HomeMy WebLinkAboutPermit Electrical 2009-9-28
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CITY OF SPRINGli'iEJ-.D, OREGON
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: A& ... ~ INITIALS 1 U
;..... - ~. DATE -a.."ZJII..l~
'I!IllIlIlllIIo \lflV . SOURCE ~"-
Dat. y{~;A> ., ,
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225 FlFTH STREET. SPRlNCFlELD, OR 974" . PH,(S4I)726-J75J . FAX, (541)726-3689
ELECTRICAL PERMIT APPUCATION
Cil)'IobNumber CO""'Z-OO f- 0 /4 z.b
1. ,f$~:fI9NPFjjV$TA"t!\,TIO:&/;~;.):W~' 3,
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LEGAL DESCRIPTION:
'8030 e.. ~ 2
O~l(OO
~:").' _1';_" ;.;. ::;..::,_'.:., . ;P";:'~~' ".':i 1--<': . .d:~.. ;:;::=,:..:;............;:"""".:~.:;,," ::.-.....'i'-~'~.~~,,~,. ..., .~\jo
A.~' j\/e". ~~ldt~i\IiI:: sr"gle <!l'~lilil:Filli\i!~rper~d~lIin;;.i(;jii?''<i'
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JOB DESCRIPTION:
~/c..v
I Z Cli''-..... +s
Service lDcluded
1000 sq, ft, or less
Each a4d.itional 500 sq. ft. or
portion thereof
S117.00
$ 21.00
Permits are Doa.traDsferable and expire if work is Each Manufact'd Home or
oot started withio 180 days of issullDce or if work is Modular Dwelling Service or
Suspended for 180 day', Feeder
.=~~~~~~ri(L;2~~:~~~~
J' NOtli';;;""I'IJ'~;;;S~el7-(jr;/ 601 Amps to 1000 Amp, S180.00
CIty U.l~(?A\Q... !nPho~~2f "'~jtiF03d'JI'V re Oyer 1000 Amp,Nolt' $413,00
\.J vJ9Q, 'ri~J<!-OOI"'&r. 1/ VY the gROco_oue.:tOnly S55.00
f/ Cq//lf/r~ 'fip!,,2-?10 t~~se rU/eol:9.f?<f~,~9<... ,,"~'!o<'.' '" "_"'C",:(.,<,- ~Jil:"-'W"^~"'~"1i':iii.~.f"
Supervisor License Numbt,f'fn/;~. -1/ ~]S~.:..::Jalt1,..~ ~Ugh 6A:~!~~~~!'r:lj"!23.S.~l-':'F.~~frf2~!]':U";~cJ-1:~...;..'1::'~!:-:7;~~i~
c'v' rhe ". (^' ,.,Ies Of '1 952' 'urlh
Expiration Date J fi I,VejJl5i{!J,,!b90h ~t?: Ihe I:;]"'!!!~ftfo", AlterotiOD or RelocalioD
~ . QUO. ..111Y/1I '2oor.-~lJJ6r1ess
) / 3322. 01", ""I!"
Con'lf. Conlt, Number I '-{. Ci S:<3':" . 344). 20rll\l1jps to 400 Amps
- - 401 Amps to 600 Amps
Expiration Dato ~/ OlCJ)~_ Over 600 Amps or 1000 Volts se. "B" abov.,
':;;;1.r;;:;::- D~f.7~::~~~~::':~~~
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Address I brAt n 'rn:r<l ~WL ~tL E';~~~~~~~~~'!!;!l.2,~~ed~,~;!!:.\'~~f~~,~,\t),:r!~l'Jt~!!~!~1';;i:
r- (') :0.. Iftl -'I./:. .. -
c.ty ~ r U A , S A>lwke Pump or irrigation S 55 00
C 'v I liOR? VI/ r SH. Sign/Outline Lighting S 55,00
OWNER INSTA~~iON~ ZED UND'JILL EXp LImited Energy/Residential S 28,00
, ,. :/~V 1 n ~I CFI1 ~ '/CD.);: 'IP/C'i" Li" ed E /C . I 55000
The lDst.lIauon "bem.1mii1lo on prop~J'dWIIlwhicli' Ii" r.t, mil nert)' onunorc.. .
. 'Uii' ",8 'IOp !.7;::, .
is not inten<kd for sale, lease or reqtER .<18.<11\( rRfl,~rn~if.fclric Permit Inspectioo Fee is S50.00 + Surcbarg..
a S" _ 100. OONE[/A'DISS'mi;roTAi.aF-A:BD~.:'';':~~'~{'Y~F';: 950
woer5 Ignat"re. ~rJ:>" ~ h ~:~surch~e Ti%""-c"~."'~J..<.,.,..,-- : (ltE
.~ s<< ~'('J'u . ~~~:::~:;~::Poe &f6~
/olli
555.00
S 55.00
$ 76.00
S1.IO.OO
10spectioD Reque't: 726-3769
TOTAL
Sbate1! Dr\'IIe(T:)IBuilding F"nmlEtccbiw Pennit Appli.ciltiOD. 7..Q7.doc
113 39\1d
al3139NI~dS 30 ^lI8
9L9E9lL
EI:Ge LeeZ/vl/I1
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'x -. - ;,,','" '. ~ ., -,',r. ". '! 0 '-I,' :''fi
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Status
Issued
CITY OF I'lYKll'l\JFIELD ,
Building/Combination Permit
PERMIT NO: COM2009-01426
ISSUED: 09/25/2009
APPLIED: 09/25/2009
EXPIRES: 03/25/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1689 HARBOR DR
ASSESSOR'S PARCEL NO.: 1803023203400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Service and 2 circuits
Owner:
Address:
WALSH DANIEL D & KRISTIN J
1689 HARBOR DR
SPRINGFIELD OR 97477
Owner:
Address:
Contractor Type
Electrical
WALSH DANIEL D & KRISTIN J to
1689 HARBOR DR requireS yOU.
SPRINGFIELD OR 9;~~'b..rnON', or~?~~ ~~~ne ore~~no~t;~~Xi1
{allOW rUle,; pv~.:_ ThOse ,urv;: ~" oo;2-0u'-
Notiticatioq \C'ON'I:RAGO[(i)R'I~.O~'T10N ,
'n OAR 952-v-. obtain cU\"~-i1e te\epnor.l~
Contrac~dO' '{ol\ rna!enter. (Note. .iit Noti1it;iceRse
CROW V A1!;BEiY'Eti~G\r~lcreg~~ ~~~_~344), 149834
nU'"V-q;EBurI;))l'N'GI~FORMA TION,
Expiration Date
12/13/2009
Phone
crowvalleyelectr
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
# 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:
. R-3
n/a
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION'
. " O&:QUlRED PARKING
Overlay Dist: .' \\'\E W ,\-\t. \j1J l'l1Ylal:
# St~et\t;;:e'ii;R~fSW\\..\.. t.YJ? S ?t.\'\WI\\ \\ Handicapped:
PavV'Drire::'Rq~: UI'lDt\'\ \\-\\ DOI'lED \,0 Compact:
% Of'm\~t'\~fJf~D 0\'\ \S !\\,;!\I'l .
1'(\\\~WlEI'lC~" oI"R\OD.
, ,,,. \ t C ~:
I PUBLIC IMB..R(i)VEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
, .
Notes:
Page I of2
Status
Iss u ed
CITY OF :Sl'Kll'1lJl'lELD
"Building/Combination Permit
PERMIT NO: COM2009-01426
ISSUED: 09/2512009
APPLIED: 09/2512009
EXPIRES: 03/2512010
. VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Fees Paid 1
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
$11.16
$4.65
$12.00
$81.00
9/25/09
9/25/09
9/25/09
9/25/09
Receipt Number
2200900000000001097
2200900000000001097
2200900000000001097
2200900000000001097
Total Amount Paid
$108.81
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,
RClIlIired Insnections I
Rough Electric: Prior'to Cover
Electric Service: Approval required prior to utility company energizing service.
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 shall 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.
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 sei of plans will remain on the site at all
times during construction.
f~L/
Owner or Contraciors.Signature
0iA
f~l
Date
Pa!!e 2 of2
City of Springfield Official Receipt
Development SeITices Department
Public Works Department
225, Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1426
COM2009-0 1426
COM2009-0 1426
COM2009-0 1426
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200900000000001097
Date: 09/25/2009
1:52:56PM
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Amount Due
81.00
12.00
4,65
11.16
$108.81
Paid By
MARTIN GRAY
l1em Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb 89~465 In Persnn
Payment Total:
$108.81
$108.81
Page 1 of 1
9/25/2009