HomeMy WebLinkAboutPermit Electrical 2010-5-5
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-37S3 . FAX: (541)726-3689
ELECTRICAL ~Ri'vI1T APPLICATION
City Job Number l.tLt11i/l/V - 00')70
1/ r;;C:-TION:::..r;s:;:..~;:,: 3. C01HPLETE FEE SCHEDuiE'BELOW
(jJ ':L-:2 ~/ NvnLLJarr ,'o" " .,. , .. ,
L\tt 03C,~;Rt\'O t)offO A. se::\~ ~::;::::ar - Si.ngleor,ivrul~"Fa""iIY perd'~~llini unii,
JOB DESCRIPTION 1000 sq. ft. or less $106.00
Each additional 500 sq. ft. or
portion thereof
:l.I1s7Jtl.6 c:--e.U.Y .,4~ ;.;)or 7U..b
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
S~spended for 180 ~ays. . .... .. ,
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2. . CONTR.4.CTOR'INSTArriHlc:"v,(?lft.~i
Electrical Contractor ~/V> ,J!,) If'ln_A--f c.
Address J-./ 1 'I oJ 1J..r eJ Av- a...
City ~IL/'" Phone 3<fj -7~'7 7
Supervisor License Number }.S;)-..6-.)
Expiration Dare lol, / ~ 10
Constr. Comf. Number
111-~-L.
Expiration Date
~/1.foc,
Signature of Supervising Electrician
~~
o rs Name ~ rn &a/(.0v .
Address 10:15 f'.Ji:6 ~mlJJ1r tJ0f
City::!(f:- ./ Phone
OWNER I ST ~LLATION
The installation is being made on property I ovm which
IS not mtenOea for S~ie. I as or rent
O ,. \0
wners :::lHmarure:, .
- '0' 0{Q/
~~
Date
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(5/6i9n~; - "
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
. ,,,. ..": ': ":,'" ::, "';:1;;~~",~;:",~:.,,,~,e,-::.: ,':~ \~,::::""7'." :", -', "::,'.,;,".; '>::.::<.'.~:),:, :,'''E \,
B. Services. or Feeders:~'JiIstalJaiion; Alterations or: Reloc:inon;:-:;}i
" -- '," ...., '.". .... ".- -., ;".':'- ". . ..- . .." '~"',' :.; , . -.'c':'O: ~
200 Amps or less
20 I Amps to 400 Amps
40] Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsiV 0 Its
Reconnect Only
$ 63.00
$ 75.00
$]25.00
$163.00
$375.00
$ 50.00
1,''','---
C. Temporary Servicc~ior:'l!'_~eder.5-~
InstnUation, Alterarion or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Ampsor 1000 Volts s,~e HB" above.
D. Branch Circuits. . .
$ 50.00
$ 69,00
$100.00
New Alteration or Extension Per Panel
One Circuit /
Each Additional Circuit or with
Service or Feeder Permit
6V
$ 43.00 '--..5'<5,
M /~, GO
E.
:\'Iiscellaneous (Service/feeder not included) -Each' Installation
Pump or irrigario!1
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
S 50,00
S 25.00
S 45,00
Minimum Elecrric Permit Inspection Fee is 545.00 + surc~arges60
4. S[]BTOT..!L OF ABOVE
S% State Surcharge
lO% .':"drninisrrative Fee
TOTAL
2,3
I f! J 7'
Shareci Drive!T::.rBuiiding rorms/E!e::rric;;l.j P=rmit A~pjic:ltion i.:}6.coc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 695 EDGEMONT WAY
ASSESSOR'S PARCEL NO,: 1703341306800
OJ'
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00570
ISSUED: 05/05/2010
APPLIED: 05/05/2010
EXPIRES: JI/05/2010
VALUE:
. .springfield TYPE OF WORK: Electrical Work Only
.._'7:,':"
PROJECT DESCRIPTION: Install electrical for hot tub
Owner: AUGUSTA P SIMPKINS TRUST
Address: 695 EDGEMONT WAY
SPRINGFIELD OR 97477
TYPE OF USE: New
Residential
I CONTRACTOR INFORMATIO~
Contractor Type
Electrical
Contractor' License
NEW REYNOLDS ELECTRIC 184921
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water.Type: "
'R*~ge Ti]i'e:' "
:"~iiergYP~th: .
'~pr;nkled;Building:
Expiration Date
0110212011
Phone
541-343-7297
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
. Occupant Load:
I DEVELOPMENT INFORM A nON I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
'.
REQUIRED PARKING
Total:
Handicapped:
Compact:
[ PUBLIC IMPROVEMENTS ~
ATTemm Ot8~'on law requires you to
toll,oVfl6WIF.lj:l6I1tSy&tilihy. the Oregon Utility
NotIfication Center. Those rules are set forth
In OAR 952-001-0010 through O!,R 952-001-
0090. You may obtain copies of the rules by
calling the center, (Note: the telephone
t Il I Icanon
Center is 1-800-332-2344),
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
lICE' ~~trnu(DeSCriPtion I
NO . SH,II.ll EXPIRE \""IO-L'~ ,
. , THIS PERMIT cli'c:'CUIS pEBhibT ~~t: r', Square Footage
DescnptlOn UTu:rl'iJe~!i<u\ll[lr. lIOiI . 'rn. Ji~" ..f B'd A
,II. nUr\l1.. \S I\B/'INDO?,!OU \IP leI' or I mount
COMMENCED OR
ANY 180 DI\Y PERIOD.
Pa~e I of2
Value
Date Calculated
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00570
ISSUED: 05/05/2010
APPLIED: 05/05/2010
EXPIRES: 11/05/2010
VALUE:
Status
Issued
, .,;.,"
Total Value of Project
Fees Paid .
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
""_.,,. ,
Amount Paid",,')'
,......,
.~ Date Paid
$8.04, ,; ,
$3.35'" .
$55.00
$12.00
5/5/10
5/5/1 0
5/5/10
5/5/10
Receipt Number
2201000000000000465
2201000000000000465
2201000000000000465
2201000000000000465
Total Amonnt Paid
$78.39
I Plan 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.
LReouired InsDections I
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete." .
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By signature, 1 state and agree, that I have carefully"ebmined the completed application aud do hereby certify that all
information hereon is true and correct, and I furthe~'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.
1 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 reqnired inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contract~rs Signature
. ";' ."','"
Date
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Paee 2 of2
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225 Fifth Street
SpriJlgfield, Oregon 97477
541-726-3759 Phone
~~~,
City of Springfield Official Receipt.
Development Services Department
Public Works Department
"e~ .1 ~
RECEIPT #:
2201000000000000465
. . ,
Date: 05/0512010
12:33:17PM
Paid By
JEREMY REYNOLDS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
55.00
12,00
8.04
3.35
$78.39
Job/Journal Number
COM20 I 0-00570
COM2010-00570
COM20 I 0-00570
COM20 1 0-00570
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
CreditCard
Amount Paid
nJm
070840 Online
Payment Total:
$7839
$78.39
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5/5/2010