HomeMy WebLinkAboutPermit Electrical 2009-10-22
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Electrical Permit A
225 Fiftb Street+Springfield, OR97477. PH(541)726-3753+ FAX(541)726R3689
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I Pennit no,: c.,Ov... \ f0~
I Date:
This permit isissued under OAR 918-309-0000; Permits are nontransferable; Permits expire if work is Dot started within 180
days of issuance or if work is suspended for 180 days.
I Residential, per unit, service included:
11,000 sq, It, or less (4)
I Each additiona1500 sq.}'!:. or portion
thereof
I Limited energy (2)
rEach manufactured home or modular, I $63.00 - .
dwelling service or feeder (2) .
I Services or feeders:.instal/ation, alt~"'ation, relocation
I 200 amps or less (2) $ 81.00 $
I 201 to 400 amps (2) $ 95,00 $
I Name: € 2tCgN (j !r1J1J) 17 I I 401 to 600 amps (2) $158,00 $
I Address: ~/Ef75 DA-I5Y Sf -# q 2-- I 601 to 1,000 amps (2) $205,00 $
I City: S;J 1</ /J/6f1Ei/J 'I State: OR. I ZfP: q 7 L/-7) lOver 1,000 amps or volts (2) $469,00 $
I Phone: 'J'i{ / :- 716. :33dll Fax: . I Reconnocl only (2) $ 63,00 $
I E-mail: r- I Temporary services or feeders: inst~llation. alteration, relocation
This installation js being made on residential or farm property I 200 amps or less (2) $ 63.00 I $
owned hy me or ,a memher of my immediate family, This I 201 to 400 amps (2) $ 87,00 $
property is, not intended for sal~, exchange, lease, or rent. OAR
479,540(1) and 479,560(1), I 401 to 600 amps (2) $126,00 I $
Signature: lOver 600 amps or 1,000 volts, see serVices or feeders section above
I_CPl\lili~C:t:0alllNSiTc~l!\!A.mlPN_ I Branch circnits: new. alteration, extension per panel
I Business name: L-,o k'. /6/?/fIJ;/J-H1.1MC- . I I a. Fee for branch circuits with purchase ofaservice or feeder fee:
I Address:bif tAJ, "LV" :5fN-ec;T I I Each branch circuit I $ 6,00 I $
ICity: 0J.;7A'li1l67'ez'2tl Slate; of.z I ZIP: 97'1771 I b, Fee'foi branch circuits without purchase ofa serVice or feeder fee:
I Phone:Stf-/ 747~06.}g I Fax:5if/~7'f7.71571 I Firstbranc.hcircuit(2) " I I $ 55,001 $
I E-mail: bIJAtAj)A(ii)~UtXl1et;ntf- I I Each addluonal br,!!ch CIrCUIt $ 6,00 $
I CCB license no.: %699 (j I BCD license no.: ci?tJ, YlGI I Miscellaneous fees: service or feeder,; not included
I Signing supervisor's license no,: '1-9 t/~5 . I I Each pump or irrigation circle (2) $ 63.00 $
I print n~me of signing supervisor:!.r;-r-<A V 6</16 4;f1k, ~ I I Each sign or outline lighting (2) $ 63,00 $
I Signature of signing supervisor. /'. --/7 /',/ .~J I Signal,circuitorali!TIited-energypanel, $ 63.00 $ I
. /.?I""'"~ ~k-.- J1 alteratJ.on, or extensIOn (2)
" ,. , -, " . /' =;;=~;~~~~NjfiWS~.~'ilI1
la requireS yout? I
;\1"ENTlON: Oregon ~he Oregon.Utllity (A) Entersubtotalofabovefces /..;?
~\lOVHU'esadoPted~seru\esareset~~ "l ",,0.. (Minimum Permit Fee $58,00) $ {J',1 ,
Notiflcationce~t~1~hrOughO!\R95~~~~1.i'J \. 1 (B) Enter 12% surcharge (,12x [A]) $ 7,561
In OAR 952.()0. tal copies olthe ru e ',V I (C) Teclmology Fee (5% of[A]) $.3 ,I.'J I
0090 'loU rnay ob n "ote' the telepho~'l\J' ~
liing the center. (" Utility Notiticatlo~ I TOTAL rees and surcharges (A: thruugh C): $'7.3, 7/ I
ca \he oregon 4) \ ~ I '
nurnberci~~ter \$ 1-600-332-234 . " . ~ NOTICE:,' . .,' ',',",.:', .
440.~584.J (9'08/C.OMJ _. ~ " \)-I' THIS PERMIT SHAtt EXPIRE IF THE WORK'
,,~~ ~- I'N'..V l\UTHORIZED UNDER THIS PERMIT IS NOr'
\.)-JV \.t\}...~ , I;OMMENCED OR IS ABANDONED fOR
v..V ANY 180 DAY PERIOD. , "
~,.
Ilk__l!0~C~~G(i)~aNMEl\ljt"~!ileg<:tl?~~
I Zoning approval verified? DYes D No .
.:JlIjIillDlC~liEGORY4Pt=.C:PNSmRJ:JCiliIPN!II!IIlE'"
l~'Residential lD Government ,I 0 Commercial
1~,OBis.lmEII!IN~0RM>>;iTIONr-<<NDiIl!OC~i1iION_
I Jobsiteaddress:~75 j),4/5V Sf: .11- 92-
I City: jjJ/</1i!6;::/ e'L/J I Stare: 61{ I ZIP: q 7'177
I Rcfer~ce:~ -- r Taxlot.: - -
1~~=;~~~~j;I~;~~1
I
$134,00
I
I
I
I
$61.-1
I
I
I
I
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I"
$
$ 25,00
$
$ 32,00
$
Status
Issued
CITY OF SPKlf"il.FIELD
Building/Combination Permit
PERMIT NO: COM2009-01553
ISSUED: 10/22/2009
APPLIED: 10/22/2009
EXPIRES: 04/22/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phoue
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 4475 DAISY ST SPACE 92
ASSESSOR'S PARCEL NO,: 1702323406500
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace Electrical Service
Owner:
Address:
BROWN EILEEN BEATRICE
4475 DAISY ST SPACE 092
SPRINGFIELD OR 97478
Phone Number: 541-746-3309
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
LRBRABHAM
License
8699
BUILDIN.G INFORMATION'
Expiration Date
12/18/2010
Phone
541-747-6638
# of Units:
Primary Occupancy Group:,
Secondary Occupancy Group:
Primary Coustruction Type
Secondary Construction Type:
# of Bedrooms:
, # of-Stories:
Height of Structure
Type of Heat:
Water Type:
Rauge 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~VELOPM.ENT INFORMATWN I
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback: .,
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Cov.erage:
Total:
Haudicapped:
Compact:
IPU~LIC IMPROVEMENTSI
Street Improvements:
Storm Sewer Available:,
Special Instruction:
Sidewalk Type:
Downspoutsffirains:
Notes:
I Valuation DescriDt,ion I
Descriptio~
Tvpe of Construction
$ Per Sq Ft
or mnltiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
-~~~j~~,IE!\j:"~;"";i''''''00
. - ': ,- i;.-,~,' >"'~ i.:. ';:.: t .,~: ,:
CITY OF SPRINGFIELD
, ,
Status
Iss u ed
Building/Combination Permit
PERMIT NO: COM2009-01553
ISSUED: 10/22/2009
APPLIED: 10/22/2009
EXPIRES: 04/22/2010
VALUE:
225 Fifth Street; Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fee~ PahlJ
Fee Description
+ 12 % State Snrcharge
+ 5% Technology Fee
Manufactured Home Service
I
Amount Paid
Date Paid
Receipt Number
$7,56
$3,15
$63.00
10/22/09
10/22/09
10/22/09
1200900000000001178
1200900000000001178
1200900000000001178
,
Total Amount Paid
$73.71
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 same working day, inspections requested after 7:00 a.m. will. be made the following
work day,
I Reotlire~ Insoedions I
Electric Service: Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefully examined the completed application and do h~reby certify that all
information hereon is true and correct, an'd 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 be made of any structure without permission of the Community Services Division, Building Safety.
I 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 eusure that all required 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
times durh~g construction. I
Owuer or Contractors Signature
Date
i
I
Pa2e 2 of 2
"l
225 Fifth Street
Sprirlgfield;Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01553
COM2009-01553
COM2009-0 1553
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Manufactured Home Service
+ 5% Technology Fee
+ 12% State Surcharge
Paid By ,
LR BRABHAM
ii~
""',~._~..".,_~,;.._--' _n _" _
i
I
1200900000000001178
,
City of Springfield Official Receipt.
Development Services Department'
Public Works Department
Date: 10/22/2009
,
Re~eived By
illh
Item Total:
Check Number Authorization
Batch Number Number How Received
38273
By tylail
Payment Total:
Page 1 of I
I
I
1:16:46PM
Amount Due
63,00
3,15
7,56 '
$73,71
Amount Paid
$73,71
$73,71
10/22/2009