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HomeMy WebLinkAboutPermit Electrical 2010-4-12 Electrical Permit Application 225 Fifth Street+Springfidd, OR 9i~77. I'H(541)726-3753+ FAX(S,u)726-36M9 SPRINGFIELD ';;s,:'::""';!..I:;~ . . J i'i -., r. ~t~ ~.~... _4;i';.,~. ~r~,~ ~~'!1..:t,\;'~Yr ""'~~Jf,!--'. ~_'f:":.....c ~~~'}:~~~;. ." ~.:.-; I DEPARTMENT USE ONLY I ~nEOID- 00 L{ 5.31 Date L( -/2- ~I D This permit is issued under OAR 9] 8-309-0000. Permits are nontransferable. Permits expire if work is not started within] 80 days of issuance or if work is suspended for ]8'0 days. Reference: ~ Name: Address: Fax: Phone: E-mail: This installation is being made on residential 0 owned by me or a member of my immediate fali1'\ property is not intended for sale. exchange, leas 479.540(1) and 479.560(1). Signature: CCB license no.: \ Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ~ - ~~'j1 ,\. ~ro~ E-7 ~'-SJ ,Q "\ 0' tx.: ~ ~Q/ . ~ l\o't\t~ 1\"1\S VE~~~ f:>-\lI\"1()~\l€ co~~tJ>\C f:>-~'{ ~ 5Q t) 440-2584-J (9/08/COM) !,\'umber of inspections per item () '0'. . Total cost $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ Residential, per unit. service included: 1,000 sq. ft. or less (4) Each additional 500 sq, ft, or panian thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Services or feeders: insraffalfon, alreralion, relocation 200 amps or less (2) $158.00 $205.00 $469.00 $ 63.00 ceders: installalion, alteration, relocation S 63.00 $ $ 87.00 S $126.00 S Over 600 amrs or J ,000 volts. see services or feeders section a~ove Branch circuits: new, alteralion, extension pn palle! a, fee for branch circuits with purchase of a service or feeder fee: Each branch circuit S I b. Fee for branch circuits without purchase of a service or feeder fee: I Firsl branch circuit (2) S I Each additional branch circuit $:? O! Miscellaneous fees: service or feeder nol included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or e~~~H.sjg.r,::{i!t~;)':" 0 Each additional in $ 63.00 S S 63.00 $ S 63.00 I S $58.00 I S ~% surcharge (.17 x lAD C) Technology Fee (5% of [AD TOTAL fees and surcharges (A through C): 1 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00453 ISSUED: 04/12/2010 APPLIED: 04/12/2010 EXPIRES: 10/12/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 451 W QUINAL T ST ASSESSOR'S PARCEL NO.: 1703274100101 ,'..,:j " ,;,.;,,,~ ' ,..Springtield TYPE OF WORK: Electrical Work Only '::-:,.'\' , , , ... y,); TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Fire damage ' i.' " Owner: HOUSING AUTHORITY & URBAN Address: 177 DAY ISLAND RD EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type General Electrical Contractor License J REDDING LLC" 160672 BEAR MOUNTAIN ELECTRIC LLC' 136298 BUILDING INFORMATION ~ Expiration Date 07/09/2010 08/1212011 Phone 503-620-2215 541-741-8844 # of Stories: Lot Size: Height ofStructnre Sq Ft 1st Floor: Type of Heat: . S >lOU'iFt 2nd Floor: l\Ulle , ' . Water Type: " la'/'l Ie go" U\I Ft Basement: lla.1Ui'tiO,IIW Ple~~d''o'l \\\e o~ealese\\~ 'tt Garage/Carport ~~I~\l!ll~O\l i\\OSe Iule O~f\ 95'2..~ tJ Other: ~ ci~~~\\\'OU~~~~\\e'U\~~~l.pant Load: DEV ' l'lo\iliCa\iO calli,,9 \\\e Oleg 0_332-2'344). ~~b\~\el is ,_80 # Street ~ees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING # of Units: Primary Occnpancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VB Front yard Set hack: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: I ::. "I~ Sidewalk Type: .~ ,-~ ,>".'- ~ Downspouts/Dr;ain,SiP.1tti..,.. ~ , ' ,~,:"!:",.,,,,. \\t. ~Q~~ :: . ~?\~t \~ \t\S ~Q1 .'~ "01\Ct. NI~ S~~\.\. 1\\\S ?t~llIU f()? '.;,::>. ,\,\\S ?t"'\ltU \)~Ut? ~~~~U()~'2 ,,0 ;, r>.\l'\'\()~~CtU Q~ \SQ~ ,'" " " . COtJIW\ a\) ~r>.'/ ?t~\ . " r>.\'!l'/ '\u Notes: bi;' ' .~tf'~; r ~ . Paee 1 01'2 ':'. '.. . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00453 ISSUED: 04/12/2010 APPLIED: 04/12/2010 EXPIRES: 10/12/2010 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description , Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project I : fees Paid ~ . :F' . , ~ '1 Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ScrvIFdr 200 amps or' less Amount Paid Date Paid Receipt Number $13.32 $5.55 $30.00 $81.00 4/12/1 0 4/12/10 4/12/10 4/12/10 2201000000000000346 2201000000000000346 2201000000000000346 2201000000000000346 Total Amount Paid $129.87 Plan Reviews ~. .'.l ,"'.\ " 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. Reouired Insnections ~ , Rough Electric: Prior to Cover .. ,\ i ;~"" ;:.,,:' 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 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 Oregou 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 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. . '., Owner or Contractors Signature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000346 1 :20:22PM Date: 04/12/2010 Job/Journal Number COM20 1 0-00453 COM20 1 0-00453 COM20 1 0-00453 COM2010-00453 Payments: Type of Payment Check cReceintl '..,,', Amount Due 81.00 30.00 13.32 5.55 $129.87 Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By HORIZON RESTORATION Item Total: Check Number Authorization Received By Batch Number Number I-Iow Received Amount Paid djb 1146 $129.87 $129.87 In Person Payment Total: 'li~, ! -.... ,.' ,. Page 1 of 1 4112/2010