HomeMy WebLinkAboutPermit Electrical 2010-3-13
City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenter@ci.springfield.or.us
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Residential Electrical Authorization To Begin Work
69600-BEL-10-00111
Approval Code: 08596Z 3/13/2010 1:13 pm
E-mailedTo:revolutionelectric@comcast.net
1Zl1 or 2 family dwelling
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Job Address: 1070 MT VERNON CEMETERY RD
Please check all that apply:
o A service or feeder beginning
at 400 Amps where the
available fault current exceeds
10,000 Amps at 150 Volts,or
less to ground exceeds
14,000 Amps for all other
City/State/ZIP: SPRINGFIELD, OR 97478
o Fire pumps
o Emergency systems
o Addition of a new motor load
of 100HP armore
o Six or more residential units in
one structure
o Health care facilities
Suite/bldg./apt.no. :
Project Name: Mt Vemon Ct Rd
Cross Street/directions to job site:
o Hazardous locations
o A service or (eeder rated at
600 amps or more
o Buildings more than three stor
o Marinas and boat yards
D Floating buildings
D Commercial-use agricultural
buildings .
D Installation of a 150 KVA or
larger seperately derived sys
o "A", "E", or "1-2" or "1_3"
D Recreational Vehicle Parks
D Supply voltage for more than
600 supply volts nominar
Branch circuits with service or
feeder each circuit
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Phone: Fax:
Subtotal $141.00
Email: State surcharge (12% of permit $16.92
totaf
Technology fee (5% of permit total) $7,05
Elee lie. no.: C354 cce lie. no.: 179066
TOTAL PERMIT FEE $164.97
Business Name: REVOLUTION ELECTRIC INC
Contact:
Address: 2171 BIRCHWOOD AVE
City/State/ZIP: EUGENE, OR 974017409
Phone: 5415058351
Fax: 5415058454
Email: revolutionelectric@comcasl.net
Metro.lie. no.:
City lie. no.:
Supervising Electrician's lie. no.:
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52475
Supervising Electrician's Name:
MATTHEW L SCHULTZ
Number of inspections included in paid services:
Residential SeNice: 4
Reconnect Only: 1
All Other Services: 2
Upon review and approval by your local Jurisdiction, your permit will be e-mailed' or faxed
Nithin one business day, with instructions on how to schedule your inspection.
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~OTE: This Authorization To Begin Work expires within 180 days if a permit Is nototitained.
rhe local building department may determine that an Authorization To Begin Work is null and
"oid if it does not meet applicable land use laws and local ordinances.
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Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20]0-00320
ISSUED: 03/]5120]0
APPLIED: 03/]5120]0
EXPIRES: 09/]5120]0
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1070.MT VERNON CEMETERY R
ASSESSOR'S PARCEL NO.: 1802044201000
Springtield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Relocate electrical service andinstall.new panel
Residential
..
Owner: GATES RONALD GEORGE
Address: 1070 MT VERNON CEMETERY RD
SPRINGFIELD OR 97478
Contractor Type
Electrical
I CONTRACTOR INFORMATION I
Contractor License
REVOLUTION ELECTRIC, INC 179066
BUILDING INFORMATION I
Expiration Date
10/30/2011
Phone
541-505-8351
# of Units:
Primary Occnpancy Grnnp:
Secondary Occnpancy Gronp:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Strnctnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occnpant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback;
Rearyard Setback:
Solar Setbacks:
Overlay'Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total;
Handicapped:
Compact:
Street Improvements:
uires OU to
PUBLIC IMPROVEME rules ~dopted by the Oregon etfort.h
Those rules are s
NOtificatIO~fJ~ottMlUgh OAR 952-001-
In OAR 952 - b\AlR9J?iltli of the rules by
0090. You ftlllYtGl' t-rotihlie telephone
. calling %~ ~~~~e!~~ uiility Notification
IUJ1\b8f Center Is 1_800-332-2344).
Storm Sew"ll~wJ<lllle:
Speciallnstl-i,itfJ.\.it::
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
r:nMMnr
\r~Y i 80 DAY PERIOD.
Notes:
Description
Type of Construction
$ Per Sq Ft
or mnltiplier
Sqnare Footage
or Bid Amonnt
Valne
Date Calcnlated
".
01.",,( 1,;.:,....." I
'Paee I of 2
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'. ,:.,./ .." ~,.,
Status
Issued
~-~ CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00320
ISSUED: 03/15/2010
APPLIED: 03/15/2010
EXPIRES: 09/1512010
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-t
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$16.92
$7.05 .
$60.00. '. .t.
$8 \,00 _,_ ~
3/15/10
3/15/10
3/15/10
3/15/10
3201000000000000084
3201000000000000084
3201000000000000084
3201000000000000084
Total Amount Paid
$164.97'
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.
ReOliired Insnections I
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
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 La'~~ 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.
1 furtber 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 require~ inspections are requested at the proper time, that each address is readable from the
street, that tbe permit card is located at the front oUhe property, and tbe approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
,
Paee 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 #:
3201000000000000084
Date: 03/15/2010
8:02:IOAM
Paid By
ONLINE PERMIT CHGS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
NJM ONLINEREVOLUTI Online
ON ELECT
Amount Due
81.00
60.00
16,92
7.05
$164,97
Job/Journal Number
COM20 I 0-00320
COM20 I 0-00320
COM20 I 0-00320
COM20 1 0-00320
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee ,. .,"
Payments:
TYI)C of Payment
ONLINE CHGS
Amount Paid
$164.97
Payment Total:
$164.97
cRecclOll
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