HomeMy WebLinkAboutPermit Electrical 2010-1-12
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City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726~3753
Email: permileenter@ci.springfield.or.us
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Residential Electrical Authorization To Begin Work
69600-BEL-10-00017
Approval Code: 012327 1/12/2010 8:48 am
E-mailedTo:tena@orelectricservice.com
o New Construction
00 Addition/alteration/replacement
11Zl1 or 2' family dwelling 0 Multi-family 0 Commercial D Accessory
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I CIty/State/ZIP: SPRINGFIELD, OR 97477
Suite/bldgJapt.no.:.1
Project Name: Jeff Fields/541-521-1399
Cross Street/directions to job site:
Tax map/parcel no.:
1703363202400
I Name: Jeff Brooks
Phone: 541-343-1681
Fax: 541~343.1683
Email:
I Elee lie. no.: C408 CCB lie. no.: 181997
I Business Name: OREGON ELECTRIC SERVICE LLC
I Contact:
I Address: PO BOX 2237
I City/State/ZIP: EUGENE, OR 97402
I Phone: 5413431681 Fax: 5413431683
I Email:
I Metro lie. no.: City lie. no.:
I Supervising Electrician's lie. no.: 13925
,;.,..
Supervising Electrician's Name:
HERMAN OLLAR
Number of inspections included in paid services:
Residential Service: 4
Reconnect Only: 1
All Other Services: 2
Upon review and approval by your local juris-diction, your permIt will be e-mailed or faxed
within one business day, with instructions on how to schedule your inspection.
\
NpTE: This Authorization To Begin Work expires within 180 days If a permit is not obtained.
Th~ local building department may determine that an Authorization To Begin Work is null and
void if it does not meet applicable land use laws and local ordinances.
Please check all that apply:
o A service or feeder beginning
at400 Amps where the
available fault current exceeds
10,000 Amps at150 Volts or
less to ground exceeds
14,000 Amps for all other
o Fire pumps
o Emergency systems
o Addition of a new motor load
of 100 HP or more
o Six or more residential units in
one structure
o Health care facmlies
o Hazardous locations
o A service or feeder rated at
600 amps or more
o Buildings more than three star
o Marines and boat yards
o Floating buildings
o Commercial-use agricultural
buildings
o Inslallation of a 150 KVA or
larger seperately derived sys
D "A" "E" or "1-2" or "1-3"
, ,
o Recreational Vehicle Parks
o Supply voltage for more than
600 supply valls nominal
I Description J Cty.
1$_~'~ic.es~:'~Me:-~~~-rS~~~-5?f'~?t :~-~~ ~(.:
I Services 200';mps or. less .
I Subtotal
I State surcharge (12% of permit
total)
I Technology fee (5% of permit total)
I TOTAL PERMIT FEE
'~
~
#,~~
..~\h .0-:
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Ea.
Total
$81.00
$81,00
$9.72
$4.05
$94.77
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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 OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00041
ISSUED: 01/12/2010
APPLIED: 01/12/2010
EXPIRES: 07/12/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1501 A ST I
ASSESSOR'S PARCEL NO,: 1703363202400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Replace burned out meierbase: Address on building says Unit A.
Residential
Owner: FIELDS JEFFREY WAYNE
Address: 1610 CAMEO DR
EUGENE OR 97405
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
OREGON ELECTRIC SERVICE
License
181997
Expiration Date
05109/2010
Phone
541-343-1681
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
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 I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
'Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped: .
Compact:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Sidewalk Type:
Storm Sewer Available: Downspouts/Drains:
Special Instruction: , S yOU to
N 0 egon law reqUire '\'
Notes: "JTlGE' AiTENiIO: r t dbythe Oregon UUlty
.f ('> . follOW rules adop e se rules are set forth
I ,/" PERMIT SHill I lOVnlnr ,r r ,_ ,,^t1fiQ'I!ion Center. ThO ....,}. nll.!'lQS2.()01-
~'UIHUI1IZED UNDER ,'-" ,,,, ""..-- In AR952-UUI-uv,~.I~;-i:SoftherUleSDJ
,OMMENCED OR IS AB~IS PERrvl'\rI~&a1fon DescriDtio~o. You may obta\l(No1e: the \e1~phon8
\NY j 80 DAY PERIOD NDONEJ !'Uti calling the cehnt~~~gon Utility No\ificallOn
, . .', $ Per Sq Ft Square ~ for t e M .,.,<).MA.4\_ .
DescriptIOn Tvpe 01 Construction I . I' B'd A "enter \8 M~ ~ate Calculated
or mn tlp,ler or I mount",
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Paee I 01"2
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"'I, CITY OF SPRINGFIELD
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Status
Issued
Building/Combination Permit
PERMIT NO: COM2010-00041
ISSUED: 01/12/2010
APPLIED: 0111212010
EXPIRES: 07/1212010
VALUE:
225 Fifth Street, Springtield, 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
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$9,72
$4.05
$81.00
J/12/10
J/12/10
1/12/10
3201000000000000007
3201000000000000007
3201000000000000007
Total Amonnt Paid
$94,77
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.
Rrollired Tnsnections I
Electric Service: Approval required prior to utility company energizing service,
By signature, I state alld agree, that I have carefnlly examined the completed application and do hereby 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 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 he 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 thefront of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM20 I 0-0004 I
COM20 I 0-00041
COM20 I 0-00041
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
3201000000000000007 '
Description
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ONLINE PERMIT CHGS
,
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 01/12/2010
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
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Page I of I
ONLINE oregon elect Online
serv
Payment Total:
IO:3J:17AM
Amount Due
81.00
9.72
4.05
$94,77
Amount Paid
$94.77
$94,77
1112/2010