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
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I DEPARTMENT USE ONLY I
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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:
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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
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,..Springtield TYPE OF WORK: Electrical Work Only
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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..,.. ~
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Notes:
bi;' '
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Paee 1 01'2
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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 ~.
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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
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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:
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