HomeMy WebLinkAboutPermit Electrical 2010-6-29
City Of Springfield
225 Fifth SI.
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenler@ci.springfield.or.us
(J/O.85Z
Residential Electrical Authorization To Begin Work
69600-BEL-10-00291
Approval Code: 519214 6/29/2010' 1:44 pm
E-mailedTo:bhalada@quixnet.net
D New Construction
IKJ Addjtion/alteration/replac~ment"'
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00 1 or 2 family dwelling 0 Multi-family D Commercial D Accessory
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.jOB:SITE:INFORMATION AND LOCA TION~.
Job Address: 2150 LAURA ,ST
City/StatefZIP: SPRINGFIELD, OR 97477
Suitelbldg.Japt.no.: 110
Project Name: Monta Lorna Mobile Park
Cross Street/directions to job site:
Tax map/parcel no.:
1703271102100
SPACE #708 Is where the work is actually being done - not available on the
e-permitting site. Install sub-panel and 2 RV receptacles.
Name: John Sutton
Phone: 541.747-8931
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Fax:
Email:
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Elec lie. no.: 20-87C
CCB lic. no.:
8699
Business Name: lR BRABHAM INC
Contact:
Address: 68 W Q ST
City/State/ZIP: SPRJNGFIELD, OR 974772142
Phone: 5417476638
Fax:
Email: lRB@QUIXNET.NET
Metro lic. no.:
City lie. no.:
Supervising Electrician's lic. no.:
4944S .
Supervising Electrician's Name:
lARRY R BRABHAM, JR
Number of inspections included in paid services:
Residential Service: 4
Reconnect Only: 1
All Other Services: 2
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Description Qty.
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Services 200 amps or less
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Please check all that apply:
D A service or feeder beginning
al400 Amps where the
available fault current exceeds
10,000 Amps at 150 Volts or
less to ground exceeds
14,000 Amps for all other
D Fire pumps
D Emergency systems
D Addition of a new motor load
of 100 HP or more
D Six or more residential units in
one structure
D Health care facilities
Branch circuits with service or
feeder each circuit
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Subtotal
State surcharge (12% of permit
total
Technology fee (5% of permit total)
TOTAL PERMIT FEE
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NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained. 0. 99//0
The local building department may determine that an Authorization To Begin Work is null and /'?
void if it does not meet applicable land use laws and local ordinances.
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Upon review and approval by your local jurisdiction, your permit will :be. e-mailed or faxed
within one business day, wlt,h instructions on how to schedule your inspection. <.
I1LAN'REVlIsV'F
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D Hazardous locations
D A service or feeder rated at
600 amps or more
o Buildings more than three star
D Marinas and boat yards
o Floating buil~ings
D Commercial-use agricultural
buildings
D Installation of a 150 KVA or
larger seperately derived sys
O "A" "E" or "1.2" or "J.3"
, ,
D Recreational Vehicle Parks
o Supply voltage for more than
600 supply volts nominal
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$18.00
$99.00
$11.88
$4.95
$115.83
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Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at.lhe job site until replaced by a Permit
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20I0-00852
ISSUED: 06/29/2010
APPLIED: 06/29/2010
EXPIRES: 12/29/2010
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: 2150 LAURA ST SPACE 70B
ASSESSOR'S PARCEL NO.: 1703271004400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install sub-panel and 2 RV receptacles
Owner: WUORINEN LIVING TRUST
Address: 2154 LAWN LN
EUGENE OR 97401
Contractor Type
Electrical
Contractor
LR BRABHAM
I CONTRACTOR INFORMATION I
,.(':" 'c. License
. ":' ".", 8699
BU'ILD'iNG'!N'FORMA TlON I
Expiration Date
12/18/2010
Phone
541-747-6638
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
. Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path: .
Sprinkled Building:
Lot Size:
Sq FI I sl Floor:
Sq FI 2nd Floor:
Sq Ft Basemellt:
Sq Ft Garage/Carport
Sq Ft Olher:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Frllntyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Sethack:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Tolal:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
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Sidewalk Type:
6m~T1lit~iDQfI'l1;lfJn law requires you to
fOll,ow rules adopted by the Oregon Utility
Notification Center, Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090., You may obtain copies of the rules by
'" . l. lIt: t:l Uf e
number for the Oregon Utility Notification.
Center is 1-800-332-2344).
Street Improvements:
Storm Sewer Available:
Speciallnstructioll:
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Nilles:
NOTICE: I I
THIS PERMIT SHALL EXPIRE IF THE "M:;t;Iuation Description I
,UTHORIZED UNDER THIS PERMIT Iqp'nTs Ft S F
DescriptillnE-'ICEUvoe of()oost~uctionD Ff'l6 ~'r'lt.ql' quare ootage
~!Jlnfl 1\ 'un Iv MUMllJUUlllL I...Or mu Ip ler ,or Bid Amount
IV 180 DAY PERIOD,
Value
Date Calculated
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Paee I of2
Status
Issued
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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Total Valne of Project
Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
$11.88
$4.95
$18,00
$81.00
:;H.
6/29/10
6/29/10
6/29/10
6/29/10
Total Amount Paid
$115.83
Plan Reviews ,
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00852
ISSUED: 06/29/2010
APPLIED: 06/29/2010
EXPIRES: 12/29/2010
VALUE:
Receipt Number
3201000000000000345
3201000000000000345
3201000000000000345
3201000000000000345
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To Request an inspection call the 24 hour f~cordiIig-ai 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.
1_ Reouired InsDections ~
Final Electric: When all electrical work is complete.
Electric Service: Approval required prior to utility company energizing service.
, .
Rough Electric: Prior to Cover
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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 auy 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 described herein, and
that NO OCCUPANCY will be made of any structure 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
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. ,/'_~._: "".
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Owner or Contractors Signa'ture
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Pa2e 2 01'2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
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RECEIPT #:
3201000000000000345
Date: 06/29/2010
2:47:08PM
Job/Journal Number
COM20 1 0-00852
COM20 1 0-00852
COM20 1 0-00852
COM20 1 0-00852
Payments:
Type of Payment
ONLINE CHGS
cReceintl
Description >~t.:;-'
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
81.00
18.00
11.88
4.95
$115.83
Paid By
ONLINE PERMIT CHGS
Item Total:
Check ~umber Authorization
Received By Batch Number Number How Received
Amount Paid
$115.83
NJM
ONLINE LR Online
BRABHAM
Payment Total:
$115.83
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