HomeMy WebLinkAboutPermit Electrical 2010-4-16
EleCtrical Permit Application
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-I;:ITYUF SPRINGFIELD":OREGON' -~-
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225 Fifth Street+Spdngfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
SPRINGFIELD ~
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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.
LOC~LOClVERNMENT APP~()VAL'.;.'
Zoning approval verified? 0 Yes 0 No
. .CATEGORy;iOFCONSTRWCtIOI'l}'
0'Residenlial
l~ift1;:;~tOB;SJrE.
Job sile address:
Cily: S
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,Num.l?er 6fj~specti():n~ per .,i.t~.~;:(.).. . Total
. ,-' . - -. . . cost
Residential, per unit, service included:
1,000 sq, ft, or less (4) $134,00 $
Each additional 500 sq. ft. or portion $ 25,00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63,00 $
dwelling service or feeder (2)
Reference:
Name:
City: .
Phone,
E-mail:
Business name:
Address:
City:
Phone:
E-mail:
CCB license no,:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (9/08/COM)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95,00 $
40 I to 600 amps (2) $158.00 $
60 I to 1,000 amps (2) $205,00 $
Over 1,000 amps or volts (2) $469,00 $
Reconnect only (2) $ 63,00 $
Temporary services or feeders: installation. alteration, relocation
200 amps or less (2)
20 I to 400 amps (2)
40110600 amps (2)
$ 63,00 $
$ 87,00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
$ 55.00 $
$ 6.00
Miscellaneous fees: service or feeder ~ot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
altera.tion, <lr extension (2)
Each additional in.~pecnKifr(i
$ 63,00 $
$ 63.00 $
$ 63,00 $
$58,00 $
$ , z-
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$
$
$ Ilf ()~
CITY OF SPRINGFIELD
Building/Combination Permit
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2009-0I364
ISSUED: 09/16/2009
APPLIED: 09/16/2009
EXPIRES: 10/16/2010
VALUE:
Status
Issued
SITE ADDRESS: 718 18TH ST
ASSESSOR'S PARCEL NO.: 1703362114400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Install feeder from house to detached garage
Owner:
Address:
'1'.":'.
ETTA JEAN MCLAWS REVOCABLE:",TRUST'
2112 5TH ST :i' "
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
License
Contractor
OWNER
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constroction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water T~e: equireS you to
p.TTE~H\ON: R\\ii?~lt W~e Oregon Utility
toiloW rules aIl~erg~ .!t~:ru\es are set forth
Notification CESp~f~~~Rjf"iJWl!lAA 952.oo1.1a
m\J':'j'3'~
OO~~\Ii: the Oregon Uti I Y \
number lor " LAA".......2-2344,.
centQlI:\$lar-lSl'~'"
'#Btreef'frees Rqd:
,Paved Drive Rqd:
% of Lot Coverage:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Resideutial
Expiration Date Phone
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq.Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
'. Compact:
Sidewalk Type:
N OTI ct" "~,:,, "tI,.",::''-;;''';' Dowlf~p'oiits/D rains:
THIS PERMtT SMAt~ V~~~~~~':fl~~~~
AUTHORIZED UNO~ ABANDONED fOR
I ' AMY 1RODI\Y PHl1~O.
Valultfi"on DeSCription' ~
Notes:
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Paee I 01'2
1.....-.
<LJ;~ ~, '~;,
Value
Date Calculated
'.
".,;.
,"I..
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
,[, FeesPaid~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$9.72
$4.05
$81.00
$1.44
$0.60..",}"
$12.00':Y:
, '
:."h
',J' ,':.
Total Amount Paid
$108.81,,;,
I Plan Reviews ~
9/16/09
9/16/09
9/16/09
4/16/10
4/16/1 0
4/16/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01364
ISSUED: 09/1612009
APPLIED: 09/16/2009
EXPIRES: 10/] 6/20] 0
VALUE:
Receipt Numher
2200900000000001044
2200900000000001044
2200900000000001044
2201000000000000365
2201000000000000365
2201000000000000365
To Request an inspection call the 24 hour recording at 726)769. 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.
".1."-
Rea'uired InsDections ~
Underground Electric: Prior to cover
Final Electric: When all electrical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
~~'l f ,'.
By signature, I state and agree, that I have carefulli"~Qami~ed the completed application and do hereby certify that all
information hereon is true and correct, and I furthefcertify tIiat any and all work performed shall be done in accordance with
the Ordinances of the City of Springlield 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 ensnre 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.
~if~
y
Owner or Contractors Signature
~op.
"1.
','
Paee 2 of 2
4-/b~/tJ
Date
225 Fifth Street
Springfle'ld, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
"
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,2201000990000000365
Date: 04/16/2010
8:24:29AM
Job/Journal Number
COM2009-0 1364
COM2009-0 1364
COM2009-0 1364
Payments:
Type of Payment
Cash
Change
Description ,', '
Add, Alter, Extend Clrc Ea Add
+ 12% St~te Surcharge
+ 5% Technology Fee
Paid By
MICHAEL EATON
MICHAEL EATON
Amount Due
12,00
1.44
0,60
$]4.04
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
djb
$15,04
($100)
$14.04
In Person
In Person
Payment Total:
Job/Journal Number
COM2009-0 1364
COM2009-0 1364
COM2009-0 1364
Payments:
Type of Payment
Cash
Change
cReceintl
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
12,00
1.44
0,60
$]4.04
Description
Add, Alter, Extend Circ Ea'Add
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MICHAEL EATON
MICHAEL EATON
Amount Paid
djb
dj1J'
'l'~')(}t
$1504
($100)
$]4.04
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\',..
.I""
In Person
In Person
Payment Total:
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Page I of I
4116/20 I 0