HomeMy WebLinkAboutPermit Electrical 2009-11-22
SPRINGFIELO-'-
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City Of Springfield
225 Fifth 5t
Springfield, OR 97477
Pho'ne: 541-726-3753
Email: permitcenter@ci.springfield.or.us
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Residential Electrical Authorization To Begin Work
69600-BEL-09-00258
Approval Code: 035798 11/22/2009 10:07 pm
E-mailedTo:levimichaeI2722@hotmail.com
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IRl Addition/alteration/replacement
I.~ New c.:ns~:uctjon
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Job Address: 443 BLACKSTONE 5T
CltyJStatefZIP: SPRINGFIELD, OR 97477
Suite/bldg.lapt.no.:
Project Name:
Cross Street/directions to job site:
Tax map/parcel no.: 1703233409000
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SERVICE CHANGE ON BACK OF HOUSE. CAN YOU PLEASE FAX OR EMAIL
ME A COPY OF THE PERMIT # THANKS
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I Name: LEVI JOHNSON
I Phone: 541-729-8727
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Fax: 541-653-8323
Email:
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Elec lie. no.: C455
185086
CCB lie. no.:
Business Name: LMJ ELECTRIC LLC
Contact:
Address: 1851 GRANT ST
CltylStatefZIP: EUGENE, OR 97405
Phone: 5417298727
Fax:
Email: levimichaeI2722@hotmail.com
Metro lie. no.:
City lie. no.:
Supervising Electrician's lie. no.:
5434S
Supervising Electrician's Name:
ROBERT S YOUNG
Number of inspections Included in paid services:
Residential Service: 4
Reconnect Only: 1
All Other Services: 2
Upon review and approval by your local Jurisdiction, your permit will be e-mallod or faxed
within one business day, with Inslruclions on how 10 schedule your inspection. ...
NOTE: This Authorization To Begin Work expires wilhin 180 days if a permll is not obtained.
The local building department may delermine Ihat an Aulhorization To Begin Work is null and
void if it does nol meel applicable land use laws and local ordinances.
I~}~,~ .:~t .,\.~:-';,~;,,':;;'!FEE.:SCHE[)ULE.-:'
I Oescriptlon I, Qty. J Ea.
IServi~es !o-~ feeders.~_:;.?t1;fi.' ~{*::':h~.~::t'~1;:~ -,~. ;~~--;,,- ~ ..",,'
I Services 200 amps or less l $81.00
l~le_4~rJcia!!p~rm!tFees~;~21,1;:' !~- ;l'h.~:~.
I Subtotal
I State surcharge (12% of permit
total)
I Technology fee (5% of permit total)
I TOTAL PERMIT FEE
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Please check all that apply:
o A service or feeder beginning
at 400 Amps where the
available fault current exceeds
10,000 Amps at150 Volts or
less to ground exceeds
14,000 Amps for all other
o Hazardous locations
o A service or feeder rated at
600 amps or more
o Buildings 1T!0re than three stor
o Marinas and boat yards
o Floating buildings
o Commercial-use agricultural
buildings
o Installation of a 150 'rWA or
larger seperately derived sys
o "A", "E". or "1.2" or "1.3"
o Recreational Vehicle Parks
o Supply voltage for more than
600 supply volts nominal
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o Fire pumps
o Emergency systems
o Addition of a new motor toad
of 100 HP or more
o Six or more residential units in .
one structure
o Health care facilities
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Total
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$81.00
$81.00 I
$9.721
$4.05 I
$94.77 I
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Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Issued
CITY VI' ~J'RINGFIELD
Building/Combination Permit
PERMIT NO: cOM2009-01683
ISSUED: 1'1/23/2009
. APPLIED: 1l/2312009
EXPIRES: OS/23/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone'
541-726-3676 Fax
541-726-3769 Inspection Line
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SHE ADDRESS: 443 BLACKSTONE ST
ASSESSOR'S PARCEL NO,: 1703233409000
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Service change on back of house,
Owner:
Address:
,
GARLING MICHAEL R & KATHY A
443 BLACKSTONE ST
SPRINGFIELD OR 97477
'CONTRACTOR INFORMATION'
Contractor Type
Electrical
Contractor
LMJ ELECTRIC LLC
License
185086
Expiration Date
01109/2011
Phone
541-729-8727
BUILDING INFORMA TION 1
# of Units:
Primary Occupancy Group: .
Secondary Occupancy Gro~p:
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:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION 1
Front yard Setback:
Side 1 Setback:
. Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvemel~ts:
I PUBLIC IMPROVEMENT~
, , "-.rENTION: Ore~on law requires you to
tlll,oW r~nl.lpl'i~tPtiy the Oregon Utility
NotiflCatlQ{!,c'IlD1tit..r~~R!les are set forth
., OAR 952':Ot1Y~6ffirough OAR 952-001-
G090. You may obtain copies of the rules by
tailing the center. (Note: the telephone
NOTICE' lIlmIler for the OregonrUtillty Notification
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AUTHORIZED UNDER T~,\,~~S'CI'iDtion I
COMMENCED ORIS ABMlnOM~nfOR ..
"'f"" 1 oI"C"'-"'j' Dnru"'D $'PeiSijF Square Footage
. vpe 0 ~ ""~ rpH'v'o" I . I' B'd A
. ~, . or mu tIp lef or I mount
Value
Date Calculated
Storm Sewer Available:
Special Instruction:
Notcs:
Description
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Paee 101'2
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CITY OF SrKll'lGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2009-01683
ISS U ED: 11/23/2009
APPLIED: 11/2312009
EXPIRES: OS/23/2010
VALUE:
225 Fifth Street, Springtield; 0 R
541-726-3753 Phone
541-726-3676 Fax
54i-726-3769 Inspection Line
. '
Total Value of Project
Fees P'li1 i
$9.72
$4.05
$81.00
11123/09
11123/09
11123/09
Receipt Number
3200900000000000767
3200900000000000767
3200900000000000767
Fee Description
+ 12% State Surcharge
+,5% Technology Fee i
Perm ServlFdr 200 amps or less
I .
Amount Paid
Date Paid
Total Amount Paid
$94.77
Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections reques~ed 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 R~Ol~ire~ J ~.spections I
Electric Service: Approval required prior to utility company' energizing service.
By signatnre, I state and agree, that I have carefully examined the completed application and do hereby certify Ihat all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
th'e Ordinances of the City 'of Springfield and the Laws of the State of Oregon pertaining to the ,,)'ork descrihed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 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 ensure that all required inspections are ~equested at the proper time, that each address is readable from the
st,'eet, 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.
Owner 01' Contractors Signature
Date
Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3200900000000000767
Date: 11/23/2009
8:04:26AM
ONLINE CHGS
"
Paid By
ONLINE PERMIT CHGS
Item Total:
Check Number Authorization
Received By Batch Number Number How: Received
Amount Due
81.00
4.05
9.72
$94.77
Job/Journal Number
COM2009-0 1683
COM2009-0] 683
COM2009-0 1683
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12'ro ~tate Surcharge
Payments:
Type of Payment
Amount Paid
nJm
ONLINE LMJ ELECT Online
Payment Total:
$94.77
$94.77
cRcceintl
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