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HomeMy WebLinkAboutPermit Electrical 2010-6-17 ~~ . '.DEI"ARTMENT USE ONLY. COvYI"Zo lel.. 00 7<f5Z Permit no.: Date; 6-17- /0 This permit b issued under OAR 918-309-0000. Pcrmit!t are nontransferable.. Pennits expire if work is not started within 180 days of issuantt or if work is suspended for 180 days. j;"'LOCAL.GOVERNMENTAPPROVAL . '., Zoning approval verilied? 0 Yes 0 No ".CATEGORY OF CONSTRUCTION' '.' o Residential lJ:1-tTovernrnent I 0 Commercial JOB SITE INFORMATION AND LOCA TlON . Job site address: 'Z Z s: 5+ k S + City: S?rb. !State:U(L IZlP:~7L(11 Subdivision: I 70 3 "5 5 3. , 1 Lot no: O.s 300 .. . .' . . DESCRIPTION- OF WORK'.' '. ~(.l,l ,c 1..." lA~E-'l. c.:L /.J....-(f/ Ul,,,t-A/t..o,/ . I PROPERTY"OWNER' . Name: C I +u uf 51'/:-L -he-I j Address: 2 Zl:;- 5 +-1.... s f- City: S;Il"V'(,.h~7.. 6 I State: oJ.... I ZIP: '17477 Phone: 91 f 726- 57.11 I Fax: - - E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate lamity. This property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR INSTALLATION - Business name: .IKL-. t.-J n~.i -,<Tin( Mire", 2.1"51 ~(\ ~lJo-f City: roo . (I n r/l T State: OV I ZIP CH411 . PhQne: ~I :-'14&- -. . I Fax:'5tH - .%-3 'i!)$ E -mnil: '"";:;>p, (Q) ...}KfJ:.lkL" .c...om CC131icense no.: 4'51 Z..'1 I BCD license no.: 2.0-2..nc.. Si[!Iling supervisor's license no.: L.\-'i,..."S Print name of signing supcrvisor>,jn.!./D I , t-AJ/ .If /l- ' Sigru-llurc of signing supervisor.: "-J ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note. the telephone number for the Oregon Utility Notification 44(l_Z584_J(9.U8ICOM) Center is 1-800-332-2344). . V' FEESCHEDULE '. .~. . ..Total .cost .' v .' ~ ...',. _,' ," . _N~~~r~fiilsp:ctio!,s:perite~().~ " Q~'~ Residential, per unit., snvice included: 1,000 sq. ft. mkss (4) ....:ach additional 500 sq. f1. or portion lhe"",f Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Cost - '. en. ~ $134.00 $ $ 25.00 s S $ S 32.00 S 63.00 Sen"ices or feeders: installa/ion. alteration, relocafiOll 200 amps or less (2) $ 81.00 $ 201.'.0 400 amps (2) $ 95.00 $ 40 I 10 600 amps (2) $158.00 $ 601.to 1.000 amps (2) $205.00 $ O\.'CT 1,000 amps.or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Te-mporary se-rvices or feeders: inslaIla/ion. alteration, relocation 200 amps or less (2) 20110400 amps (2) 40110600 amps (2) $ 63.00 $ $ 87.00 S $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Brancb circuits: new. alteration, extension per panel a. Fee for bmnch cilCuits with purchase of a setVice or feeder tee: Each bnmch circuit S 6.00 $ b. Fee for branch circuits without purchase (If a service or feeder fee: first branch circuit (2) Each additional branch circuit I $ 55.00 $ S 5 7 $ 6.00 $'-12 1\.tisceUaneous fees: service or feeder nol included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal L.'ircuit or a limited-energy panel, alteration. or extension (2) Each additional insprction: (l) . .. . :APPLlCANT ,USE. $ 63.00 $ $ 63.00 $ $ 63.00 $ $58.00 $ , : .:-:c. $ Clr $ II bl( $ i.{SS- $ 115'!J.. . ..' (A) Entcr subtotal of above fees (Minimum Permit....ee $58.(0) (8) Entl.'T 12% surcharge (.12 x [A)) (~) Techno\l-.gy Fee (5%oflA}) TOTAL fees and surcharges (A through C): f) ~. ~~^""O 8/ ~~~"( NOTICE: THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. t~~~ ~V ...:.'~;')' L Building/Combination Permit PERMIT NO: COM2010-00782 ISSUED: 06/18/2010 APPLIED: 06/17/2010 EXPIRES: 12/18/2010 VALUE: Status Issued . ':'jl:f 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line "<.:":" CITY OF SPRINGFIELD SITE ADDRESS: 225 5TH ST ASSESSOR'S PARCEL NO.: 1703353103300 Springtield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Replace lights under.:JitY'haiIi:Jib,rary', ',__If.._ .J~. J.,~. ..~ ,. t',: . Owner: CITY OF SPRINGFIELD Address: 344 NORTH A ST CITY HALL SPRINGFIELD OR 97477 TYPE OF USE: Repair Public I CONTRACTOR INFORMATION ~ Contractor License J K GUCKENBERGER ELECTRIC INC 45129 BUILDING INFO~MATlON ~ Contractor Type Electrical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ,".i' "# of Stories:' ': f!eight of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 04/24/2012 Phone 541-746-4656 ilIa Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occnpant Load: ...:.'.~? ',;,"': Y~': I DEVELOPMENTINFORMATlON ~ "-Ov'hlay'Dist: #'Street Trees Rqd: ATTENTION: Oregon law r~~.: follow rules adopted by thsPlPilll' e' Notification Center. Those rutes are set fa g. In OAR 952-OOH1010 throu h OAR 952-001- . oumayo calling the center. ENTS Street Improvements: number for the Oregon Utility Notification Storm Sewer Available: Center 181-800-332:2344). "'" Special Instruction: l' ; " ~~;l:;r j ; 1\, Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Notes: ~ , ,. . ", I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Date Calcnlated Type of Construction "~~'~~~";~i'~-5~~'~'P..!.f;.,. ' , "':-;f..... ~~...:. paee 1'01' Z -''''n''C'-~'; I~ "'i"f:":1 . N,-:-' REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: NOTICE: F THE WORK THIS PERMIT SHA~~ \~~~~RMIT IS NOT ~~:~?~,\~ED UND DONED FOR VVIVIlVOr.-IO ANY 180 DAY PERIOD. Valne Status Issued ,j',;' ,I,'.':': CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00782 ISSUED: 06/1812010 APPLIED: 06/1712010 EXPIRES: 12/1812010 VALUE: ~~()~. I ';,'f7~~ ..~;\~:.:~!..~.~,~. ~ ," 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Valu~ o~ Project L Fees Paidj" Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount.Paid Date Paid Receipt Numher $11.64 6/18/10 2201000000000000710 $4.85 6/18/1 0 2201000000000000710 $55.00 6/18/10 2201000000000000710 $42.00 6/18/10 2201000000000000710 Total Amount Paid $113.49,_,:;.~ ,t '0. ' . .k;;:"":.'" 1..,'(L ,k~_' "ct.. .J' '. J cE!,l!.n Il\ly'i.e~s ~ 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. L....Reouired Insoections I Rough Electric: Prior to Cover ",' ::i.';\, .1'j . If. t;" Final Electric: When all electrical work is complete. By signature, 1 state and agree, that 1 have carefully examined the completed application and do herehy certify that all information hereon is true and correct, and I further certify that any and all work performed shall he done in accordance with the Ordinauces 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 structnre 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 ensure that all required inspections, are requested at the proper time, that each address is readable from the ,_ ',,".'r.'q ._'I"~.. ;~:' _ ' " street, that the permit card is located at the front of.the~prilj5""tY; and'the approved set of plans will remain on lhe site at all times during construction. ,;~~~ .Jo'~';:';1'._. tl ' Owner or Contractors Signature Date '1" , , ....:'. . ,-,- l"f ::'. ,. ..,'.1 Page 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone '/ ':r-'." City of Spririgfield Official Receipt Development Services Department Puhlic Works Department RECEIPT #: """" {..... ;'1 2201QOOOOQ000000710 Date: 06/18/2010 9:21 :02AM Job/Journal Number COM20 I 0-00782 COM20 I 0-00782 COM20 I 0-00782 COM2010-00782 Payments: Type of Payment CreditCard cReceintl Description Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 12% State Surcharge + 5% Technology Fee ','J'''' \ Paid By Re~eived By JEFFREY GUCKENBERGER djb Check Number Batch Number , .:/. .'/ "' .;, j.i~ ", . .';;:i ., :', ."-::~' . .' ';, j" :~.,. /;~.::~l ~""~~,.:'J<l ~',/;P.-ij>'.1 , "l,-:,it, "'~:t.,:; : <,,' '. i I"~ ~ .t., ;:.M'-~:.,,+;. :i~~'tn. h:l,: "~:.~'::' ,'\ .1 . Page I of I Item Total: Authorization Number How Received Amount Due 55.00 42.00 11.64 4.85 $113.49 Amount Paid 02507d In Person Payment Total: $113.49 $113.49. . 6/18/20 I 0