HomeMy WebLinkAboutPermit Electrical 2010-7-8
Electrical Permit Application
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225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726.3689
SPRINGFIELD
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DEPARTMENT USE. ONLY
C'OvlAZOIO ~oo 90?
Permit no.:
Date: 7- & - /D
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.' . .
'PROPERTYQWNER 201 to 400 amps (2) , $ 95.00 $
Name: tlJ1All-lf! 1/r1e-01/VSOAf' 401 to 600 amps (2) $158.00 $
Address: 7 ~ 8, 5"3 12--' PL 601 to 1,000 amps (2) $205.00 $
City: s.1>Pl.. I State: cJ- 1 ZIP: 9'J{(7g Over 1,000 amps or volts (2) $459.00 $
Phone: _ _ 1 Fax: _ _ Reconnect only (2) $ 63.00 $
E-mail: ! .,:rTENTI )N~SerVices.or feeders: installation, alteration, relocation
This installation is being made on residential or farm ~a'~" s ~'!t:~~~"res you to $ 63.00 $
owned b~ me or a member of my immediate family. TIri'tl~~t'on 5?. nJm-.toT~lJ.iIW~~.on Utility $ 87.00 $
property IS not mtended for sale, exchange, \ease, or rtlll9 52 ~O, -,'I,I{ 1J11I11i" ~ 'VIm
479.540(1) and 479.560(1). '. OU r a' 1\f\ll9_bUU'lMli!~~R 952-''';;' $126.00 $
Signature: n~~~';,~ ~he c t1}e~r lflQ,w'jjp,coPLllllil WltsSs!l<yservices or feeders section above
,CONTRACTOR INSTALLATION. ...... ,,;:,:.. ~~~~~li'ei,{dbif!Y1Wt!J(!1',~\\~n, eXlenslonperpone/'
Business name: I : 1=1 ...." a. Fee :r'8~~14:)J.its with purchase of a service or feeder fee:
P.O, BOX 11708
City: EUGENE, OR 974<<)
Phone:'1L/J."1/.(tj - '1'12--'1< 1 Fax5'f1-3'1'1lf'1tff
E-mail: JtUf/;:;i L-i ViiJ;Jrf!..IL m.cJ7?IC O;JONi., a?/'V\
CCB license no.: S/1J091 I BCD license no.: :JO-99>
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IlfF:F .,LozltR..
Signature of signing supervisor: -. # tA A -
'LOCAL:'OOVERNMENTAP,PROVAl' '~
Zoning approval verified? DYes D No
. . CATEGORY :OF'CONSTRUCTION> '-
ID Residential T 0 Government 1 0 Commercial
'f!i1;~0;Xj:OEl5$lrE"..INFORMATlON;ANjj;:;LO_CA:rION;,~i; Ii;::!:
Job site address: -; c1')( AI "53 cl' P/..A?:..L.
City: C;ltt /i,U6/1l!L-(). I State: V't-- .1 ZIP: 9-;1'-/7<2
Reference: ) 7 D 2 ~ if 2 r 1 Taxlo!.: DC 1;;.08
'. DESCRIPTION OF WORK'" " ':".'-
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Address:
Signing supervisor's license no.:
Print name of signing supervisor:
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ANY 180 DAY PERIOD.
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..~umber' ?fin.spe~t'io'?~ .~er ,i't~.~;O ," Cost To'tal
.. Qty. ;":.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 feeder (2)
Services or feeders: installation, al.teration, relocation
200 amps or less (2)
J $ 81.00 $ 'l / ~
Each branch circuit
$ 6.00
$
b, Fee for branch circuits without purchase of a service or feeder fee:
_ First bra~ch circuit (2)
$ 55.00
$
$
Each additional branch circuit
$ 6.00
Miscellaneous fees: service or feeder '}ot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
$ 63.00
$
$
$ 63.00
Signal circuit or a limited~energy panel,
alteration, or ,extension (2)
Each additional inspection: (I) $58.00 $
"i~~~,;,~~h~Y}~~3~l~'i~:Kl,~~1:AR)~jjcA'NTDJJ~fEt:j,\,~;;:;>;:~~~.i;;f;i!:;:;;~t.;_;S.
(A) Enter subtotal of above fees
(Minimum 'Permit Fee $58.00)
$ 63.00
$
NOTICE:
THIS PERMIT SHAll E ~tW Jm&WIillilJ{ (12 x [A])
AUTHORIZED UNDER "HtSt1f!ilMtllSe~l,of[A])
COMMENCED OR IS A Illfl'd surcharges (A through C):
$ <gl-
$ '1,7'l
$ 4.11 C;
$-Q4, i7
440.2584.J (9/08/COM)
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CITY OF SPRINGFIELD
Building/Combination Permit
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Status
Issued
PERMIT NO: COM2010-00909
ISSUED: 07/08/2010
APPLIED: 07/08/2010
EXPIRES: 0110812011
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 758 53RD PL
ASSESSOR'S PARCEL NO.: 1702332100608
Springlie'd TYPE OF WORK: Electrical Work Only
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TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace electric panel
Owner: MELANSON MARIE Y
Address: 758 N 53RD PL
SPRINGFIELD OR 97478
Contractor Type
Electrical
I CO~!RACT?R'INFORMA TION I
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ontractor +~:;..;, . tcense
LIVE WIRE ELECTRIC INC 56697
BUiLDING INFORMATION I
Expiration Date
05/1612012
Phone
541-344-4928
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
R-3 Height of Structure
Type of Heat:
VB Water Type:
R~'1!l.w1il'il/tlires yOU \0
ATTENTION: ore~\J~oregon Utility
toll oW rules adoPI'Sffii.M!~lliDiiRa .\ lorth
. < ''';~oti()l'' Center. ' . -001-
\~OAR 95. L lllH
OOOO.Yoo (oe .
calling the cenler. uiility NotilicatiOn
number lor tM C{AAg~~:!>.!~\344).
Center IS If Sl'reet Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
~. .~
I PUBLi<i~iMeR0V:El\-1ENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
-', <,',~ ..
Sidewalk Type:
DownspoutslDrains:
Tvue of Construction
NOTICE: . . P'RE IF THE WOR\(
THIS PERM\1 SHr..ll EX IS PERM\1 IS NOT
OR IS ABPlN
Valuation Des 6~" RIOD.
PINY Ui\ PE
:.Squa~e Footage
~ ttr. Bid Amount
Notes:
Description
$ Per Sit Ft
or multipli~r
Value
Date Calculated
~.\ /.!
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Paee 1 of 2
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'\'1:
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00909
ISSUED: 07/08/2010
APPLIED: 07/08/2010
EXPIRES: 01108/2011
VALUE:
Status
Iss u ed
rli:':'"
Total Value of Project
Fees Paid i
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Perm ServlFdr 200 amps or less
Amount Paid
$9.72 ..'
$4.05
$81.00. '
D,ate Paid
7/8/10
7/8/10
7/8/10
Receipt Number
2201000000000000808
2201000000000000808
2201000000000000808
Total Amount Paid
$94.77
I Plan Reviews I
To Request an inspection call the 24 hour r~~~rgt!l.~!,llPf6-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspectionsrequ'ested after 7:00 a.m. will be made the following
work day. .'.,'
.+'.:.:,i;
"I
l Reouired InsDections ~
Electric Service: Approval required prior to utility company energizing service.
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 any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws ofthe State.'of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without p'ermission of the Community Services Division, Building Safety.
I further certify that ouly contractors and employees\vho are iU'eompliance with ORS 701.005 will be used on this project.
I further agree to ensure that all reqnired inspeetions ,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 un the site at all
times duri,ng construction.
Owner or Contractors Signature
Date
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Page 2 of2
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000808
II :27: 19AM
Date: 07/0812010
Job/Journal Number
COM20 I 0-00909
COM20 I 0-00909
COM20 I 0.00909
Payments:
Type of Payment
Check
cReceintl
Description
Penn Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
L1VEWIRE ELECTRIC INC
.1, f,'
Amount Due
81.00
9.72
4.05
$94.77
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Item Total:
'~;)., Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
$94.77
$94.77
13153
In Person
Payment Total:
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Page I of I
7/8/2010