HomeMy WebLinkAboutPermit Electrical 2009-7-6
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~ _.. Permlt'no.:
IDate:7-b-O( I
Electrical Permit Application
~~!~TY ctF'SPRI~GrIELI);;OREGON'- ,-
225 Firth StrttttSpringfield, OR 97477tPH(S41)726-3753tFAX(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 issuaQce or if work is suspended for J 80 days.
11'~]1tI~_U0.c:~l!.1[GCi1~ERNMEN[,~I?i''lBRCDx{~~1l~1 Q~~ij.$:GllIsQl!Jae~~~161
i~;~;~;~~~i~~;';:CDEi~~~R!!I~ili'CD~:'~lI ~1&~~ll~~~11
I Residential, per unit, service inc:!uded: I
i~~~~~~~~~F~E~'Nk~R~~~7~~;I?iN[)1~:;~~~;;~1~~111,000 sq, ft, or less (4) $134.00 $ I
I I I Each additional 500 sq. ft. or portion I
Job site address. SZ~ ~q.rt1 thereof $ 25.00 $
I City: 5p(:\d. I State: De.. I ZIP:G"08 I Limited energy (2) I $ 32.00 $ I
i=;r~~~~~I~T;~~Ni0~W~J~K~~Ji~i J~~~I~~~ ~~~:r~~~o~ I $ 63.00 $ I
I )"j ~ ~l ,~iceso~1).mstallajiOf!'flileratl~ion I
'=R,,-~:~- -- Nl."'O"-\'''H ,,""'0 t'<'lL':'''', ,- ;-,.^ ",z,t
I '~_ __ ____/ ( 200 amps or less (2) a.j $ 81."!' $::>. r7
1""!q,W"'G'~",1,,,"r,,r;'''R0' "ER"'''''0' 'W NER!'1\"'i"'"'4,,,.,,,,,,,r~;j""., ~O] to 400 amps (2) $ 9<,(0 $ I
,~,';J;:r:'_~_\t;,\<{:1';;;"*)J3;;j~__K!ZrTI'J_~_;ir;, ,. J::: _~I!)It;;_-___ _ _ _,,,,~:;'t:'k:;;;t+1Q\-&;;;ir#,;;tiis~jL:\J ~'
Name, [)...., <t I.f-- 'T", ....,..<,.... I 40t to 600 amps (2) _ ___ --$158.00 $ I
Address: -:! EO r L7fl4: sa J r dft. I I 60t ~v aur~' \"J -- I I $205.00 $ I
I City: eu..:.r:..i: I State: a<L[ ZIP: '?l.(u( I I Over 1,000 amps or volts (2) , I 1$469.00 $ I
I Phone: - Un S- =sill I Fax: _ __ I_Roe,!<Offi\"f~'Y!!,tl(~}S you,':'~J' I I $ 63.00 $ I
PJ'n< 7J. --1.......1'1. I , \..,....~. r'l.rQnOll \.H"'. . I
I E '1' Al \ t:1\lI I\.J' '.In, ,jXenipora1f.y.lsetvices or (eede"" installation, alteration. re{ocalion
-mal \ al v n'-' J . _...... o:;:d; ,u'\\'1 -
. t "-'" ," es '20m-oo "Ii~o /;'" I I I I I
This installation is being made onresidential or f~Wi;P:r,~p}.tt,)I' CelIE t. ''''~,~:;';lS1~\ 952-00 - " $ 63.00 $
owned b~ me, or a member of my Immediate fami!yc~!jf~ 952-00 ,-g,~2!J6~1Q8i'!r!!~t2)'e 1~\~.::Y $ 87.00 $ I
property IS not Intended for sale, exchange, lease, lfr tent. 9A.'f.ll1a I CI~.- ,. "n\hO 291""" ,-,.- I I
479.540(1) and 479.560(1). 0090.. 0 the ( er t~P.I(~,!iPO'" .JJS:(tL"i~,,\ion $126.00 $ I
calling 1"0 --6i'" \ fl"'" ." . ' I
Signature: ".........\')AJ 10r 'fIe. ~ wer~ _~.j;'BPjt}3~~~~qQ volts, see services or feeders sectIOn above
il:,5~i~~tv":;"~'i~i::::::;::::~";:=;;:::f::;:i':" i
CityWfJI11i V) U::LJ Stat y-f 1 zIP4 '/ I b. Fee for branch circuits without purchase ofa service or feeder fee: I
Phone, 7lJ. ~I ,1. T'J Y I Fax: 7'-J- 1.} IIJ 4 7 I First branch circuit (2) I I $ 55,00 I $ 1
I E-mail: Each additional branch circuit $ 6.00 $ I
I CCB license nJ.:;:'(J) ~ 4- i; I BCD license no.:.J. 0 -- 4lfll( Miscellaneous fees: service or feeder not included I
I Signing superv~sor's Iic'ense no.: L/.. '7.::A J ~ . 1 I Each pump or irrigation circle (2) $ 63.00 $ I
I Print name of signing supervisor ~ ,. . ()_ uJ I Each sign or outline lighting (2) $ 63.00 $ I
I . .. , /.., " J III ~r' ) 'A AM I Signal circuit or a limited-energy p;anei, $ 63.00 $ I
Signature of slgnmg supervl.!JOr: ~ V VU ..M_l. alteration, or extension (2) :.
_ Each additional inspection: (1 )!! J $58.00 $ I
$
$
$
COMMENCED OR \~: ~TO'rAL fees and surcharges (~tbrough C): $ .:s 7l11' ~
ANY i80 DAY PER\ .- ·
440-2584-J (9/08/COM)
_ ~,l'!:lil~1l!~111i;!-2, ~ _,
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1!
CITY OF SPRINlitlJ<;LD
11
Status
Issued
Building/Combination Permit
I'
PERMIT NO: dOM2009~00991
ISSUED: 01/0712009
APPLIED: 0:?/07/2009
EXPIRES: 01/07/2010
VALUE:
. 225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 523 39TH ST
ASSESSOR'S PARCEL NO.: 1702311403100
Springfield TYPE OF WORK: Eleclrical Work Only
TYPE OF USE: Repair
Commercial
PROJECT DESCRIPTION: Rebuild meter base and service
Owner: DWIGHT JANSSEN
Address: 3208 LAKESIDE DR
EUGENE OR 97401
Phone Number: 541-485-5571
Contractor Type
Electrical
1. CONTRACTOR INFORMA:rION .D
AT I Cl'llIIVI'4. .....,.....::;l...." ,-_. . - I -.,
Contractor fDIIDw rules adDpted by the ,Or;I1f.t~~;~;ih Expiration Date
k' ""M"~~ c"j]t<;r JhDse ru e:; u,~ "~, "
BURRELL BR\?S'EJ:';T"',Rr~"~i?:\\"Iq,r()llnh cJ.3Ji(l~~2-001- 08/20/2009
o09lil:' Bi:HUDING'INFORM'4.'nON1~~~~eDY
CallHl\::) lilt: I.;-\:;:allc". \.."".-. ...- .'. .
number #C'ofISi'O,<;\!f:9on Utility N44o)tlflcalion
R2 r..,r.!5J: ~ lAl00-332-23 .
'ffel~lIt VI ~rfucture
Type of Heat:
Water Type:
Range Type:
Energy Path: '
Sprinkled Building:
Phone
541-747-2724
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2,hd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
, ,(
Occupant Load:
n/a
I DE~ELOPM~NT INFORMATION'
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
" REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
IPvm..J~PROVEMENTS ,
. r.'IL . _ "- ,_,_
THIS PERMIT SHALL EXPIRE IF'lfI'ltllJ!tC'M!e:
AUTHORIZED UNDER THIS PERMlJnL~J\lUJDrains:
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
I Valuation Descri?tion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
Status
Issued
eIT'] OF SPRINGFIELD
"
"
Building/Combination Permit
!!
PERMIT NO: COM2009-00991
ISSUED: 07/07/2009
APPLIED: 07/07/2009
EXPIRES: 01/07/2010
VALUE:
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541_726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
. Fees P~id I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
$38.88
$16.20
$324.00
7/7/09
7/7/09
7/7/09
Receipt Number
;;
1200900000000000778
1200900000000000778
1200900000000000778
Total Amount Paid
$379.08
I Plan Reviews ,
"
I',
To Request an inspection call the 24 hour recording at 726-3769. All inspections rJquested before 7:00
"
a.m. will be made the same working day, inspections requested after 7:00 a.m. wil\!,be made the following
work day. Ii
I Reoll,jr~d In~l1ecti,~,!,~ I
Electric Service, Approval required prior to utility company energizing service.
,/
By signature, I state and agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is true and.correct, and I further certify that any and all work performed shallibe done in accordance with
the Ordinances of the City of Springtield 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 Servi~les 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 tbe
street, that the permit card is located at the front of the property, and the approved set of plans wil'i remain on the site at all
times during construction. '
Owner or Contractors Signature
Date
Page 2.01"2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-0099I
COM2009-0099I
COM2009-00991
Payments:
Typ~, of Payment
CreditCard
cReceintl
RECEIPT #:
1200900000000000778
Date: 07107/2009
Description
Penn ServlFdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
BURRELL BROS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
05559c In Person
Payment Total:
Page 1 of 1
9:58:14AM
Amount Due
324.00
16.20
38.88
$379.08
Amount Paid
$379.08
$379.08
7/7/2009