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.:
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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)
~.
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NOTICE:
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
t~~~
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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.,~. ..~
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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"
, ,
....:'.
. ,-,-
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,.
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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
,
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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