HomeMy WebLinkAboutPermit Electrical 2010-5-20
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Electric-al Permit Application
225 Fifth Street. Springfield, OR 97477 +PH(541)726-3753 +FAX(541)726-3689
,')" .. bE~~RTMENtUSE ONLY
Pennit no.: C/U - (:;/7
Date: S~d-O~ /0
This permit is issued uuder OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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Zoning approval verified? D Ves DNa
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PROPERTY OWNER
5,,- if.5
Dc,y; y 5t-
State: 0 f-
Name: ~dS G.-
Address: )1)<\ '-1
City: sP FL..-[)
Phone:5~I -SID_ 'lZ-o"
E-mail:
ZIP: 97478
Fax:
This installation is being made on residential or fann 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) and 479.560(1)/: )
Signature: /(?'7j,~4/~
.CONTRAClOR INSTAllATION
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
Signature of signing supervisor:
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440-2584-J (9/08/COM)
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Residential, per unit, service included:
Total
ellsf.
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)
Services or feeders: installation, alteration, relocation
200 amps or less (2)
20] to 400 amps (2)
40 I to 600 amps (2)
601 to ] ,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
$ 81.00 $
$ 95.00 $
$158.00 $
$205.00 $
$469.00 $
$ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I 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 of a 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)
Each additional branch circuit
$ 55.00 $ 0-:::: c-
$ 6.00 $
Miscellaneous fees: service or feeder 'Yo! 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: (1) $58.00 $
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(A) Enter subtotal of above fees
(Minimnm Permit Fee $58.00)
(8) Enter'12% surcharge (.12 x [A])
(e) Technology Fee (5% of [A])
TOTAL fees aud surcharges (A through C):
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$ 0,d~
$ :J _ ~_o
$ 07-x0
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00617
ISSUED: 05/18/2010
APPLIED: 05/17/2010
EXPIRES: 11118/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5094 DAISY ST
ASSESSOR'S PARCEL NO.: 1702333301729
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: install ductless split
Owner: 'SANDERS MARC
Address: 5094 DAISY ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION ~
, -
Contractor Type
Electrical
Mechanical
Contractor
OWNER
J COO INC
, ,
License
Expiration Date Phone
169209
BUILDING INFORMATION ~
0510612012 541-746-7065
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type: _ '00 \0
# of Bedrooms: (\0\\Q~) \)\\\\\'1
\?;\N {B ';"'~eQ,O'0 \ \o{\'n
~ol' ,- \'-,Q \), '8 se ,,\-
((:).v. ,\_.1 .\- ,.. <;;\.\ \J
:\1\:,-\'1\1 . :'a.60\W\~Ose \,~~ Of'~e LOPMENT INFORMA T10N
" \\110 \,\01. \\110'-' 0\ \I,
\0110'IJ \\01' ce : .00\ 0 co?\eS e \ele? _'\On
._'. _,,\\~~ _ ~ QO ' \a.\I' . \\1 \\\Ie- .
Fronl}Un:!~t!f.lel{. a.'J 0'0 \.\,\o\e. 'li\'J \,\0 Overlay D.st:
Side I '5'e'tlJ~~1>!0\l ': cel'W\e90l' ~'2--'2-~~~). # Street Trees Rqd:
Side 2 ~g~W,9 \\10\ \\le.o \.'(;,';)0- Paved Drive Rqd:
Rearyard ~!\w.'Q>fI\::\ e\\\e\ \S . % of Lot Coverage:
Solar Setb~Cks: G .
# 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
REQUIRED PARKING
Total:
Handicapped:
Compact:
,'.'i-'C
Street Improvements:
Storm Sewer Availablli:
Special Instruction:
I PUBLic IMPROVEMENTS ~ \-It.IJIJORY'
~,~t II' \ C' "0\
O"'\C\:: "Side,iyalk Typ,e'l:I Ie>"
~i I . 1\ S\-II"\..'- ~ S I'l:.nW\ R
\\-IIS I't.R\'J\ \It-lDffoJ~~~\)Wl\ii.rP.
f>,\l\\-IORI1t.D \) OR IS f>,'Oi\i
CO\'J\\'J\t.t-ICt.f>,'i I't.RIO\).
f>,t-I'i ~ \\0 \)
Notes:
Paee 1 01"3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726"3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00617
ISSUED: 05/18/2010
APPLIED: 05/17/2010
EXPIRES: 11/18/2010
VALUE:
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
tbe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUP ANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employe~s 'Who ,.ire"in compliance with ORS 701.005 will be nsed on this project.
I fnrtber ag~ee to ensnre tbat all required inspectio,~s ';'re requested at the proper time, that eacb address is readable from the
street, that the permit card is located at the front of,ihe property, and the approved set of plans will remain on the site at all
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Owner or Contractors Signature
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Date /
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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I Valuation Description r
Description
Tvne of Construction
$ Per Sq Ft
or multiplier
Square Fnntage
or Bid Amount
Total Value of Project
~
Fee Description
+ [2% State Surcharge
+ 5% Technology Fee
[st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend C;rc
Minimum/Adjustment Electrical
Amount Paid
$9.48
$3.95
$79.00
$6.96
$2.90
$55.00
$3.00,,:.;:
'r.::'.
Total Amount Paid
''''"\If'l
$[60.29 . .
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IPI'an Reviews I
Date Paid
5/18/10
5/18/[ 0
5/18/10
5/20/10
5/20/10
5/20/10
5/20/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00617
ISSUED: 05/18/2010
APPLIED: 05/17/2010
EXPIRES: 11/18/2010
VALUE:
Value
Date Calculated
Receipt Number
2201000000000000524
2201000000000000524
2201000000000000524
1201000000000000505
1201000000000000505
1201000000000000505
1201000000000000505
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.
~.DI~ir~rUnsne~tions ~
Rough Mechanical: Prior to Cover
Final Mecbanical: When all mecbanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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Pa~e 2 of 3
225 Fifth Str~et
Springfield, Oregon 97477
541-726-3759 Phone
iliO
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2010-00617
COM20 1 0-00617
COM20 I 0-00617
COM20 I 0-00617
Payments:
Type of Payment
CreditCard
cRcceiot 1
RECEIPT #:
Date: OS/20/2010
I :49:49PM
1201000000000000505
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1"1" ",-"
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MARC SANDERS
Amount Due
55.00
3.00
6.96
2.90
$67.86
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
.:.-"
Amount Paid
0066942 In Person
Payment Total:
$67.86
$67.86
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