1 I Signing supervisor's license .no.: "'1100 ~JiHnR'7~n ~~ ~bfffikl1,f~!!i~~~.JntJilftKJ I $ 63.00$ 1 I Print name of signing supervisor: i ~f.'I/~illo c." ~\ibt\I~t!tiWI# 1 $ 83.00 $ I I Signature of signing supervisor: igwl circUlt -.;; JaSYmlt~~nergy panel, I $ 63 00 I $ I ftllr2tlon, or extensIOn (2) . I Each additional inspectinn: (1) 1 $58.00 I $ I . ~~~~l~gfIi'!iG~~it~UJ~:e_j[~ (A) Enter suhtotal of above fees (Minimum Permit Fee $58.00) 1 (B) Enter 12% surcharge (.12 x [A]) 1 (C) Technology Fee (5% of [A]) ] TOTAL fees and surcharges (A through q, $ $ $ $ $ .~~ ~~'AY ~LfJ( ~ $ b?> $ f~b 1 $ 3" I .$ 7") ~ 440-2584-J (9/08/COM) \y(V e-, ~ r:' c) Or '3~6Q . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00048 ISSUED: 01/21/2009 APPLIED: 01/1212009 EXPIRES: 07/21/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 7236 GLACIER DR ASSESSOR'S PARCEL NO.: 1802022102500 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Fire Damage Owner: Address: NESKE-ROBINSON DANA S 7236 GLACIER DR SPRINGFIELD OR 97478 # of Units: Primary Occupancy Group: Secondary Occupancy Gronp: Primary Construction Type Secondary Construction Type: # of Bedrooms: . ..\0 I. CONTRACTO.RIN!?RM~ti0JN! ~ la"" 0169u \ \Olt, . Contractor n,\.OI6'00~ 'O'l ,"61l'es -O:tit6en~\' ~\ \~. il.6" 1 .\ a .,,"~ 'o'l THORNTON 1j',J:;J::CTR.~!=)Ne? \"oS~,'r\" Of1.!g~~S _ \O'~\o:"1 ~BUI~D'.NG' iNFORMA:iIbN,~~~\O(\ ~o\\'" ?, \J"~ :J: 0"'-. ~o'~...\ \~\.,. ,\ \'"O~ '(ol/t\f~t-'fl.. ~ \\ 1.\\\\\~Z,Ali). r;I21J. ,y('" '" or r~le'0o <>,'32... R-3 () ca\l\\\'0Hfdgij~l{)fS\(l\efure \\1l\"\\'OElf~IW6J\ Preat: VB Water Type: Range Type:. Energy Path: Sprinkled Building: Expiration Date 08/21/2010 Phone 541-686-4151 Contractor Type Electrical Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Sctbacks: Overlay Dist: Total: # Street Trees Rqd: ~a . pped: Paved Drive Rqd: ~~~: % of Lot coverar.: tf-.'r\?t. \~ ~\\ \<2> el ~~~\~:?~~\\ <2>~j:;p. \~\<2> ;~~I~D ~()? I PUBLIC IMPROVi;;MEN'I1~ \J "? \<2> r>,'Pi'l1 "J n:~\l\l \J ;"o\(\\l C()~~t. ~~ 'rtiRl'eWalk Type: r>,~'l ~ 'O\) Downspouts/Drains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 2 Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541 ~ 726~3676 Fax 541-726-37691nspection Line CITY OF SPRINGFIELD B uildin g/ Com b inatio nPermi t PERMIT NO: COM2009~00048 ISSUED: 01/21/2009 APPLIED: 01/1212009 EXPIRES: 07/21/2009 VALUE: Tntal Value of Project Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Temp Power 200 amps or less + 12% State Surcharge + 5% Technology Fee Temp Power 200 amps or less Amount Paid $7.56 $3.15 $63.00 $7.56 $3.15 $63.00 Total Amount Paid $147.42 Plan Reviews I , Date Paid 1/21/09 1/21/09 1/21/09 3/5/09 3/5/09 . 3/5/09 Receipt Nnmber 2200900000000000072 2200900000000000072 2200900000000000072 1200900000000000159 1200900000000000159 1200900000060000159 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. Re(JlJirerlll1snecti~~s I Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that 1 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 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 Contractors Signature ,.. Date Pa2e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00048 COM2009-00048 COM2009-00048 Payments: Type of Payment CreditCard cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Department . Public Works Department. 1200900000000000159 Date: 03/05/2009 Description Temp Power 200 amps or less + 5% Technology Fee. + 12% State Surcharge Paid By JEM ELECTRIC Itc_m Total: Check Number Authorization Received By Batch Number Number How Received djb 142245 In Person Payment Total: Page I of I 8:15:24AM Amount Due 63.00 3.15 7.56 $73.71 Amount Paid $73.71 $73.71 3/5/2009