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HomeMy WebLinkAboutPermit Electrical 2010-4-5 Electrical Permit Application ,v'" . .', l~",.'-'. _,-:-~~.t'+ ' ......-"'-"'. ,,,:~.,,,_, ':-;"JO.i;.",.;:~, ~ ..... '<' ~,,,,\_, :CITYOF SPRINGEIEI.;D-',.OREGON.t. :.f".'..~, ~....'i :._ ;;>~-~ "I'I ",~J .., i-I j!Q~;..~'\ ~ '"':.:''i!,:Jc~e! ,;t-.." ~~,~, '. .; ,;_,,~,..J ~,- 225 Fifth Street. Springfield, OR 9747HPH(541)726-3753+FAX(541)726-3689 DEPARTMENT USE ONLY Permit no.: (! /0 ~ ~I J' Date: --5 -- /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. . . lOCAL: GO\lERNMENT APPROVAL>':" Zoning approval verified? DYes D No ..,.'.CA TEGORY;OFCQNSTRUC1}ON:,' ~ Name: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479,560(1), Signature: E-mail: CCB license no.: Signing supervisor's license no.: Print name of signi.ng supervisor: , Signature of signing supervisor: ~V~ ~*. ~oQ/ '0 'k~~Q/ ~~ 440.2584.J (9/08/COM) .' )y,\:.{!t4~~:~:~q1t1r~-';-i:-~E~%SCR EJiXJG'E:i: :~'1 ":;;:-i'i,1;;t~!X.tf~~i;:~~~~~:f*~i! _ c , Cost Total Number" of..inspectio:ns per item: ( ) Qty. . .',' -.', .'. .... --";.-,'i--,, ~~." cost Residential, per unit, service included: 1,000 sq. ft. ar less (4) $134,00 $ Each additional 500 sq, ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ $ dwelling service ar feeder (2) 63.00 Services or feeders: installation, alteration, relocation 200 amps ar less (2) ) $ 81.00 $,;'/00 20 I ta 400 amps (2) $ 95.00 $ 40 I ta 600 amps (2) $158.00 $ 601 ta 1,000 amps (2) $205.00 $ Over 1,000 amps ar valts (2) $469.00 $ Recannect anly (2) $ 63.00 $ Temporary services or feeders: instal/ation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 ta 400 amps (2) $ 87,00 $ 40 I ta 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ 6.00 $ 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 ar autline lighting (2) Signal circuit or a limited-energy panel, alter,!tion, I?r extension (2) $ 63.00 $ $ 63.00 $ $ 63.00 $ Each additional inspection: (1) !>f,;;;;;(i1~5~~i-.ili'~;'~'Ap"etJlb-ANm'i'tJsEt~::. (A) Enter subtatal af abave fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) (C) Technalagy Fee (5% af[A]) TOTAL fees and surcharges (A through C): $58.00 $ :j.;~:~;;.~\'~:;: .'-';:, .,;,";:: $ 5"/60 $Y:4: $ ~.o.,- $ 9'7: 77 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00415 ISSUED: 04/05/2010 APPLIED: 04/05/2010 EXPIRES: 10/05/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 404 C ST I ASSESSOR'S PARCEL NO.: 1703352410600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Service change Owner: COLEMAN-FRASER SUSAN Address: 404C ST SPRINGFIELD OR 97477 I CON'fRAGT0RINFORMATlON , Contractor Type Electrical Contractor . License COMPLETE ELECTRICAL INSTALLATION 184274 BUILDING INFORMATION' Expiration Date 10/14/20 I 0 Phone 541-225-7827 # of Units: Primary Occupancy Group: Secondary Occupllncy Group: Primary Construction Type Secondllry Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Rllnge Type: . Energy Pllt": . Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GllrllgelCarport Sq Ft Other: Occupant Load: nlll I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Afn:'iiJ'ff' '""~; .~.f9I/ow rUI~sN~~;egon law requires you.~o PUBLIC'IMP. ' ter. Those rules are setforth 001 0 throuQ~ OAR 952-001 0090.. You may obtailiiOO~JfJtfla: rules b . callmg the center. mWI1;.lbllt~e y number for the. Oregon Olmly Notification Center IS 1-800-332-2344). Frontyard Setbllck: Side I Setback: Side 2 Setback: Rearyard Setbllck: Solar Setbllcks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description NOTICE: I Valuation Description I THIS PERMIT ~~lsnfIRE IFTijj;,WPmbt Type of C~i1~Jf~fWZED YflJlri~RiJi~\S PERMl,t ~J@;o:~; COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD: Value Date Calculated Paee I of 2 " ,~.~ .,::, CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-004I5 ISSUED: 04/05/2010 APPLIED: 04/05/2010 EXPIRES: 10/05/2010 . VALUE: . .."..\.. ...~:.. ~::"'-'" Status Issued ;'\. 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Yalue of Project LFees Paid , . Fee Description + 12% State Surcharge + 5% Technology Fee Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $9.72 $4.05 $81.00 4/5110 415110 415110 2201000000000000318 2201000000000000318 2201000000000000318 Total Amount Paid $94.77 I Plan Reviews i ";,>A~; ,",,' ":';;:l'~ "i.e..;).- ',< ~,. .. 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 to utility company energizing service. By signature, 1 state and agree, that I bave can'fuIly.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 structnre without permission of the Community Services Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 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. , .,.: ~?;i,;f~:,. :J;::;"~ ~~~;'\: '. ~''';~'";' Owner or Contractors Signature Date Pa2e2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000318 Date: 04/05/2010 10:00:26AM Item Total: Amount Due 81.00 9.72 4.05 $94.77 Job/Journal Number COM2010-00415 COM20 I 0-00415 COM20 I 0-00415 Description Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee . '-'" Payments: Type of Payment CreditCard Paid By COMPLETE ELECTRICAL Check Number Authorization Received By Batch Number Number How Received Amount Paid njm 080905 In Person Payment Total: $94.77 $94.77 r .: ". , . \' .;: , " cReceiotl Page 1 of I 4/5/20 I 0