HomeMy WebLinkAboutPermit Electrical 2009-10-1
22S Fifth StreeUSpringfield, OR 97477+PH(S41)726-37S3+FAX(S41)726-3689
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I Date: /0 - 0 f -0 cr I
Electrical Permi(Application
This permit is issued under OAR 9]8-309-0000. Permits are nontransferable. Permits expire if work is oot started within ]80
days of issuance or if work is suspended for] 80 days,
'ily,.(1";,,,:, '1,"!,it:OC,' AL':,G. OV,E_RNNlEN:nA" 'P, P'" R""OV, A[,"'''.'_::,~t,'r.'i<,),',':.ii*,;,l;',:,;',''.:_-,1 li\,I,:i~'i,,""li\'~i,~r,')ii\Wc:"1."E E"S'CR' E' D'U' '"E'
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I Zoning approval verified? ,D Ves D No I I:Nuiriiieriiif-ih~p~'cti~\;;fp~rii~~i();:::;IQiq':.,g6s,O:T;Total,1
1~\;~;~tf,}:~~~;~{~i;~_CATEGbR~~tj'Fi~,CbN S1\ROCTldN41:6'F~:;~1)i2:\f !,;-j;'2\:1 ":'''''',:.:~::'~,~';i ,<<;- ;..:;_,~,'(;::;,"\~:;:.t'!;',,;~;j;{i,' .,~t""o;l'D~~: ,'.."' :~.- :-:),l;"~
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e:~i~~"~~~~:~;;~! 1 ~;~:i::;~'~~(~':":~~~,~:'" ;':::; 1
I City: ~~.AIl~~') 1!.Stat<(l')~, I ZIP:QlA'\1 1 I Limited energy (2) $ 3200 $ I
I Referenc~;/tJD~~~~~~'wJJ~~;;~:;.::~~~~~ 1~~~~I~:nS~~~~~r~~ le~~:;(~)adular $ 63.00 $ I
I L" \.p _"" 1Ii.,...., \.'~.-.'- """",,.R"6 I I Services O,~J)',t.d~G"iriStallatian,'alteratian, relocation I
A\'''\\\.l''n..~ l':)~ n L\y-tfil~ VV -Y"..r'\-tiU..... . :-.' I~U.....' . 't\\\.\1
~- . ,,,--- ,b ,'~' GrE ~O ~200.'I,moPtR8~~s(2), :M;h $ 81.00 $ I
~~"'ll>.'\~-1.b.~:\&~'L \j.J~~, -\e"'" - i-orP~c,'- I
",. :'\;, :PROF'ERT;Y:OVVNER"':::I\\MrU\!l5}'''.~;. ,,\?,%!.o:400:~'l'P?Lf)?_OO\- $ 95,00 $
1 Name,:, I~\(~ (~,' ~\ \~ ":f _N~\iliC!~~~~~;':C J\ b40Iqb,\~~b~,'!inp'~,(2)l,\eS \)~ $158.00 $
II Ad~dre~s I \L~ 1~h0-1" \)~~ il~::~~~io(~:,~~~j~~ll%ojj~?I~~-O'O~o~~;~T~~$;)~'I';~(n $205.00 $
Ci' \,<It:(~ h. . Statel J{ ZtR"'liI~::1;'l' IhE1 (\ <i~~~_ ;,,;: ,~'1'~2.~! vo ts 2) $469.00 $
I Ph;;(e 0.o;\I0~b\~ . I Fa~:' , _,(\\JmU""c~ntetli51\Recan'nectanIY(2) ,,$ 63,00 1$ ,
I E-mill7 \L.\lrlr'... I n\ Cfl GQ.'{'tl~ .lh'lYl I TempQrary servIces Qr feeders: Installa/lOn, alteratIOn, relocatIOn
This installation' is l~ made on residential or farm property I 200 amps or less (2) $ 63,00 $
owned by me or a m~er of my immediate family, This I 201 to. 400 amps (2) $ 87,00 $
property is not intended for sale, exchange, lease, or rent. OAR I
479,540(1) and 479~5 I), (f) 401 to 600 amps (2) $126.00 $'
Signature:(~ J., 6.. .r ~.... lOver 600 amps or 1,000 volts, see services or feeders section above
I :'" ,;, \)C,0NT- C ,OR",r>l'ST,lIl.Li'\-TION!" :', ,< _, " ' .' I Branch circuits: new, alteration, extension per panel
I Business name: ,...c"'), '';./ /V~n. I I a. Fee for branch circuits with purchase ofa service or feeder fee:
I Address: . I Each branch circuit I I $ 6,00 I $
I City: State: I ZIP: I b. Fee for branch circuits withou~ purchase of a service or feeder fee;
I Phone: 1 Fax: I First branch circuit (2) 1 $ 55.00 $ h~
I E-mail: IEaehadditio.!i.\.f1rNlc!J.\lU-Hl.i; {~$ 6,00 $?J t}
I I I ' nlUI-- I' ' \" Mil ~ f.... 'I
CCB licel)se no.: ; BCD license nO'.:1 f\1'\C'E:. _'" 1 r>.~isce.l"~n~o~.J\l)e,~f\'ffrvlce'tJ7' feeder not included
I Signing supervisor's license noo,: I~~\S ?t.\'I~~-~ D\I;\~~_qll p,\-'rr\;;>.olJi:il&at1Plllci~le (2) $ 63.00 $ 1
I Pdnt name of signing supervisor: 'fi.t\\\-IO~~~-;:-~I) r W4cj1 ~iW't\~'6'';;line lighting (2) $ 63.00 $ I
I Signature of signing supervisor:, COM\\I\C-"~,-^ I' II@jiMll-brcuitaralimited-energypanel'$63.00$1
'-' ., -I. QJ\ ur alteration, or extension (2)
p..\'!\ ,-
I Each additional inspection: (I) $58,00 $ I
1?:Ni1i:&?~~Jij{11f$~~~~Fi~ffiQ#NT~)j'~fEt~ilJ&~f~~q~}X~;jf~(1){,:~ ::1
$ 7/ I
$ 10 ~L.
$ l/.srS-
$ (Db 4'2
~v.o'^'
\S)~ '
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(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
,I (B) Enter 12% surcharge (.12 x [A])
I (C) Technology Fee (5% of [A])
1 TOTAL fees and surcharges (A through C):
440-2584-J' (9/08/COM)
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Status
Issued"
CITY OF SPRINli.l'lELD
Building/Combination Permit
PERMIT NO: COM2009-01426
ISSUED: 09/25/2009
APPLIED: 09/25/2009
EXPIRES: 03/30/2010
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
Springtield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Service and 2 circuits
Owner: WALSH DANIEL D & KRISTIN J
Address: 1689 HARBOR DR
SPRINGFIELD OR 97477
I CONTRACTO~ INFORMATION I
Contractor Type
Electrical
COIltractor
CROW VALLEY ELECTRIC
License
149834
Expiration Date
12/13/2009
Phone
crowvalleyelectr
VB
I BUILDING INFORMA TION ~
. s '{OU to
#'of Stories: n laW lequlle n utlllt'Lot Size:
Heigh!Jiif. sH-\l~&re." t\1e 0le90e set \0(81) Ft 1st Floor:
h:T1rJ'"' A~nteU ~l I s al .
,.,. Type'.<tf,Heat: ,\1ose lU eO'''' 952-0(S<j Ft 2nd Floor:
'ol\Q~, . v ~^~\el. 9\1""" ',,/
, i\~l'J.t~r('I\~Rroo~ 0 t\110U01 t\1e lule5~q Ft Basement:
l-lotcRange',Type: "t~In COll,es,., telen\1onSq Ft Garage/Carport
0" 1,",\' _ ...., Q\J '" t . \\le t' t.-n
I Oc,JS,!e~gy.Pal!i:n\el. ~I-lo e, '\t l-lo\:l1ice ISq Ft Other:
o 'Sl1rinkll>d' Bliilding]On ut\2\ ~2n/a\). Occupant Load: '
Cc."~: .~., fn\' \ne V'. ,..",n_~'3 - ......,
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
L_r ,_ , ~
I DEVELOPMENf'fNFORMATION ,
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyanl Setback:
Solar Setbacks:
Overlay Dist:;
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Description
Type of Construction
Sidewalk Type: v..
Downspouts/Dr~"l'\\t. 'tJ~~,
, t.'!-.\l\?-.t. \ Wi\' \s \~
~IS'i\C\Wi\' s\\f>.\..~?-. ,\\\S ?t.~t.\) rO?-.
\~:~J~?-.\lt.~n\\~~ \S f>."'f>.~\)O
" -~ -~\'l\J'-~ Q\\Ju,
I " r-r.\\'J\NI' ",/ ?'CD
" Valuation Descriotion, )() \)t"
1""".
Square Footage
. or Bid Amount
$ Per Sq Ft
or multiplier
Value
Date Calculated
Street Im,provements:
Storm Sewer Available:
Special Instruction:
Notes:
Paee I 01'2
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspectio~ Lin~
,
CITY OF ~nur..GFIELD
Building/Combination Permit
PERMIT NO: COM2009-01426
ISSUED: 09/25/2009
APPLIED: 09/25/2009
EXPIRES: 03/30(2010
VALUE:
. i
Status
Issued'
Total Value of Project
Fees Pai.~ I
Fee Description"
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Exteod Circ Ea Add
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt N umher
$11.16
$4.65
$12.00
$81.00
$10.92
$4.55
$55.00
$36,00
9/25/09
9/25/09
9/25/09
9/25109
10/1109
10/1109
10/1109
10/1109
2200900000000001097
2200900000000001097
2200900000000001097
2200900000000001097
2200900000000001125
2200900000000001125
2200900000000001125
2200900000000001125
Total Amount Paid
$215.28
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 saine working day, inspections requested after 7:00 a.m. will be made the following
work day.
.~ Reollir~d I~~n,ections 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, 1 state and agree, that 1 have carefully examined the completed application and do herehy certify that all
information hereon is.true a~d 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 he 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 reqnired 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
'""" 'on" ;rr~ G\ . (' ~a
ownC 5actors Signatj
"'"
\l)~1/~1
/ I
Date
raee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
---- .~---...---_.
*~
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200900000000001125
Date: 10/01/2009
9:40:36AM
Payments:
Type of Payment Paid By
Check ,MICHAEL MINER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 5041 In Person
Payment Total:
A moo ot Due
55.00
36,00
4,55
10.92
$106.47
Job/Journal Number .
COM2009-0 1426
COM2009-0 1426
COM2009-01426
COM2009-0 1426
Description
Add, Alter, Ext~nd Circ
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State Surcharge'
Amount Paid
$106.47
$106.47
cReceintl
Page I of I
10/1/2009