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Home My WebLink AboutPermit Electrical 2009-10-27 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH,(54I)726-3753 . FAX, (541)726-3689 ELECTRICAL PERMIT APPUCA110N, s: City Job Number C Ou-\7....c-c:> 9 _ 0 I .s-O ZON INITIALS DATE --- SOURCE Date /cJ -?.7 -0 ? " -',.,0., . .', "'. ....: '.,.' _ .,' ,_,.'.._..." <..!,,~ _ ".~ ~. I. Ldl::A TJ(}fV OI!JN$T#0TION: I'D /1 . 5 ifo-tL. P J ._d......, ,'_ __n". "". ."..:; _,,_,_ "'_,'_" . 3. COMPLETE fi'EE SCHEDULE BELOW."':. . _ "' "'0,. _,,' . _..~.., '" "", , ;~-' . ~";';"""-". -. .';"~:'..,;.~:!.,6'" "''',.-,~~; ....c-:: ..... '11'" .'. ',' " ", ',f, .":.' ~ ',._ . '.:;" ";' /; A. New Reside'nli:il.~ Single'or Mtilti'Fillnily per ilwellini!,unit:,~,,,.. 2. c::x::x::::x::: Service Included LEGAL DESCRIPTION: /80 Z. c> Gr f.{ JOB DESCRIPTION: l}l~ \-e P'i C 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ".,!~,".U;';.o.:;';L~a",*""'/A"<--:',.':';..;r4f;"":'t~m,.~r;;':!~1...:4.."'.,,,"~';,......,":::;:0,-;%",,":<'.".1_'<: 2 '."CONTRACTORlNSTALIIATION ONLY' . '.<~""., ;",p",," ,.'; .'T'~;;' 'i'L"'-" _ ',,-"f'~~." ~i';;;;::::,,"";.rj-'N~ .. . .<,~' "",.- '''''', - ., Electrical Contractor L..j- C $121.00 $ 22.00 $57.00 B. .:,'~!f;l~~~~~~;f~~~~#'~~~'.~:i ~~'!}~U.~.'~1~~;~~~tt"e:r.~tr.~~~~~';ft~(4~t'~1.~~~~1~ New Alteration or'Extension Per. Panel One Circuit . ." ,:-:' o?-~ I ~O S-r Each Additional Circuittl!'''fNl. ~ 01 o I) I. + C J-.. Uo-<<,.!:.Service or F~~~~r 'l~ \~ N $ 5.00 Owners Name \), lice W I "v""-' 0"''Vl'' l\U "",~. \-J\.~ 'O~f>.\.\. 1\\)'O ?~~\.. fO? . Address -z, '" '7 3 51t" .;,.-.l l yJ 1\-\IS \lE?-llt~'~~lsB"}..~U~er not included) -Each Installation , \)1\-\ORI/.. OR IS ~ Phone b'6 (, - '1 it S- ~_ ~OW\,,^~G.~Qr ~~0Th, $ 57.00 ~'1 ~ ~'htliri'; Lighting $ 57.00 p.. Limited EnergylResidential $ 29.00 Limited Energy/Commercial $ 52.00 Minimum Electric Permit Inspection Fee is $2:00 + Surcharges . ,,/\ 0 I t\~./ 4. SU, WiVl'Al. dFAlioVE '>1:l 58 .1)\)\\1:1" ~f\ ,<1 12% State Surcharge h S:~ r\ ~~ ~ j2,V\ +lh. "ommlstranVe iee \J:Y\ ~l^: \ \)~~ 5% Technology Fee Z'" ~ Inspection Request: 726-3769 ~?\ TOTAL b 781> ~ Shared Drive(T:)lBuilding FonnsIElectrical Permit Application 7.08.doc Address q Z. '6 S :, 200 Amps or less ) .' ,... . i; 2.9h1mpSjq,4~1l5 you,to :r n'"c r Ac ye S .:, a(l0,I,ArriIis1<t\looOfmjlSln Utility I .' .I')" CG60lrA;:;~~Rl'lrilll~, set forth Phone 5 l J - 'f I i9 d'i;\r\ G52.00bv.g.1IOoarR!!.Q~ D t. 95~-oO~y' UU'-'IJ' You ma'Rps'WtlpcYP-l2Ws I ne ru es ;aliing the cenler, (NOte, the telephone number for,.!he9regon Utility ~otification Celltllr i& efl8611I&l~'Z3if.4}.()r Fceders City Sf C \~ Supervisor License Number Lf I 7 'i - ')- ~ /2110/1/ . Constr. Contr. Number I b S- '--/ 7 )'- 3)10 Expiration Date Installation, Alteration or Relocation 200 Amps or less 201 Ampsto 400 Amps 401 Amps to 600 Amps . Over 600 Amps or 1000 VoIls see "B;' above. D. 8ra~ri.~h..€~rc(li#';'~,:-r,~~;"'~.::".(~. ~'\ :~.--:_".: Expiration Date Signature of Supervising Electrician F~ {~t{\N?l ~ - - City t: uS'::.",... OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 $ 57.00 $ 79.00 $114.00 Status Issued <:' ,~: 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. . .:" \. l~ . . '. , . '.:' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01505 ISSUED: 10/1412009 APPLIED: 10/13/2009 EXPIRES: 04/27/2010 VALUE: Springfield TYPE OF WORK: Mechanical Only SITE ADDRESS, ". 1019 S 40TH PL ASSESSOR'S PARCEL NO.: 1,802061420000 _I r' PROJECT DESCRIPTION: Install air conditioner Owner: Address: TYPE OF USE: New Residential BRUCE WIECHERT .CUSTOM HOMES INC 3073 SKYVlEW LN '. i,: EUGENE OR 97405 . , \ ' . I, CONTRACTOR INFORMATION I . S \IOU ~... ,. leQUIle !."l't Contractor Qlegon laVl QlegOIUK: L & E ELE<t.r~(Jl~\'. dop\ed b'/ ~~\es eJe ~~ ~. COMFOR1;'.i.\fe,O~A~~(; l%!s_, .nh Of>.f\ Ii~'!.~.. b'i Not\I\C"d"Bu~&m:; I.~~"ffh' nil , in Ofl,f\ ~JJ ,llJ',. 11~r"J! ,i. J:Mr~l~ion 0090. \1 fSp\..lll. \l\\\\W ,~ calting \ 1l1~!l'tW!J~_~'L.23<\<\)' . null\PIlI Oe~t~ucrlire ell pe of Heat: Water Type: Range Type:..~_. Energy Path: Sprinkled Building: 1, -: j. Contractor Type Electrical Mechanical .' ; . # of Units: Primary Occupa'ncy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: " Frontyard Setback: . Side 1 Selback: Side 2 Setback: Rearyard Setback: Solar Sethacks: .. Street Improve'!'ents: Storm Sewer A~ailable:. Speciallnstructio~: Notes: ~ t ( "I . . ) ., " " .,..... - Expiration Date 03/30/2010 06/2712011 Phone 541-933-2653 541-726-0100 c:',.:. Lot Size: Sq Ft 1st Floor: ~q Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: n/a 1 DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist:. . c..","' 'Total: # Street Trees Rqd: . . ...,..;;~;f:M\~li?i"'....~andicapped: Paved Drive Rqd:_...,..:j;tq:';"-1"""~t 't1Q~"\\o'inpact: % of Lot Cov~~.~ge:':,""" Sl\?'t. \~ X1'i ~O.)V ..t\"'\'\Ct'. }"1 c."~\.'--~\-\\S \''t.?\J'\n fO? g',;" I PUBLlc.i~'8R&v'ir.'iEN.jfs.,,~' ~Bf>.~\)\)\~ . i"'; , Hi iJ' '""~'.j.f:O'" . f>.1j()~~~~c't.~ y~?\OU"'ide;"alk Type: C.,,, '\ \)\) UP', DownspoutslDrains: f>.\~l. . r Paee I of 3 . .. CITY OF SPRINGFIELD I Building/Combination Permit PERMIT NO: COM2009-01505 ISSUED: 10/14/2009 APPLIED: 10/13/2009 EXPIRES: 04/27/2010 VALUE:, Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax ;. ~,; .' :J,t:c, 541-726-37691I~spection Line '"J 1: I V ~Iuation Descriotion I Description Tvpe of Construction $ Per Sq Ft "'or multiplier Square Footage or Bid Amount Value Date Calculated . ": : .' "::~; ~~1.: ' ~ ': .' . Total Value of Project J{pp<. P~irIJ Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance." ,. -~. + 12% State Surcharge + 5% Technology Fee . Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Nnmber ~, -." : ."".. , d $9.48 $3.95 $79.00 $6.96 $2.90 $55.00 $3.00 10/14/09 10/14/09 10/14/09 10/27/09 10/27/09 10/27/09 10/27/09 1200900000000001140 1200900000000001140 1200900000000001140 1200900000000001192 1200900000000001192 1200900000000001192 1200900000000001192 Total Amount Paid $160.29 I Plan Reviews , 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. ~p~ Rough Mechanical: Prior to Cover i II . ! Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: Wheu all electrical work is complete. ., " Page 2 of 3 q I' Status Issued. '. ;/<~. .' "H' .,,'.,. 225 Fifth Street;Springfield, OR';: ~;:r .' 541-726-3753 Phone" . 541-726-3676 Fax 541-726-37691n'spectionLine CITY OF SPRINGFIELD B~i1ding/Combination Permit PERMIT NO: COM2009-01505 ISSUED: 10/14/2009 APPLIED: 10/13/2009 EXPIRES: 04/27/2010 VALUE: By signature, 1 state and agree, that I have carefully examined the completed application and do herehy 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 that NO OCCU?ANCY;will be made of any structore 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 he used on this project. !.further agree to ensure that all required inspections are requested at Ihe proper time, that each address is readahle 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:' ..v Owner or Contractors Signature ~; . ~, :'F- . t .: " . ;t~ ( , . -~...,,"' ~: " ,. ,;..." c ~~ t: .., ,J ., Paee 3 of 3 Date . ..H.t. ::.y,;;/t~ 225 Fifth Street}::;.? ,-:- Springfield, Oregon 97477 . 541~726-3759 Ph()ri~' .;:i,; '." a_~~. f~'-~-' /":. .,. City of Springfield Official Receipt Development Services Department Public Works Department " ".;" RECEIPT#:. 1200900000000001192 Date: 10/27/2009 II :S2:02AM Job/Journal Numbe~..) ._~ pes~~~p~i~,~:__ (i~i~~J;~::~J.-.!:::.:~:~'\ COM2009-0 1505 ,':f(.:;:Add;"Alier;EXtend'Circ .. ~,- ", " ", . ;,," .,~ .", . COM2009-0 1505 :::(. ";';'MinimumJ Adjustment Electrical COM2009.01595 <h:;...t~r. '1;.echn~!ogy Fee COM2009-0 1505. .;;;."';(tt-I;2% ~tat~.~urcharge " . " ~ ..~.,~.,,:> :','. " . "- ':,~ ~" Paid By .BWCH' lIem Tolal: Check Number Authorization Received By Batch Number Number" How Received Amount Due 55.00 3.00 2.90 6.96 $67,86 Payments: Type of Paymenl CreditCard Amount Paid ".,~~li~: " ".' .~,;.-:::~~j:~~!~r~~ ~~: djb 05512d In Person Payment Total:. $67.86 $67.86 ." .<{, ..,..' ;-., ,;', .... .) -." ., -,' " " :J ., { :.:,. .' r' . \' ~h \h ( " cRcceintl Page I of I 10/27/2009