HomeMy WebLinkAboutPermit Electrical 2009-11-4
SPR'NGF'ELD W:',.D~-h~~~tMEi'n;'u~E"oNLY ',:'1
. ~. ., ~ I Pemit no.: C,q - l C() "14 I
I Date: \ \ .4,. D1 \X>~)ro
FJ:;~ ~~~~~lai~::S~:1f~nO~~i?~~P~~~;:i~~~~Oo ~:~:"tS are.nontransferable, Permils expire if work is nol slarted wilhin 1\\~q/
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~~~ I I Residential, per unit, service Included:
I!::fKesidential 0 Government 0 Commercial
~{tiit~i~OBj(SF"E;'lINF,ORMATIONr:AND~l?'QC'A1iloN~,t~~~ 1,000 sq. ft. or less (4) $134.00 $
I Job site address; i --3 13 I.. /JvU }1'rl "'f'C ce. ] ~~~~oatditionaI500 sq. ft. or portion $ 25.00 $
i,,~~;;~~~O\~(~!~~{~F..:l;~~~::~~~~": ! ~~~~:;~:;;;~~;;~ 7e~~:r (~)odular : ::::: :
I ~ /. / I Services or feeders: ins/allarion, altera/ion, relocation
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I I 200 amps or less (2) $ 81,00 $f) \
I 'PROPERT:Y'OWNE~. ..' , . I 201 to 400 amps (2) $ 95.00 $
I Name. ::::S:/rI J../ WI --.,{Rr- /)) on 11&C ?<1J<i~"" 1401 to 600 amps (2) $158.00 $
I Address: I~ /3 f,4'W _~/'I ~---L.. . I 601 to 1,000 amps (2) $205.00 $
I City: \!-,/ ,"'",1:J /.)'1 State. b;c I ZIP.9i Vi') lOver 1,000 amps or volts (2) $469.00 $
I Phone,s'-l.l 4?- "i '--(--;30 I Fax. -.-A<! D I Reconnect only (2) $ 63.00 $
I E-mail: ./Z/ b I Temporary services or feeders: instaJlation, alteration, relocation
This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $
owned by me or a member-))fmy immediate family, This I 201 to 400 amps (2) $ 87.00 $
property is not intend<;d'fof sale, exchange, lease, or rent. OAR
479 .540( I) and 4 7J-'5~(f), / ) ",' ~ I 40 I to 600 amps (2) $126.00 $
SIgnature:,~ ~ ~ lOver 600 amps or 1,000 volts, see services or feeders section above
I. ::::t:.ONTRAC"tOR. INST AtLATION: . I I Branch circuits: new, alleralion, exlension per panel
I Business name: (0 !) (\~O...JfZ-.- "'f' _ I I a. Fee for branch circuits with purchase ofa service?f feeder fee:
Address; T47nT/lif: I I Each branch circuit I "I $ 6.00 I $
City: I State: AI~lJZMIT sJ:M.J ~ b. Fee for branch circuits without purchase of a service or feeder fee:
I Phone: I Fax; COMM;~~tO UN~ r; ~fJ!I1fsffr . uit (2) I $ 55.00 I $. I
I E-mail: ANY tan DA~~i?R IS AB/i)j:'rI-ii14Wif. 1 ~T hcircu~t 14 $ 6.00 I $ V:. I
I CCB \tcense no.' I BCD license no.: tRIOD.1 ~11lc{1iJil,IiaJli'es: service orf~eder nol meluded I
Signing supervi~b}'~ lit'ense .j-tc;;{.Jii3,..,6r. i~l'!o' ~ [. Each pump or !rrigatio~ circle (2) $ 63.00 $ I
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Print name of,;rg9)llKi,!J:Ill-~iMOP-<<l by the Ortlpon IAiliK;' I Each sign or outline lighting (2) $ 63,00 $ I
I Signature of 9ig,i);~;;'<~~~i r<er. I rlOSe roles are 81M. to: I I Signaleircuit or a limited-energy panel, $ 63.00 $
'''Q''',,;-..r'7''Jt,I~ -001 Q thi1)tJOI lOAM WlI! alteration, or extensIOn (2)
~ _ ':~?;lt.rnay. Obtain ~ oJ{t.... raM.~' I. ~a..~"h.~~ditionatinspection:~I).... .. . .... ... $58:00 I. $
,6t(W\ €~ft~=~= 1~~;'{~::::;:::~~:~~~~ANT~~LSE~fJJ~~~~~U")tft~;~
(\. ~.. . I ' ,,,,.,:,'~?-,";,~). (Minimum Permit Fee $58,00) $l D'S~?
~t'b ~\)~'I (B) Enter 12%surcharge(,12x [Al) $ lQ..(ptl)
\l . [) . ^ f (Vi II ',A ("""J91() I (C) Technology Fee (5% offAl) $ Q,1_'1
~ Q~ ~U W\~lVfY ;;:A;:~d~r;~:(A~::c): $1~'i.f>S
440.2584.J(9/08/COM) W {I.t.M ~~CU\ ~~SOY\ 'l2b-~loDt-'
Electrkal Permit Application
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225 Fifth Street. Springfield, OR 97477. rH(54t)726-3753+ FAX(541)726.3689
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Status
Issued: _
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',225 Fifth Slreeti'.'Springfield,.ORt
541-726-3753Ph~ne'; ',.:/-,{:t 'ii
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541-726-3676 Fax.
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01574
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 05/04/2010
VALUE:
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SITE ADDRESS:"~;(I.~13 LAWtffiIDGi AVE
ASSESSOR'S P.AR~EL NO:: .1703252204100
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Springfield T.YPE OF WORK: Electrical Work Only
TYPE OF USE: New
.. PROJECT DESCRIPTION: .' Add circuil for oul building
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Owner:
Address:
JOHN WINTER "
1313 LA WNRID'GE j\.VE .
SPRINGFIELD OR 97477
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Contractor Tx~ejt";L~ontractor
Eleclrical ,r' OWNER
# of Units: ..t.'_
:",,11
Primary Occup~ncy Group:,~ . .;,11 !2'R-3
Secondary Occtipan~y Group: .
Primary Conslruclion Type VB
, Secondary Construcliori'Type:
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# of Bedrooms: .... ~. . .:~ . ,'-~. ...~
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Frontyard Selba'ck::; :~"". :;7- "
Side 1 Setback:~' . f ..' .'
Side 2 Selback: I " '
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Rearyard Setback: i': '::.\ .
Solar Selbacks: .;; . ,_..~ ,"', ..
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Streel Improvements:
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Slorm Sewer Available:,~~ 'I'
Special Inslructlon: i' .
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Notes:
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Description 5: T~p~ --:f!f Construction
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I, CONTRACTOR INFORMATION I
License
~UlLD~NGINFORMATION I
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# of Slories:
Heighl of Slructure
Type of Heal:
Water Type:
Range Type:
Energy Palh:
Sprinkled Building. .
n/a
I.DEVELOPMENT INFORMATION I
Overlay Disl:
# Slreel Trees Rqd:
Paved Drive Rqd:
% of Lol Coverage:
) PUBLIC IMPROVEMENTS I
Residential
Phone Number: 541-465-4530
Expiration Date Phone
LOI Size:
Sq FI IsI Floor:
Sq FI 2nd Floor:
Sq FI Basement:
Sq FI Garage/Carport
Sq Ft Olher:
Occupant Load:
~EQUlRED PARKING
Total:
Handicapped:
Compacl:
Sidewalk Type:
DownspoutslDrains:
'" Valuatio,n DescriDtion I
$ Per Sq FI Square Foolage
or multiplier or Bid Amouut
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Paee I 01'2
Value
Dale Calculaled
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01574
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 05/04/2010
VALUE:
Status Issued" .. _..:~------_. - "-.
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225 Fiftb Slreel;;Spnngfield,'OR,,,"''1:'' ...
541-726-3753 P~oneT.:." '. ,.
541-726-3676 Fax .: . "
, 541-726-37i;9iri'~~~itio;;:Line.;;:<
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Tolal Value of Project
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Fe.es Paid I
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'; Fee DescripliOll\l.... :\~."';~"
+ 12% Slale S~f~hj~ge'Y' .
+ 5%' TecbnologyFee . .
Add, Aller, Extend Circ
Minimum/Adjustmenl Eleclrical "
+ 12% Slale Surcbarge ~.~;
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+ 5% Tecbnology,F~ei~.m~ " ' ' -;., :;-,.
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Add, Alter, Exlend :Circ Ea Add' '.
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Perm ServlFdr 200 amps or less
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TolalAritonnt Paid ';.
Amounl Paid
Dale Paid
Receipl Number
$6.96
$2.90
$55.00
,j $3,00
$12,60
$5,25
$24,00
$81.00
10/27/09
10/27/09
10/27/09
10/27/09
11/4/09
11/4/09
11/4/09
1114/09
1200900000000001191
1200900000000001191
1200900000000001191
1200900000000001191
1200900000000001228
1200900000000001228
1200900000000001228
1200900000000001228
$190.71
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. I Plan Reviews ,
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To Request an in~pection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be ni.all~' th,e,sl!'!le .working day, inspections requested after 7:00 a.m. will be made the following
work day. ' :~. ' ,
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Reol1ir~d hlso~ctions ,
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Rougb Eleclric: Prior 10 Co';er'
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Final El~clric: Wben all electrical work is complele.
I
Electric ~.e~\ce: ;Approval required prior to uliIity company energizing service.
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By signalure, 1 stale and agree, Ib'at i have carefully examined Ihe compleled applicalion and do hereby cerlify Ihat all
informalion bereon is true and correcl, and 1 furlber cerlify Ibal any and all work performed shall be done in accordance wilh
the Ordinances of the City of Springfield atid Ibe Laws of the Slale of Oregon perlaining 10 the work described herein, and
thai NO OCCUPAN,<::y',will ~.e mad~ of any struclure wilbout permission of Ihe Community Services Division, Building Safety.
1 further cerlify;~ba.t~,!ly conlraclo~s and employees who are in compliance wilb ORS 701.005 will be used on Ihis project.
I furtber agree 10 ensure Ihat all required inspections are requested al Ihe proper lime, that each address is readable from Ihe
slreet, Ihal the permit c~rd is located al Ihe fronl oflbe property, and the approved sel of plans will remain on the sile al all
times during co~str~Cti,?n.;: I.;
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Owner or Conlraclors Signature.., ,;
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Page 2 of2
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225 Fifth Stre~:;.{r.;i'~,;:.';;!it<;'f~~;)Y~$;%~::;;,:. '.': .'.': .
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Springfield, Oregon.' 97.477;. ....'.C '.
541 ~ 726-3759 P:~)~~{it;~'if;i;J~i~i;\jt,~t~i43.;':;
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City of Springfield Official Receip.t
Development Services Department.
Public Works Department
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;-1"":;;',: "RECEIPT#:
10:15:09AM
Date: 11104/2009
1200900000000001228
Job~~~unial N~mb.~~~~i1'FRe~~~~~tJ~~:,,<...:.1..:,;/:.: .~. ::
COM2009-0 1574"';:;,::,;'Peni1~eryIF,4r;fPO.amps or less
COM2009-0 1574 ""~dciJAlt~f, E~t.:rid~iri: Ea Add
COM2009-0 1574 :,' + 5% Technology Fee
COM2009-01574 ,,+12% State Stif.ch';'g~'{
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Amount Due
81.00
24,00
5,25
12.60
$122.85
Item Total:
Authorization
Number How Received
Check Number
Batch Number
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Cash: . ",,:;;,":;:~DONNkWINTER ....i' .'
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Amount Paid
Received By
$122.85
$122.85
In Person
Paymenl Total:
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11/4/2009
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