HomeMy WebLinkAboutPermit Electrical 2010-2-23
225 Fifth Street. Springfield, OR 97477.PH(541)726-3753+ FAX(541)726-3689
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DEF'~~TMENt USE ONLY.
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C-O/lf//Zoru . G023"7
Permit no.:
Date: -t-Z 3-/ 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.
. '\:L0CAL:)G0VERNMENT:' AF1F'ROVAUy;,i::"'.:'~1'i';":T!\.\,
Zoning approval verified? 0 Yes 0 No
::;,,::li!:;;,;;'(~c:ATEGORY,~OF,: ::CbN.StRUCTION~,'I!;"~<{: ,:,..;
~esidential I 0 Government T 0 Commercial '
~~.q;j,b,I3~SITEl1INFORM~..r;IONfAN[j"ltO.c'A'FION~!;,~~\\"
Job site address: Lf"l q I r II -<.---1 ( & Z (5-
City: 5 .---1.1 StatOR zfP:Cf'7'1I/
Referencel 170 'S"3 $2- l/ I Taxlo!.: J :13.00
.; ':.', : ~-;'. . "llESCRIPTION' G>F"'~W().RK!:'~'i}'F~;>~~~p~~Y~~:>,;c
~ I ."'~ 0 r'(J"_....r.LJ + P-..MJfn.E...Q.
'PRORERT~ OWNER I~-' T S, ::~~om:;oo::::;::)~,: ::::: ?~~~
Name: 1\..1.M h D. <:f...f-p M I'l 0 Jill". 401 to 600 amps (2) $158.00 $
Address: 1/J?<Ji) .SC.,o..r:tnv? -'I 601 to 1,000 amps (2) $205.00 $
City: 'Z'J', L.Jl-^ n State:~ R. zIPqiJ.../V I.J Over 1,000 amps or volts (2) $469.00 $
Phone:5~ -tLJR0 ti5?=?2.J!Fax: _ _ Reconnect ani: (2) $ 63.00 $
E-mail( , 1'1: ( re ol'f'\a"':f~\l~~_rs: installalion. alteration. relocation
This instN)ation is being made on residential or fa&-~ 'T' H'lIl~S ae p 9l!I<bVr1!\%Uii,si\}(Yset lortn, $ 63.00 $
owned by me or a member of my immediate fami .' ionce te :)/.:[ ~iII2j952.-UU~:. $ 87.00 $
property IS not Intended for sale, exchange, lease, 0 -0 . ,s..Q.\'1W "
479.540(1) and 479.560(1). In YOIIrn8 0 ~~~s.'-one $126.00 $
Signature: . 009,2,ilna the c n ~v . 'l'ldltWOa\llW,see services or feeders section above
, '3CONTRACrOR" INSTALlATION' ftUrnbef lOI " ~l :-4~\lij8taj\'\,1l", alteratIOn, extension per panel
Business name: (J,4 7Vf\tnV\ I ) ~ f t "Mtr \lUlU.. a. Fee for branch circuits with purchase of a service or feeder fee;
Address: Co (/J')'< lA)7'T.AI ;; ,/l r\(RP Each branch circuit 2, l $ 6.00 $/g;trc,
City: er-;l;;:SC1 ,v 6 (P b;~ ZIP:) b. Fee-for branch circuits without purchase of a service or feeder fee:
Phone!)'-/) ,-LA. '/ 6'/ ..... Fax: - - First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
E-mail: ~ I">
CCB license no.: -J f ",'1, o2j I BCD license no.:2 Z)... )1./ A ~
Signing supervisor's license no.: '<,'-J' 7 q ~:;
Print name of signing supervisor: I.' ,. 1LC7/? (j^ "ttrl'r ^,
S. f" . -.. I . ,(' -
19nature 0 sIgnmg supervlsor:t Nr, ~r7'1 f).. . 6.
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~':;~:~j:;:~~~i~~2~)~tf,)~:tG'it?fJ:,f;~S't.HEp_l.Jt!E_~:'~\~'f#rD1{tifttJt~:~\~W~t\~}f
. .... .,; ',':". . . ,j'. ,'1"""'" Cost", '. 'Total
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Residential, per unit, service included:
1,000 sq. ft. or less (4)
$
$134.00
Each additional 500 sq. ft. or portion
thereof
$ 25.00
$
Limited energy (2)
$
$ 32.00
Each manufactured home or modular
dwelling service or feeder (2)
$ 63.00
$
Services or feeders: installation, alteration, relocation
Miscellaneous fees: service or feeder ,:ot included
Each pump or irrigation circl.e (2)
Each sign, or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
$
$
$
$ 63.00
$ 63.00
$ 63.00
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Each additional inspection: (I) $58.00 $
?':i':(~"i4!f':'!&'i)::"'~'1k,!g!"'A'ri"i';-I'C"'A'N''''''U' -S"E'1','Ri'"r.i\io;,c'ite>3ik "/ ,I. , .~
fdl;\~)-:i.:'hl:i~1tl~):;;;&'ffi1i)i~;",,;j, ,_ _ r::Gi.;. _ l . ~I~"j::' _. _ ;-'1;.',Wi?i.i:,-,!~"'..;;lf;;;:Li~:'P':;~:S;:i\:',\.:::.V) u..,....---
(A) ~.~~_t.~~.:st!btoia'l~bf ~Ho~e- fees'
NOi\C~~ '. '(Minim~!ll . RHl)~or,
1\1\8 PERMli 51-\_ \lal&~IlI<[{\]) .
AU1HOR\7.EO UN ~~~[A]);:.
COMMENCED O~'" AL fe.~sa~d'sui:cliiirges (A through C):
" ANY 1 BO DAY P
440.2584-J (9/08/COM)
$ ~<'>L ~w-.,
,
$ J" <' '^ ti'2:T'
$ II. "'- p)1.80
4-1.,'rJl b
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00237
ISSUED: 02/23/2010
APPLIED: 02/23/2010
EXPIRES: 08/23/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetinn Line
SITE ADDRESS: 429 C ST APT I
ASSESSOR'S PARCEL NO,: 1703352413300
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Change services and aUer stove outlets in apts 1,2 and 3
Residential
Owner: HENDERSON LLOYD R & BEVERLY
Address: 4844 SCENIC DR
EUGENE OR 97404
I CONTRACTOR INFORMATION ,
Contractor Type
Electrical
Contractor License Expiration Date, Phone
W ALTER J CANNON 76304 09/09/2011 541-747-0959
BUILDING INYO~lleS Y~I~;'
,~~t:'l"V"" _. ~-rld~byt e egoO \.0....
,,,, ,..' Qr10pte Ie se , 'UI
\"".(#,iof<.s/o'i-ie-s;\tet, 1\1Ose lules a R 9S2-O~.t Size:
:,\o\:\Heig~PoCf'Sf~tI6W'\i'lIOU,gh ~t\he lulesllfFt 1st Floor:
\n OWI~;;'rw.,~'6btaiO capleS 0 \elephonliq Ft 2nd Floor:
009W~'{e\\Jt2Ib~\1tel. ll'lote: ,\~e NOiIt\aaUllll\ Ft Basement:
cRlill~~'ll'ie OlegO\1 U\~~~). Sq Ft Garage/Carport
\1\Efi~}'-~il{!!i Is 1-800.33 Sq Ft Other:
Sprinl<t.!'d'Building: n/a Occupant Load:
R-I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
VB
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Sctback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Covcrage:
Total:
Handicapped:
Cnmpact:
Notes:
I PUBLIC IMPROVEMEN~ ,." ,?~ 'f1\\'C.'N~Ol
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f>,\li\\O?\lt.~tl O\\\!~~~ . '"..' .
CO~~t.~C ~ ?t.?\Otl.
f>-~'{ ~ \)0 tlr>:
, .
Street Improvements:
Storm Sewer Available:
Special Instruction:
"
I Valuation Description I
Description
Type of Constrnction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of 2
Status
Issued
~~(;
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00237
ISSUED: 02/23/2010
APPLIED: 02/23/2010
EXPIRES: 08/23/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeclion Line
Total Value of Project
LFees Paid _ '
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 201 to 400 amps
Amount Paid Date Paid Receipt Number
$42,72 2/23/10 1201000000000000168
$17,80 2/23/1 0 1201000000000000168
$18,00 2/23/10 1201000000000000168
$243.00 2/23/10 1201000000000000168
$95.00 2/23/10 1201000000000000168
Total Amount Paid
$416.52
I PI~n 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 Insoections .
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
.Final Electric: When all electrical work is complete.
By signatnre, I state and agree, that I 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 inspecti6nsiiire r'eq',Yested at the proper time, that each address is readable from the
street, that the permit card is located at tbe front o(the prop~rty, and the approved set of plans will remain on the site at all
times during construction. >.
Owner or Contractors Signature
Date
Page 2 of2
229 Fifth'Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Reeeipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000168
Date: 02/23/2010
1:19:50PM
Job/Journal Number
COM2010~00237
COM2010~00237
COM2010-00237
COM20 I 0-0023 7
COM20 I 0-00237
Description
Penn Serv/Fdr 200 amps or less
Perm Serv/Fdr 20 I to 400 amps
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
'.'
: '. ,
Item Total:
Amount Due
243.00
95.00
18.00
42.72
17.80
$416.52
>
Payments:
Type of Payment
Check
raid By
W ALTER CANNON
Check Number Authorization
Received By Batch Number Number How Received
Amollnt Paid
djb
23217
In Person
Payment Total:
$416.52
$4 I 6.52
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2/23/2010