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HomeMy WebLinkAboutPermit Electrical 2009-10-7 ZON 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; ~eA'ifo.:jiJto'/.."Ji.Ns. 'iiA.'J!ri~AtYiloM;iill~"l.'.b' 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 . -',' ~/. Status Is~tied'; . "0 " " . t~ ~ "," ';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 ~, \",. . ',' ~~:.: TYPE OF USE: New Residential '.'1 'f" Owner: KIKER KEVIN L & JO ANN . Address: 638 56TH ST SPRINGFIELD OR 974'-8 ' " .f '~'11:~r'!:", . " , . I CONTRACTOR INFORMATION I License 38497 Expiration Date 01110/2010 Phone 541-461-0291 . . I;", i. " Contractor TYp'e:\-!:fontractor , o ",.f " J .1'".,. 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 + . ~ " ,~ ~ '0 ~; J Paee 1 of2 ~ ., , -.- .',- '\i:' .t". 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 , ,: . "';' '. :" ,~ '~~p;:::.'t'~-~;~{,~ . . .:~::;~:~ Total Value of Project ..i ;) Fees P..~id I . " .' ~?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 ~:~', f; .J;,::jf; ~h!,'" ..1...... ~:"fil~'" .~~ . .,t: ."" .,. 'l.. ~ "': ': ' , . , I Plan Reviews I ..: :~.. I ~ l ~ ;~ .: 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. ", '. .' "j~ :~, . f' ~'~~ . . Electric Service: Approval required prior to utility company energizing service. . ~i: ': ~ ' 'J .i, , . ,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 ,~I \. !:-.h;!:1 .Hr' :~1:.;i! ' :! ., . , '1 '. = ~.- ., . ... ,. " ~ ,.'.' '! 'j. . .... . .~... ~ II 'i I:, . , Pa~e 2 of 2 } :.. :.,~" 22S;Fifth Street Springfield,OregOlr?7fl77 S41~726-37S9 Phone';::::. " ..;',,;.:)":',',:"':"::"';:, , . _.,' ,:.>~t;", .. ".:".:\~;f'r:{,:~';:, - "(~ \-~<~-K"':;{:~::: ":' '.1 :',': RECEIPT #: ~~~;~;;~~~t:;ri{~:q:~~?#r;~~~~~i~'hi~ct. ..... C0M2009~01479+..5.% Technology Fee': COM2009'01479 12% State Surcharge .- ". ~ r " :.,;--..:: :... ,- '..' '. , '" ..';' Payments: ";'::<'~.C".:;, . Type of Payment' .)'iPaid;BY':"" Cash d'!,I)", , ..,::+>;~~~I~;.~I.4!~i\i':;,)~: ,'. ~' .:. t r' j, '. i:r,:] , " , . ",L~l:~ :I':)~ . ::: " . ~.'I d iH'::l;:'.;.. ,.,; 'I,i .. . ,I . ~ ' ': 'l: ;\i",I.~'l . , ., ,tIt.! .' ''I,! i ",' ; . .::: ,. oJ!' ." + .. , ,I , , it r ~l j ;f .0 'l' '\ tl'. ~ it ~ '>.." :.: O' f ! e;. ,,~ 11.' " I. o 1{ , ~ ~, ~ .L ,.,.' . , cReceintl :. f'.'!'~.~P"".~:aI."'--.-" .'....... . , " . -, -- - ~:' .; "-'Ii" ." - . ", -.,,' -' , " """,-- .' . . . , "",<'-.',',' '. "" ~_,,_"'" --,'-0--,,""" ',.. 2200900000000001148 <":heck Number Received By. Batc~ Number nJrn ..', " 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