HomeMy WebLinkAboutPermit Electrical 2010-3-29
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERlViIT APPUCATION
City Job Number ~/ D - 3 ? G"
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JOB DESCRIPTION
. 3!cJQj;D
Date
3. 'rmMEDETEFEE'SCHEDUJ:,EJBEJ)CHV,i''S^''''
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
;(! €-
$ 19.00
Permits are non-transferable and e ire if work is
not started within 180 days of issuance or if work Is
Suspended for 180 days.
Each Manufact'd Home or
. Modular Dwelling Service or
Feeder
$50.00
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2. Ji,J;{r:{{!~~2!!.:1JVS'{1ff5H1>Tr!ON\O)VI'iY/
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Electrical Contractor
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
" 60 I Amps to 1000 Amps
Phone () fl r; tJ/- 935, / Over 1000 AmpsN oIls
,/1.5'-1 Reconnect Only
(,I/p/<)
1011/1'-
Constr. Contr. Number ' ;'09 f(iP t/
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$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$~
fe:! 00
Address ).. 57/) tj
S.A1Q.v1Ji.
o
City
c. ,:'~trlfptft:a'rykS~!o/it~s\o'r4:'fe~a~,rs~~'
Supervisor License Number
Installation, Alteration'or Relocation
I
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D B' "'Ii'''':' '.'"
'1-,ranc .'i,~I~CUlJS_)('i"i'
Expiration Date
$ 50.00
$ 69.00
$100:00
Expiration Date
Signature of Supervising Electrician
. j)p!~~
Owners Name OJ ~c,
Address ?t/t. D ,/h. e..~'r/aPe.
City <)" r Phone 9I-7G~
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
~owners Signature: ~
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O.J~ v \.,\
~ ~nspection Request: 726-3769
~ateSurcharge (2-PJ()'
j9%'Administrative Fee ("k
TOTAL
'7?!::.-
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rr~ . '7 /
~~"'\ ~~~e~ ~'S ~ ~\oo\ WV,(Tl/BUilding FnrnWEloclrical P,nnilApplication I-Oldoc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00376
ISSUED: 03/29/2010
APPLIED: 03/29/2010
EXPIRES: 09/29/2010
VALUE:
SITE ADDRESS: ,2460 HARVEST LN
ASSESSOR'S PARCEL'NO,: 1703234401000
Springfield TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Reconnect electrical
TYPE OF USE: Alteration
Residential
Owner:
Address:
ALVES JOSEPH E SR & SHERYL K ;.,~". . ,,.U\O
2460 HARVEST LN ileS ,/0 '\W#'
SPRINGFIELD OR 9747;,n"0(\ la~::~,e~O(\,,~~~ot\~
:\\0"" ~ leO \11 - \eS ~24>'
1>:r~~~Ules a~~~,. \~ :;_!~IRMATlON .
\01;0 iClJ,\\O(\ C \ .00\ ~ co?le \ela? - _.\ftt\
,(5Ii~b;l!Pfo~~'4 O'o\lJ,\(I'~O\e" \"a ~o\l\iC--- License
il) S(~ ' '0(\ '0\1\\\'/ 1\4). 109864
ClJ,\I\~a' \0' \"~ is DING INFORMATION
I\U{{\ Cellle
Contractor Type
Electrical
# of Units:
Primary Occupancy Group:'
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction :
Notes:
Description
I PUBLIC IMPROVEMENTS ~
Expiration Date
01/14/2011
Phone
541-935-2154
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basemeut:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Haudicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
I Valuation Description ~
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Paee I of2
I:;': i" ,
Value
Date Calculated
':.. If: i...,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00376
ISSUED: 03/29/2010
APPLIED: 03/29/2010
EXPIRES: 09/29/2010
VALUE:
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Status
Issued
225 Fifth Street, Springlield, OR
54]-726-3753 Phone
541-726-3676 Fax
54]-726-3769 Inspection Line
Total Value of P.-oject
: 'J . Fees Paid4
Fee Description
+ ]2% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$7.56
$3.15
$63.00
3/29/10
3/29/1 0
3/29/]0
2201000000000000284
2201000000000000284
220]000000000000284
Total Amount Paid
$73.7]
l~, ..:,
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.
I Reouired InsDections ~
Electric Service: Approval required prior, t~..utiiity coinp~l1"y 'energizing service.
Final Electric: Wben all electrical work is ciihiplete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all .
information here?n is true and correct, and I fnrther 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 structnre without permission of the Commnnity Services Division, Building Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project.
I fnrther agree to ensure that all required inspections are reqnested at the proper time, that each address is readable from the
street, that the permit card is located at the front oflhe. propefty, aild. the approved set of plans will remain on the site at "II
, ~"I ,- "
times ring construction. ' ~', !'
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Owner or Contractors Signature
Dale
Paee 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 #:
"
2201000000000000284
11:27:46AM
Date: 03/29/2010
Job/Journal Number
COM20 1 0-00376
COM20 1 0-00376
COM20 1 0-00376
Payments:
Type of Payment
Check
cReceintl
Description
Service Reconnect
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
DELLS ELECTRIC
Item TotaJ:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
63.00
7.56
3.15
$73.71
Amount Paid
cjc
$73.71
$73.71
1789
In Person
Payment Total:
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