HomeMy WebLinkAboutPermit Electrical 2009-9-16
Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477.PH(541)726,3753' FAX(541)726-3689
SPRINGFIELD -
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PenTIlt no.: I
I Date: 9 -/6 --0 '7 I
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. .
111l~~1i'0:C~P,;i!lG:!:)"\lE:B.f\lM~Nif'~B&.R'QM,6;~~~.
1=;;~;~~~~~:~~GF.!({~N~m~~H3illIQ~'\~~i I Residential, per unit, service included: I
~~~+~~~:~~m;~ I~t;:;::::'(::,",,,.." ;'::: I
City: 5 p ~L D I State: Of( I ZIP: CJ 7 'I 77. I Limited energy (2) . $ 32.00 $ I
=_~~~$iB.i;lJ~~~.lwJ~~~~~~I~ J~~~I~~S~~~~~~ ~~~:r (~)odular $ 63.00 $ I
I KtfAJf< Co N f) 'v I T A -r (YI;( r t-f( 8 A 5 tE.] I Services orfeeders: installation, alteration.relocation I
I .' . I 200 amps orless (2) $ 81.00 $ I
f~;~ii~:~e~r;=~f:~~~~~!:1~!:dj;;~y:: :~~ ::: ~~~ :1:::::: [
I Address:, ?::1t( ~1rl!.~r.....7hoser~le~~~EI~:lt6~01~U,1,000amps(2) $205.00 $ I
I City: S{> 1':'1) in 1~~a~~5~~:I~'i\P:~~:7.,2ml.,'~lig~ffJ,000 amps or volts (2) $469.00 I $ J
I Phone' uu"u.! F~:"-l_~\e' (Note' Ihe leI< ptlcReconnect only (2) . I $ 63.00 I $ 6.$
. ("'~1l r.. .:-19 Cl;.. t' 'fCI.....non
I E-mail: numberfortheOregonulIlIlYI.Ivl1 'Temporary services or feeders: lnstallatlOn, alteratlon, relocatIOn I
_ . '-" o^n_'?:~,)-?:i441. I I
Th.. II' . b . 'd '0' '~""'\l' '"c' - - - 200 amps orless (2) $ 63.00 $
IS msta atlOu IS emg ma e on reSl entIa or ,arm property
owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 67.00 $ I
property is not intended for sale, exchange, lease, or rent. OAR I I ['
479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $
Signature: lOver 600 amps or 1,000 volts, see services or feeders section above 1
I ~:::~N~~;~~~~N~1it,(~~~~~~ii,;~ili;1 : :r;::~o:i:::~~ :i::~j~t:~:::r:~:7:~na~::i::e~r feeder fee: i
I Address: '3 '3.15'3 lf3oSCAG-f vA""E I I Each branch circuit I I $ 6.00 I $ I
I City: 5 fJl(' CD I State; () f<.. I ZIP: ~ 7 V 7~ I I b. Fee for branch circuits without purchase of a service or feeder fee: I
I Phone: - 7<((-/ V~'71 Fax: -736- Y%01 I First branch circuit (2) $ 55.00 $ I
IE-mail: RIeK..G^:STSIOE.0.r~J.lc)...b..JCC>!VJIIE!.ll.1.S..iti?)jal~b?aWJ~ circuit $ 5.00 $ I
I CCB license no.: 1/7770 I BCD lice~Wn\,\t.;:2;q,nrV <t$\'G\.ll:}\fi~'.\f!i~~f\~~f~fs:\'1~h}ice or feeder not included I
I Signing supervisor's liceuse no.: ~ 7 2 ~r:t;~ ;;;i7ED, \.lNDI; ~~~,P:~'Ili![o'i)i~ig~on circle (2) I' I $ 63.00 $ I
I Print name of signing supervisor: 1< () G etS".n~l~I~~~~2~ \Q ~ach SIgn or outlme hghtmg (2) I I $ 63.00 $ I
I Signature of signing supervisor; <0_....., '0.'. '"80 DP,~ I ~SlgnalctrcUltoraltmlted-energypanel, 1$63.00 $ I
1t...AJ ~)' I{N"lq I alteratlOn, or extensIOn (2)
.~ ' 1~~::;=;;~t~;~~~ANff~iiS-.-..El~~""'.~f~~'~~_W2",,1
~ 91 ~_ 00... ~y; ~=;::==~~~:: fe~s'fc"',"~ . _O!i'f,,,"~",,,.~l
~~ J>.... (\\ \~;N^ (Minimum Permit Fee $58.00) $ b:1
\\)' . , '-\'\ \V) I (B) Enter 12% surcharge (.12 x [A]) $' 7') Ie
\\ W- I ~~~:~n;~:~::es~:::;;;; (A through C): : i~~ ~
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440-2584-J (9/08/COM)
CITY OF SPRIr~b.H}1,LD
Building/Combination Permit
PERMIT NO: COM2009-01366
ISSUED: 09/16/2009
APPLIED: 09/16/2009
EXPIRES: 03/16/2010
VALUE:
LJ1'5~"./ <A
['Pi' G/ j
(1\ ~ \
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Status
Iss u ed
225 Fiftb Street, Springfield, OR
541-726-3753'Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 594 HAMIL TON ST
ASSESSOR'S PARCEL NO.: 1703341206200
Springfield TYPE OF WORK: Eleclrical Work Only
TYPE OF USE: Repair
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
. % of Lot Coverage:
NO!I~~":'''T "\..I~I( EXPIRE IF 1HE~?~~
I r"" , L' ..... - .. _-_......... "1 \\Vlll IV..........
A~PU~~!lJ:UV(fR0~EMBNTS:.1EO FOR
CEO UK I" /,wn'w.'
COMMEN Sidewalk Type:
ANY 180 DAY PERIOD.
PROJECT DESCRIPTION: Reconuect
Owuer: HEBERT PHYLLIS
Address: 594 HAMILTON ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
laIN leC\ulI""o , UliliW
~~!'!~-~~f,~~: Ol:~:~ b~ 1\\8 0\e90n5el \Olln License
E~S.T~IIl,~?ELECT~,~~~€,le~ ~~~ C\"2-00'\~ 117770
1'-"-'- . vl:;;j\.~' . --".,,,~. .-.... ""
Notilical\~~,DO'\ _OO<(U BUlLDlNG\lNFORMA TION I
in OJ\\~ 90u (\'\a~ ob\,,'" Note.\ne '""'~'~i~a\ion
#ofUuits: 0090. '{ '"e cen\ec \ #of,storiks:\l
\1'nC' H' go" V" . . '\
Primary Occupaucy Group: ca \ "R-3\he Ole. ,Height?of'Slructure
(\'\bel 'v' . 1 SOuv
Secondary Occupaucy Group:'J center \S - Type of Heat:
Primary Construction Type VB Water Type:
Secondary Coustruction Type: Rauge Type:
# of Bcdrooms: Eucrgy Path:
Spriukled Building:
Contractor Type
Electrical
( DEVELOPMENT INFORMATI(m ,
Froutyard Setback:
Side 1 Setback:
Side 2 Selback:
Rearyard Selback:
Solar Setbacks:
Slreet Improvements:
Storm Sewer A vailable:
Special Iustruction:
Resideutial
Expiration Date
10/04/2009
Phone
541-915-9828
u/a
Lol Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basemeut:
Sq FI Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compacl:
DOWllspoutsmrains:
Notes:
I Valuation Descriotion I
Description
$ Per Sq FI
or multiplier
Square Footage
or Bid Amount
Type of Coustruction
Paee I of2
Value
Dale Calculated
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01366
ISSUED: 09/16/2009
APPLIED: 09/16/2009
EXPIRES: 03/16/2010
VALUE:
225 Fifth Street, Spriugfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Iuspection Line
Total Valoe of Project
Fees Paid I
Fee Description
+ 12% Stale Surcharge.
+ 5% Technology Fee
Service Reconnect
Amouut Paid
Date Paid
Receipt Number
$7.56
$3.15
$63.00
9/16/09
9/16/09
9/16/09
1200900000000001069
1200900000000001069
1200900000000001069
Tolal 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.
Reoui~ed Insnections I
Electric Service: Approval required prior to utility company energizing service.
By siguature, I state and agree, that I have carefully examined the completed applicaliou and do hereby certify that all .
iuformation hereon is true and correct, and I further certify Ihat auy aud all work performed shall be done iu accordance witb
tbe Ordinances ofthe City of Springfield aud the Laws of the Slate of Oregon pertaiuing to the work described herein, and
tbat NO OCCUPANCY will be made of auy structure withoul permissiou of the Commuuity Services Divisiou, Buildiug Safety.
I further certify tbatouly contractors and employees who are iu compliance with ORS 701.005 will be used ou tbis project.
I further agree to eu~ure that all required iuspectious are requesle<i at the proper time, Ihal each address is readable from the
street, that the permit card is located al the frout of Ihe property, and the approved set of plans will remain on the site al all
times during construction.
Owner or Coutractors Siguature
Date
Pa2e 2 of2
225 fifth, Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number.
COM2009-01366
C0M2009-0 1366
COM2009-0 1366
Paymeuts:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
EASTSIDE ELECTRIC
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001069
Date: 09/16/2009
Item Total:
Lheck Number Authorization
Received By Batch Number Number How Received
djb 072934 In Person
Paymeul Total:
Page 1 of 1
11 :47:0IAM
Amount Due
63.00
3.15
7.56
$73.71
Amount Paid
$73.71
$73.71
9/16/2009