HomeMy WebLinkAboutPermit Electrical 2010-5-17
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CITY OF SPRINGFIELD
Building/Combination Permit
-PERMIT NO: COM201O-00615
ISSUED: 05/17/2010
APPLIED: 05/17/2010
EXPIRES: 11/17/2010
VALUE:
Status
Issued
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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PSITE ADDRESS: 6808 IVY ST
ASSESSOR'S PARCEL NO.: 1802031400900
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: One circnit for pond.
Owner: DIAL JAN & DONNA
Address: 6808 IVY ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Contractor
OWNER
License
Expiration Date Phone
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BUILDIl,i"G,j'NFORMATION I
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# 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:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION ~
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Notes:
NOTICE:
THIS P I "VDID" Ie T
AUTHORIZED UNDER THI& PFgMJT.,(~ WriT' .. I
COMMENCED OR IS ABANO'.?,'.:.'5flm-,rJescnPtlOn
ANY 180 DAY PERIOD $ Per Sq Pt Square Footage
Type of Construction'
or multiplier or Bid Amount
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
ATTENTION: Oregon law r
I PUBLIC IMPROVEMIDlOf&iatiD;Centtr eTh Y the Oregon Utility
~t-\i!\ 952.J1fl ' ose rules are setforth
, ' 0090, You rirJ1yt~\lftaUJJl" 9/l8~gh OAR 952-001_
, . II' n C,QPI!lS of the rul b
,.3'iZ ','P., ',ca rng theO!lm!I!90~Mtlf6~ms: es y
;::1f.. ' ' ,.., number for the Or~gon Uii/'t e ~el~~hone
1" Center is 1-800'332~k4~~flcalion
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
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Description
Value
Date Calculated
Pagelof2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00615
ISSUED: 05/17/2010
APPLIED: 05/17/2010
EXPIRES: 11/17/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541- 726-3 753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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'. Total Valne of Project
I Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid
Date Paid
Receipt Number
$6.96
$2.90
$55.00
$3.00
5/17/10
,5/17/10
5/17/10
5/17/10
2201000000000000505
2201000000000000505
2201000000000000505
2201000000000000505
J
Total Amount Paid
$67 ;86 '
I Plan Reviews 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, insp,ecti,?n,~requested after 7:00 a.m. will be made the following
workday. :':e~; "4";'-' '
-'
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, .
I Reauired InsDect~
Rough Electric: Prior to Cover
, Final Electric: When all electrical work is complete.
By signature, 1 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 Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure witbout 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 con~~~o
"5-1,- 10
Date
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Paee 2 01'2
Electrical Permit Application
225 Fifth Street. Springfield, OR 97477tPH(541)726-J75JtFAX(541)726-J689
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';: . .DE~f}~TMENT USE ONLY
-
Permit no.: (!-/(J - 00&/')
Date: $-/7--,0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
.' , . '-;'lObCAL:GOVERNMENT~,l\~~ROVAl!:;,'.."",;';!-'ii"r\:
Zoning approval verified? D Ves D No
;:: "["i!:.:;,:a,C,l\TEGORy.iioF;;CONSTRUCTIONt,iif'-:"':.;' ,.'
(;2fResidential D Government D Commercial
~~1li\9()B;i;SI]E~!INF()RMATIQNi".l\ND!'jtQcA;r,ION\li.lm~~1~
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'PROPERTYOWNER :.
Name:
City:
Phone:$(i -
E-mail:
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) an 79.5
Signature:
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
ZIP:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (9/08/COM)
t~;?<<~~~"ff:~:Ati(f~~~~,f~l~?~i~Z.1F"eE~2:s-c.H E_P_U,[jEt~~~f~~~t~[iir~\~f~<~~~
;N~II!~erofinip~,~ti~~lp,~r)i~8().:;;!; 1~y.;~~t "1~;~1.
Residential, per unit, service included:
1,000 sq. ft. or less (4)
Each additional 500 sq. ft. or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 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)
401 to 600 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
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) J $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
,~ .,--~ ~ s,Ej;;~~~:,;+;~:!~~~;~!f~tl~~~;;';:~J: .:~:'~
'"-~ ~
~ rer-sITDtotal ofabnve-fe~
~ (Minimum Permit Fee $58.00
\")""o, '"" surcharge (.12 x [A])
(C) Technology Fee (5% of[A])
TOTAL fees and surcharges (A through C):
$ Sf", a.::J
$ ~_ t'v
$ ?_< 90
$ (;,7. X{"
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000505
Date: 05/17/2010
9:07:19AM
Job/Journal Number
COM20 I 0-00615
COM2010-00615
COM2010-00615
COM2010-00615
Payments:
Type of Payment
CreditCard
cReceintl
Description
Add, Alter, Extend Circ . " ,(".;
Minimum! Adjustment Electrical"';
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
JAN DIAL
Amount Due
55.00
3.00
6.96
2.90
$67.86
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
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$67.86
$67.86
o 1732P In Person
Payment Total:
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5117/2010