HomeMy WebLinkAboutPermit Electrical 2010-3-29
225 Fifth Street. Springfield, OR 9747HPH(541)726-375HFAX(541)726-3689
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DEPARTMENT USE ONLY
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Co_zoiC> ~oos.7.8
PermIt no.: .
Date: ~.Z, "/C:>
This permit is issued under OAR 918-309-0000. Permits are nontra!)sferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
<COCAL(t;30VERNMENT "A~PROVAC~"1\;"\
Zoning approval verified? 0 Yes 0 Na
,,".CMEGORY'OFCONSTRUCTION'/:" -.
G1l Residential 0 Gavernment 0 Cammercial
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f. State: V".. ZIP: 97'17
D:>25"33 Taxlat./~7C C
DESCRIPTION, QF'WORK'\'
Jab site address:
City: S'
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Un' .e.
Name:
Address: 'iJ~bl-7
City: ~&'
Phone:
E-mail:
.e..
7lfO;-
Business name:
Address: s,,~
City:S r n
1"1
e.A--
Jb3/5
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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440-2584-J (9/08/COM)
Residential, per unit, service included:
1,000 sq.ft. ar less (4)
Each additianal 500 sq. ft, ar partion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service Or feeder (2)
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amps ar less (2)
201 to 400 amps (2)
40 I to 600 amps (2)
60 I. to 1,000 amps (2)
$ 81.00 $ .5
$95,00 $
$158.00 $
$205,00 $
$469.00 $
$
$ 63.00 $
$ 87.00 $
$126.00 $
volts, ~ee services or feeders section above
: new, alteration. extension per pane!
ranch circuits with purchase of a service or feeder fee:
$
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 ou}line lighting (2
$ 63.00 $
$- 63.00 $
$ 63.00 $
$
a:t:~;!;i(~J~>}L;~;Y';o'
$ t'/
$ .,
$ 'fD~
$ ?-'I77
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00378
ISSUED: 03/2912010
APPLIED: 03/29/2010
EXPIRES: 09/29/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1312 MODOC ST
ASSESSOR'S PARCEL NO.: 1703253314700
Springfield TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Service change
TYPE OF USE: Repair
Residential
Owner: STEPHEN & JODIE WIZE JOINT REYOCABf
Address: 85627 DILLEY LN
EUGENE OR 97405
Contractor Type
Electrical
I CONTRACTOR INFORMATION i
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
n/a
I DEVELOPMENT INFORMATION i
Expiration Date
0211912011
Phone
541-505- 7223
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
,..
DownspoutslDrains:
I Valuation Description I
$ Per Sq Ft
or multiplier
Sq uare Footage
or Bid Amount
Type of Construction
Paee I of2
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Value
Date Calculated
~' ~ ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00378
ISSUED: 03/29/2010
APPLiED: 03/29/2010
EXPIRES: 09/29/2010
VALUE:
.. ...Lt?,f ~~,,;:, e:..4 ',,,,.
. .;<:':: ~ .,.r. i :1" l .
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~ Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$9.72
$4.05
$81.00
3/29/10
3/29/10
3/29/10
1201000000000000270
1201000000000000270
1201000000000000270
Total Amount Paid
$94.77
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f1.an 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 Reauired InsDections I
Electric Service: Approval required prior to utility COmpan)" energizing service.
I I , !'
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify lhat all
information hereon is true and correct, and I further cerlify lhat 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
streel, that the permit card is located at the front of the proper"ty, and the approved set of plans will remain on the site at all
times during construction. .'. ;;:,;1:, .".".;0:. ::-" .
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Owner or Contractors Signature
Date
"I'
Pa2e 2 of 2
225 Fifth Street
Springfil~ld, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000270
Date: 03/29/2010
I :49:28PM
Job/Journal Number
COM2010-00378
COM20 I 0-00378
COM20 I 0-00378
Description
Penn Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
CreditCard
Paid By
AZAP ELECTRIC
Item Total:
Check Number Authorization
.' "" ~ ,-,.
Received By Batch Number Number How Received
Amount Due
81.00
9.72
4.05
$94.77
Amount Paid
djb
472517 In Person
Payment Total:
$94 77
$94.77
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