HomeMy WebLinkAboutPermit Electrical 2009-7-16
225 Fifth Street. Springfield, OR 9747HPH(541)726-3753.FAX(541)726-3689
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perrnit:o.J29-/0J? -/
Date: ;V/ t,/ lJ 7 _I
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This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if wo,rk is not started within 180
days of issuance or if work is suspended for 180 days. II
Electrical Permit Application
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I Zoning approval verified? DYes D No I
'1I~Ci[4i!1J;:GilllB\Y.L0'J':.'"g;1[~-$mB:~:C:l.11"QJi~~.'ir~11 Residential, per nnit, service incl4ded: I
~;:~;~IDij;iIN~~g~~i;~~Jlf1\~~~r;;~;;~,#l'i I 1,000 sq. ft. or less (4) 1 $134.00 $ I
I I I Each additional 500 sq. ft. or portion I
Job site address: ./12 c../ /'11'1//1/ thereof ;, $ 25.00 $
I City: <: PFt..-() I State: d-YL- I ZIP: 9'l'f I I Limited energy (2) , $ 32.00 $ I
F~~~~I~~~f~wJ~~~ I !:~::~:~:::~:.~:~:}~~:d:Ltian. rela:a::~OO $ i
I I 200 amps orless (2) 1- $ 81.00 $ /~2-1
~~~~"t~.JlllIeRQe]~BilkY,I~W!\t!:.R'!i\~~~~;~~ I 201 to 400 amps (2) $ 95.00 $ I
Name: A/If K rr R JI.H L 40 I to 600 amps (2) $158.00 $ I
I Address: "3 '-1'74 Sf~/'.I{. iJLVD 601 to 1,000 amps (2) $205.00 $ I
City: PU (.. ~1"" I State: t:J~ I ZIP: .,1 l(4) lOver 1,000 amps or volts (2) $469.00 $ I
Phone: I Fax: I Reconnect only (2) $ 63.00 I $ I
I E-mail: I Temporary services or feeders: in~tallation, alteration, relocation I
This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ I
owned by me or a member of my immediate family. This I 201 to 400 amps (2) " $ 87.00 $ I
property is not intended for sale, exchange, lease, or rent OAR
479.540(1) and 479.560(1).' 401 to 600 amps (2) I' $126.00 $ I
Signature: Over 600 amps or 1,000 volts, see s~rvices or feeders section above. I
=~:~)f1~2j'j:~;~i~!#~Ml : :r;~:~o:i~:::~ ~::~i~t:i~~::r:~:~~~n:.~~::e:r feed~r fee:- . [
I Address:, 76(a.7'7 /57IfO,recl,~v -DIZ I I Each branch circuit I; I I $ 6,00 I $ I
I City: 7); rf" NCA. I State: 0"e I ZIP:979.:?<71 I h. Fee for brancb circuits without p~Jchase ofa service or feeder fee: I
I Phon6-9f9'f")(,:-;': -'3:'7":2 I Fax: I First branch circuit (2) i $ 55.00 I $ I
I E-mail: /l-E7r;/ L. ',.LeI ~ '7 €J ocue5fc:J:rJ-te,/lX?; L I Each additional branch circuit ).2- $ 6.00 I ('1.'- I
I CCB lice~se no.: /51'0091 BCD license no.~ -7&; gc:: I Miscellaneous fees: service ar f~eder nat included I
I Signing supervisor's license no.: ~/;",,)G.... "') I Each pump or irrigation circle (2) i' $ 63.00 $ I
I Print name of signing supervisor: hL.A.2p, /::::'Inn 1:'~Ch sign o~ outline lighting (2) _ $ 63.00 $ I
I Signature of signing supervisor: ~ ff . .I # h , A/ SIgnaI CIrCUIt or a lImited-energy P"!'. el, $ 63.00 $ I
. ~.A.L-AfI"'3J"" n:. /L-- . U --", alteratlOn, or, extensIOn (2) !
. E_ach addition.al inspe~tion: (1)' . . ) $58.00. $ j
_fI"',.i;l>("""'~~ r~"'-'",'~''''.''''''''''''''",",'';!."",,1i_',,",_
1i1,\!C\,.-~~~gg!!!!i>~ti!lf>lli"'$J::~a""'''l1',!j~\"j:i:;~""j
(A) Enter subtotal of above fees I' $ I
(Minimum Permit Fee $58.00) ,
I (B) Enter 12% surcharge (.12 x [A]) ,i $ ~S"' ~ I
I (C) Technology Fee (5% of [A]) ]! $ t'l '101
I TOTAL fees and surcharges (A \hrough C): $~41!-t
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440-2584-J (9/08/COM)
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
. l
Building/Combination Permit
I
PERMIT NO: COM2009-01037
ISSUED: 07/16/2009
APPLIED: 07/1612009
EXPIRES: 0111612010
VALUE: . ;,
:'
SITE ADDRESS: 1124 MAIN ST hJTI=NTION: Oreg~I!'t!pgfi~I~_I1"=Y;p'El(i)FJWORK: E1e~trical Work Only
ASSESSOR'S PARCEL NO.: 17033541044100 les adopted by the Oregon Utility I
~~ru ," .
N IT t" on Center. Those rules TMP.E O1'111)SE: Remodel Commercial
PROJECT DESCRIPTION: Install sen'i~~ ~~fij,lsubUpanelrfor.laundri1l11ai,R 952-001-
10 Uf-\n ~..J'- - v I "'...... OJ .- ,. - ...J
MQf'l Ynll mav obtaif'l copies 01 the rules by
II' the center. '1~Ote; lll~ ''''~I"'''V''V
ca mg \.. 'f' t'
. number for 'the Oregon Utility Notllca Ion
Center is 1-800-332-2344).
Owner:
Address:
KRYLMIRKA Y
3474 SPRING BLVD
EUGENE OR 97405
Contractor Type
Electrical
I, CONTRACTOR INFORMA nON I
Contractor
KIDD ELECTRIC INC
License
154009
# of Units:
Primary Occupaucy 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:
Description
Type of Construction
N OTlI~ BUILDING INFORMATION I
THIS PERMIT >;HAI,.L EXPIRE IF I Ht WORK
r\UTHORIZffly~\~\t~~Il'A:TH\S PERMIT IS NOT
B Height oCSlructureONED FOR
COMMENCf{'peJ,\'1 ife,\WAI~U
ANY 180 [iWat\1t1j\~~[;\. .
Range Type:
Energy Path:
Sprinkled Building: nla
I DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% 01 Lot Coverage:
I PUBLIC IMPROVEMENTS'
Expiration Date
01/27/2011
Phone
541-942-1352
,.(
,
Lot Si~e~
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft <;:;arage/Carport
Sq Ft Other:
Occupant Load:
:,
REQUIRED PARKING
I Total:
Handicapped:
Compact:
j: ,
Sidewalk Type: "
"
Downspouts/Drains:
I Valuation Descriotion I
$ Pe.. Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of 2
I
Value
I,
Date Calculated
'i _RIN~f1Ig&;l),;
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I'
CITY OF SPRINGl'u,LD
,
Building/C6mbination Permit
"
Status
Issued
PERMIT NO: COM2009-01037
ISSUED: 07/1612009
APPLIED: 07/1612009
EXPIRES: 01/1612010
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'
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$35.28
$14.70
$132:00
$162.00
7/16/09
7/16/09
7/16/09
7/16/09
2200900000000000803
"
2200900000000000803
2200900000000000803
"
2200900000000000803
i,
..
Total Amount Paid
$343.98
I Plan Reviews I
To Request an inspection. call the 24 hour recording at 726-3769. All inspections r~quested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will' be made the following
. Il
work day. . . ". ':
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I ~e/ll~~~ed T~snecti~ns I !
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
.!i
By signature, I state and agree, that I have carefully examined the completed application and do h~reby certify thai all
information hereon is true and correct, and I further certify that any arid 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 Servi~es Division, Building Safety.
I 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 a1ddress is readable from the
street, Ihat the permit card is localed at the front of the property, and the approved set of plans wi!'1 remain on the site at all
times during construction.
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Owner or Contractors Signature
Paee 2 of 2
Z25 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Sp~ingfield Official Receipt
Development Services Department
Public Works Department
If
I
Job/Journal Number
COM2009-0 I 037
COM2009-01037
COM2009-01037
COM2009-01037
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200900000000000803
Date: 07/:16/2009
Description
Perm ServlFdr 200 amps or less
Add, Alter, Exlend Circ Ea Add
+ 5% Technology Fee
+ ] 2% State Surcharge
Paid By
BLAID KIDD
Item Total:
t.:heck Number Authorization
Batch Number Number How'Received
J'
31610A In Person
Payment Total:
I
Received By
cjc
Page 1 of 1
II:OI:12AM
Amount Due
]62.00
132.00
14.70
35.28
$343.98
Amount Paid
$343.98
$343.9M
7/16/2009