HomeMy WebLinkAboutPermit Electrical 2009-7-23
City of Springfield
Electrical Authorization To Begin Work
E-mailedTo:jackie@bearmountainelectric.com
Check on status of permit
By Phone: 541-726-3753 or Email: perrnilcenter@ci.springfield.or.us
~~~:::i~...:7'J#'''%0f%0~?;PtAN'REViEW~ .::~-'-~;--,,,,:~-:
I D New Cons~ction 0 Addition/alteration/replacement
0~:~::::.-~.~~iCAtEGORy:'6Fjc6N-STRUtTION~_0iY4
I D I 0' 2 fwnilydwell'" DM""'~f.nilY DCommm',' D Ac""oO
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Job Address: ] 034 3RD PL
City/StatefZII': SPRINGI'iELD, OR 97477
Suite/bldg./apt.no.:
Project NlIme:
Cross Streel/directions tojob site: Centennial to 5th to Depue to 3rd place
I Tax mall/llarcel no.:
reconn<::ct power due 10 fire
,~me:R~Alv~z I
Phone: 541-953-7348 Fu: I
I Em,i1, HTI=NTION' Greaon law reauires you to I
Ii: \9!1;;~~'<~fl~\lb(ii~ti~c:6NTRJ>ii:foRtfi'lJ:l<:1r.eg9n'l;l,tlltW"Y~~~1
I Elee lie. no.: 20-448Notif.ication Cente&cltV?n1~ r~~~1s~~e _5_8: T:,!~n I
I Business Name: BEMR ~...iH(Jr;i~itf'ECfC+RJC-U~ lllt U~~ll Vr\l t CI-.)c....-VV I - I
_.__.... \' __ _'_.L_._ ~~...,"'... ......f.fho r.doC' h~1
I Contllct; VV~~;;.-.::~h'~'~'o;;t:~r-" it-.I~t~.- t-h~ tp.lp.ohone ~
I Add"", 85'" DILL1i\i':II~Ii~~1W the Grecion Utility Notification I
I C',>,IS,,,.ZlP, EUGENE, OR 9700nter is 1-800-332-2344), I
I Phone: 541-741-8844 Fax: 541-741-8845 I
I Email: jackie@be~nllountainelectric.com I
I Metro lie. no.: City lie. no.: I
I Supcn'isinp: Electrician's lie. no.: 46405 I
I Supervising Electrician's Nllnle: Chad Perkins I
Number of ins pecti OilS included in paid s~rvkes:
Residential Service: 4
Reconnect Only; I
All0IherSen'iccs:
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 i~spection.
NOTE: This Authorization To Begin Work expires within 180 days if a
permit is not obtained.
The local buildirig 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
Please check all that apply:
o A service or feeder beginriing at
400 t\mps where the available fault
CIJtTcnl e~cceds 10,000 Al11ps al
150 Volts or less to ground
e~ceeds 14,000 Amps for all other
ins1allations
o Firepumlls
o Emcrj;encysystems
o Addition ofu new motor load of
100 HP or more
o Six or more residential units in one
struCture
o Heallhcarefacilities
69600- B E L-09-00048
7/23/2009 7:53 am
App~o\'al Code: 045878
DllaxardouSJocations
DA service or feeder rated at 600 amps
"ormore
~BuildingsmorethanthreeslOrie5
[]1\brinas and boat yards
DFloat;ngbuildings
[]Commercial.use agricultural
I,buildings
[jlnstallalion ofa 150 KVAor larger
;:seperatelyderivedsys
0, "A" "E"or"I.2"or"I-)"
, ,
[J Recreational Vehicle Parks
QSupplyvohage for more than 600
::supplyvoltsnominaJ
Descrilltion
I :1~:\~~~~~r:~~~~2;;-~I~~:'
1~i.ect~kul:Per~iUFee5;'" ...
ISubtolal
I Stale sur~h<lrge (12% of penn it
Iota])
ITcchnology fee (5% of per mil lotal)
1 TOTAL PERMIT FEE
~ q -\0\03
I QI)'.
Total I
1
$63.001,
',;,,1
$63,UU I
$7.561
$3.151
s73,711
E"
',li"'
'!",,'~,
'I
$63.00
~~,A
.~t.: ,.
kL 1\03 \Oq
I,
NOTICE: ;, ' THE WORK
THIS PERMIT SH/'\LLETXH~~~~~MIT IS NOT
/,\UTHORIZED UNDER R
COMMENCED OR IS/'\B/'\NDONED FO
^~IY 180 D/'\Y PERIOP,
'~ ~
~~~.cf\ ~t4.oq
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This Authorization To Begin Work must be posted at the job site until replaced by a Permit,
, '
_ "l~~I~liIil:El.~" ,
t" i\'" ',... ""4'
W'
CITX OF SPRINGFIELD
Building/Cdmbination Permit
Status
Iss u ed
,
, PERMIT NO: COM2009-01063
ISSUED: 07/23/2009
APPLIED: 07/23/2009
EXPIRES: 01123/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54] -726-3676 Fax
541-726-3769Inspection Line
SiTE ADDRESS: 1034 3RD PL
ASSESSOR'S PARCEL NO,: 1703352105300
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Reconnect power due to fire in residence
Owner: WHiTE KRISTIN
Address: 1034 3RD PL
SPRINGFIELD OR 97477
Owner: JACOBSEN ELIZABETH
Address: 1034 3RD PL
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
Electrical
Contractor
BEAR MOUNTAIN ELECTRIC LLC
License
136298
Expiration Date
08106/2009
Phone
541-741-8844
BUILDING INFORMATION I
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construcp,q')"e."i'M'ON' 0 . Water Type:
Secondary const~~",tj9J1rtrl!~:~d;egOn law requirRlll'g\i T~pe:
# of Bedrooms: Notification Centtrted by the Orer.!"nH~/:f'i'th:
.. in OAR 952_001_00'10Those rules aISp,rm\t!P.WJBuilding:
IV"...,.., .. throlJnh n ^ 0 n~,... _ _ .
~;'jingVth~'~~~~~~'(N~f.i:D&VE~ORM:~~1INFORMA T10N ,
number for the Ore 'U-', :..- 'C'''/JIJone
C ' gO/1 t'lity Notification
Frontyard Setback: enter IS 1-800-332-2344)~)verIay Dist:
Side I Setback: # Street Trees Rqd:
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback: % of Lot Coverage:
Solar Setbacks:
Lot Siz~:
Sq Ft I ~t Floor:
Sq Ft 2nd Floor:
, Sq Ft Basement:
Sq Ft d~rage/Carport
Sq Ft O,ther:
Occupant Load:
nla
"REQUIRED PARKING'
I Total:
;~Handicapped:
,; Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOTICE: ___ i'H\'''' ,.".,011
I PUBLIC I~PROVEME~#rV\l1 ~~8~R ~~S '~~RMI~\S NOT
COMME~~E~rJ'i9f'i"\.y1j\'B)fiNDONED FOR
ANY 180 DA'tdO~liHCj;\,tsfDrains:
Notes:
Paee 1 of 2
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
541-726-3676.Fas
54]-726-3769Inspection Line
Description
Tvpe of Construction
Fee Description
+ ]2% State Surcharge
+ 5% Technology Fee
Service Reconnect
Total Amount Paid
I V aluation Descr~Dtion .1
$ Per Sq Ft
'or multiplier
Square Footage
or Bid Amount
CIT\j: OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01063
ISSUED: 07/23/2009
APPLIED: 07/23/2009
EXPIRES: 01/23/2010
VALUE: "
Valuel.
I,
Date Calculated
Total Value of Project
Fe~' Paid ~
Amount Paid
Date Paid
Receip't Number
I>
]200700000000000828
1200900000000000828
1200900000000000828
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. '
$7,56
, $3,15
$63.00
7/23/09
, 7/23/09
7/23/09
Electric Service: Approval required prior to utility company energizing service,
$73,71
I ' Plan Reviews I
I Reouired T n,"ectio", I
111 1,
By signature"I state and agree, that 1 have carefully e.amined the completed application and do hereby certitl' that all
information hereon is true and correct, and I 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 auy structure ';'ithout permission of the Community Servi~'es Division, Building Safety.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 wi1l:be used on this project.
1 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. .
Owner or Contractors Signature
Pa2e 2 01'2
Date
225 Fifth Street .
Spri~gfield, Oregon 97477
541- ~26-3759Phone
Job/Journal Number
COM2009-0 I 063
COM2009-01063
COM2009-0] 063
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
1200900000000000828
Received By
KR
<;heck Number
Batch Number
1:
City of Sprihgfield Official Receipt
Development Services Department
Pui)lic Works Department
Date: 07/23/2009
,
9:03:50AM
Item Total:
Authorization
Number
Amount Due
63,00
3,15
7.56
$73,7]
How ~eceived
Amount Paid
ONLINE BEAR Online
MOUNT AI
N
Page I of I
$73,7]
Payme~t Total:
$73.71
7/23/2009