HomeMy WebLinkAboutPermit Electrical 2010-2-5
'Electrical Permit Application
225 Fiftb Street. Springfield, OR 97477+PH(541)726-3753+FAX(54J)726-3689
COoM 2:.0(0 - . _
Permit no.: 0.01:::'3
I Date: Z- - '5' - I 0
This permit is issued under OAR 918-309-0000. Permits are nontransferable, Permits expire jfwork is not started within 180
days ofissuance or if work is suspended for 180 days.
1~'ilI:'!fm1flllll~l!~CA~C;()VERNMENTIARRR()VAL!c~~!fmJli'GJ!'
1 Zoning approval verified? 0 Yes 0 No
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1~~~~~~~~lmEm'N~~RG~i;~~~'~ND](~~C~;~~~;\f 1 ~~~:::ti:t,:,~:s:~~~ service included: $134.00 $13 l{
I Job site address: Vi' 'ZJ-) . bl( \,u..,r ('>( :<\ I ~~~~;ritional 500 sq, ft, or portion $ 25.00 $ I
I~~~~~~~, i~~~~:~:~~:::",~",~ i: !
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1 Address: (' i'iN _ ~p9Lr-/~ 1 I 601 to 1,000 amps (2) $205.00 $ 1
1 City:S~ VYJG 1 State:tiL- -rzip.{,' I Over 1,000 amps or volts (2) $469.00 $ 1
1 Phone: 411 &~4S--d do<::.l Fax: _ lbtlQM, . OJ Reconnect onty (2) , 1 1 $ 63.00 1 $ 1
I E-mail: :~ OJ fi-..ces or feeders: il'lstallat ion, ~lteration, r~location I
This installation is being made on residential or. ' III ~Ih~_~ to I $ 63.00 $ I
owned by me or a member of my immediate fami i ilia.. thl\9.4 I 'Ii '(Iffy 1 $ $ I
property is not intended for sale, exchange, leas "".., u, If, I 87.00
479.540(1) and 479.560(1). forthe. ..1eiP1'JFI'f.'':; ~-OO1. $126.00 $ 1
E~r;:T~~~~~~;::';~=~::" i
I Address:"s,"Sr,7Lt CnV'<'Q'; ~Y--<A\p ~ 1 Each branch circuit I 1 $ 6.001$ 1
I Cityr_~e><.v\:)~ "" 1 State: c"\~ I ZIP: 9'1~ 1 h. Fee for branch circuits without purchase ofa service or feeder fee: 1
1 PhoneG41.z;zf:~7'6e.? 1 Fax: 'I 1 First hranch circuit (2) I I $ 55.00 I $ I
I E-mail: I -I Each additional branch circuit $ 6.00 $ I
I CCB license no.; \<2l.1? '74 1 BCD license no.: C:'J-iL+1 1 1 Miscellaneuus'fees: service or feeder notinc/uded I
! Signing supervisor's li~ense ll(~.: ~~7--=:; ;..- I I Each pump or irrigation circle (2) $ 63.00 $ I
I Print name of signing supervisor: fVk:I't-r Co r Cre,./ 1 1 Each sign or outline lighting (2) $ 63.00 $ 1
I Signature of signing s pervisor: A"~ "" V"1 I I Signal circuit or a limited-energy panel, $ 63.00 $ I
. u #' ~/?' / ~ / alteratIon, or extension (2)
. ~ 1 Each additiunal inspectiun: (I) $58.00 $ 1
~OTICE: ~- ~.~.'SJ ~t:\O
HIS PERM ~''','','- " b:~@~
~UTHORIZEff JHAH ExP/~~;'~ti,;~'ii"t,\"",~.
A~~l~~NCED O~~:~ THIS PERMW-1s "':RI(,
, DAY PERIOD. ~DONED FOR.:~~f'
.'\ .~, ';'r,,~.t~:!~>:,)\.::.;~~l~!:.:
440-2584-J (9/08/COM)
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
1 (3) Enter 12% surcharge (.12 x [A])
1 (C) Technology Fee (5% of[A])
1 TOTAL rees and surcharges (A through C):
$ 1'5 <-j
$ J bO (I>
$ , 670/
$ 156 I.?t..
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00153
ISSUED: 02/05/2010
APPLIED: 02/05/2010
EXPIRES: 08/05/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1434 WATER ST
ASSESSOR'S PARCEL NO.: 1703274408100
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
#of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Buildi\i: ' nla
. - '1,,11
~\~~~Xcfi\ll~TION 1
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o ," '. ,,\\'Ie OI9\l:" ,,!>:z.~"
ce.\\\~~. \01 \\'I~ ,.. ,.&aU--
t\U"- C61!)iiJBLlC:IMPROVEMENTS I '
. ~-
.-- Sidewalk Type:' \f ,\\"- ~~, .
. C~. DoWn~t'C'~}~tl\\lI~ ~
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I Valuation Descriptio/}1
PROJECT DESCRIPTION: House rewire and panel change
Owner: PONDER HAROLD D JR .
Address: 1434 WATER ST
SPRINGFIELD OR 97477
I CON:~C:T.?R IN~ORMATION.I
Contractor Type
Electrical
Contractor License
COMPLETE ELECTRICAL INSTALLATION 184274
BUILDING INFORMATION 1
# of Units:
Primary Occupancy Gronp:
Secondary Occupancy Group:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VB
Front yard Setback:
Side I Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
..
Street Improvements:
Storm Sewer Available:
Special Instruction:
..
Notes:
Description
$ Per Sq Ft
or mnltiplier
Square Footage
or Bid Amonnt
Tvpe of Construction
Pa2e I of 2
Residential
Expiration Date
10/14/2010
Phone
541-225-7827
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq FtBasement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
, Handicapped:
. Compact:
Value,
Date Calculated
CITY OF ~rKll"t.FIELD
Building/Combination Permit
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
't"._ .
PERMIT NO: COM2010-00153
ISSUED: 02/05/2010
APPLIED: 02/0512010
EXPIRES: 08/05/2010
VALUE:
Status
Issued
.J, 'T',
~"
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Residence Wiring 1000 Sq Ft
Amount Paid
Date Paid
Receipt Number
$16.08
$6.70
$ 134.00
2/5/10
2/5/10
2/5/10
2201000000000000106
2201000000000000106
2201000000000000106
Total Amount Paid
$156,78
I Plan Reviews I
To Request an inspection call the 24 hour re!,wrding.at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, ins'~ections requested after 7:00 a.m. will be made the following
work day. .
Re(].ui~~d Insnections I
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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,eontractors and employees wbo 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 atall
times during construction.
, ..,~' l.'
Owner or Contractors Signature
," ")"
,,', '.;
Date
Page 2 of2
22S Fifth Strcct
Springficld, Orcgon 97477
541-726-3759 Phonc
Job/Journal Number
COM2010-00l53
COM20 I 0-00 153
COM20 I 0-00 153
Payments:
Type of Payment
CreditCard
cReceintl
. RECEIPT #:
Description
Residence Wiring 1000 Sq Ft
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
CMPL TE ELCTRCL INSTLTNS
City of Springficl~ Official Rcceipt
Dcvclopment Scrviccs Dcpartmcnt
Public Works Dcpartment
2201000000000000106
Datc: 02/05/2010
Item Total:
, :q' . ,Check Number Authorization
Received By Batch Number Number How Received
djb
050164 In Person
Payment Total:
,., "
"
':", 'f
'.;.fr
Page I of I
9:15:24AM
Amount Due
134.00
16.08
6.70
$156.78
Amount Paid
$156,78
$]56.78
2/5/2010