HomeMy WebLinkAboutPermit Electrical 2010-2-23
225 Fifth Street. Springfield, OR 97477'PH(54J)726-375H FAX(541)726-3689
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Permit nO.:
Date: z- Z 3 - /0
ElectrIcal Permit Application
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.
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Zoning approval verified? 0 Yes 0 No
~;:I~lr',"~"~.CATEGORy;;mFiTc:bN~TRUCTI()Ni}v;.:, .\,.
o Residential l.Er6overnment I 0 Commercial
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Job site address: ~ 9f( 5, I Y ~
City: C 'P FJ:> I State:,cV2 I ZIP:
Reference: 1703:5 (; ~ I Taxlot.:OO r60
.".. '. ......DESCRIPTION; Of WORK"ii,,\,r'''''iy,,;,,,I'';'
IIJ V/l/I II !i7'--e --I-n JVCYIIV--e.r+
I:) D tJ --j,:p ;;t '-/0 1/ /11-e.-f<-e-r 200 amps or less (2) / $ 81.00 $ 11"/ -
. 'PROPERTY OWNER,;. 201 to 400 amps (2) $ 95.00 $
Name: C 1"+ Y o-f'-"'?::? F..b (401 to 600 amps (2) $158.00 $
Address: 2 Z ~ s;-+t,... '5-r- 601 to ],000 amps (2) $205.00 $
City: <; '? Fb I State.oC'L I ZIP: '} 7l(77 Over ],000 amps or volts (2) ",'. ,,,..., $469.00 $
Phone: S'C{ \ --72{, - J7S] I Fax:' _ _ j ~~ct only (2) $ 63.00 $
E-mail: N~It<llU~~Ol~g.li.!~eders: installation. alteralion, relocation
This installation is being made on residential or farm property~ ~In I ~ ~;:-'.Iefl ~bY th;";F..!T reS yo ,-- $ 63.00 $
owned bJ: me or a member of my immediate family. This o. MID'iiJ.U.Rl1rlil6rlfii:e~e rUles ;~un tJ il;ij, $ 87.00 $
prop. erty IS n..ot..lOt.ended fO. r sale, exchange, lease, or rent. OAR Ii ~ 0 'y' nit'..
479540(1) and 479.560(1). . IIu "'~$:1 &:JDi:~' 'AR 95~.iC:" $126.00 $
Signature:. ". .. . tAle;';;;;, ~~O mi~e~ fUl8!t'bW feeders section aboye
.. :cCONTRAC"[ORINST ALLATION" Br;~~~ (ll,.lni$oi';:''l1/tYr~'l;.~~n per panel
Business name: -a/o I? yW,..J Ei~~)C a. Fee for branch circuit~~ff~A>urchaseffl a service or feeder fee:
Address: PIP /? - L,(D 'I $I Each branch circuit $ 6.00 $
City: A/h I State:~ I ZIP:9 7~r;:- b. Fee for branch circuits without purchase ofa service or feeder fee:
Phone: _ _ 9~s--0:9..!l-i Fax: _ _ First branch circuit (2) $ 55.00 $
E-mail: Each additional branch cir~uit $ 6.00 $
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. Cost'
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~
Total'
.. cost,
Residential, per unit, service included:
1,000 sq. ft. or less (4)
$134.00
$
Each additional 500 sq. ft, or portion
thereof
$ 25.00
$
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$ 32.00
$
$ 63.00
$
Services or feeders: installation, q/teration, relocation
CCB license no.: /1103.29 l BCD license no.:
Miscellaneous fees: service or feeder ~ot included
$ 63.00
~^y t>,.>--\) .
l:'I ~ ~<J(
o V: t;j
~
440-2584,J (9/08/COM)
Signing supervisor's license no.: ;5 (9/7 S Each pump or irrigation circle (2)
Print name of signing supervisor: Ke:> C )<,/ '77/{P K!.}..lJlJ N Each sign or outline lighting (2)
Signature of signing supervisor: A A" /""\ /J (...L :::2)jiltgnatl CIrCUIt orta hmlte(d2-)energy panel,
./ .LJ a era Ion, or ex enslDn
'-;t' j' Each additional inspection: (])
NOTICE_ __
THIS PERMIT 8 (A) Enter. ~p,~t:otal of above fees
AUTHORIZED HALL ~mum Pe'i'iiin Fee $58.00)
X'.~fo{~CED ~XDER 2iJ ~INOitJ(]2 x [A])
~~~pm!gD~ :~~::~(Afu~"q,
$ 63.00
$
$
$
$ 63.00
$58.00 $
~~
$2'/~
$ 972-
$ l.{O~
$ 91{ 77
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00234
ISSUED: 02/23/2010
APPLIED: 02/23/2010
EXPIRES: 08/23/2010
VALUE:
_R~,N91!1~~
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 298 S 18TH ST
ASSESSOR'S PARCEL NO.: 1703360000500
Springtield TYPE OF WORK: Electrical Work Only
TYPE OF'USE: New
PROJECT DESCRIPTION: Convert 120v service 240v service
Owner: CITY OF SPRINGFIELD
Address: 202 S 18TH ST ATTN SPRINGFIELD UTILITY BRD
SPRINGFIELD OR 97477
Contractor Type
Electrical
I CONTRACTOR INFORMATION I
Contractor " . '., ,License
THORNTON ELECTRIC INC "',, 116329
I BUILDING I'NFORMATlON I
# of Units:
Primary Occupancy Group:
Secondary Occupaucy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
, # of Stp'rie~quileS yOU to
EN'TlON: 01ft~flOf~lr~lln Utility
~TT ules ad~W~Y;t~a""s ale set lonh
101l0w r . rn'IUI~ 952.-001-
tilieation CentW'at &Wjh OAR
No OAR 952-001-~h ~1~lt\S 01 the lules by
~090. 'fou may ,tli\ g , 1!!'t\1e te'~~hO~~n
!ling the ee!3t.~.o tili\i'l1l.\lPtl\ICat nla
ea. ~,,~e'Oie ""44\.
llUlllf. ; . "I Ilo.3e2-
i JiJ d~P\\1'ENT INFORMATION ~
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Public
Expiration Date
08/21/2010
Phone
541-686-4151
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
"". ),t<,~~;",~'0'4.~~~rH:i..{I!~'" '.
I PUBLIC IMPROVEMENTS ( \Rt. \f 1\\~ ~Q1 j,
,~O\\~~~~\i S\\f>.\Rf{~\'S'~~ ,,;:,;:j,:::
F;j~~\'\O?IIE\) \l~~ IS ~\3~"'~~o~,~S/I?rains: '
, ~OI'J\\iJ\t~Ct.~ ?ERIQ\).
",~'1 ~ S\) \)
Street Improvements:
Storm Sewer Available:
Speciallustruction:
Notes:
I Valuation Description ~
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tv pc of Construction
Paee I of 2
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00234
ISSUED: 02/23/2010
APPLIED: 02/23/2010
EXPIRES: 08/23/2010
VALUE:
225 Fifth Street, Springfield, 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 Fcc
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$9.72
$4.05
$81.00
2/23/10
2/23/10
2/23/10
1201000000000000163
1201000000000000163
1201000000000000163
Total Amount 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.
L Reauired InsDections ~
Electric Service: Approval required prior to utility company energizing service.
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 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 arc in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all j'equired inspections arc 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.
Owner or Contractors Signature
Date
"
,"r
Paec 2 of2
225 .fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
~ii.
City of Springfield Official Receipt.
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000163
Date: 02/23/2010
10:11:23AM
Paid By
ROCKLIN THORNTON
Item Total:
Check Number Authorization
Received By Batch Number Number How Re,ceived
djb 00588a In Person
Payment Total:
Amount Due
81.00
9.72
4.05
$94.77
Job/Journal Number
COM20 1 0-00234
COM20 I 0-00234
COM20 1 0-00234
Description
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
Cred itCard
Amount Paid
$94.77
$94.77
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cReceintl
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