HomeMy WebLinkAboutPermit Electrical 2009-7-6
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225 Fifth Street+Springfield, OR 97477.PH(541)726-3753.FAX(541)726~3689
I permi~~t,tUJO ? 00 9 '6''7
I Date: ,,--r - b -0 ;
"Electrical Permit Application
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'--"0''''''(!''''G' '0VER'N" ME' ,= :- " 'R'0'-' '(!'="""ill__'hl
~~lk%iz201..z. ' ;~tit. Jlt,".t,:L__,._;___.J~lliQjt~~e,_jY!A' ~Xfl;-5rt0?L'li:;mg-illB1
I Zoning approval verified? ~ Yes D No
1!I!I.'1ll.llliJ.C:'All1EG0RlfJ~i01T'feoNSl1RUc:;r10N!I!I.~ ~d 'I ' "I d d ------- '" I
I eSI entIa, per UUlt, service me u e : ----..."
D Residential D Government I ~ Commelcml I II ~
.!I!I!I!IJ0BiSll1E~INIi.0RMAim0N~''ANDi~1!0,C:MI0N~~6 1,000 sq ft or less (4) : $134,00 $ (1
... \ ~ Each additIOnal 500 sq ft or portion
Job site address: 5Z 3 ?,q 1>4 .. -z. thereof I $ 25,00 $
City: Sfl;lct I State De.. I ZIP' 91lPB I ~~2) I _~"'$ I
I Subdivision: /7c?SflL( Lotno,:03/DO I Each manufactured home or modular I $ I
dwelling service or feeder (2):1 I $ 63.00
I Services or feeders: installation, alteration, relocation I
I 200 amps or less (2) $ 81,00 $ I
i 20 I to 400 amps (2) $ 95,00 $ I
I ''^ I 'T" I 401 to 600 amps (2) $158,00 $
Name: v.... <l h-t" .1 "U"S"...
I Address: 3ZoF u4-tc-S/~f: AIt. I 601 to 1,000 amps (2) $205,00 $
I City: ~-t::;r.le: I State:c<L- I ZIP: , 7'fCJ/ lOver 1,000 amps or volts (2) $469.00 $
I 6 I I Reconnect only (2) $ 63.00 $
Phone: - liD"!' - 5"5, I Fax:
I I Temporary services or fceders: ins".lalfazion, alteralion, relocalion
E-mail:
This installation is beirig made on residential or farm property I 200 amps or less (2)
owned by me or a member of my immediate family, This I 201 to 400 amps (2)
property is not intended for sale, exchange, lease, or rent. OAR
479.540(J) and 479,560(J), I 401 to 600 amps (2) $126.00 $
Signature: _ lOver 600 amps or 1,000 volts, see s~rvices or feeders section above
1~::=c.~>N?~ei(,j~~ijrrj~IE~~O~i~'lJ!~ I : :r;::~o:i:::~:S~ :i::~~:t:~~Op:r:ts~:;:':~i::e:r feeder fee
I Address: ,,:) (i -; ;oh/)\:(, Orr(rpf:JI8J1 requires you to I Each branch circuil 1 $ 6,00 I $
I City: W fJ 11~(v.i' J ':.f~ fJ'~t~~:tt::)_YJj~_~J,l.jF!l:t7~<!t$fI I b. Fee for branch circuits without purchase ofa service or feeder fee:
I Phone: 7-*7). ~)}q:J:iFa~::'hrJ,;: ,-; 'AR-fi~ 3 _ I First branch circuit (2) 'I I $ 55,00 I $
I E-mail:' c',." 'r.-::,y obtain copies 01 the rules oy ,I Each additional branch circuit i, $ 6.00 $
I ' ICA,/:\Jl:ji'1 "E[rW' ",'Ule, ll'''<<j'I'H'H'/o 1/11 M' II ,. ' fi d 'I d d
CCB license no. ,'. .!!1.T.. . _~... .I?GP).I~~f!S.~i!}~::~~fi~t"""r6f\\J-.-' Isce aneous lees. servIce or ee ~r not me u e ,
I Signing supervi;~~~; 'ITc';,;";;n~ ,-;s- {J;6Tf-:Y3~-~44J,. 1 I Ea~h pump or irrigation circle (2) I I $ 63,00
I Print name of signing supervIsor: I r fuvu1~' I Eat:h Sign or outltne bghtmg (2) I $ 63,00
I ' ' , -./' IIIJ in I"i I I Signal CIrCUli or a IlIl1lted-energy panel, I I $ $
Signature of slgnmg supervlsOf/ y" ' \AliA alteration, or extensIOn (2) It 63.00
~ I Each additional inspection: (1) II I $58.00 I $
l\ ~'b . ~W r3\ ~~ (A) Enter subtotal of above fees
\..; ~ cb:iS) . I V-- ~\ (Minimum Permit Fee $58,00) II
NOTICE: I;-J; \j::Wl:~.\l12%SUrCharge(12X[AJ)1
THIS PERMIT SHALL E IRE l~~I~(Rl !;~l'I'vology Fee (5% of[AJ) ii
AUTHORIZED UNDER THISDPOENEDld{~rAL fees and surcharges (A'through C):
COMMENCED OR IS ABAN. ::
ANY 180 DAY PERIOD.
17_""",', .....
jJ..,r
ll.:,,,,p 1'r.T "
$ 63,00
$ 87,00
$
$
$
$
$ I J''f
$ lbO,'
$ &'/''1'
$ ISO '(3'
440-2584-) (9/08/COM)
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
eIT):: OF. SPRINGFIELD
Building/Cdmbination Permit
'I
"
PERMIT NO: COM2009-00989
ISSUED: 07/07/2009
APPLIED: 07/07/2009
EXPIRES: Oi/07/201O
VALUE:
SITE ADDRESS: 523 39TH ST APT 2
ASSESSOR'S PARCEL NO.: 1702311403100
Springt1eld TYPE OF WORK: Electrical Work Only
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II
TYPE OF USE: Repair
, ,
PROJECT DESCRIPTION: Rewire unit complete'
Owner: DWIGHT JANSSEN
Address: 3208 LAKESIDE DR
EUGENE OR 97401
I CONTRACTOR INFORMATION 1
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC
License
136446
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Descriptio'n
Tvpe of Construction
I BUILDING INFORM A TlON I
# of Stories: \l \0
R2 Height of Structure ~~ "11-1'"
~p'~\.'\>- v~ ,\,
Typelo((Heat:Ole90\\ \\01\\\
C -llU \ ~v,p. se
VB IO~" Water l!iype:' leS a.te 'O?.GG~-
..-\\O~\ leS a.CRli'~~~\I\yjJe!\l" O~t\ 9 \lIeS 'o~
'O\~-t\l ~ cd8~rgy,"Niii\\9"s 0\ \\\e t "'o\\e
." '\\01' 'nq. j -n\ , \e?\\
\,-o\\\\ca:.9'O ?_GCSprin,l,9,ed;Build!!lg:\e \1\\ca.\lcnia
r..1\~ __1':\,,] QU ,,,\ote, ..... NO
\l' .- . ..,,,., . ~}
GG9\JI.DEV.EDOPMENiI"INF;QRMA'fION I
ca,. \O\~""\ ~U'"
\\\It\\'oet ce\\\el IS
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I.
Commercial
Phone Number: 541-485-5571
I'
,
Expirati~n Date
08120(2009
Phone
541-747-2724
Lot Size:
"
Sq Ft I Sf Floor:
I
Sq Ft 21)d Floor:
Sq Ft Basement:
Sq Ft q,arage/Carport
Sq Ft qther:
Occupant Load:
,I
REQUIRED PARKING
'Total:
Handicapped:
Compact:
Sidewalk Type: ,/
.. \~IOV-"
. Do~p,'(ulS:)l)rlti~~Ul
~Oi\~~~\'J\\1 S~~iv-~;;\S \Jt.~~~ ;;V-
1\-11S \-IOV-I1t.\) \l\'\ IS [\1'>[\\,\\)0 .
/I,\l1 __"rl"O OV- , .... ,,!
.m."",,_.- ,q~['\,V'
I \JV'" 01-\'.' "-
Valuation Des,cr.Mion I
$ Per Sq Ft
or. multiplier
Square Footage
or Bid Amount
Page I of2
II
Value II
Date Calculated
CITY OF 1'll'KINGFIELD
Building/Combination Permit
, Status
Issued
"
PERMIT NO: COM2009-00989
ISSUED: 07/07/2009
APPLIED: 07/07/2009
EXPIRES: 01107/2010
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
$16.08
$6.70
$ 134.00
717109
717109
717109
Receipt Number
1200900000000000779
"
1200900000000000779
1200900000000000779
,
,
:'
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Residence Wiring 1000 Sq Ft
Amount Paid
Date Paid
Total Amount Paid
$156.78
I 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. wilI:be made the following
work day.
I R~(J.uired Insneetions, I
Rough Electric: Prior to Cover
Electric Service: Approval required prior tO'utility company energizing service.
Final Electric: When all electrical work is complete.
By signature, I state and 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 shalli'he done in accordance with
the Ordinances of the City of Springfield ;md the Laws of the State of Oregon pertaining to thewo'~k described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Servic'es Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 willi 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. I
Owner or Contractors Signature
Date
Page 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
II
City of Sprihgfield Official Receipt
I'
Development Services Department
I,
Public Works Department
1~
Job/Journal Number
COM2009-00989
COM2009~00989
COM2009-00989
Payments:
Type of Paym~nt
CreditCard
cReceintl
RECEIPT #:
Date: 07/Q712009
9:59:28AM
1200900000000000779
Description
Residence Wiring 1000 Sq Ft
+ 5% Technology Fee'
+ 12% State Surcharge
Amount Due
134.00
6.70
16.08
$156.78
Paid By
BURRELL BROS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 05559c In Person
Payment Total:
$156.78
$156.78
Amount Paid
, Page 1 of 1
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7/7/2009