HomeMy WebLinkAboutPermit Electrical 2010-2-18
Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
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- DEp,t'RTMENTUSE ONLY
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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
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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
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VB \IIo~~if\ll\l~ ~"'0\8'~ ",o\\\\cali
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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 ....
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. 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
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.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