HomeMy WebLinkAboutPermit Electrical 2010-6-29
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· . Electrical Permit Application
225 FUlb Str..t+Springfield, OR 97477+PH(541)726-3753+FAX(54I)726-l689
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DEPARTMENT USE ONLY
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PermIt no.:
CITY OF SPRINGFIELD, OREGON
Dale:
(,r2 7- /0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissnance or if work is suspended for 180 days.
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FEE SCHEDULE
Numbe~ of inspections per item ( ) Qty. Cost Total
ea. cost
Residential, per unit, service included:
1,000 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 fceder (2) Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
60 I to 1,000 amps (2) $205.00 $
'Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
E-mail: An-ENnON- -- Temporary services or feeders: ins/aJ/alion, alteration, relocation
This installation is being made on residential ~ado te fRqlllf!l$;~:MO .u to $ 63.00 $
owned bJo: me or a member of my immediate f4MOtjtiaafion Cente. mill '.. '::L $ 8700 $
property IS not mtended for sale, exchange, ledltOAR:86~ .;; l' .............. .
479.540(1) and 47?56"". /' . OO9O=YOU l~ ~i ..u_<OAI'U~-Oo1" $126.00 $
Signature: ~ ~ s: ~. 8 cent... _1lrl'v'11oo I1lyts, see services or feeders section above
CONTRACTOR INSTALLATldWm rrorfllilo e ~fl/i" . eralion,exlensionperpanel
Business name: 0 t.../ /If t'i'L . . . "enter /8- - -<iU4lf;J> CirCUIts with purchase of a service or feeder fee:
Address: Each branch circuit $ 6.00 $
City: State: I ZIP: b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - I Fax: - - First branch circuit (2) I $ 55.00 $ sS-
E-mail: Each additional branch circuit Z. $ 6.00 $ I '2-
CCB license no.:
I BCD license no.:
Miscellaneous fees: service or feeder not included
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Eacb additional inspution: (1)
I,' . . :,' , .. . APPLICANT USE
- '.: :~'~~.'\~'%;;:~~;!:~,~~ ';{I.\Y~'Enter.subtotal of above fees
NOTICE: ALL EXPIRE IFTH . .i;:PermitFee$S8.00)
THIS PERMIT SHNDER THIS PERM'''' 8l\ll~..I.i%surcharge(.12X[A])
AUTHORIZED U,
COMMENCED OR IS ABANDONED mll~~>~OIOgy Fee (5% of [A])
ANY 180 DAY PERIOD. .. ,~. ,,,,,,f', \T9T~Lfees and surcbarges (A tbrougb C):
'Sl.cy
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$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
.
$bf
$ 12-
$ ROlf
$ 7K "l
440.2584.) (9108/COM)
Status
Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 634 HAMILTON ST
ASSESSOR'S PARCEL NO.: 1703341206400
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00851
ISSUED: 06/29/2010
APPLIED: 06/29/2010
EXPIRES: 12/29/2010
VALUE:
Springlield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Electric snpply to heat.pnm.1? ".'
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Owner: SCHOENBERG MARK A & DEBORAH"
Address: 634 HAMILTON ST .
SPRINGFIELD OR 97477
TYPE OF USE: New
Residential
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
OWNER
BUILDING INFORMATION ,
. # of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construclion Type:
# of Bedrooms:
R-3
#.of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Patij:
. Sprinkled B,uilding:
VB
License
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq' Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
"'.'.. sit Fi'6'tii~r:' ,;c". - .. ~
n/a Occupant Load:
I DEVELOPMENT INFORMATION , OU to
. .!.. ',. c. . ..1\' "".. 10"" : Oregon law r!lW,lJr.~,X'aRIIRARKING
follow rules adopted by the'Url{Qtll'l' \J' ,
,'.',Overlay'Dist: Notification Center. Those ru\llR:lI{e set forth
, #!Street Trees Rq1t; OAR 952.()Q1-0010thrO~g\lil;Wi\,gBJeQP~
Paved Drive Rqd:Q090. You may obtain copletllfJl:l/M\ es "'J'
% of Lot Coverage: calling the centBr. (Note: !hiitelej)hone
number for the Oregon Utility Notification
2-2344 .
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Irnprovemeqt.sh.
. NuTICE:
Storm Sewer AvatlrWIS . ' ",: ,
Special Instruction- I PERMIT SHAll EXPIRE IF THE WOB~, .'
AUTHORIZED UNDER THIS PERMIT IS NOT": ' "
Notes: COMMENCED OR IS ABANDONED FOR )",:.t
"'1," .
ANY 180 DAY PERIOD",', -, '... :\ ','..
I Valuation DescriPtion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Date Calculated
Tvpe of Construction
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Sidewalk Type:
DownspoutslDrains:
Value
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
- ,
Total Valueof Project
L - Fees Paid _
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$8,04
$3,35
$55.00
$12.00.." .
-n::,:, -:~i7:..'.-~:~"i"::
6/29/10
6/29/10
6/29/1 0
,6(29/10
Total Amount Paid
":
$78.39....,..,,). '_,'.' , ,
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I Pl~n Reviews ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00851
ISSUED: 06/2912010
APPLIED: 06/29/2010
EXPIRES: 12/2912010
VALUE:
Receipt Number
3201000000000000343
3201000000000000343
3201000000000000343
3201000000000000343
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. ' .
Reuuired InsDections .
Rough Electric: Prior to Cover
,
. j.
,.
Final Electric: When all electdcal work is complete.
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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 described herein, and
that NO OCCUPANCY will be made of any structure\with,out permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who areiri compliance with ORS 701.005 will he used on this project.
I further agree to ensure that all required inspections.are re'lu:ested at the proper time, that each address is readable from the
street, that the permit card is located at the front o(!)ie.property, and the approved set of plans will remain on the site at all
times during co struction. .
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Owner ~ Contractors Signature
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Paee 2 01'2
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ate
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
DevelopmentServices Department
Public Works Department
RECEIPT #:
3201000000000000343
Date: 06/29/2010
1:41:37PM
Job/Journal Number
COM20 I 0-00851
COM2010-00851
COM20 1 0-00851
COM2010-00851
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
.1",_ . >'1
Item Total:
Amount Due
55.00
12.00
8.04
3.35
$78.39
Payments;
Type of Payment
CreditCard
Paid By
MARK SCHOENBERG
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
b71947 In Person
Payment Total:
$78.39
$78.39
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