HomeMy WebLinkAboutPermit Electrical 2009-6-17
City of Springfield
Electrical Authorization To Begin Work
E-mailedTo:tena@orelectricservice.com
R,:,ceipt # EC553R53
6/17/20099:14:26 AM
f\\J
n. /~
(j-\
Check on status of permit
By Phone: (541)726.3753 or Email: permitcenter@ci.springfield.or.us
I 0 New construction
IX] Addition/alterationlr~placement
10 lor 2 family dwelling
D Multi-family
[K) Commercial/Industrial
IJubllo.: IJob1tddress: 1051 28THST
I City/State/ZIP: SPRINGFIELD, OR 97477~4318
I Suitc/bldg.lapt.no.:
I Project name:
Cross street/directions to job site:
ISubdivision:
ITax map/parcel no.: 1702312202000
ILot no;:
Install 2 circuits for welders
I Name: JefT Brooks
) l'hone: (54l) 520-6034 j Fax: 520-6034
I Ema;l, ATTENTION: Oregon law requires you,t,O
follow !\!,le$~~(}Tc9R'~tne,<;,' \1.\J~!'Y;!'!!Y.. ,!ii'r,'~'f'j,.
I . 1~5fIl'IGcuiu~c..~~ll'ta."~ ~u~c; ~;;';' .;-;'~~ .se~!~trth~' ~at"
EI. he. no.: C408 He. no.: I 9~b at::'J nn1
~1 ~'\~-3::r::: ~ I - - -
I Bus;"" Nom" OR~El~ln};~lil\i\\q~iI+~r\nip. of the rilles bv
I Contact, -ron. Brooks ,-,~llinn the center, (Note: the telephone
[Add,,,,, PO BOX 223f1umber for. the Oregon ,utility Notification
City/State/ZIP, EUGENE OR 97Gljlnter IS l-I;jUU-;j;j~-~J"").
Iphou" (541)3431681 IFa" (541)3431683
I Emllil: tena@orelectricservice,com
II\'letro lie. no.:
I Supervising electrician's lie. no.: 1392S
I Supen'ising eleCtrician's name: HERMAN OLLAR
I City lie. no.:
Upon review and approval by your local jurisdiction, your
permit will be.e.mailed or faxed within one business day,
with instructions on how to schedule your inspection.
NOTE: This Authorization To Begin Work expires within 180
days if a permit is not'obtained.
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~~
The local building department may determine that an
Authorization To Begin Work is null and void if it does not
meet applicable land use laws and local ordinances.
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"
I Description
Qty,
[1,000 sq, ft. or less [4]
I Ea. addl 500 sq. f1. or portion'
I-Limited energy, residential
(with above Sq. f1.)
I-Limited energy, multifamily
residential (with above sq. f1.)
I - Liniitedenergy, commercia-t not offl::red online at this jurisdiction
(with above so. f1.)
I ~ Stand-alo11e liniited energy, .
resIdential
I - Stand~alone1imited energy,
multi-family
I - Stand-alone limited energy,
commercial
1[~~~,~~~~*:!~lrs~~S!~!!A'!!?~iJt~~!jont.~Jip!(j!'x~ii~~~tj~li_,,~~j
1'200 amps or less [2]
[201 amps to 400 amps [2 ]
140 I amps to 599 amps [2)
1200 amps or less [21
1201 amps to 400 amps [2]
1401 amps to 599 amps l2]
1;'B~,I~h:cftc~!~'~~~~J1fJ~~il)oiJJi:gBSxf!~'Bi~;:pc~~raJiel "'_~' " ~:I
A. Fec. for branch circuits with I
Me(tIDE~er fee, each
~hnc~CI[cUlt
Bl-oo \J>f1!lt<V1~I,*n~i~!\LL t I\l-'lKt I~ I HlssWlb Hi<. $55001
mt~,a:f1:\~~p;\l1IJm:R 1 HIS PER Mil IS ~ or
l(Odc\''\4M~[ibtJR IS A~ANOON:O FcmO $6001
~1~1~&@iOA,*pPttRIQO$,c"";::':~;~:;';-c;;'~;;.:'~::,
II Service reconnect only [2]
, I Each rmmufactured or modular
dwelling, service and/or feeder
J (2J
-11 Pump or irrigation circle [2]
j I Sign or outline lighting [2]
Signal circuit(s) or lirriited-
energy panel, alteration, or
extension (2)' ,
~':<'.:'>> ,.:. .:' .. ..~ ..':..-.''f'''J'....... ... ..,' -,. ",- ..... .... ...,.'.,. ..: ""';.' " .... ,.
ffi~~;;:;~~~:;f;~!?H~CTJ3~!8~,.F?ERMITj~FEESt::~,",'~ '
I Subtotal I
I State Surcharge (12% of permit fee)
I City Of Springfield fees "I
I TOTAL PERJ\HT .FEE I
.. City OfSpri11gfieJd fees: 5% TechilOJDgy Fee
[DeJault number oJinspections alloil'edJ
"~kf?JJ[
'. "- '*+~. 14,.; : i
$6 LOO I
$7,32 I
$305 I
$7137 I
CYl '6l G>
kL l.Q[nI01
/
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00876
ISSUED: 06/17/2009
APPLIED: 06/17/2009
EXPIRES: 12/17/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726~3769Inspection Line
SITE ADDRESS: 1051 28TH ST
ASSESSOR'S PARCEL NO,: 1702312202000
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Install 2 drcuits for welders
Owner:
Address:
NORTHUP RANDY
PO BOX 70624
EUGENE OR 97401
I CONTRACTOR INFORMATION 1
Contractor Type
Electrical
Contractor
OREGON ELECTRIC SERVICE
License
181997
Expiration Date
05/09/2010
Phone
541-343-1681
BUILDING INFORMATION I.
# of Units:
Primary Occupaucy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
REQUIRED PARKING
Frontyard Setback: 'Ore on law requires9~\Of11!lY Dist: NOTICE: . Total:
Side I Setback: ATTENT1ION, d ptged by the oregoM SJ!iMtTrees R~IIS PERMIT SHALL EXPIRfffltiI~~lipl\,lIORK
, ~_ru~ao '., .
Side 2 Setback~~ ifcation Center, Those rules areP,.;Y~drDnve Rq<jl,UTHORIZED UNDER THISiRf'ffi'.l'W\6 NOT
Rearyard setbr~~lR 952-001-0010 through OAR ifo~olJllO! Covera~OMMENCED OR IS ABANDONED FOR
Solar Setbacksb090, You may obtamcople~ of.t~:~~I::nbY ANY 1 fin nAY PERIOD, ".
calling t11~ Lil;::llll:'l. \,........,...... ...- .- -,
mber for tlie Oregon UtililP,ltB\tII<C<IM\'IROVEMENTS I
nu 332 . , ,
Street Improvements: Center is 1.800- -""'....J, ,
I DEVELOPMENT I,NFORMATlON 1
Sidewalk Type:
Storm Sewer Available:
SpedaUnstruction:
DownspoutslDrains:
Notes:
I Y~luation DescdDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Sq uare Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
CITY OF SPRINGFIELD
Building/Combination Permit
,
Status
Issued
PERMIT NO: COM2009-00876
ISSUED: 06/17/2009
APPLIED: 06/17/2009
EXPIRES: 12/17/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726.3769 Inspection Line
Total Value of Project
Fees Paid I
$7.32
$3.05
$55,00
$6.00
6/17/09
6/17/09
6/17/09
6/17/09
Receipt Number
1200900000000000697
1200900000000000697
1200900000000000697
1200900000000000697
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Total Amount Paid
$71.37
Plan Reviews I
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'1uired InsnectionsJ
Rough Electric: Prior to Cover
Final Electric: When all electrical'work is complete,
,
By signature, I state and agree, tbat 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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,
1 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 pia liS will remaill 011 the site at all
times during construction. j
Owner or Contractors Signature
Date
Pa2e 2 of2
225'Fifth Street
Springfield, Oregon 97477
541-'726_3759 Phone
Job/Journal Number
COM2009-00876
COM2009-00876
COM2009.00876
COM2009-00876
Payments:
Type of Payment
ONLINE CHGS
cRcceintl
RECEIPT #:
1200900000000000697'
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
City of Springfield Official Receipt.
Development Services Department
Public Works Department
Date: 06/17/2009
Item Total:
<":heck Number Authorization
Received By Batch Number Number How Received
Paid By
ONLINE PERMIT CHGS
KR
Page I of I
ONLINE OR Online
ELECTRIC
SERVICE
Payment Total:
9:27:31AM
Amount Due
55,00
6,00
3,05.
7.32
$71.37
Amount Paid
$71.37
$71.37
6il7f2009