HomeMy WebLinkAboutPermit Electrical 2010-6-10
Electrical Permit Application
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TITY'OF -'SPRINGFIELD",(jREGbN:'~:l
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225 Fifth Streett Springfield, OR 97477. PH(541)726-3753+ FAX(541)726-3689
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DEPARTMENT USE ONLY,
LO........COl6- 00 7Sj
PermIt no.:
Date: b-/O-/O
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 ]80 days.
'LOCAL'GOVERNMENT . APPROVAG":,<'i'.'
Zoning approval verified? DYes D No
i ':', ,CATEGORY:!OF,CONSTRUCTION)\' ,
Residential 0 Government 0 Commercial
~i.'!ti2;j.OEl;:,SIJ:E:;INFORNlATIONiTAN[j;Il(jCAtION;M;~!PXn
Job site address: /.( ,,-:7'
City:
~ t-(;
70~ 15/ ::s Taxlot.: 13boC
DESCRIPTION, OF WORK'"";,,,
r
Name:
7' 'iIr OS'
,
Phone:s</
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) and 479.560(1),
Signature:
,CONTRACTOR INSTALLATION
.xfk'l.
Address:
City:
Phone:
E-mail: ,..;J..
CCB license no,: /O,f-;).o1...
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor,
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NOTICE: ~'-~.".., ~~
THIS PERMIT SHALL EXPIRE IF THE WORK ..j>
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR .'
ANY 180 DAY PERIOD.
440-2584-1 (9/08/COM)
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Total
'. cost
Residential, per unit, service included:
],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 I to 400 amps (2)
40 I to 600 amps (2)
601 to I
$
$
$
$
$
$
40] to 600 amps (2)
$
$
$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 se'rvice or feeder fee:
Each branch circuit
$
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Mjscellaneous 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,
alteration, Or extension (2)
$ 63,00 $
$ 63.00 $
$ 63.00 $
$58.00 $
Each additional inspection: (I)
;i~:~:::;-:f~~"!{$:.~~~il'tYMf~~~;AR'ei2IcAN*~2:U$.E~'~~i~~i:\
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter ]2% surcharge (.]2 x [AD
(e) Technology Fee (5% of [AD
TOTAL fees and surcharges (A through C):
.;~?~Lfr'lW'::..2;::r\;:: I:: .,
$ 5'3
$ b'
$ Z O?
$ 67
I
Status
Issued
'1"
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00751
ISSUED: 06/10/2010
APPLIED: 06/10/2010
EXPIRES: 12/10/2010
VALUE:
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 932 B ST
ASSESSOR'S PARCEL NO.: 1703351313600
Spriuglield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Burglar alarm ..
Owner: . FA VIER FAMILY TRUST
Address: 3985 UNIVERSITY ST
EUGENE OR 97405
I CONTRACTOR INFORMATION ,
Contractor Type
Low Voltage Electrical
Contractor ."J:,. ,i .u'. ,. License
.', - .'
RUIZS CUSTOM SECURITY SYSTEMS INC 108202
BUILDlNGINFORMATION ~
Expiration Date
08/25/2011
Phone
541-687-9202
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
'19 Range Type:
~ .~~Energy Path: :
~rI> ~ ~...d':'~ rinkled Building:
~.. q,0" 9>'Ii' ENT INFORMATION
'fIi ~ A~'" 0 ~ R
o~"04., q,'-1!:o ~ ~!Ij~
Frontyard Setback: 0...q,~....tt,~.....,<::><:J> ~ovtq,'!t olS'q,'~~~Verlay Dist:
Side I Setback: O~. bo{;ie.... 1o.f!:j~ cP~0.'"'~$\~ Street Trees Rqd:
Side 2 Setback: ~~~e."~tt,~~#.~~~\J"":' Paved Drive Rqd:
Rearyard Setb~ ..:!S.~o~ ~...~ Q ~II-' e(f. % of Lot Cove~age:
Solar Setbacks,", ~o~vt: Oj~q; ~'Ii'(Jlq, 0"... .
,~~<:;.:&-~t:t.,l.",o"e~1I- I PUBLIC. IMPROVEMENTS ~
0" ~G Cl 'J'
Street Improvements: ~~...- ",j:;~:,~~ '. ~":':~J
n/a
REQUIRED PARKING
Total:
Handicapped:
Compact:
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
.'
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Sidewalk Type: . ..c}" "'- ~ ~,\)'\ ~;,
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DownspoutslDrains; ,~~ ~ 'Ii <>.. ...;;. ,
$;.. \' ~' f::>" -"'.'
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Valuation Description I~~ '0.<:0 <:!. ~"v~ ~'V r::so<V~
'\'<' ~'0r::s ~\J ~ ~
,Square Footage) ~~~ ~ 't I
,or Bid Amount,,<::S \"\ ,,'B a ue
~,~: .' . ~~
: \')7,"
'if'
J';~;frF "J ~~r",'!..'
",;;',
Storm Sewer Available:
Special Instruction:
Notes:
..
Date Calculated
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Sta tus
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
Total Amount Paid
. "i;':'
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.: .
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....
Total Value of Project
LFees Paid ~
Amount Paid
Date Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00751
ISSUED: 06/10/2010
APPLIED: 06/10/2010
EXPIRES: 12/10/2010
VALUE:
Receipt Number
2201000000000000680
2201000000000000680
2201000000000000680
To Request an inspection call the 24 hour re~O'rdiiig"atii6-3769. All inspections requested before 7:00
a.m. will be made the same working day, ins'pecti(}Iis requested after 7:00 a,m. will be made the following
'./O"'~" '.. ,. 'j
workday.,.,':'
I Reauired InsDections ~
Low Voltage: Prior to cover.
$6.96
$2.90
$58.00"
6/10/10
6/10/10
6/l0/10
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 Oregon pertaining to the work descrihed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Commnnify Services Division, Building Safety.
,L~
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 required inspections are requested at the proper time, that each address is readahle 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
$67.86
I Plan Reviews ~
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Pa~e 2 of 2
Date
225 Fifth Street
SpriIi~field; Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000680
Date: 06/10/2010
2:19:19PM
Job/Journal Number
COM2010-00751
COM2010-00751
COM2010-00751
Description
Low Voltage _ Commerciallndu.~;:'II~I . ",\4 ,~,j{
I,;".>>b '1'0, I"
+ 12% State Surcharge . ,
+ 5% Technology Fee
Payments:
Type of Payment
CreditCard
Paid By
TED RUIZ
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
58.00
6.96
2.90
$67.86
Amount Paid
DJB
006334 In Person
Payment Total:
$67.86
$67.86
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