HomeMy WebLinkAboutPermit Electrical 2009-10-7
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INITIALS
DATE
SOURCE
225 FIFTH STREET' SPRINGFIELD, OR 97477 . PII:(54I)726-3753 . FAX: .(541)726.3689
ELECTRICAL P.EJ.WIT APPLICA1],ON
City Job Number . ( J' cy --- () / ~I V;
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1. R~~#amaM:I$Uill&n?J.i~1IiWfflin.imitdfWJitJ4hitk'Z,iik~..;~1t
{,2fii? <'C" yd 5'/
. b/ ~ - ~O~~ '%"'~W;.ri1jl'ilijif~1::0ffiT~"''"''I~ Jt!F,;t0/r:~~Sfi"'=:q2!1;';M1&0i'lJ};jlY:-~&g\i~1MimR~l.W'1~Sn~
LEGAL.DESCRIPTION: \1()1. ~, -...L.U.A. N~W~eS!!I..e.'!.t~It~~~~Ii~.JJJ~i~l!Wj!Yll\~JI'ell!ng'UnitJ
::J?/0 "~f?zf9 ~n ;; ?V"?? ServIce Included
JOB DESCRIPTION:. 1000 sq. ft. or less
. Each additional 500 sq. ft. or
. ~ L.e i2'-'L.6-dJ~'. portion thereof
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended fo~ 180 days.
2.
. ElecmcalContractor Johnsen Electric Inc
dba Beacon Electric
Address 2585 Roosevelt Blvd
City' Euqene Phone541-461-0291
Supervisor License Number
34858
Expiration Date
10/01/2010
Constr. Contr. Number' 3849-'
Expiration Date
01/10/2010
3. 'llieoM2i!fiFE0FEE'SiiJliifiifffooTiiE"ii.'. '7om'.1'f":,:j1 11 ,",'
~4iiii_Wiii2Miijjjs:J/'j;W"d"A""U;[;t'0~j$~~~_4'-I!?iillir#WM__l"=l~2ti"dq
$117.00
$21.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$55.00
B.
200 Amps or)ess
201 Amps to 400 Atllps
401 Amps to 600 Amps
.601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 70.00
$ 83.00
$138.00
$180.00
$413.00
I
c.
Installa1ion, Alteration or Relocation
200 'Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 or 1000 Volts see
$ 55.00
$ 76.00
$110.00
D.
New Alteration or Extension Per Panel
One Circuit' $ 48.00
Each Additional Circuit or with '
. ) "". {'j' /r~, Service or Feeder Eermit Or~~on ,^:.. ,n~; '\r~3~;00to
'w.. "--- ~G/ A'I!::"I,.,,,. . v-. , Ut'I't
' ".'. ". _I__.......A .k" tho nrp.oon II Y
Ad ess (;; S&~ s / E. ,FSiJIim~l~ftii~lrtl:?1!lli~fi[~~~~~ili~m.j)~(?lr
'O!\R n52-0Q1-UUl U 100UUY" VP" ~ - -
~ o~ In , " .' sofl~"'I'lnsby
Ci .' cr- Phone Pump or irrigationou may obtam oople $ 55.00 "
I"~ u......... . . (1\1 . tplp.nf1un~
THIS' F'-R"MIT SHALL EXPIRE IF THt VVUr\1\ SignlOutline;Eightin'gle oenter. O'.~:.,','.'~ $ 55.0Rd~n
_ PERMIT IS NOT .......' Irr'~~r.fr.r t.~l:! GregGl1 ,..H'''.' N\..h11l.....
OWNER,INSTAJ:J:;AT<~ONIS Luntted Energy/Resldentlal.ls 1 Sn(\.,<,<?_?3l$,g8;00
J-\lJ I nurut......w v..--. n FnR Ueme, - v .. ,
Dt~lw~.l!IJ\~t.!.o.:ri)(Oemg ~:I'd)'~e\Qghl~erty r~wn ic Limited Energy/Commercial $ 50.00
i~V~O~ ~lmd3<MoPta}~,'J~~e or r:: # \ f'\~~c)\. M~.nimum ElectricPermit Inspection 'Fee is $50.00 + SU~~h:';.r:;re..s ::: ~
Owners Signature: ~ ~ '-.p ~ -....>\.V
_'~_ 12% State Surcharge
~\.Y 30 10% Administrative Fee
\ ~~ ' ~ 5% Technology Fee (.l, . \ ~
Inspection Request: 726-3769
TOTAL 7.S. 7/
Shared Drive(T:)/Building FonnslElectricaJ Permit Application I-08.doc
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Status Is~tied';
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';e225 Fifth Street;'Springfield, OR.
541~726-3753 pli~rit..,.\( c:\,';?
541-726-3676 Fax . . ..-
541-726-37691nspection Line
CITY OF ~rKll'lL.l'lELD
Building/Combination Permit
PERMIT NO: COM2009-01479
ISSUED: 04/10/2010
APPLIED: 10/07/2009
EXPIRES: 10/10/2010
VALUE:
SITE ADDRESS;:,.t(j~1! 56THST,:t'
ASSESSOR'S ~!\R\E.L NO.: 1702331402500
Springfield TYPE OF WORK: Electrical Work Only
: '.~ :
.' PROJECT DESCRIPTION: Service Reconnect
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TYPE OF USE: New
Residential
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Owner: KIKER KEVIN L & JO ANN .
Address: 638 56TH ST
SPRINGFIELD OR 974'-8 ' "
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I CONTRACTOR INFORMATION I
License
38497
Expiration Date
01110/2010
Phone
541-461-0291
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Contractor TYp'e:\-!:fontractor
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Electrical'" " JOHNSEN ELECTRIC INC
BUILDING INFO~ATION I
# of Units:
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction' Type:
#'of Bedrooms:o~t. .1. F o."~'~ ,..
# 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 D~VELOPMENT INFORMATION I
Frontyard Setback:" ,..".
. l~' .
Side 1 Setback:) " ! '
Side 2 Setback:' :-.
. - ~~ :\ ~
Rearyard Setback: '", . ,.
. . ,
Solar Setba'cks: ...,
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
:._....4,..
I PUBLIC IMPROVEMENTS I
, . .
Street Improvements: ,. . Sidewalk Type:
St S A'\ bl :.. ':'1..~ ATfE~TION: Ore)\j'n Jaw requires you to
orm ewer vaIa., e:f'-' . . follow. J>.':!!ls!'31J~.vJ'1Jrs,:"e Oregon Utility
Special Instruction: l Notification Center. Those rules are set forth
;: .;; ! in OAR 952-001-0010 1hrough OAR 952-001- .
Notes: . NOTICE:'. ' 0090. You may obtain copies of the rules by
___. ..~ ^., ^' l ~'vDIOI' II' THF WORK callinQ the center.. (Note: Hie telenhonA
I nl0 r '-'."": 0 UVN"O' 'E-R THIS PER~III' I.) i,v-;- rumDer TOr me oregon Utility Notification
AUTHORIZED ANOON[' Valuation Descriotion Center is 1-800.332-2344).
. COMMENCED OR IS AS. ' . , ,
D . ('^'JY 18CTr)~ ~t~lgPr. 't' $PerSqFt Square Footage
escrlp IOn ;' VP ~ . n rUClOn or multiplier or Bid Amount Value Date Calculated
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01479
ISSUED: 04/10/2010
APPLIED: 10/07/2009
EXPIRES: 10/10/2010
VALUE:
Status Issued
. .',.
225 Fifth Street, Springfield;OR;>};--'.. .
541-726-3753 P~o~~:li;,::,", ,,'~i/!;j~~:':
541-726-3676 Fax..t:~.:.:.....; ., .' <,
541-726-3769In;sp~ction Line
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Total Value of Project
..i
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Fees P..~id I
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.' ~?h.;~. X:t'k1i;.''-
Fee Descriptio~~: .;: f .' ..
+ 12% State Surcharge..
; \.. .....j .... ,\
. + 5% Technology.Fee .....,
Service Reconnect
;i~;\;;~~;:?l' . .
Amount Paid
Date Paid
Receipt Number
$7.56
" $3.15
$63.00 .
10/7/09
10/7/09
10/7/09
2200900000000001148
2200900000000001148
2200900000000001148
Total Amount Paid
$73.71
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I Plan Reviews I
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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.
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Electric Service: Approval required prior to utility company energizing service.
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,Renuired Insnections I
By signature, 1 state and agree, that"1 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
thai NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contracto~s 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
I street, that the permit c":rd is located at the front of the property, and the approved set of plans will remain on the site at all
'itimeSduringconstru~~.....----- //)~ 7, (')..;
Own Date
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22S;Fifth Street
Springfield,OregOlr?7fl77
S41~726-37S9 Phone';::::.
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:',': RECEIPT #:
~~~;~;;~~~t:;ri{~:q:~~?#r;~~~~~i~'hi~ct. .....
C0M2009~01479+..5.% Technology Fee':
COM2009'01479 12% State Surcharge .-
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Payments: ";'::<'~.C".:;, .
Type of Payment' .)'iPaid;BY':""
Cash
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2200900000000001148
<":heck Number
Received By. Batc~ Number
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Page 1 of 1
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 10/07/2009
Item Total:
Authorization
Number How Received
In Person
Payment Total:
10:30:45AM
Amount Due
63.00
3.15
7.56 .
$73,71
Amount Paid
$73.71
$73.71
10/7/2009