HomeMy WebLinkAboutPermit Electrical 2009-3-11
o
,
Date
1r:L(
INITIALS N M
DATE 3~\/b'-1
SOURCE fvI~.J
J//1/07
ZON
I
I
~*'
22S FIITH STREET. SPRINGFIELD, OR 97477 . PH:(S4t)726-37S3 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number IlPPft) 1tJ Ch -Ifa '7
New Alteration or Extension Per Panel
9ne Circuit ' $ 48,00
Each Additional Circuit or with '"5 $ 4,00 / '\
Owners Name ---::'c<2V\:-l...-b \!\..J I;. U:CLIL lZQ\--J(; S:rvice orFeederpe:lt , "''''_'_ _ ._ ..
le>S}~l~;-!;",.\]'1';.,]::1.'4:S_~'~!B--'~?;;~~h'nl~:":l.':).:~~Jo':!' """';":":;:''''1~r;t'..^:,;--t''..,~,.>., .,'~-'. -<;;"--' .-
E. kl\'l}Scell~,ii.eo'~~:(Ser.yice/ree9,et'qot',i~clud,~a,) ,;::Eac~ ~I nstalla tio n
".c.,-J",'~ ,;.~;L.,'}.,.,,~.,,;,,'~_'; -:.~ic\""".,)!'4!;);'''~''!<'''''-:9";,:~'<.!tJ"...".:".. ,.,4-:-', ,.><~."...~. .. ,",1'1".- ;':. .
:,' """".;' :_;,',;:'P..~-~~;!,~F.::,^,._'I'>f.'>f' ;'1o;~.i<':'~~_"K~f,.i<X;.--p;<:r":'O-:<;;H9;i'~'Wf.
1. I,9CATIO,N.OF, :INS,TALLATION.~Fit:,'~""'"
_"<<".~"..' .,,",N__. ,,,' ""{"~,':",!(,L;,~&'"""'"""~"~:'19~,,,,:<.:.;;(~,;l1tG,~:;;;.Iz,~4li
/tP2S /1t.7Vi)VL$Cy .;i R-1D
LlE~03~~ \?f!jJfl-
JOB DESCRIPTION:
A\;:)0 '5 C-l I(L LA.. \ ,S
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
.,":~,l':f<.~':t'''I."'''"~I<''''\,<~!'--'Wi,~''''r",p,"''x~:rP1:i',~1-1t<;_r:I'F'/'(""'7Ut~~#;
;',CiJN'ikA'cTo"R;mSTALiJA'fi'ONONEY,;:t
2. ~f";:;,,.'i: i~:;;:r;,~ ;;i,;ai;:lt;,"~\'';;MJ:<-.;tL';m-~:'~>::k)~'ti~>;;~i::;,jt,~~:Tt.i:f.
Electrical Contra€HltG.ohi FI ~rTR!r,,~
P.O, BOX 2237
Address _~n~w r)R g-'48" '
.:...._....'.E,... " '"
City
Phone 5 4 1 - 141-1 681
Supef\.'isor License Number
13928
Expiration Date
10-1-10
Constr, Contr, Number C4 0 8
/181997 CCB
Expiration Date
Sign ure of Supervising Electrician
7r
rj~/
Address I G 2<: rtrjJ D't-C>- ~ ~
City t:=U..c, E:\vt=: Phone (. 'tel - CJrJ'L '\
OWNER INSTALLATION
The installation is being m~de on perty lawn which
is not intended for sal~, lea'S'"e or . ~
Owners Signature: _ ~ {X ~
"- ~~v-;
~ ~
. \\-t~~
Inspection Request: 726-3769
:m::'~Z:;:-;:':I;(,J:.t1f;:"'1V'~:;:~~.'I1j).!t""7'~""~~-""~<<'-':-""'>}"''''''!'r[i,'~;."r;~>"':~:;'~""'~:F~::"~:;;(:'
3.i'GOM-RE-ETE 1'-EESCHED.UL'E:B-!lLO.\1I;'~~&;,:I'i'i'::U,1:':", 'I'
",",':M""'J"~'<.i"""";"I;,", .~~-<lN":'lWk,H\,I";;>.\a"'-~1~"<,\.*i}U-;.\)i'>'<fu-,.,>".."~.w..",tl..,,t~:"""".",._"",;;c-,~,.,..I:..""",
;";\14:'-r~r~:'1't'~i\l:;'!~{~I~'i9~;~>'l11:':f:ti~1i~~"~,\iFv.-'-':'t:~~<1,'~TfI~W~~\:;'>'f,y;,'r;,::""'I:'>':".'
A. :":N~w;Resideriti.I:E;Singli'oi::MiiltFF amily'perdWelliti'g' u riit::,::'
lj'~';;!,~';l~;;'I>',~;<~1',i.i.Ucl;L..Je::kii:l'd,1",,~':f~\il.'~~::ilt.....:.c,.,:.",..u.."',~...... ;".i..Y;;.>'~;;..,,; _ ......,-,;".,;;, ,.;~:':"\
Service Included
1000 sq, ft, or less
Each additional 500 sq, ft, or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
feeder, '
$117,00
$ 21.00
$55,00
~'''~'t:~#-'f}~l~~1J.\:~'ift.t~il:'\~]~f(int\~~1$5.!;ri!ifr0~'~~'t.~!?7f~?J}i;:ih'{/'~':.f;~~::F~r;?;'r:,;,:~~..~ "-"
B. ~~Sel'vlces:.or;Feecle'rs;rs:;JnstallatlOrI,)~:lterahons'or;.Relocation:: "
~i~:t..i;};4it'ti'i.<::i:t.;D:.:~~lz;.ti~'ri\.'!ii.j;~.'t'k6':iiJ,!:~'Jl,;t4:-':Ii:'; ;,-~,l}j;~j.J'-S~t.).:':",;\<.,d:.'\"~,",-:';:"': ."~~ .
200 Amps or less
201 Amps to 400 Amps
40 \ Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpslV olts
Reconnect Only
$ 70,00
$ 83,00
$138,00
$180,00
$413,00,
$ 55,00
~t'!!'<'\f"'l'l.~,-".~.(,;",.:.w"""'~,"","'~'~1''''''U''='-''''''If.f'l:'''1;''''''~~<~'''''j!l1'-:M>'" .....,.,,'c,', ,,.<~...~. ..,....,"..,,". .--',....
~;-:i~ 'io~F, ;(:""': _~.,:~"H\' ~....*, ,"-'/:;~"'''';t d~' J!;'::.<'iJ';~; ..:,<:il{';;;:.'\i.:" .:p: tj .;f"'.>:'i,.t;: ,', ~'" >f.Ft.; '" '+---~-'"",~""",: .' :
C. ~Temporar.y)'SerV1cesior,'FeooersJ.i.1~j>i~i',.;".1)t-~r~S~~,~ej;t:~:'~*i',~~f~t&1:ll ,'~;f~7.
71~_t\ '" _.?"'<,'W~;<'. ;.j;",,,,,,,~,,,,,;,,,,,",;;;:;;..;~,;,, "~~"'""\\'.'Q;lt;{",,~ i1l.;>L':;A~."..u::~.:~ ;o"',~t>.:.,..,J.'A-,,.:,,;vt.-:...:... ;.~ .... . .
Installation1 Alteration or RelocatioD
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above,
D. ~t~Z4~fP~1tS~]~~~I~~~r~~~~~}~~t~1~~~~~J~;:}!01~:'~:::~':~':,.'
$ 55,00
$ 76,00
$110,00
Pump or irrigation $ 55,00
Sign/Outline Lighting $ 55,00
Limited EnergylResidential $ 28,00
Limited Energy/Commercial $ 50,00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
.-~'{:.,::i~~"'~';,J\!{l1!'=;::,!--'7;,;:"I:i.~i,'i'i';;,;!'~:-!"';~~;;":~t~':;'t_;7;",'~\2-;.gt!~?:f"j;:
4. ~;$UB'TOTA:L'.OF';'ABOY.'"E<Mji~~-~~;~~![)~:(~~',if.g;~'
~,f",';.!,~:~""~;;;;f~'<t:;':;d.l~:~t~;':'...\};;;.!;j;"i:i*",~,,:;b'~t',;ik~mvm!,;;;3{~;;W;,;;
Q MI, State Surcharge
lQo~ (Eimmi[tr7t~... :-<>.:':-
5% Technology fee,
?-~
TOTAL
(') '10
.)..l~
Shared Drive(T:)/Building Forms/Electrical Permit Application 7.07.doc
"
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00169
ISSUED: 02/05/2009
APPLIED:, 02/04/2009
EXPIRES: 09/10/2009
VALUE: $ 10,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726~3769Inspection Line
SITE ADDRESS: . 1625 HENDERSON AVE SPACE B1 Engene
ASSESSOR'S PARCEL NO.: 1703344313302
TYPE OF WORK: Mannfactnred Home in Park
TYPE OF USE: New Residential
: ., \/t'l'l tn
PROJECT DESCRIPTION: Manufactured.dwelling,placement'spacerb10'(Moved'from Eugene) ,
, p', I ".., ,,' "'I Ii," 0:e90n vdlllY
.s,~: _,., :-4=I!'; '3.(,:),.,.d u _ __~~,...,\"th
. -." . ,(' titOr. I ilU:;.t:; p..\'~"-' ~,- _
Owner: JERALDlNE LECKRONE N:J!~'.I~"?~ ,e1_0010 througl1 OAR 9:02-001. Pbone Number: 541-689-9025
Address: 1625 HENDERSON AVE SPACE'BIO"b.:.-OO blain copies of the rules by
EUGENE,OR 97403 OO:'?lii,~~~h~;e~ter, (Note,~he ~~~fP.~~t~;n
r"rnhAr for me ure'::jUl,l, ~::':"~,...';-~)
I CON[J;RA(iJll~R'tNFt'}RMf\:TtON I
Contractor Type
Electrical
Mecbanical
MannI' Home Inst
Plnmbing
Contractor License
OREGON ELECTRIC SERVICE 181997
PRIORITY ONE HEATI!"G & AC INC 154686
JERRY PAUL OTT 69455
READY ROOTER DRAIN CLEANING & R S~92524
Expiration Date
05/09/2010
03/11/2009
09126/2010
02125/2011
Phone
541-343-1681
541-689-1004
541-935-2696
541.744-799t
VB
fll--BlJ-[hDING INFORMATION I .
'- C MIT ~HALL EXPlRt I~ THE WORK
THIS P#~j;'~S'~l'~~iJER THIS PERMIT IS NOLot Size:
AUTHCHeigbt of ~fru~lpreANDONED FOR Sq Ft 1st Floor:
COMW,fyp~FJf H\Pat\S I\tl Sq Ft 2nd Floor:
ANY 1,waiH;\tfpe?.I0D. Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: , Sq Ft Other:
Sprinkled Building: n/a Occnpant Load:
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms: '
R-3
I DEVELOPMENT INFORMA T10N .
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
, ' Handicapped:
Compact:
I PUBLIC IMPROVE~E,~TS ,
Street Improvements:
Storm Sewer Available:
SpeciallllStrnction:
Sidewalk Type:
DownspontslOrains:
Notes:
Page t 01'3
Status
Issued
225 Fifth Stre~t, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valu~tion De~~riq,tion ~
Descriotion
, $ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Total Value of Project
I Fpp<, P'j'><1 I
_. r" .
Fee Description
+ 12% State Surcbarge
+ 5% Tecbnology Fee
Manuf Home State lssuance
Manufactured Home Placement
+ 12% State Surcharge
+ 5% Tecbnology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Heat Pump
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$47.64
$19.85
$30.00
$397.00
$10.44
$4.35
$6.00
$81.00
$11.52
$4.80
$79.00
$17.00
$2.16
$0.90
$18.00
2/4/09
2/4/09
2/4/09
2/4/09
2/20/09
2/20/09
2/20/09
2/20/09
3/6/09
3/6/09
3/6/09
3/6/09
3/11/09
3/11/09
3/11 /09
Total Amount Paid
$729.66
Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009~00169
ISSUED: 02/0512009
APPLIED: 02/04/2009
EXPIRES: 09/10/2009
VALUE: $ 10,000.00
Value
Date Calculated
Receipt Number
2200900000000000132
2200900000000000132 '
2200900000000000132
2200900000000000132
3200900000000000105
, 3200900000000000105
3200900000000000105
3200900000000000105
2200900000000000233
2200900000000000233
2200900000000000233
2200900000000000233
1200900000000000176
1200900000000000176
1200900000000000176
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 R~n'I"Jn~nprtmJ
Manuf Home Set Up: Wben installation of all piers or stands is complete.
Final Manuf Home Set Up: After all required inspections are requested and approved and porcbes, skirting,
decks, venting, street address numbers, trees, driveway, etc. have. been installed.
Rougb Electric: Prior to Cover
Final Electric: Wben all electrical work.!s complete.
Pace 2 01'3
By signature, I state and agree, tbat 1 have carefully examined the completed application and do bereby certify tbat all
information bereon is trneand correct, and 1 further certify tbat any and all work performed shall be done in accordance witb
the Ordinances of tbe 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 oftb" Community Services Division, Bnilding Safety.
1 fnrtber certify tbat only contractors and employees who are in compliance witb ORS 701.005 will be used on tbis project.
1 furtber agree to ensure tbat all required inspections are requested at the proper time, that eacb address is readable from the
street, that the permit card is located at the front oftbe property, and tbeapproved set of plans will remain on tbe site at all
times during construction.
~;~Sb~:.:",
Sta tus
Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Pbone
54t"726-3676 Fax
541-726-3769 Inspection Line
Rongh Mecbanical: Prior to Cover
Final Mecbanical: Wben all mecbanical work is complete.
Page 3 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00l69
ISSUED: 02/05/2009
APPLIED: 02/04/2009
EXPIRES: 09/10/2009
VALUE: $ 10,000.00
"?~ ;)-() r;
Date
I
225 Fifth Street
Sptingfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00 169
COM2009-00 169
COM2009-00 169
Payments:
Type of Payment
Check
cReceiotl
l'
RECEIPT #:
City of Springfield Official Receipt
DevelopmentServices Department
Public Works Department
1200900000000000176 ,
Date: 03/11/2009
Description.
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
MARGE BARBER
Item Total:
CheckNlfmber Authorization
Received By Batch Number Number How Received
cjc
In Person
Payment Total:
9274
Page I,of I
10:46:24AM
Amount Due
18,00
0,90
2,16
$21.06
Amount Paid
$21.06
$21.06
3/11/2009