HomeMy WebLinkAboutPermit Electrical 2010-3-22
Electr-k.al Permit Application
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225 Fiflh Slreel.Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
SPRINGFIELD ~
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.DEPARTMENT USE. ONLY
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Pennit no(]::;M;?eW- ~
Date: 3-J--2--- .t-f3"
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
. "l!OCP,.VGOVERNMENT.'Ap'PROVA('.,,,::~. tV.?".
Zoning approval verified? 0 Yes 0 No
"" ';;'CATEGORV:'OF:CONSTRUC1'ION';;;">"
o Residential 0 Government 0 Commercial
~~ttili~OB;{SITE;'INFORMATIONt:AND~(;Oc'AtloN~.t'~r'Tj.~.
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Name:
3.e;T
ZIP:4
Address:
City:
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent OAR
479.540(1) and 479.560(1).
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440.2584.) (9/08/COM)
"":~'.~;t~.'t_;~?~l~~~~~:':~~ FEE~~' SC H ED_(ftEI:\\'J.~!t~~~;];Wf;R1.t;~F1.1!
Number'ofinspe~tionsper itim()', Qty. Cost, Total
:.....,' ,-....' ". ,.;:..,_....~'".,!__.':'~"......_.. ,;','ea~.;' ;-'cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft, or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or fee~er (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2)
20 I to 400 amps (2)
40 I to 600 amps (2)
60 I to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00 $
$ 95.00 $
$158.00 $
$205.00 $
$469.00 $
$ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per pane!
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)
Each additional branch circuit
l $ 55.00 $
::} $ 6.00 $
Miscellaneous fees: service or feeder '!ot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
S'ignal circuit or a limited-energy panel,
alteration, or extension (2)
$ 63,00 $
$ 63.00 $
$ 63.00 $
Each additional inspection: (I) $58.00 $
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(A) Enter subtotal of above fees
$
(Minimum Permit Fee $58.00)
(8) Enter 12% surcharge (.12 x [Al) $
(C) Technology Fee (5% of[Al) $
TOTAL fees and surcharges (A through C): $
,
$l'!'''rf.aCiI!!;IEt!-~'
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00343
ISSUED: 03/22/2010
APPLIED: 03/22/2010
EXPIRES: 09/22/2010
VALUE:
225 Fifth Slreet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 360 21ST ST
ASSESSOR'S PARCEL NO,: 1703361306900
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Residential
PROJECT DESCRIPTION: Altering 2 and Adding 2
Owner: FOLSE PAUL J .
Address: 1160 W 15TH AVE APT 303
EUGENE OR 97402
Contractor Type
Electrical
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Contrac ptification Center. Those rules are 8J1ti~e
MY ELE ,.()Q1 0 through OAR 1.
oaIl1ngtl1umiBl\~IIl~~
number ~regon UlIIIlY ....omlSll8h
Center ~'SKl~-2344).
R3 Heighl of Structure
Type of Heat:
VB Water Type:
Range Type:
Energy Path:
Sprinkled Building: No
Expiration Date
11/20/20 II
Phone
541-729-1454
# ofUnils:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Conslruction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft I sl Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION ~
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
(Yo of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Slorm Sewer Available:
Special Instruction:
. _CIMPROVEMENTS.
THI ". '.. .
AUTHO~~Mrr BHAll ExPIR """"",Sidewalk Type:
COMMEN~~l,UI\IDER THIS k: THE ~outs/Drains:
ANY 180 D ~P,OR IS-ABANDON MIT IS NOT
~y PERIOD. ED FOR . .
NOles:
I Valuation' Description ~
c
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20I0-00343
ISSUED: 03/22/2010
APPLIED: 03/22/2010
EXPIRES: 09/22/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Tntal Value of Project
Fees Paid ~
Fee Description
+ 12% State Snrcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid Date Paid Receipt Numher
$8.76 3/22/10 2201000000000000266
$3.65 3/22/10 2201000000000000266
$55.00 3/22/10 2201000000000000266
$18.00 3/22/10 2201000000000000266
Total Amount Paid
$85.41
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
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work day. "
ReQuired Insoections ~
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereb}' 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 tbe Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structnre withnut 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 be nsed 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 during construction.
(~.. ..QIJJ ~ ~!29-1 /i)
Owner or Contractors Signature Date
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Page 2 01'2
225 Fifth Street
Springfield;.Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
22010000000000~0266
Date: 03/22/2010
9:37:16AM
Paid By
MY ELECTRICIAN
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
55.00
18.00
8.76
3.65
$85.41
Job/Journal Number
COM20 I 0-00343
COM20 I 0-00343
COM20 I 0-00343
COM20 I 0-00343
Description
Add, Alter, Extend Clrc
Add, Alter, Extend Clrc Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
CreditCard
Amount Paid
KLK
KLK
014045 .In Person
Payment Total:
$85.41
$85.41
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3/22/20 I 0