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HomeMy WebLinkAboutPermit Electrical 2010-2-18 Electrical Permit Application lc- ~;; ;;,. -.u. . ",\" -, ,.- -. '''',..," "':.'ir:.# 1 '" .;icriY'01rSPRIN~EIE.JJn-"';40REG'ON~~ ~. ~m.'(d.",_ . .~~ . ':;?:. ", _ '::"""A"~"",..'''''''!-:''''. "- ~~ ' ''''':_ 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 .'.;. ..',' .-....... - DEp,t'RTMENTUSE ONLY Cowr'ZOIO- OOZ.! ( Permit no.: Date: '2 -;8- / D 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. . ,'. "'<.liOCAVGOVERNMENT"AF1F!RO"A~,,,('i;'!ti' Zoning approval verified? DYes D No ':, ::, "\ .: ':'CATEGORV$'OF::CONSTRUCTION':;". ".,' .: esidential 0 Government 0 Commercial ~;{i~i!~30B};SITEl~INfORIVIATIONt'AN[j~tOCA'1iION:~1;;(l:.t;\' . Job site address: '6 \ L 1"Ir-, ~t City: G", Y\ ~ e State 6 ZIP: Reference: 70 Z-.J '3 I Z- Taxlot.: OZ-lOO . . . DESCRIPTION OF WORK' ,.,. <''''':.'f;~.'':'' .': I\'ev- >f e- (10. Cr- 'no u ~c:. :PROPERTY OWNER Name: C ~I -n"'o......... 50-- Address: [51 ( S'(-f-l... ~ City: ,.; () Phone: E-mail: Signature: E-mail: CCB license no.:~ ~ ~\~~ \.\)'~ 440-2584-J (9/08/COM) Total . cost $134.00 $1 $ 25.00 $ $ 32.00 $ $ 63.00 $ Residential, per unit, service included: 1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Services or fe~ders: installation, alteration, relocation 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) $ 81.00 $ 95.00 $158.00 $205.00 $469.00 $ 63.00 $ $ $ $ $ $ : installation, alteration, relocation $ 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 panel a. Fee for branch circuits with purchase of a se'rvice or feeder fee: Each branch circuit b. Fee for branch circuits without purchase of a service or feeder fee: $ First branch circuit (2) Each additional branch circuit $ 55.00 $ $ 6.00 $ Miscellaneous fees: service or feeder ':lot included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or extension (2) Each"additioi)aJ~in.lipection: (I) $ 63.00 $ 63.00 $ 63.00 $ $ $ 13 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20iO-00219 iSSUED: 02/18/2010 APPLIED: 02/18/2010 EXPIRES: 08/18/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 81] 54TH ST ASSESSOR'S PARCEL NO.: 1702331202100 Springfield TYPE OF WORK: Electrical Work Only ':(' TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Rewire part of house Owner: THOMPSON CLEN H JR & JANIS K Address: 811 54TH ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor License COMPLETE ELECTRICAL INSTALLATION 184274 ~"ou\e I BUILDING INFOR 0\\1\\'1 "0\ (lJ ... \ot\ll _ _n"\:' Ole.... d '0'/ ~e ale 5'" ^"\_ ~tl\l'l"OI~~\4. el\l\e5 ~9GZ-UV R-3 ~\OW"'~BhWtS~\'0U9"O ~elu\el\'O'/ ~O\i\\Ca\~~~~\~1\ CO~\~l\ ~ \e\e~"OI\~n VB \IIo~~if\ll\l~ ~"'0\8'~ ",o\\\\cali ~\\~~901\ ~~~4)' t\\I\11~e\}l\l" i9t;1~: nla I DEVELOPMENT INFORMATION ~ Expiration Date 10/14120]0 Phone 54]-225-7827 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Sethack: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: .:~<:,.,~~,?;/:. Notes: I PUBLIC IMPROVE~ENTS I ~ \f1\\;'~ "01,;: \'\O\\C\WI\i s\-\~\.\.~~~~~....tQ...~. .F(:!'~' \\-\\'2>?t. IOn \)WJt:r,~IN".::c .... . \.r'i\\G\'.\lt.V O~ \S ^ ,.6:':'';:'' . IX GtJ\Wlt.~C~~ ?;.~\OU. .' . C(l.Wn?lQ Oil' Street Improvements: Storm Sewer Availahle: Special Instruction: I Valuation Description I Description Tvpe of Constrnction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e 1 of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Une Fee Description + 12% State Surcharge + 5% Technology Fee Residence Wiring 1000 Sq Ft Amount Paid $16.08 . $6.70' , $134.00 Total Amount Paid $156.78 Total Value of Project Fees Paid . I Plan Reviews ~ Date Paid 2/18/10 2/18/10 2/18/1 0 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00219 ISSUED: 02/18/2010 APPLIED: 02/18/2010 EXPIRES: 08/18/2010 VALUE: Receipt Number 1201000000000000151 1201000000000000151 1201000000000000151 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. I Reouired InsDections . Rough Electric: Prior to Cover Low Voltage: Prior to cover. Final Electric: When all electrical work is complete. By signature, I state and agree, that 1 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 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 at all times during construction. Owner or Contractors Signature Page 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~~Q...~"'"..~~~.... ....'.. ~!.. ; .m".Ii' : City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000151 Date: 02/1812010 2:49:2IPM Job/Journal Number COM20 1 0-00219 COM2010-00219 COM20 I 0-00219 Description Residence Wiring 1000 Sq Ft + 12% State Surcharge + 5% Technology Fee Amount Due 134.00 16.08 6.70 $156.78 Payments: Type of Payment CreditCard Item Total: Check Number Authorization Paid By Received By Batch Number Number How'Received CMPL TE ELCTRCL lNSTL TNS djb 049309 In Person Payment Total: Amount Paid $\56.78 $156.78 cReceintl Page I of I 2/18/2010