HomeMy WebLinkAboutPermit Electrical 2010-2-23
Electrical Permit Application
225 Fifth SlTeet+Springfield, OR 97477+PH(541)726-375HFAX(541)726-3689
COW'! EOfO.O (:) Z 3
Penmt no.:
Date:
- 2~- /0
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
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Address:
City:
Phone:
E-mail:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
~ ~,
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NOTICE:
THIS PERMI
AUTHORIZEl tffAll EXPI
COMMENCED 0 DER THIS
ANY 180 DAV D R IS ABAN
VI~ERIOD.
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~S~
440-2584-J (9108/COM)
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 feeder (2) Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Its, see services or feeders section above
~ith purchase of a service or feeder fee:
$
without purchase of a service or feeder fee:
Each additional branch circuit
I $ 55.00 $ ~ ~
$ 6.00 $>0
Miscellaneous fees: service or feeder not 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 additional inspection: (1)
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
$ ..-'
I?:::.
$ 6'Z
$ lfey:
$ ~
Building/Combination Permit
PERMIT NO: COM2010-00239
ISSUED: 02123/2010
APPLIED: 02/23/2010
EXPIRES: 08/23/2010
VALUE:
,
,
Status
Issued
225 Fifth Street, Springfield, OR
541- 726-3 753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
SITE ADDRESS: 3735 OREGON AVE
ASSESSOR'S PARCEL NO.: 1702314300311
. Springfield TYPE OF WORK: Electrical Work Only
.. I.'
PROJECT DESCRIPTION: Kitchen remodel
TYPE OF USE: Alteration
Residential
I PUBLIC IMPROVEMENTS ~ _.,,;,:.~,,(:'c'. .
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Owner: BOLLENBAUGH TERRY & M A
Address: 3535 OREGON AVE
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION ~
Contractor Type
Contractor ile~~~e
. n \a'N leo,u on U\I\I\'/
,r,,0<10 li_'e~h
I':nei ' Buii,.mN<i"&" .. :00\-
\O\\~~~\lon Ge\\l~" ~ 0 \\'IloU9 \\M lules n'l
NO\\ Ivp, 952.-0(o'r'SW~~'cO\l\es 0 \e\e?,,0~8
R-3106 'IoU IH<I~\lXJ ~\l\QtfU,~~e l'lo\i\ica\iOn
009" \\'I1!~'1l~' (\ U\IIIW 44)
VB C~~~~l \(W~i\.Il\ l\P800-332-23 . .
l\ CRQ\ll!e ype:
Energy Path:
Sprinkled Building:
"- .
-' , '.
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
n/a
I DEVELOPMENT INFORMATION ~
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: '
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Speciallnstrnction:
Notes:
Description
Tv"e of Constrnction
$ Per Sq Ft Sqnare Footage
or multiplier :....' o'r Bid Amount
,',
Paee I of 2
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occnpant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
--".~'. ,-..-,' ,''-''-'- , CITY OF SPRINGFIELD
WiL '.
,
'"'__f' :; Building/Combination Permit
..".-..,",::....".- .' J
Status Issued PERMIT NO: COM2010-00239
225 Fifth Street, Springfield, OR ISSUED: 02/23/2010
541-726-3753 Phone APPLIED: 02/23/2010
541-726-3676 Fax EXPIRES: 08/23/2010
541-726-3769 Inspection Line VALUE:
Total Value of Project
I Fees Pllid .
Fee Description Amount Paid Date Paid Receipt Number
+ 12% State Surcharge $10.20 n" 2/23/10 1201000000000000169
,it.:; ,
+ 5% Technology Fee $4.25 . 2/23/10 1201000000000000169
Add, Alter, Extend Circ $55.00" 2/23/10 1201000000000000169
Add, Alter, Extend Circ Ea Add $30.00 2/23/10 1201000000000000169
Total Amount I'aid $99.45
I Plan Reviews ~
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 InsDect~
Rongh Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefully ~xamined 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 Date
Paee 2 of 2
..
, ....,....,~ .
iira
City of Springfield OffieialReceipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
1201000000000000169
Date: 02/23/2010
1:39:16PM
Job/Journnl Number
COM20 I 0-00239
COM20 I 0-00239
COM20 I 0-00239
COM20 I 0-00239
Payments:
Type of Payment
CreditCard
cReccintl
Description
Add, Alter, Extend Circ
. Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
55.00
30.00
10.20
4.25
$99.45
Paid By
ROGER KING
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 03584c In Person
Payment Total:
$99.45
$99.45
Amount Paid
Page I of I
2/23/2010