HomeMy WebLinkAboutPermit Electrical 2009-8-18
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225 FIFTH STREET. SPRINGFIELD, OR 97477'. PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number m - j /C} ~
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I. ',:LGCATION OEINSTALLATION:'>,o,,;i:',i~'
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LEGAL DESCRIPTION:
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JOB DESCRIPTION:
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Permits are non~transferable and ~xpire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor ::J6 l6 LE C'TR.I C I "lc. .
Address Ltfo85 L cSABE:t..LE sr-R.E.€T
f. '
City 6U6~j.Jf:. Phone 9ft! ~7-~"'nO
Expiration Date'
3~7a'- 5
ttl,I\(D
loLf-q ~'1
3/t;; /9-0l
Supervisor License Number
Constr. Conll', Number
Expiration Date
Owners Name ~\ef ~{;\KaA:f"
Address, 'h'l.."'\lo ~ ~(
City ~.(lL... Phone
OWNER INSTALLATION
The installation is being made on propel'ty I own whIch
is not intended for sale" lease or rent.
Owners Signature:
Inspection Request: 726-3769
Y'//J/1J7
Date
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A, ::',l'l~w;Residential.- Shigle ,orilV\ultjc\iarilily, p"~2welljllg'ti.nit.,;: '~
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Service Included
1000 sq, ft, or less
Each' additional 500 sq, ft, or
portion thereof
Each Manufact'd Home or
Modular Dwelling ;;ervice or
. Feeder
$106,00 '
$ 19.00
$50,00
B,
200 Amps ~r less
20 I Amps to 400 Amps,
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpslV oIts
Reconnect Only
$ 63,00
$ 75,00
$125,00
$163,00 '
$375,00
$ 50,00
c.
Installation, Altera'tion or Relo,cat~on
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
or 1000
$ 50,00
$ 69,00
$100,00
D..
New Alteration'or Extension Per Panel
One Circuit /
Each Adqitional Circuit or with 2)
Service 6r Feeder Permit
$~
>>
1<;
.E.
Pump or inigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
Minimum Electric PermitIllspection
$ 50,00
$ 50,00
$ 25,00
$ 45,00
4,
T)J~
. ~ uurcmirge.
I :;z..l>Wo Administrative Fee
5% Technology Fee
VOl,.
~=:?
TOTAL
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Shared Dlive(T:)/Building Fonns/Electrical Pennit A~plication.g-06.doc
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Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01196
ISSUED: 08/18/2009
APPLIED: 08/18/2009
EXPIRES: 02/1812010
VAL,UE:
SITE ADDRESS: 471 S A.8t
ASSESSOR'S PARCEL NO.: 1703353113300
Springfield TYPE OF WORK: Electrical Work Only
ATTENTION:Oregorl COl'SIRACTOR '~FORMATION I
follow rules adopted by the Oregon Utility
N~!!!.lJ!:!!~t.9rnter. Those rules are set forth License
in qB,IEIJECiI'RJC01 0 through OAR 952-001- 104929
UU8U, YOU may omaln ~m"'''' .., "'~ .. ..~~ ""-
calling the center. (I.. BUlLDING.INEORMA TION I
. number for the Oregon Utility Noti!ication
# ofUmts: Center is 1-800-33!!.q!'",8,tl'f.'es:
Primary Occupancy Group: ' Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building:
PROJECT DESCRIPTION: Alter 4 circuits
Owner: SWAGGART LESTER C & M A
Address: 3276 LAKE MONT DR
EUGENE OR 97408
Contractor Type
Electrical
TYPE OF USE: Remodel
Commercial
Expiration Date
03/14/2010
Phone,
541-687-5770
n/a
Lot Size:
Sq Ft I ~t Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
NOTICE: I DEVELOPMENT INFORMATION I
THIS PERMIT SHALL EXPIRE IF TIJE W.ORK
F.rontyard Setback:AUTHORIZED UNDER THIS pPh'l5fiIf~.r>I~nT.
Side I Setback: ~ StreerT;~g Rqd:
Side 2 Setback: COMMENCED OR IS ABANDOp\f.QdFfii'rve Rqd:
Rearyard Setback: ANY 180 DAY PERIOD, % of Lot Coverage:
Solar Setbacks:
I PUBL~C IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruciion:
, Notes:
I V aluati~n D~scriDtion I
Description
$ Per Sq Ft
, or multiplier
Square Footage
or Bid Amount
Tvne of Construction
Page I 01'2
REQUIRED PARKING
, Total:
,.Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
Value
Date Calculated,
_"'~'!!~~!:~~~~n"" ,
]" ,," ',:+
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01196
ISSUED: 08/18/2009
APPLIED: 08/18/2009
EXPIRES: 02/18/2010
VALUE:
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
F~es Pai~ I
Fee Descrintion
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt Number
$8.76
$3.65
$55.00
$18.00
8/18/09
8/18109
8/18/09
8/18/09
2200900000000000925
2200900000000000925
2200900000000000925
2200900000000000925
Total Amount Paid
$85.41
\ 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.
I Reouired T nsnections I
Rough Electric: Prior to Cover
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 shalt: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 Services Division, Building Safety.
1 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 readable from the
street, that the permit card is located at the front of the property, and the approved set of plans wilf remain on the site at all
timeSd~;:ti~ ~ z/;!/~7
Owner or Contractors Signature
Date
Pa~e 2 of 2
225 Fifth. Street
Springfield, Oregon 97477
541-'726-3759 Phone
Job/Journal Number
COM2009-0] ]96
COM2009-0] ]96
C0M2009-0 1196
COM2009-0] 196
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Pu.blic Works Departm'ent
2200900000000000925
Date: 08/18/2009
Description
Add, Alter, Extend Clrc
Add, Alter, Extend' Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
SUSAN COX-HAMMOND
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc 1715 In ~erson
Payment Total:
Page I of I
1O:29:13AM
Amount Due
55,00
18,00
3,65
8,76
$85.4 I
. Amount Paid
$85.4] ,
$85.41
8118/2009 '