HomeMy WebLinkAboutPermit Electrical 2010-6-25
EIectrical Permit Application
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225 Fifth Street. Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
DEPf-RTMENT USE ONLY
COptA z..e:. (C~OO 8-o~
Pennit no.:
Date: b . 2 '5 - ( U
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.
Name:
CCB license no.: 13 (,3'7) I BCD license no.: JO-4tilL
Signing supervisor's license no.: (j bog,)
Print name of signing supervisor: ~hlll\Q L Al\tCl/\ e..-JJ[I.
Signature of signing supervisor: q/rw~ ,;z ~ :::trC.
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Total
cost
Residential, per unit, service included:
1.000 sq. ft. or less (4)
pa . 0 sq. ft. or portion
th~"
$134.00
$
$
$
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Each additional. insp~ct\~n:,(.I)" $58.00 $
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TH\S PER~ Vf\B1I\,,^ tl mm't<$ NOT
AUTHORIZ ID'\l,wliltt.ll W\\l,i, ~%'~#:V~R,' $ :;; I
COMMEN ~SuiCharge(.12X[A]) $ 9>Z
ANY 180 ~(Q)f<!chH01ogyFee(5%of[A]) $ I{OJ-
TOTAL fees and surcharges (A throl'gh C): $ 'if n...
I
, . '.,' ." LOCAL' GOVERNMENT APPROVAL';';' "i",:"',
Zoning approval verified? 0 Yes 0 No
"".,.Cfl,TEGORY:,OFCONSTRUCTIONY' ':' ."
o Residential 0 Government I 0 Commercial
it't;r~J:lt0l3mSITE;;INFORI\IiA"IOIII;'AN[jt:'110CATiON~ii+)ij('i
Job site address: L: I ~/ .}\ .. .. IJ. ~ .5\0';:
City: -50fl'r'.. t felf. State:OR... I ZIP: qrllf?'7
ReferenJe: '-1702 '3:s.Z- t.f I Taxlo!.: 0(&::;0
., . DESCRIPTION, OF WORK"',....:.:\:"',.,
50nJiu UtA/IC,Q,
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PROPERTY OWNER : .
l.--v,f,,,+....-.. S yvt\o'5>
Address: 1'2.\..(, \J:\\.Af'L~ 'Sot 601 to 1,000 amps (2)
City: l:::-v.c..-e-"'/e- State: C>.fL I ZIP: C-""U.t.....'J. ". _Over I,O~O amps o( volts (2)
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Phone: _ _ I Fax: _ _ foll.ow "!llel Ul!Ilm!l1'1'I\ ~ I 'tint" $ 63.00 $
E-mail: InOARo<;..._~fiui!.rwlEis.srllt!~nstallatiOn. alteration, relocation
This installation is being made on:eside~tial or fann~rtYOU IT a~ . ... $ 63.00 $
owned b~ me o~ a member of my ImmedIate famlly.11Q~ing thelcE ntef.t<(Nljt8lDlhe:fuleDhone-' $ 87.00 $
property IS not Intended for sale, exchange, lease, Or r'l'itl~ for th B u~M~(R' IT Ii
479.540(1) and 479.560(1). Cen erl ,'fVTlli'~O Ilea on $126.00 '$
Signature: Over 600 amps or'l,Ub volts, see services or feeders section above
. CONTRACTOR INSTAllATION Branch circuits: new, alteration, extension per panel
Business name: 6Jf'vt/ \ltll r::7e,r i, Ie S'Prv\ (P /1\(... a. Feefor branch circuits with purchase of a service or feederfee:
Address: In'''lq~ ..tr"~ Plo. d... ., Each branch circuit I $ 6.00 $
City:,"),,(\(,j,oVl c"ilv State: G f( I ZIP: Q71lf 8 b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: ~1-1'I2::. 1-1.51] I Fax: 5'f1-?,W 10 2l- First branch circuit(2) $ 55.00 $
E-mail: Each additional branch circuit $ 6.00 $
440-2584-J (9/08/COM)
$ 25.00
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
$ 32.00
$ 63.00
Services or feeders: instal/ation, alteration, relocation
200 amps or less (2)
/
$ 81.00
$ 95.00
$158.00
20 I to 400 amps (2)
401 to 600 amps (2)
$205.00
$469.00
Miscellaneous fees: service or feeder ':lot 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
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00805
ISSUED: 06/23/2010
APPLIED: 06/22/2010
EXPIRES: 12/25/2010
VALUE: $ 5,179.00
Status
Issued
, 225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5135 F ST
ASSESSOR'S PARCEL NO.: 1702332401600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Replace roof with trusses and revise electrical and plumbing
Residential
Owner: SYRIOS WILLIAM L
Address: 1247 VILLARD ST
EUGENE OR 97403
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I CON,fRAeT<)R1NFORMATION ~
Contractor Type
General
Electrical
Engineer
Plumbing
,
,;-.;
."'1
Contractor
DAVID NATHANIEL AUSMUS
EVERYDAY ELECTRICAL SERVICE
ARTISAN ENGINEERING, LI,C 'IoU \0
C & R PLUMBING L leQUIles utili\'! 167015
j>.'tiE.l'l'I~~'~dO{l\ TION
\OliO'll tUI celltel. ~gn lilIes
# of Units: t\\ica\iOll 0\ -00\ ~ \nl \sljif()H~ nOll,e
Primary Occupancy Grou~~ O!>.\'. 95R-~a'l ob\alllnC 'glb~f~o~ettt~
Secondary Occupancy Gro~o. '(all celltel. \ "'\iliI~~r
Primary Construction Type callillg ~l tne 9Ie~~~?-'F~~e.
Secondary Construction TYP"/llltllbelcelltel is \- Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building:
License
170340
136371
Expiration Date
OS/28/2012
08/12/2011
07/01/2010
Phone
541-937-2627
541-607-6908
541-338-9488
(541) 736-9582
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
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
K~r~~tr~~s Rq~:
':pliVed(J}riv~ R, qrl:
, ", Jl,~'V t"' 'i
. :"!o:of Lo(qoverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
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Paee 1 of 3
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: COM20IO-00805
ISSUED: 06/23/2010 '
APPLIED: 06/22/2010
EXPIRES: 12/25/2010
VALUE: $ 5,179.00
Status
Issued
. ,po,
I Valuation Descrivtion ~
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
5,179.00
Value
Date Calculated
Description
Total Value of Project
$5,179.00
$5,179.00
06/22/20 I 0
~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit
Fixture
Minimum/Adjustment Plumbing
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
-'.~;- .
6/23/10
6/23/10
6/23/10
6/23/10
6/23/10
6/25/10
6/25/10
6/25/10
Receipt Number
2201000000000000729
2201000000000000729
2201000000000000729
2201000000000000729
2201000000000000729
2201000000000000745
2201000000000000745
2201000000000000745
$18.60
$7.75
$97.00
$57.00
$1.00
$9.721:'0;' ,
" ~:, ,
$4.05";;<: ,d
ilf:li~
$81.00/""..
:~ ,:
,'~""
. ~.',
, ,
Total Amount Paid
$276.12
I Plan Reviews ~
To Request an inspection call the 24 hour recrrdingat 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
workday. .,1,' . ,:',)
~eollire1Jnsnections ~
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Ceiling Insulation: Prior to cover.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is,complete.
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Final Building: After all required inspectiol~..~;ave'b~,~n' requested and approved and the building is complete.
Electric Service: Approval required prior t~.;u!i1ity company energizing service.
Pa!!e 2 of 3
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00805
ISSUED: 06/23/2010
APPLIED: 06/22/2010
EXPIRES: 12/25/2010
VALUE: $ 5,179.00
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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By signature, I state and agree, that I have carefully,ei'""i~~dthe 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
;0;"
the Ordinances of the City of Springfield and the ~aivs of the;State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure ;'ithout 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 construction.
Owner or Contractors Signature
Date
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Paee 3 of 3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
DevelopmentServices Department
Public Works Department
RECEIPT #:
2201000000000000745
Date: 06/25/2010
II :28:40AM
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Item Total:
Amount Due
81.00
9.72
4.05
$94.77
Job/Journal Number
COM20 J 0-00805
COM20 1 0-00805
COM20 1 0-00805
Description
Perm ServIFdr 200 amps or less
+ 12% State Surcharge ~: ~:i~
+ 5% Technology Fee ';'.21L
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Payments:
Type of Payment
CreditCard
Pa id By
EVERYDAY ELECTRlC
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
000571 In Person
Payment Total:
$94.77
$94.77
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6/25/20 I 0