HomeMy WebLinkAboutPermit Electrical 2009-10-13
225 Fifth Street. Springfield, OR 97477.PH(541}726-3753.FAX(541)726-3689
II
I:'
'I~~i;9~~~~~ri!iXiiBm1
I
Permit n'o: f' q-1D3 I
I Date: hO'\~'a1 I
I,
Ii
This permins 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.
.Electrical Permit Application
1~:;;:;~~~~~~~~~ggNM~jr~~FIFI;I~~W!b~
,,;:,'0 .:" (;;~mE:G@RY#fEf:.FlEf0NsmiR0e,'ft10N"""""'~I""'ii:J.jt "
- 'Reside~~i~l'~"' l~ci~~e::~~t-~ L, [Q~=:::~"*~ I Residential, per unit, service included:
''it\'~bB'''SlffiE:i1lINE0RM~(0jijjfANe~l!eG'AmI0Nfi['i''''''~ 11.000 sq ft, or less (4) i,'
I ;:::: ~d;es~:' ~~\~~~--~S~f\"~ 1 ~~~~:ritiona] 500 sq, ft, or portiO?
I City:.. x-fl ~ j State: O'<l- I Zn<\""'A1c;') I I Limited energy (2) ii
~==.!ii~~f~\J~fJ\W,~_~~~~~1 ,I ~~~~]:::~s~~~~~~Fe~:'!~r(~)OdUlr $ 63,00 $
I .. rY~J(\ )\ ( f' --' 4' (\ lJ\. tu \ -\- s . I Services or feeders: installation, aiteration, relocation
~~- :[~f~~~i,) I i I .~.~~ rl
,I City: <rD6-f~ j State: D'<L I ZlP:lt\AD\ lOver ],000 amps or volts (2) $469,00 $
I Phone: - -lo~ .q:6'L..! Fax: _ -' I Reconnect only (2) I $ 63.00 $ I
I E-mail: I. II Temporary services or feeders: in{ta/lation, alteration, relocation .,1
This installation is being made on residential or farm property 200 amps or less (2) , $ 63.00 I $ I
owned b;: me 0; a member of my immediate family. This I 201 to 400 amps (2) $ 67,00 I $ I
, property IS not mtended for sale, exchange, lease, or rent. OAR ' " I I
479,540(1) and 479.560(1), 401 to 600 amps (2) I! $126,00 $
: Signature: Over 600 amps or 1,000 volts, see s~rvices or feeders section above I
~e(;),NmMCill11iR~lf$ISm~I!l~t.\:lil0N~<t;;'i..i~' Branch circuits: new, alteration, e:!,tension per panel I
1 ;~ines: ~~~~:';"~:;:::i1&I-f,jtd;F-~~-E WORK ,e'e, ~ I a. Fee for branch circuits with purchase ofa service or feeder fee: I
I Address: AI3-o~R;k:D UNDER THIS PERMIT IS NOT I Each bf!pfQ:fjrpHilN: Oreqon law lE@jil~~}~~.:q~\~I" $Ia I
I City: c"/~1"n.':;;"F'r?~D OR IfS~te.'1~~NEpiiP."~a1Y'7" I' I b, Fee fQrDhranchcircuitslwitnouVp'Ul'chm,of, aservlce"or.feeder fee: I
[I'YIIIU~",~ k.. 7 ~o I \IUVVI"'....-. . ~....~....,...i"IIP~&'8;;)\:.o I...'~'. .
I Phone: i=\~/ll%~'(-9R1.53ipFax::5"W ~7"'l.- ,'2' ~'Z--I I First bf~\l!Iiitc~R (fX~~'~~'16'i~r-ou ~h OJ\F$855';a'~'12,~ I
I J II /.J II II"'~"W__ , aSO'lllI-'u,w-, I
E-mail: ~<e1-Id/UfS2.-~Iks.u.l...dW1Each~i1pl!ipn~.:.bJ..!)P!!\cirCilit.ln.~OP:..~^to.tn~;~Hll , $
I CCB license no.:. 1'% $/ ~ I BCD license no.: 20"'111 ~ I I Miscellanej)u'sife~s!:serf??rq~J~~~~~~~iLfnf[u!i~4dhcation I
I I I nl'rrm~' "J' ,",v - v, ni4^) I I
Signing supervisor's license no,: :J 55'1- 5 Each pump or Itrig~t\9,~I>!fc!S (~)BOO-3 l2-,;.' $ 63,00 $
I Print name of signing supervisor: h IV AJ fJ. ~ I I Each Sign or outIme hghtmg (2) $ 63,00 I $ I
'I Signature of signing supervisor: ...,~ /)/J I . I 1 Signal circuit or a limited-energy panel, $ 63.00 I $ 1
~~ ,... ~ alteration, or extension (2) ~:
=;;~;;~i~~G~~~~~Y~~l~~
"
(A) Enter subtotal of above fees II
(Minimum Permit Fee $58.00) ~:'
I (B) Enter 12% surcharge (.12 x [AD!i
(C) Technology Fee (5% of [AD :i
TOTAL fees and surcharges (A through C):
'I
Ii
I'
I
I!
Ii
$134.00
$
$ 25,00
$
$ 32.00
$
.'~V.-R ~~ ~~~,
~~V " ~.~
.\~~
440-2584-J ~OM}
$ Ct\
$,\\. Ill>
$4.\~S I
$1 D't,.~ I
. Status
Isshed.:,.
- ~"
, CITY OF SPRINGFIELD
Building/Cpmbination Permit
,
PERMIT NO: (WM2009-00703
ISSUED: OS/20/2009
APPLIED: OS/20/2009
EXPIRES: ' 0312312010
VALUE: $ 2,000.00
,
,
"
225 Fifth Street, Springfield, OR
541-726-3753 Phone
,541-726-3676 Fax
541-726-3769 Inspection Line
. , . ,:'" ~ .. .
SITE ADDRESS:,' ,,5657 THURSTON RD
" ASSESSOR'S PARGEL'NO.: .' U02331100300
"
Springfield TYPE OF WORK: Sin*le Family Residence
PROJECT DESCRIPTION: Plumbing Repair to Bathroom.
TYPE OF USE: Rep,~ir
Residential
Owner: WILMA LANTZ '~.: .:
Aildress: ,3700 B1l:lCOCl( LA~,#114
EUGENE 'OR 97401 '
Phone 'Number: .541-688-9582
Ii
I
I!
';';';'i; ..}
I, CONTRACTOR INFORMATION I
Contractor Type
Electrical
Plumhing
Contractor
LYNNS ELECTRIC
OWNER
License
102316
,
I'
Expiration Date
"
10/14/2011
Phone
541-726-7895
.1 .'
BUlLDI~G INFORMATION I
# of Units:
Primary Occupancy, Group: R-3
Secondary Occupancy Group:
Primary Construction Type ' . VB
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft ist Floor:
"
Sq Ft ~,nd Floor:
Sq Ft I,lasement:
Sq Ft Garage/Carport
Sq Ft 0ther:
OCCUP'lDt Load:
j)
u/a
. 'f":
I DEVELOPMENT INFORMATION I
I: .
:'1
" REQUIRED PARKING
"
Ii Total:
:, Handicapped' .
ATTENTION' Oregon'II?C'''' reOU,iJS yOU to
. .. omp.act: ..
follow rules adapted flY me u, egon Utility'
Notification Center, Th,ose rules are set forth
in OAR 952-001-001 0 through OAR 952-001-
. ~090 YOU may OOlaUlICUfJlt::~ VI Lllt:l' IUICi..J vy
I PUBLIC IMPROVEMENTSl 11'. th e' nter (Note' the telephone
, ca mg e c '" ., , , ' .
. numtSideWaikbTyPeDon. Utility Notification
Center is 1-800-332-2344),
Do~nspouts/Drains: '
NonCE:
F~ontyard Set~~~~: PERMIT SHALL EXPIRE IF Tl-l!1vm:a&,lJ)ist:
SIde 1 Setback: UTHORIZED UNDER THIS PERM Iii ~rr.e~Trees Rqd: .
Side 2 Setback'!- ' NED p.a"ed Drive Rqd:
Rearyard Setba~!t:1MENCED OR IS ABANDO , %uo~Lot Coverage:
Solar Setbacks: NY 180 DAY PERIOD, '
. Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
: \~ ':"
,~
i, l ~p ,
\
Pa!!e 1 on
. Status
Iss'ued,: ' .
, .',
CITY OF SPRINGFIELD
Building/C?mbination Permit
c .
PERMIT NO: €OM2009-00703
ISSUED: 0'5/20/2009
APPLIED: OS/20/2009,
,EXPIRES: 03/23/2010
VALUE: $ 2,000.00
I;
225 Fifth Street; Springfield, OR .
541-726-3753 Phone'
,: 541-726-3676F~x.\ ,"
. 541-726-3769 Inspection Line,
- .i"
,."..,
,:.1 Valuation Descrintion I
Description
..;"..
,:'."', .,". ...::
TVv~:6j- Constr~ciion
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
I:
Date Calculated
Total Value of Project
If"". PiW1J
$6.96
$2.90
$57.00
$1.00
$23.40
$9.75
$79.00
$55.00
$58.00
$3.00
$11.16
$4.65
$6.00
$6.00
$81.00
5120109
5120109
5120109
5120109
6116109
6116109
6116109
6116/09
6116109
6116109
10/13109
10/13109
10/13109
10113109
10/13109
,
Receipt Number
I
3200900000000000382
"
3200900000000000382
. 3200900000000000382
,
3200900000000000382
3200900000000000464
3200900000000000464
.
3200900000000000464
3200900000000000464
3200900000000000464
3200900000000000464
"
1200900000000001137
1200900000000001137
,
1200900000000001137
.,
1200900000000001137
1200900000000001137
Ii
Fee Description
+ 12% State Sti'rcharge
+ 5% Technology Fee
..Fixture .". ~~" ..
Minimum/Adjustment Plumhing
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Add, Alter, Extend Circ
, Building Permit . ,.
Minimum/Adjustment'Electrical
+ 12% State Surcharge
+ 5% Technology Fee :
Add, Alter, Extend Circ Ea Add
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Total Amonnt Paid
$404.82
.. -. i~" ~ ';C
Plan Reviews I
~i
To Request an inspection call the 24 hour recording at 726-3769. All inspections ~~quested 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. '.
'.' . ' _ ~ i ~ ,- ,.
l~mrrt)'1m I
.'
." .
Underfloor Plumbing: Prior to insulation or decking.
Underfloor,Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing,
Final Plumbing: ,When all plumbing work is complete.
,;l ,.,.
Pa2e2 of 3
..1\ ..j- ,-1.
Status Issued),'..
';.. .,;-.~'
., 225 FifthS~reet,,:Sprjngfield, OR
541-726-3753 Phone('
, 541-726-3676 Fax
541-726-3769 Inspection Line
,
'~,
CITY OF SPRIN{Jl'lELD
I
Building/Cpmbination Permit
"
PERMIT NO: COM2009-00703
ISSUED: OS/20/2009
APPLIED: OS/20/2009
EXPIRES: 03/23/2010
VALUE: ~ 2,000.00
Framing Inspection: Prior t~' cover ~nd after aU rough in inspections have beeu approved)l
. _ . . ,.. '.!' ~i
Final Buililin'g:',After.aU r~q~ir~d inspections have heen requested and approved and the building is complete.
Rough ~ech~nIc~I: Prior to Cover I:
Final MechanIcai:. When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
I'
By signature, I state,aIld agree, that I have carefully examined the completed application and do ~ereby 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 w,9rk described herein, and '
that NO OCCUI'ANCY will be made of any structure without permission of the Community Services Division, Building Safety.
, l'rurther certify'ihai only contractors and employees who are in compliance with ORS 701.005 wilI be used on this project.
, ,
I further agree to ensure that all required inspections are requested at the proper time, that each ~ddress 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
times during construction., . . I,
Owner or Contractors Signature
Date
, :~:. ! . J: ~ -]".,
.
:!i
.
~:'
J. ' I
,
;;
Page 3 of3
. " ,~,.;. . - !, " .~:-
~i5!Fift~ Str~~t'ji01!r1i~!~;:}fGjjt~*\';~!!~~~~h':"'!r;'
Sp' r, ingfield 'Or,ig",o,Jii,9'7,-,47'7c;:'i..":,?::,,, '
. ,,, . ,.' ',.' .," t /.. ..,~ '
54im6~3'759 rclfifri'eJ;. '
" "i'::j'?dfj}~::;.{~~.:ti-~~~n;;~'\(sk;;~;;~;i,~\::';~~);~:i 2~::;.L' : ',';:.:,'.:.; ".
, " :.. ~RE~EI~'ii;#:'~'-.;: 120090000000000113'7
. "
j\'
City of Springfieh! Official Receipt
Developm~'nt Services Department
,. ,-
Public Works Department
11 :25:52AM
Date: 10/13/2009
,
Job/Journal Number)?;;,<:: Description- 1..;<:.". ,'" ..' .
... '. .~. ", .,. .: . -;: .- ,.- ,;..- '..,': -. c..: .:: . ::.:. _ . ":i, ", ')' ". '. .
C0M2009-00703 t;:::(;,:pe!1Ai>"ryI.F9r~OO:amps or less
COM200<j-00763.;,2;;i:j:0Aa~:'Aitifj, !i~tiiid,Circ' Ea Add
. . '.', ' ':. :"~''''"':'.': ..~,,".,,;.,, ""~,.." .. ""."" J~:-:" ::. ,.- ".' .,
COM2009-00703 \;,,',5UiA:ddi'Alier, Extl!nd Circ Ea Add
, . . . ::"".;;,;":'.'i:"':),'~;""';' '. .,
C()~2009-00703:~,/?:t 5% Technology Fee
,., "'. . ~" ~',,!, >;'.'~, ':;:. c. ,. , ,.'
COM2009,00703[,:,?;,)Li:f42%, State'S urcharge, '
, . <; .;.,:,:'.". :<' c. ."';'~~'i:':'~~'1~ir~tf;.;!r{\;r~;?,:};::~~~\r';~;:~,~~;.''':.;,;/.: ;" ,,.
Amount Due
81.00
6.00
6,00
4,65
11.16
$108.81
Item Total:
Authorization
Number Ho-w:iReceived
Check Number
Batch Numher
- ..;;,.. .,: .:'.'...;< .~:~~ ';
Payments:
Type of Payment
Cre,ditCard'
Received By
Amount Paid
,Paid By ,
02543B Phone
Paym~nt Total:
I,
$108.81
S108.81
KR
<.,
:'i.;'
" "
'J'I:
,)
.;.:~,:i.~';~n:"-
rj~".~::'l ~t: '
,
. .:,......
!., i~! f'i'I)'"
.~: :,;j!~~'I'.;
:~ .~
~c~if:'';;';':(
, ,:'I~
,.
i; : , ,f~.
.,1
,:';i,<;h
J
."
":.,':' ,.
,.~ .
:,,(to
u
Yj:,"'~l*:i
j;:',1,li,~~~~,'
. .'.. ~:~. t~ "...
... "l~"" \1' '," "
. ~'- ~....\! "Ll. ,.J
,f ..
..
,'t;l';l!:.'
)
~, .!
;"';
'il ~
,)
,.
;:1.;: :-:i~.j~'
. 'j t,
,
~: I-.~ s: ..,t!'"
:t' , ~.h:;;>:
,f;'~ V';: '
';; .\
.j~i,; II
.t" ~ '
,.
,~,(.
"
.,
,
.
"
~~~ ~~
;,
;; 1,; 1'r,:g
, ,.!I".,'
'. I r...
~ . ': 11 ~ .
'~ .'
\ ".
If":b,
,
,..
'~+i .~
\:I.'"
. '
".
1.l .
,)
.,{j~
....:'ll:
Page 1 of 1
10113/2009
cReceiotl
'.f ~; _. ':!:.I
~: :!j t>.:.--:--