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HomeMy WebLinkAboutPermit Electrical 2009-4-17 Electrical Permit Application 1l~';~EF!'gRTMENT;!tiS-Er0Nfi.Y)'~1 I~"~" ~-._:\ti<~..".""., _,_ "'~"""n'1't1>;;:;i'E""gti=:;::"-r,:;.'r~f..,~I?i~ , pe~?t:.~O 9-o0SI J' I Date: 'i -/7- 0 ~ 215 Fifth StreettSpringfieId, OR 97477.PH(541)726-3753.FAX(541)726~3689 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. 1~1i!Ij~IE()Ji~~i,!!!!G()"'E8.NiVlENitj'.a:egR<:>Y~i,!!!!Sif<<m Zoning approval verified? 0 Yes 0 No I ~JliIillll(;AmEG0RY&().fJl!'::()riISmRt!J!3jTiI.<:>N~~~11i!ll;i~~1 :fst. Residential I D Government I D Commercial I '~l'U()E3IlS'iTIEiJ'NF,,()[MP,.\li'Ql\IfAl\IDIl!O!':'A'Ij'()Njf~?€~lI I Job site address: 'Z-bo S. Sf "t- I'L I I City: '5 P,:;) I State: ()(L I ZIP: 97C( 7 g I I Subdivision: /702- 533> I Lotno.:ooYOO I 1~~QE$~8.IF,i;t;l()NIi()FJIW()R~~~~1 I. 5t:Utc..e kcO'-'.....(:'T_T $134.00 I I~TotaI!~:1 ~l~o~~ I I I I $b~ I I I I I I I I I I I I I I I I I I I I I I I .1 Residentia!. per unit, service included: 11,000 sq. ft. or less (4) I Each additional 500 sq. ft, or portion th ereo f Limited energy (2) Each manufactured home or modular dwelling serviCe or feeder (2) I Services or feeders: installation, alt,?ration, relocation . I 200 amps or less (2) $ 81.00 $ ~~~~~I,:r"'~P..R'O' 'P..E. R;r~ii;T0'W' NE R"->iZY#11~f~",-,,,,:;r.l"\1,.1i, . I 20 J to 400 amps (2) $ 95.00 $ =C;H0;E),$~.zres:L__~"., __ '- ," '_10,1~", __" ",'" ;~,,,;~c.;t:4>:Y;f.l,,,,'J~~,~,i~,,,,!l'J.f~ Name:, ~f!'Y\..o.(' ...-A/J/f Vi (" :,: '111: Oreqon I~", _ I 401 to 600 amps (2) $158.00 $ I Address~::z. 60 [, Cine. f~J~:;c&p,;c:~,~:te_d bl'thr~Il'6bl't9'hQo,9)amps(2) $205.00 $ I City .I//t'/fi If! aJ- flJd"1 Sta:te;C0~j]~~j:ZIPDcii 0 ;~~~~~~l/eJ 9~~fl!t~~'rps or volts (2) $469.00 $ I PhoneJ-, ,e...jc~ _,-7 G vA Fax'!ing '.'1 ~y Obtain CO ," I' S dRes<mlJ_'fihqlrly (2) I $ 63.00 $ /, l:;" 1,.1f _ Ie, QM_ Pre!; tf, cn _" .\ E-mail:. ' "Ul/IO~~for the 'O;~n~~O!~.:..~ e If''f:.~4~~:ElI1Yl}erViCes or feeders: installation, alteration, relocation This installation is being made onresidentialcM'fifrffl pr<imj~32"~' ^ c.rl9~~~~or less (2) $ 63.00 $ owned b~ me or a member of my lffimedJate famIly. ThIS -"" 341/):201 to 406 amps (2) $ 8700 $' ~:;~;)~~;;::xc~ent~ ::~,., . i ~~:rt::~:::::~~ooo volts, see se~ic~s or fee:~:'6s:~tion :bove 1~~"".!,:()Nm~!':JT:()R#INST:Jl:\!!IfAml()N~;iy.F!J~'ii~1i't. I Branch CIrCUItS: new, alteratIOn, extension per panel I Business name: I!-c,f/IA/I J...() if ~U~A~ I I a. Fee for branch circuits with purchase ofa service or feeder fee: I Address: .J I I Each branch circuit I $ 6,00 I $ I City: I State:. I ZIP: I I b. Fee for branch circuits without purchase of a service or feeder fee: I Phone: . I Fax: I I First branch circuit (2) I $ 55,00 $ I E.mail: , ,..j 6tbT/CE: 'I I Each additional branch circuit I $ 6.00 $ I CCB license no.:()1/ . ! H!J'i'diiB6il!ln&Mll EXPIRF II: ~H~ W~'nI/Jneous fees: servIce or feeder not Included I Signing supervisor's license~BL~~_~I~~D UNDER THIS PERMIT L~'Yihffmp or lIT/gabon circle (2) $ 63.00 I Print name of signing supe~~ru;:'~VlCIVut~ U.Ii'~ ~BANDONEt'1 F )ffch- sign or outline lighting (2) $ 63.00 I .. . SC ::lA\ f'ffi,uu I S' I" r' d I Signature of signing supervisor: . . 19na . cIrcuit or a l~lte -energy panel, $ 63.00 $ , alteratIon, or extenSJOn (2) I Each additional inspection: (1) I $ 25.00 $ 32,00 I $ 63.00 $ $ $58.00 $ ~6' ~..p~ ~. ~ (A) Enter subtotal of above fees . (Minimum Permit Fee $58.00) I (B) Enter 12% surcharge (.12 x [AD. I (C) Technology Fee (5% of[A]) I TOTAL fees and surcharges (A through C): 6.3 $. 75'(, $ "$IF $ 73~ $ 440,2584,) (9/08ICOM) $ $ $ Status Iss u ed 225 Fifth Street, Springfield, OR 541-726,3753 Phone 541,726,3676 Fax 541,726,3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00S18 ISSUED: 04/17/2009 APPLIED: 04/17/2009 EXPIRES: 10/17/2009 VALUE:. Springtield TYPE OF WORK: Electrical Work Only SITE ADDRESS: 260 S 51ST PL ASSESSOR'S PARCEL NO,: 1702333300400 TYPE OF USE: Repair Residential PROJECT DESCRiPTION: Service reconnect . Phone Number: 541,726,7994 Owner: DA VIS,JAMES ALTON & MARY-ALICE Address: 260 S 51ST ST ' SPRINGFIELD OR 97478 Contractor Type Electrical Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: , Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improv~l11ents:. Storm Sewer Available: Special Instruction: Notes: Description Type of Construction I CONTRAC!OR INFORMATION' License 'Expiration Date' Phone '/'1"1 f:BUIIJDING,INFORMAnON'IIOU to . j, ;:,'w rUles adopted by the Oregon Utility i;uiiticqtio# of,Stories:hose rules are set forth R,3 in OAf, 95;HeigbCOf,Stiiuctu!:'!l OAR 952-001, 0090. YOUType 6fJHeat:;opies of the rules by VB calling t1W:itcf.frypeNote: the telephone number tR'ar.ge 'Fype:Jn Utility Notiticalion , C'E]jef~ Path'1p-332'2344), Sprinkled Building: n/a Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: Total: Handicapped: Compact: , !!'JT'f'\:' -, 'C"J' I.,.:: -' '+ EXPIKt Ir I nL I.v'"' I PUBLIC <P !;lMEmlS ~i'MIrl1' .\.' h THIS PERMIT IS NOT AUTHORI u UI~UL Si"" NElJ'ffiR COMMENCED OR IS ABAI'.fUU ANY 180 DAY PERIOD, DownspoutslDr"ins: I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page I 01'2 , Status Issued 225 Fifth Street, Springfield, OR 541,726-3753 Phone' 541,726,3676 Fax 541,726-3769 Inspection Line Fee Descripti~n + 12% State Snrch'1rge + 5% Technology Fee Service Reconnect Total Amonnt Paid Aulount Paid $7.56 $3.15 $63,00 $73.71 Total Value of Project Fees. P~i~ I Date Paid 4/17/09 4/17/09 4/17/09 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00518 ISSUED: 04/17/2009 APPLIED: 04/17/2009 EXPIRES: 10/17/2009 VALUE: Receipt Number 2200900000000000403 2200900000000000403 2200900000000000403 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 Re(Juiredlnsne~ti(JJ1s I Electric Serviee: Approval required prior to utility company euergizing service. By signature, I state ,~nd 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 aud 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 oHhe Community Services Division, Building Safety. I further certify that only contractors aud 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 propel' 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. ff-rAl'd'J:) ~ ~ P-evWJ Ob/Der or Contractors Signature Pa2e 2 01'2 LJ-/'-/;" oq Date 225 Fifth ,Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009,005 J 8 COM2009-00518 COM2009-00518 Payments: Type of Payment CreditCard cReceintJ RECEIPT #: Description Service Reconnect, + 5% Technology Fee -+ 12% State Surcharge Paid By , JAMES DAVIS City of Springfield'Official Receipt Development Services Department Public Works Department 2200900000000000403 Date: 04/17/2009 Item Total: Check Number Authorization Received By Batch Number Number How. Received djb 150200 In Person Payment Total: Page I of I 1 :56:49PM Amount Due 63,00 3.15 7,56 $73.71 Amount Paid $73,71 $73.71 4117/2009