HomeMy WebLinkAboutPermit Electrical 2009-8-6
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Eledrical Permit Application
225 Fifth Streett Springfield, OR 97477t PH(541)726-J75H FAX(541)726-J689
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Penmt no,: -' I
I Date: &> - b ~ 0 7 1
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~~J[0:0P,i"'~~~VEa:NME:Nwf~e&RQM~~~ li.i'I~1~lll!I2il"~illls:.i;;JJl!:-QC!!2,E:
1 Zoning approval verified? ):;J Ye~' 0 No' Im~~'ffi','~~~,'.ri;,p;.r.J~)I'I!Q~I.~"€eJia-~~, ~19, t~
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=~~~".;~f&:J~~~ i ~~~~~~;:C"~:~";'" ;':::: i
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1 "'e: \ C" ) . )Cl \ ~ '~t()ltrl' ,.,1 '?ervices,or feeders: mstallation. alteratIOn, relocation 1
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I \ 'kJ 'w""i'EI'io 200amp~",[jless(2)eqUjres "2 $ 81.00 $ -7Y'I~
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fI ':'/,~ -t'7=. ,::>c fY~ D. 51 -'U;C::' n - .... v1eg 'W
~~.;IIiFf~ERi&:-{0W~E~~~~ifi"~~~~~ U < ,,29\ J,qI1?~ amps:(?h/"" _ on Ut"ltv $ 95,00 $ I
I Name: 1\ rM...g~6-tf ~Y/N~ +rVo;:?-'f;g fhr~~~:::'?2,9,~~:~!1~OAR"o~~r~~r,t~ $158.00 $ 1
1 Address: 'if % h 6+ c.... ""e~I'o,IIP,Q,1 }? 'I,O.oOL"ffiPS, ,(2.) ~ the rUfeo hi, $205,00 $ I
1 City: <>1' r'J 1 State: ~ I ZIP: <]7l(' /0I'nlE0ys;:-,i~9!);~psIQr/;R)r1%fLnone I $469,00 $ I
1 Phone: 1 Fax: 1 1 Reconnect-OJD~12i344), "-q<lon :' $ 63,00 $ I
I E-mail: I I Temporary services or feeders: ins~allation, alteration, relocation ,I
Th" II' 'b' d 'd' I '< I 200 amps or less (2) I I
IS msta atton IS emg ma e on reSl entm or ,arm property , $ 63,00 $
owned by me or a member of my immediate family, This 1 201 to 400 amps (2) $ 87,00 $ 1
property is not intended for sale, exchange, lease, or rent. OAR I
479.540(1) and 479,560(1). 401 to 600 amps (2) $126,00 $ 1
Signature: lOver 600 amps or 1,000 volts, see services or feeders section above I
f~:=~;N~~:~='i~@: : ~r;::~o:i:::~~ ;i::~~:t:~~::r:::~:na~:~::e~r feeder fee :
Address: fl. 0 ,~ ? 5'fo ~ . NO Ti r. :: 1 Each branch circuit :: 1 1 $ 6,00 1 $ 1
City: D.-.otA ~ 1 State:~ I ZIP:! ?'JEaS'dlll)/~' ~ee for branch circuits withoutpu(chase ofa service or feeder fee: I
Phone~f9~\O ' ?<:;(j--/, I Fax~-7{(, -R' i:$:tiORI2'Fh' IfF~lli)J!an~Ji:,ciri\,!!tm_ :. I I $ 5500 I $ I
I ' , -V/VIIVI/:-N I W'H't-" -',-" I"'~ -,/ ' I I
E-mail: AAtv~_iE.)r!i~c!i~a~diti9jI31.9\..aI.P}1.9!..rcuit OR/( $ 6,00 $
1 CCB license no./%'C 0 ,\b 1 BCD liCense no,: "/ au LjA\I' }Vi;!;.s~!I~!e:;.!''!f~1J;i~;.yHAij.'\!iil,rnol included I
'I Signing supervisor's license ~o,: _~? 51.:, <; , ' I I Each'puWip or iITigatio~~,i;~I~?2) $ 63.00 $ 1
1 Print name of signing superviS'l"'-l~t) A;PA1...:;, V /f{')5 ~ I E~ch s<gn or outline lighting (2) '. $ 63,00 $ I
I Signature of signing supervisor: u/ / \ I SIgnal, CIrCUIt O"r a h!lllted-energy panel, $ 63.00 $ I
. I..... ~^-- alteration, or extensIOn (2) .:
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Each additional inspectinn: (I) I $58.00 $
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(A) Enter subtotal of abovefees $ , "I
(Minimum Permit Fee $58,00) Z<( ?
,
I (B) Enter 12% surcharge (.12 x [A]) i. $ Z' f '"
I (C) Technology Fee (5% of[A]) i, $ I Z IJ
I TOTAL fees and surcharges (A through C): $ 'Z8 <(15 (
440-2584-J (9/08/COM)
Status
Iss u ed
CITY: OF SPRINGFIELD
Building/C~,mbination Permit
PERMIT NO: c'OM2009-01l45
ISSUED: 08/06/2009
APPLIED: 08/06/2009
EXPIRES: 02/06/20]0
VALUE: '
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,SITE ADDRESS: 918 66TH ST
ASSESSOR'S PARCEL NO.: 1702341200100
"
Springfield TYPE OF WORK: Elect'rical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace service and 2 feeders
Owner: AILEENE YARBROUGH LIVING TRUST
Address:' 918 N 66TH ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMA TlON ,I
Contractor Type
Electrical
Contractor License Expiration Date
CRAFTSMAN ELECTRIC LL!= ('\,,"~~~ 10", 'c,\~6,0~~ \lnll In 03/231.2011
I BlHLDlNGINFORMATION'I'U" Utility
: ,'HI_!1...-. ~IVil VIJI !l...... ",.............. ,...'....... '"'.~e set forth
in OAR ii~Ht7.}iQr1 0 through O.A,R 952-001- Lot Size:
R-3 0090" \IH;igr,t~fSif'.l~tti?ples of the r[!les by Sq Ft I~t Floor:
call1nT~ Ih" "f'Ht8r, ll~Ole, the telephone S F 2 .'d FI '
, yr!e 0 eat, U 'I't N t'f' t' q t n oor,
numb0W' ,nr tnTC) uregon II I Y 0 I lea Ion I'.
,ater y.pe: 800 332 2344) Sq Ft Basement:
Lente! I.;) I ~ - - ."
Range Type:, 'Sq Ft G,~rage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupaht Load:
~~
Phone ,
541-954-7589
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
I DEVELOPMENT INFORMATION'
Frontyard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Nonl;rL~~~~;~"tXPIRE IF THE WORK
T~,~ ,~~~In IIMnER THIS PERMIT_~S NOT
I ptiUQiIM\?R(1)\JJilME~;PS,UUI~CU I Jf,
ANY i 80 UAY t'cnIU~' Sidewalk Type:
Downspouts/Drains:
"
"REQUIRED PARKING
Total:
"Handicapped:
'Compact: '
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
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CITY OF SPRINGFIELD
1:
Status
Issued
Building/C<i,mbination Permit
PERMIT NO: dOM2009-01145
ISSUED: 08/0612009
APPLIED: 08/0612009
EXPIRES: 02/0612010
VALUE: '
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726,3769 Inspection Line
Total Value of Project
Fees Pai~ I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$29,16
$12,15
$243,00
8/6/09
8/6/09
8/6/09
,
220Q900000000000888
2200900000000000888
2200900000000000888
Total Amount Paid
$284.31
I Plan Reviews ,
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.
,
Renuired Insnectinns 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 hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shaU,be doue 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,
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 address is readahle 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
Date,
Paee 2 of 2
225 i?iftli Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01145
'COM2009-01145
COM2009-01145
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
2200900000000000888
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Paid By Received By
CRAFTSMAN ELECTRIC LLC djb
Page I of 1
[
City of Springfield Official Receipt
Developmeilt Services Department
1 .
Pub.lic Works Department
,
Date: 08/06/2009
11 :48: 12AM
Amount Due
243,00
12,15
29,16
$284,31
Item Total:
Check Number Authorization
Batch Number Number How Received
,
Amount Paid
5219 In Person
Payme~t Total:
$284,31
$284.31
8/6/2009