HomeMy WebLinkAboutPermit Electrical 2009-8-17
08/17/2009 14:54 FAX
IiiI 001
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Electrical P~rmit A
2UI FlII_ s,....,.sprID.lIeI!I. OR 117471. PH(!4117.16-J7~. FAXrll4l)n6.J6ll9
_:o.:~ I
~. Penn it no.: (!.1- 1/9/
Oat.: J(;7/0/
DEPARTMENT USE ONLY
I
This pennlll. i"ued ,..der OAR 91s.J09-0000. Pennlta are nontranaferable. Permit> .xplre If work I. not started within 180
dBY" 0(1".811.. or If "ork Is .ulpended f\>r 180 day.. '
I LOCAL Gd)vERNMENT APPROVAL l
Zoning approval verifl<ld? [fVos ON\> J N....bor.flo.peelf...porilom()
I CATeGOltY OF CONSTRUC110N I
I ,..( , J J RftldeDt"l~ per ~"il., 5CI""lt:e iDcludlld:
IIU Resldentiid b Government 0 Commercial
JOB SITE INft)RMA110N AND LOCA110N I 11,000",.II,orl"'(4) $130,00 I $
III I Each addilionol SOO sq, II, or portion I
lob site address:'. 1,79. ..... ~T , <herroC' $ 25.00 S
I City: SPR.I~u~J~Li:J I Slate: OR. I ZIP: q 7~ 77 Limited en"'llY (2) S 32.00 I $
I Referenee: \II !,J ~f,\ '?' b'\ ,'_TlIXlot.:ll"1LliJ. Each Rlanulllelurod bom. or modular I $
I DI!8CIUPTION OF WORK dwelling s....ieo or te.:d... (2) $ '83.00
~.u:.T'Ag,.. A).(J.) SF../l. Vll.( i /"'IA /1,) ~AtJCL. Service. or r_en: 1'I3/ollatloo. ollem'lan. telocalian
.M I ZOO amps or I.... (Z) I $ 81'00 I S 8)
Aoo y"/clfO~Vf. $T?>V& (./lzclJlr j J)1-SJHJAsur.n. '
I PROJ:fERTY OWNER I 21) Ito 400 omp. (2) $ 15.00 $
Nomo: ~T C.OLC:I"?AIJ /40110600 amp. (2) I $1811,00 I $
I Address: J't 7 ~ 1.-. s. T r 60110 1.000 ""'p" (2) I Szoa.oo I $
I Ciry: SP(l.1J.)(",tc.tJ I Slate: On. I ZIP: '17477 I Ovotl,0000llllpsorvolls(2) I $ql,oo I $
I Phono:EftJ- (-Q.b . ~ /f,3D I Pax: I RocODIlectOllly (2) I '$ ~,OO I s
I E.mail: ITemporaryJC".I~mOrfeeden:/Mfallation..allerotiOn. relocaf/ol1
This installation Is boing'made on ~idential or flum ,L' . r .,./ ZOO amps orle.. (2) I I $ sa.oo I $
ownedbymeoramembt/'ofmyimmedialefomilY,lhi$ I 201 10 4lIO amp. 0) I $ 87,00 1$
property is nOllnlended 6>l' sat., oxchango, lease, or rent, OAR I
479,540(1) and 479,560(J). I 401 10 600 amp& (2) I I $128,00 I $
Signat.ure; . lOver 600 amps or 1,000 YOlfli, see servlccs or feedets section above J
I CONTAAC1OR IN8T ALLA 110N I Bran.h <ll'<uill: '""", all.mlion, exte",l." Po" }k;'" j
I ausinessnamo: OJRrt, T EUC"ftl./W C0071lAC.~ I..Feoforb18l1chcin:uilswilhpun:/ulocof.""",leoorCot<krfoe:
I Address: P.D, 80oll; J6S't . J I E.chbranchcim.it' I ~I $ 8,00 I s t1;:
I City: n ll{VJn elr;" I Slate: Oh I ZIP: q7~-'1.1. I I b, Fee fur bronoh cl=l.. without pl11'Oha.. of...tvi.. or feeder Ceo:
I Phone: 503. 7Sb :.34~lJpllX: ,~O_\. ~7U" I' firslbranchoin:uit(2) ,. I
I f.rnail: tt.UD1D.BTflH.. r9 GYllAIL, COI"'J I EaclladditlOllalbranchci",ulr f;-if.-:< .,~,.,c::." I
I CCB liconse no,: '81/78 -, BCD license no.: r \~~ J I MJ."'II80.....,,..., ..rvi~' orfeederna, i""lwiBd j
Sigolngsupervisor'slloenaeno,: 534~S ~ 'E<lchpwnPorllTigIl!iOllcueJe(2) 1$$3,00 I S I
I Print name of sign ingsu~isor: lEIle.yD VI J / ElU:hsignoroutlinellghting(l) I I S 83.00 , $ I
I S' f' I :~' 1 \ I Sisnalclrcuit or a limittd-e1lo1g)' panel. I I $ I I
IgnaWre 0 ..go ng s.~'or; I ~ ~ _. lIIleration, or.",...loo (Z) , 8~,00 $
/ --..J I I U I E.eh additloool ;o.poella.' (1) I I $..00 I $ I
~ LA.-" I APPLICANT USE ~I
~ (A) Enteraublnlalor.b:JveCees $ ~({).:;-
, ".~~ ~~1 (:::.::::.::(~.~~]) /~~ =~
f\.\.~ ~ \\\ .U-,' I (C)T.chnologyFoo(8%ofCA]) 7:::E$"'7-:-)1J?-"~
'\j-N" ~ ~ .~.({V I TOTAL f....nd..rch.'1le.IAthr..Ch C): $~~
1:1 \\ ~'<\ 122 ,'~;>
440,2584,J <"1081(;0M)' ~
FEE SCHEDULE
IQty,/
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COlI I ToIIII I
ea. cost
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_ ,_u__,._.. _, ._....-. ___
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009.0II91
ISSUED: 08/19/2009
APPLIED: 08/1712009
EXPIRES: 02/19/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1978 L ST
ASSESSOR'S PARCEL NO,: ).703253403200
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
PROJECT DESCRIPTION:' NEW SERVICE AND PANEL
Owner: COLEMAN ROBERTM
Address: PO BOX 72222
EUGENE OR 97401
Contractor Type
Electrical
AT11,-C0N:rRACIOR ,INFO:~A,~IO~t
follow rules adopted by the OrR(!On Utility
Contractor Notification Center, Those rulesll,IS!;l!~\brth
TERRY DEVRIESAR 952'001-0010 throuah O,I,~'B!!..001-
uu~u u_.. --.. --..,. ..".,_. ."C_ ""lJle b
calLBillLDlNGlNEORMATlONI s y
',;,;. , , IVIIO
number for t~e O(eqon Utility Notification
c4Mt,Sn)rl~~iJO.332'2344 )
Height of Structure .
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
03/21/2010
Phone
503-756-3457
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
NOlh~IWELOPMENT INFORMATION I
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZEl9mU~~~imIS~PtRMIT IS NOT
COMMENCEp~I~'i1'~'1STXBeli 'd,BNED FOR
ANY 180 v~:ye lJrIVe'K .
DA.//Jf I16l!C:overage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improveme.nts:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation DescriDtion I
Description
Tvpe of Construction
$Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I 01'2
-~~~!il!@'!~!~~j ~'j..
h '
l
L1,
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of ~roject
Fees Pai~ .
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
Amount Paid
Date'Paid
$12,60
$5.25
$24.00
$81.00
8/19/09
8/19/09
8/19/09
8/19/09
Total Amount Paid
$122,85
I Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01191
ISSUED: 08/1912009
APPLIED: 08/17/2009
EXPIRES: 02/19/2010
VALUE:
Receipt Number
1200900000000000944
1200900000000000944
1200900000000000944
1200900000000000944
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, in~pections requested after 7:00 a.m. will be made the following
work day. '
Reo~ired Insnections ,
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
By signature, 1 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 shall be done in accordance with'
the Ordinances of the City of Springfield and the Laws of the State of Orego~ 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 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.
~,,~,o~ \;~:"
Page 2 01'2
g - '1 - CJ '1
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-0119!
COM2009-01191
COM2009-01191
COM2009-01191
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Date: 08/19/2009
1200900000000000944
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
TERRY DEVIRlES
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
CJC
183634 In Person
Payment Total:
Page! of I
8:20:39AM
Amount Due
81.00
24,00
5,25
12,60
$122.H5,
Amount Paid
$122,85
$122.85,.
8/19/2009