HomeMy WebLinkAboutPermit Electrical 2009-9-8
Ci.ty of Springfield
Electrical Authorization To Begin Work
E-mailedTo:kclly@builderselectric.com
Check on status of permit
By Phone: 541-726-3753 or Email: permitcenter@ci.springfield.or.us
~;~,:,,':-.< ^^ ~~~~~'-"'iie'G~TYPE:OF.;WO-FfK~-~.c'.~';:"..:,_"4'~':P\'~'.:.... -^ ;\..,"<~~ + '.':~I
I D New Construction 0 Addition/alteration/replacement I
I~~ -:^j~%t:? ';:~:.':~~i!:i,C'A~TEG6RY OF:CONsTRijcTioN~~;:-::'!:;:$\ -:;1::1::1:~;s~T..'1
10' ,,' f=']y dwd",. DM']ti'f="Y Dcomm,,,'w D A"""'Y I
I~ ~',:'];',;'<i~t~JOB'siTEliNFcrlfMATi6N'ANDLocATION'': :~E"i;Cj0!i[, " ;{ I
I Job Address: 425 5TH ST I
I City/StalcJZIP: SPRINGFIELD, OR 97471 I
I SuiteJbldg./npt.no,: I
I ProjecfName:09-5684-s I
Ie,"" 5""udlmti",,0 job ,II" I
1 T:::;'P/P,,'~ ::"Xl~~_ ' HY\g:.J, _,,"~. "I
z::_"_i)~",'-i"o;">i..;.,<,"""':~~~DESCRIPfIO,~~P~,~WORK':,,_~,~~,_E.~.":r":' "',r,1:~ ":-"'=~
Reconnect service disconnected by SUB
I) . :':#i?:€~'1}j7~:~::';;';~ :~-:Si:tE-CONTAGT';.<~';'-:'?_...}i7':~', ~';"':Y'-"'~' f.~"..=,.:'r\."',-,I
I Name: Kelly O'Brien I
I Phone: 541-485-0922 .'ax: I
Email: kelly@builderselectric.com I
,"'I
Elec lie, no.: 20-12C ceo lie. no.: 4296 I
Busineu Name: BUILDERS ELECTRIC INC I
Contact:
Addren: 195 MADISON ST
City/State/ZIP; EUGENE. OR 97402
Phone: 541-4,85-0922
Emnil, FRED@BUlLDERSELECTRIC,COM
Fu:541485-4055
Metrolic.no.:
Citylk, no,:
Supnvising Elrctrician'slic. no.:
Supervising Electrician's Name:
Number o(inspections included in paid services:
Residential Service: 4
Reconnect Only: l
All Other Services: 2
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 inspection.
NOTE: This Authorization To Begin Work expires within 180 days if a permit is
not obtained,
The local building 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
69600- BE L-09-00 123
9/812009 1 : 19 pm
Approval Code: 518041
\~}0(
fA/
()
Please check all lhat apply
~. '%"'i'"" .., -~''''~~_~'~Y_-:'_'.Pl.AN:REVIEW '
Dllazardouslocations
DA service or feeder rated a1600
amps or more
DBuildings more than llttee slOries
DMarinas and boal yards
DFloatinllbuildings
DComm~rcial-u.se agricultural
buildings
DlnSlallalionofalSOKVAorlarger
seper~lely derived sys
D"A","E",or"I-2"or""3"
DRecreational Vehicle Parks
DSupp')'vol!age for more lhan 600
supply volts nominal
Qo',
~I.
1
I.
$63.00 ~~_+~ ~6~.~0 I
$63,001
$7,56 I
$3.151
$73,711
o A service or feeder beginning at 400
Amps where the available fauJl
cunentexceeds 10,000 Amps al
lSOVoltsorlesslOgroundexceeds
14,000Ampsforallolher
installations
o Fire pumps
o Emergency sySlems
o Addition ofa new motor load of
100 Hl'OT llIorc
o Six or more residenlial unilS in one
structure
o Heahhcare facihties
Eu.
Tulal
I Description
I~!~'uanious '~<-,:~J..:, ~~;< ~'_
1 Service reconnect only
Ifj~Hicall~cr-mitJi'~~~"
I Subtotal
1 State surcharge (12%ofpemtil total)
ITechnologyfce(5%ofpermittotal)
1 TOTAL PERMIT FEJ.:
.~
~sfi(~
(O=\~)'
]!
~~q.-
C\.\0.0\
~<:Rf-
~
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
fYJ/?1LOO:1 --
n/Yl
()e~
9~() --Q 9
-~!~~~~~-~~l;,~-,,)%~t~~I'
1il'~ f'-: ,',p-,~'~~~~):1' " \!t
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01324
ISSUED: 09/0812009
APPLIED: 09/08/2009
EXPIRES: 03/08/2010
VALUE:
Status. Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 425 5TH ST
ASSESSOR'S PARCEL NO,: 1703352410900
Springfield TYPE OF WORK: Electrical, Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Reconnect
Owner:
Address:
BROWN FAMILY JOINT TRUST
1294 1/2 HORN LN
EUGENE OR 97404
I ,CONTRACTOR INFORMATION i
,
Contractor Type
Electrical
ContraCtor
BUILDERS ELECTRIC INC
License
4296
Expiration Date
12/10/2011
Phone
541-485-0922
BUILDfNG INFORMA nON I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PU~LIC IMPROVEMENTS'
Description
I nlv t"Ct\IVIII vnflLL CAnt"= :~ :~= "," '~-,
P UTHORIZED UNDER THIS IpViiHU'iftion\jDescriotion I
,';OMMENCED OR IS ABANDUI~tU tUK
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
,N'i'ypl'oLConstrh'ctibh
Sidewalk Type:
Downsp,outs/Drains: .
ATTEI~TION: Gregon law requires you to
follow rules. adopted by the Oregon Utility
Notification Center, Those rules are set forth
, In OAR 952-001-0010 through OAR 952,001-
1"\1"\""1"\ \1_,,__,,_I_.L_:__'__.~__r" "
- - - - -.,/ _,,-"_h" --1-'-- _, ...... ............. '-']
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center i~ 1-800-332-2344),
Value Date Calculated
Street Improvements:
Storm Sewer Available:
Special Instruction:
"
Notes:
NonCE:
Paee 1 of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01324
ISSUED: 09/08/2009
APPLIED: 09/08/2009
EXPIRES: 03/08/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$7.56
$3.15
$63,00
9/8/09
9/8109
9/8/09
3200900000000000636
3200900000000000636
3200900000000000636
Total Amount Paid
$73.71
I Plan Reviews I
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 R,elluired Insnections 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 shall be done in accordance with
the Ordinances ofthe 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 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
Date
Page 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01324
COM2009_01324
COM2009-0 I 324
RECEIPT #:
Description
Service Reconnect
+.5% Technology Fee
+ 12% State Surcharge
Payments:
Type oCPayment .Paid By
ONLINE CHGS
cReceintl
ONLINE PERMIT CHGS
City of Springfield Official Receipt
Development Services Department
Public Works Department
3200900000000000636
Date: 09/08/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
ONLINE
builders Online
Payment Total:
Page I of I
1:40:38PM
Amount Due
63,00
3,15
7.56
$73,71
Amount Paid
$73,71
$73,71
, '
9/8/2009