HomeMy WebLinkAboutPermit Electrical 2009-6-11
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COMZPO '1-'00 ~3 8
Permit no.~: .
Date: ~~ 5
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,
p!;';1':;,''''Z!li:0C/!.Lf:'.GOYERNMENTMP'RR0.\1AIf~,!;vi!};i'i'';!,~i<;i,
I Zoning approval verified? DYes D No.
1:')i.i!i"3.';;i;',~)i!'cA;rE GORV;'~OE'::C'0I11S"'RU' eMIO' 'N"'?;'i,~':"":CS\",'.r,,::
"'.> .1~\'V".,..."",.,.".....__,.'1- ..' .'It..'? _ '>f<.'." . .....,1;. . )1.<.... ~~~" '_' -,~~,;, i,'
I t!p Residential I 0 Government I 0 Commercial .
I~Eril.OBlSfIiE~INF:ORMAmIQN~;ANO~I.!QC'A'liI()III~~i,\[r!
I lob site address: :J~bO G-5i-
i ~~~~r;c~r~~:~~b~7 I State: 0 ~a~I~:P~~~~
I'Pi~!.i";'!;':."'[) ES CRIP.T:IO NlIOF.:W()RK\l~}{;'iilS;\i,j~:[:it~,'t,''f1
$("', \J ,> ___ c\r'O\v'\r.>\-p I
'J . 1 200 amps or less (2) $ 81.00 $
: '_'PR0PERTi'(,:;QWIIIER,,:.:: . . :;,:' . I 1 201 to 400 amps (2) $ 95.00 $
1 Name' C,.......,} '() [',p v\ r 05,-:;e '^ I 1401 to 600 amps (2) $158.00 $
I Address m--f7 '~~ ~ r . A!T 'N ~~~~:,o 1,000 amps (2) $205.00 $
I City:~"""r 0. J State: (J(V I ZIPn?,I(fJML1 rll?~er l',OOO~'mpj~~volts (2) " $469,00 $
'J..' 1t\'!J" P a..-, "ti,/..I.:-,... . --qUOf)+ . -..'t::lfU Ii
I Phone: ~b4 - ~ C[>;Q \ I Fax: - _ jn OA'~'I!I/( 'I!<S<;.\'nr-",t ~ly;(2)hA ()_~res you In $ 53.00 $
I E-mail: G""'O/ c ~ ~ r .A ^ UD90. ~ ;0, !iem~PQt~'rY: ~~~~iceS'.dr:iei~E.~~:jh!liPjtltion, alteration, relocation
Ll --., =--'f'\ '" ,,,A'S", I n vv \ -. (,.. ", ~'''''V''ln 0 '-, 'urrn
Th" II' . b . d - " 'd . I c VOl/lnc II 200 ampsJo'lless (2) AR 952" $ 00 $
IS msta atlOTI IS emg ma e on res] entia or !ann propertY .. P n",_, ., I...-Lin/c>^ _ ~ ~n0.'f 63.
owned b~ me Or a member afmy immediate family. This qvtnbe, ,Ie r2~btpJt~f!..lJ'rI"f"'(2)h;'t~,':~Ules 6v $ 87,00 $
property IS not mtend~d for sale, exchange) lease, or rent. OAR l ,e, If'" -. . - .-,....1, I,Y".t . -""'IUne ',I
479.540(1) a~9.5' ~), ' 401/fb6Q!blJ,11P,~,(ftY Notifj"",,;_ 11$126,00 $
Signature: r-~j ,(~ . lOver 600 amps ~;-{oo6~1Its, s~es'e'~~ices or feeders section above
I' . .:' '. ,. ;"C0NTRi\Cf; R:INSTAl!.lATION: "., I I Branch circuits: new, alleralion, eXI~nsion per panel
I Business name: I I I a. Fee fqr branch circuits with purch~~e of a service or feeder fee;
Address: I I Each branch circuit II I I $ 6.00 I $
City; State: I ZIP: I I b. Fee for branch circuits without pur~hase of a service or feeder fee:
I Phone: I Fax: I I First branch circuit (2) $ 55.00 I $
E-mail: I Each additional branch circuit $ 6.00 1 $
CCB license 1)0.: I BCD license no.: I Miscellaneous fees: service or feede~ ':lot included
Signing supervisor's license no.: I I Each pump or irrigation circle (2) ]1 $ 63.00
Print name of signing supervisor: Nn I Each sign or outline lighting (2)11 $ 63.00
7'/n_
I Signature of signing supervisor: THZS' . "I:: I Signal circuit or a limited-energy pariel, $ 63.00 $ I
.1 Pf;r;." alteration, or extension (2) . Ii
"1ur, -'llVl/ r . :,
A:~Z~~f%g ~bi~ A~L&~;;~~~~~;A~~~~~;6;N~~\iliSE~1i~~~;?gfi1;~~&j;t;
80 DAY p R IS AS' fAf'f;)lJrri/15J'VoR'1fove fees Ii D (
'\ ('..,\~/ '[RIOD,L ~I'f',..t~~f<'e $58,00) 1: $ CJ
\}.)\~~d" . .1 (B) Ente; 1Z\{!turcharge(.12 x [A]) .Ii $
~ ~~ 1 (C) Technology Fee (5% o[[A]) II $
\9' ~ I TOTAL fees and surcharges (A \~roughC): $
~
Eler.trical Permit Application
225 Fifth Stm" Springfield, OR 97477+ PH(541)726.3753+ FAX(541)726,3689
440,2584,) (9/08/COM)
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['~i:{0iFt4!}~~~~:;:o~';1!};)\'H'q)!l"!ir,j .. _~ .'.' _. _. '.. L;; _ 'f;'N~i~':1!~~4ljf~1ttr#7t~;r.1
I.'N ;-;ni~e/iifi~;~'e'cti~:~;'p~;;;i~;;ri"()::l:".IQ'ty:I" "'.f.'osr7;:i ;\1'otat'r ';'1
-l"'""7!~, A-:::",;r'" ;'\J;~'!:!';J,;L,-!; l."'~~",:::i?'f:.;"t;,~t : /'c"'_,\.i< ": '~\.#~',.._,.-,,~'y ,.. <) \' ,\~e~; : (; _ ,;: of; ~c.os; '. ;\"
Residential, per unit, service includ~d: I :
1
I
1
I
I
Sfl
I'
I
I
1,000 sq. ft. or less (4) I
I Each additional 500 sq. ft. or portion J::
thereof L
"
I Limited energy (2) I'
H
I Each manufactured home or mOdUlarj'I'.
dwelling service or.feeder (2)
Services or feeders: installation, alteration, relocation
$134.00
$
$ 25.00
$
$ 32.00
$
$ 63,00
$
$
$
lj7l.
l.{O)j
'N771
Status
Issued
II
eIT,,!! vJ< ;osrKINGFTELD
I.
Building/O~mbination Permit
,J
PERMIT NO: COM2009-00838
ISSUED: 06/11/2009
APPLIED: 06/11/2009
EXPIRES: 12/11/2009
VALUE:
_S!\,"U"'GJi',l<<<l'9-'
.~ ..,
.,
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225 Fifth Street,Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2660 G ST
ASSESSOR'S PARCEL NO.: 1703361109100
Springfield TYPE OF WORK: Site Work Only
. I~
TYPE OF USE: New
PROJECT DESCRIPTION: Service change and sewer lines for partitiun approval
Residential
Owner:
Add ress:
GEOFFREY COSSEN
2660 G ST
SPRINGFIELD OR 97477
Phone ~umher:
541-954-3821
Contractor Type
Electrical
Sewer
Contractor
OWNER .
OWNER
.1 CONTRACTOR INFO~MATlON I
prT .
, ENT . . II
fOfloJV r /ON: Ore License Expiration Date Phone
Noti/leA/i(J es a.dopt!Jon Ia.w re. Ii
In 04A' On Cent ed by th qliJres y I"
n"~: 95::>,n~. er. rh~_ e Or,,~_ O(J to I
BU1LDiNGviNFOR'MA'TI0N'I~~%I~ a.re;~~~/fit~:
uU/1Jb - .. '- <;ent" cUPle AR 952 oort/j!
er tnr th er. (N t S of th - Q 1 I,
# of Stories: e Ore 0 e: the t e r(;Lo(::iize: .
Height ~(,S"ruotu~e8900n Utility Neleph,Sq'J"flh Floor:
o 3 ott' - I'
Type of Heat: - 32-2344) Itca.sglt 2~d Floor:
Water Type: . . Sq Ft Basement:
Range Type: Sq Ft qarage/C.rport
Energy Path: Sq Ft dther:
Sprinkled Building: nla Occup~!nt Load:
.11
# of Units:
Primary Occupancy Group: R-3
Secondary Occupancy Group:
Primary Construction Type VB
Secondary Construction Type:
# of Bedrooms:
1 DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I, REQUIRED PARKING
1 Total:
'I Handicapped:
;I Compact:
Street Improvements:
Storm Sewer A vail.ble:
Special Instruction:
MnT/rr,
1 PU\l;ll,~(PlM'I?Rf)}(E;IYlF;NTS' i!
Au rHO '-- ~'" IRE ~ TI-I~ \"ClPll .'
R/ZED UNDER THIS PE WoWa k-/')'pe: I"
COMMENCED MIT IS NnT J
ANY OR IS ABANDOM?l1vfCjll/lursrDrai,ns:
180 DAY PERIOD. 11 I'
I,
II
I
I!
I
Notes:
Pa2e 1 of2
I'
II
I!
Status
Issued
CITY: OF SPRINGFIELD
II
Building/C6.mbination Permit
PERMIT NO: COM2009-00838
ISSUED: 06111/2009
APPLIED: 06/11/2009
EXPIRES: 12/11/2009
VALUE: i:
I:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation DescriDtio~ I'
Description
Type of Construction
$ Per Sq Ft
or m'ultiplier
Square Footage
or Bid Amount
I
Value!,
Date Calculated
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Sanitary Sewer - 1st 100 Feet
Amount Paid
Date Paid
Receipt Number
$27,96
$11.65
$81.00
$152.00
6/11/09
6/11/09
6/11 109
6/11/09
,.
1200900000000000659
'c
1200900000000000659
120~900000000000659
1200900000000000659
ii,
i!
Total Amount Paid
$272.61
Plan Reviews I
!I
,-
To Request an inspection call the 24 hour recording at 726-3769. All inspections re'quested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will '~e made the following
~~. I'
I
"
I Re'luired Insnections I
!(
I:'
,>
,
II
I'
Sanitary Sewer Line: Prior to filling trench and including required testing.
Electric Service: Approval required prior to utility company energizing service.
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00838
COM2009-00838
COM2009-00838
COM2009-00838
Payments:
Type of Payment
CreditCard
cRccciotl
RECEIPT #:
1200900000000000659
Description
Sanitary Sewer - 1 st 100 Feet
Penn Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
GEOFFREY COSSEN
Received By
Check Number
Batch Number
djb
Page 1 of 1
,.
City of Springfield Official Receipt
I .
Development Services Department
Pu~lic Works Department
"
Date: 06/H/2009
Item Total:
Authorization
Number
12:00:18PM
II
Amount Due
152.00
81.00
11.65
27.96
$272.61
"
How Received
Amount Paid
003 I 04 In Person
payme'nt Total:
$272.61
$272.61
r:
j:
6/11/2009