HomeMy WebLinkAboutPermit Electrical 2009-9-24
ClTY OF SPRINGFIELD, OREGON
2lS F1FI1I SlllEET . SPRlNGFlEUl, OR 97477 . PH:(54I)726--J7SJ . FAX: (541)726-.3689
ELEC11UCAL P!f.RM1T APPliCATION
City lob Number C9 -- O/~::J--O
~
WN
INlTIALS
DATE
SOURCE
Date 1- ~ 2- '-(- () 'l
1. ~Lo'C!A71':;,,' ~,Ly"iA.tr:-l(rrdN:~ 3,
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!r>N / / 7~ P/</tC ~
LEGAL DESCRIPTION: 11 r?lJr,., 03 <6 \3A. ~~~IlJ\ii~j~l~Jiij~lWIJ~m.wW~
'.2<-1'1.,-,> b~;;tl~:1.(-e.., Service Included
lOB DESCRIPTION: 1000 sq, ft. or less ' $117.00
() lt1 " f\r. A A ~ ./ Each additional 500 sq. ft. or
\ X 0 f'l.UA."..O \ ~ / 1IV1J! ~ portion thereof ' $ 21.00
'Permits arltnon-tra~ferahle and ex relfwork Is ~"" tf) .hch Mannfact'd Home or
, not started within 180 days of Issuance or if work ~ Modular Dwelling SerVice or
Suspended for 180 days. Feeder
2. ,
;QiMi~
'111l"lIlrr~~
Electrical Contractor II f~ r + f J... L.. -{,:L 'J:h G-
Address /'17c AJ Z-B-rt, r-l-
City ~'";":i-C"..J/
Phone 7 '-f 7- 2.2/1
Supervisor License Number S () b:2 5>
Expiration Date /0/ I / 20 J 0
CoIlS1r. Coutr, Number 'I L-- '7 '7 "L
Expiration Date > (1-J:i /zo 1/
Signature of Supervising Electrician .
k~vr--,
V"" ,;;- '- -
~~= Nam~ ill tt(Y/\.../
Address / Q~r II ~rL ,
City~iJ.4 __ Phone
OWNER INSTALLATION
The installation is being made on property I owu which
, is not inle~ded for sale, leas~O: ren
Owu= SJgWItw'e: . ~ " "
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Cd ~~y6';,/
Inspection Request: 726-3769 ~V ~v
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.
COMpIiETE.'JmiliS(J/mi)tli1it'n~
~ ,..,..11. ,.1.titrt:rt~ ~'~---~IIl-._.Ilr.r:r.,':'""..:..U
$55,00
B'~,ift~~~
A!~. "r,,,,,, ="~:uaIII
, 200 Amps or less $ 70.00
201 Amps to 400 Amps $ 83.00
401 Amps to 600 Amps $138.00
601 Amps to 1000 Amps $180,00
Over 1000 AmpsIVolts $413,00
ReconnecIOnly . J $ 55,00 '" f' -~ ,
. ',' /.- ~ 0'--'
c. &tefI~~~~~~~~~
Installation, A1teralion or Relocation
200 Amps or less $ 55.00
201 Amps to 400 Amps $ 76.00
401 Amps to 600 Amps $110.00
Over 600 Amps or 1000 Volts see "B" above.
D. ....~!li! ",.."
New Alteration or Extension Per Panel
One Circ!'it
Each Additional Circuit or wiih
SerVice or Feeder Permit
$ 48.00
$ 4,00
E.~~~~~~
Bl;:"f)(trrlP.iEI~'
Pump or inigation , $ 55.00
Sign/Outline Lighting $ 55.00
Limited EuergyiResidential $ 28,00
Limited Energy/Commercial $ 50,00
Minimum Electric Permit Inspection Fee Is S50.00 + Surcharges
4.lItlo~~~~~ -.-l>T. <":>.&3,
8% State Surcharge t:f;-r:f.? 3. , ) S-
10% Administrative Fee t '() 7, ~~
5% Technology Fee :J. l-S
1I1~ 'r
TOTAL , I{) '_--I ' : _
S!w.d Drivc(T;)lBuiJding FonnsIEJed1ica/ Penn;! AppJ;.,.,Joo 7.{J7,doc
73,7/
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01428
ISSUED: 1O/30i2009
APPLIED: 09/25/2009
EXPIRES: 04/30/2010
VALUE:
225 Fiftb Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1864 11TH PL ,
ASSESSOR'S PARCEL NO.: 1703261403813
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace damaged meter base
Owner:
Address:
TRAN HUYEN
890 W 18TH AVE
EUGENE OR 97402
I CO~TRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
ALERT ELECTRIC INC
License
12772
Expiration Date
OS/22/2011
Phone
541-747-2213
BUILDING INFORMATION I
VB
# of Stories:
Height of Structure
Type of Heat: '
\\;ater 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:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction TYP,e:
# of Bedrooms:
R-3
n/a
I DEVELOPMENT INFORMATION'
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dis!;.
)0;.,,-
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped: .-
Compact:
Street Improvements:
J;'~~~-/.,.J.ll 'I~I'J. UIt:YUIII4:l.VV 1t:4UII\10 )'VU LU'
I PUBLIC IMPROV '1"Iif~;I~..o" adopted by the Oregon Utility
Notification ce~J':liR~. s are setlorth
In OAR 952-001-0010 throu h OAR 952-001-
0090. You may~fPtI8 ~f"~ rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notlfioalion
Center Is 1-800-332-2344).
.
Storm Sewer Available:
NtYr!iaL-Ipstruction:
lit.
;WIit.Ps~RM'T SHAll EXPIRE IF THE WORK
, THOR/ZED V~nFR T/.IIS 121! -
(,uIVI/VltNCED OR IS AS RMlfl9 tle"
~NY 180 DAY PERIOD. ANDONED FOR I Valuation Descriotion I
Description I
Type of Construction
$ Per'Sq Ft
or rimltiplier
"':OSquare Footage
or Bid Amount
,
,.
Value'
Date Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMlTNO: COM2009-01428
ISSUED: 10/30/2009
APPLIED: 09/25/2009
EXPIRES: 04/30/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid, '
Date Paid
Receipt Number
$7.56
$3.15
$63.00
10/30/09
10/30/09
10/30/09
2200900000000001239
2200900000000001239
2200900000000001239
Total Amount Paid
$73.71
I 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.
, Re,\ I~ired r nsnections I
Electric Service: Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefully examined the completed applicatioo and do h'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 tbe 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.
Ifurther certify that only contractors 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
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 dU1Jing c struction.
~/l---'-- /?J~3(F- 0/
ow~or Co ractor~'Signatu!e_/ Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 9747?,
541-726-3759 Phone
Job/Journal Number
COM2009-0 1428
COM2009-01428
COM2009-0 1428
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
GREG/ALERT ELECTRIC
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001239
Date: 10/30/2009
Item Total:
Check ~umber Authorization
Received By Batch Number Number How Received
njm 030989 In Person
Payment Total:
Page 1 of I
2:10:25PM
Amount Due
63,00
3,15
7.56
$73,71
Amount Paid
$73,71
$73.71
10/30/2009