HomeMy WebLinkAboutPermit Electrical 2009-10-7
This permit is issued under OAR 918-309-OO00.Pcnnits arc nontransferable. Pennits expire ifwnrk is not started ,,'ithin 180
days ofissuantt or if work is suspended for 180 days. .:. .
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~de~ti31,per unit, SHVice included:
L 1,000 sq. fl. or 1= (4) $134.00 J $ .!
" ..::.a. ch additional 5.00 sq. ft. or portion
thereof . $ 25.00 $
Limited energy (2) $ 32.00 $
Each manufactured home or modular
dwelling service or feeder (2)
I Services or feedf'rs: hls/allaliol!, alterat'-o1J.J~relocatfon
I 200 amps or less (2) II I $ 81.00
';' 1201 to 400 amps (2) $.95.00
I 401 to 600 amps (2) $158.00
I 60 I 10 1,000 amps (2) \' $205.00
o..'cr 1.000 amps or volts (2) I ~9_00
~ecOlmect on~y (2) I jJ . $- 63.09 $
I Temporary ~rvicl"S o~ feeders: instal/atto!), a/teraliqn, re{ocatio~, 1
i 200 amps or less (2) \ ::$ 63:00 $ 1
] 201 10400 amps (2) ,'. $ 67.00 S 1
I 401 10600 amps (2f I,' $126.00 $1'
lOver 6qo ~ps or 1,000 \'olts, see services ~r f~ers section above .1
I Branch circuits: new. alteration. extenSron1jJer panel -
a.,Fee for brunch ciryuits with puTCha..~ of a, service or feeder fee:
".
AddIe,s: 2..1"5,."';)0(\ ~II01 I Eadt branch circuit I ,I $ 6.00:'1$
I City: ~Vl~l. II rd I State: 0 V I ZIP: q;4.11 1 I b. Fee ~or branch circuits Withoot purchase:of a service or feeder fee:
I Phone: ':WI -'14,=>,%'6'0 I Fax:'5l[-1 -14b-3~.ss I I First branch circuil (2) I: I $.55.001 $
I E-mail: '"1P>(@,JK'-Elh(...-L1TI'Y\ . . 1 I ElIch additional branch ci",uit I ! $ 6.00 . $
I CCBliccnse no:: L\6 I loll I BCD license no.: lO-2-nL \ I Miscdlaneous r..s: service orfeedernotir,lc/uded
\. Sigiung sUpervisor's license nO.: <4-'il''5 S 1 'ElIch pump or irriBalion circle (2), $ 63.00 $
\ Prinl name of signing supervisor:0fl4k.-~ J.{ W ~.n ~( Each sign or outline lighting (2). . . $ 63.00' S
I Sigrutlurc of signing supervisor: ~ ~. a1Sitgnalt.(";fCllitu~.~.-mitcd-energypa~ l s,&rllo sr:....a...OO
. ~.......-__/' "'........ . J eralon"orexlenS10il\,,"J.-~ 'v(l'
. . u .1 Each additional ins~~on: (1)1 $58.00-' $
ft1Ni;~~.~~}:~~~~>~~iX,;~~~.Jt A~PllCAN.t~OSE;)i;;~~;i.i~~A:.;?i:..:,tf~.1!, '~i~
I (A) Enter subtOtal. of above fees I 50-.. (11
(Minimum Pennit Fee S58.oo) $ U. .
I (B). Enle'r 12% surcbrge (..12 x [AD $ 1..0.4\.0
I (el Technnlogy Fee (5% of lA]) $ T[.Gt 0
I TOTAL fees and surcharges (A Ihro.igh C): .~. 6tp
Electrical Permit Application
1t~~~~"Mtf~!m~R~;fI~~l~
225 Fifth S~t.Sprin:tkld, OR 97477.PH(s..D716-37~.FA.X(Sfi)716.3689
\>c': -"\. LOCAL'GOVERNMENT;iAI'I'ROV"'li~'~:':"'~Y/:""''':'
I Zoning approval veri lied? 0 Yes 0 No
r.~i~~:;;~t~~TEjR~G~:::~~TRUr;~o;:~~::i:; ~ I
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I City 'e--.nn'{\C\HO~()slalc O\L-- [ Z~4l I
I Subdivi:J." . r . ! Lot no.:
.. ,..:'-'<':',;DESCRIPTION','OF;>WORK' {.,;;:",:;;;;::. ,.'::' ..
\0\.0. \)0 LA _
I T}O'"?5p';;) i_ ':) \"1 AO \
.... ';;.'c;..:.;>."'PROPERTY.J)WNER
\ Name: ~O\\:~(\\lm-rf\e~
I Addre~ \i. c:;:. ~ ~f'rf
I ~~:~e~~~' . fJd}Slla:~{t;.._. I_ZIP~14111
. 1
E-mail:
This instal1ation is being made onre:sidential or (~rm property
owned by me or a member of mv immediate tamiIv. This
property is not intended fOT sale~ exchange~ lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
\,_,"::; ", :CONTRACTOR';INSTALLA TION ;'0",
Business name: ~)Kc." ?-_ll/ r+vtt--!'<::Cn(.J
~~v
t:x.N
c-
s~~ r.::;~[)~~ARi~!~@~~S>~~~!fil
~~, Penml no.~ q. V\\oS
Date '\D'l'CA 1
$ 63.00
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$ .
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'$ I
$ )
$ 1
$ I
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-'40.2584-J (9/08iCOM)
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Status
Issued' ,
, ~ ": ,',': ,;
U 1 Y OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01463
ISSUED: 10/02/2009
APPLIED: 10/02/2009
EXPIRES: 04/06/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection' Line'
. :~" '. h.; -;-:;:.~. ,'.,
;.,. ,<"
, ,SITE ADDRES~:';; ;, ,188 W B ST
ASSESSOR'S PARCEL-NO::.: 1703352312401
Springfield TYPE OF WORK: Electrical Work Only
.. " TYPE OF USE: New
PROJECT DESCRIPTION: Replace light fixtures and relocate six receptacles,
Commercial
, ,
Owner: JOLLYlNVESTMENTSLLC'
Address: 175W B STBLDGL"~'
SPRINGFIELD OR 97477
.
. '
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, I CONTRACTOR INFORMATION'
Contractor Type
Electrical
Contractor
r,
J K GUCKENBERGER ELECTRIC INC
,License
45129
Expirati!lD Date
04/24/2010
Phone
541-746-4656
,;},': .
BUILDING INFORMATION I
# of Units: ," ,;
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range'Type:
Energy Path:
Sprinkled Building:
Lot Size:
SqFt I st' Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft O'ther:
Occupant Load:
~
nla
"
..;, :.; i'
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
" Frontyard Setback: ;--
Side 1 Setback:
Side 2 Setback:
Rearyard Setback: '
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
1"':
Notes: NOTICE:
THIS PERMIT SHAll F)(PIPi: IL'T"~ ,,,__
COM1U;~I~tU'UNDER THIS PER/I1;i-,~.~,'~'~ I
f\,1!:f\I~E!j'OR is ABANOONEV~Ii1~tion DescriDtion , '
ANY 180"DAY'PERI " 'un.
,,; 00" $ Per Sq Ft Square Footage
DescnptIOn "Type of ConstructIOn I ' I' ' B'd
l,r ' ~, or mn tip Ief or I Amount
I PU~LIC IMPROVEMENTS iriON: Oregon law requires youto
" f6i1ow rUleSSiiiewalltTyp€:e Oregon Utility
Notification Center. Those rules are set forth
in OAR 952_cBq't'!.,sP.9!1\~iP..r~a\n~:\R 952-001-
0090. You may obtain copies of the rules by
cailing the center, (I~ote:, the telephone
number for the Oregon Utility Notlilcatlon
Center is 1-800-332-2344),
;1
Street Improvements:
, Storm Sewer A vailable:'~
Spccial Instruction:
Value
Date Calculated
Page I of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
,',
'--"i);V;;\J<RECEIPT,. #:
City of Springfield Official Receipt
Development Services Department
.
Public Works Department
2200900000000001146
Date: 10/07/2009
Job/Journal Number
COM2009-0 1463
COM2009-0 1463
COM2009-01463
De~~~iption' '.'
Low Voltage - Commereiallndus
+ 5% Technology Fee
. + 12% State Surcharge
. .:{\.;:.,:;{:,~~:itl'l":"
Payments:
Type ,of f'ayment
".,
"Paid By
CreditCard
., " 'JENNIFER BELL- ~
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cReceintl
Received By
Item Total:
Check Number Authorization
Batch Number Number How Received
015551 In Person
Payment Total:
Page 1 of I
9:S6:2IAM
Amount Due
58.00
2.90
6.96
$67,86
Amount Paid
$67,86
$67,86
10/7/2009