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HomeMy WebLinkAboutPermit Electrical 2010-7-12 Electrical Permit Application o ellY OF SPillNGFIELD, 'OREGON _. 1< ~. \~" ...... , ~l, ~ " . DEPARTMENT USE ONLY c~ "20(0- e 0(; Z, Permit no.: 225 F;(th Street. Springfield, OR 97477.PH(541)726-375J+FAX(541)726-3689 Date: 7 - I 2.. - .I 0 Tbis permit is issued under OAR 918-309-0000. Permits are nonttansferable. Permits expire if work is not started witbin 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? DYes D No CATEGORY OF CONSTRUCTION esidential D Government D Commercial JOB SITE INFORMATION AND LOCATION Job site address: lOb ( Ct:iA: L--'" ~ ~ City: ;j> F') State: oa.. ZIP: 771(7- Reference: /70"3 ZbC(C/ /z..iDO DESCRIPTION OF WORK A- 5" C, rC<A~ PROPERTY OWNER Name: cJ...lAC-. L tk vi Address: N 2-~-r City: (::-"t.\..'-~ 6r FEE SCHEDULE Number 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 feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ !~ Cli&b\\\lht6\QMi~)You to $ 63.00 $ t :I"'~"'ers: installation, alteration, relocation r. I T\,e.lll.Jl,n (9lKj-li'I!~'jlOA'li\m2-001- $ 63.00 $ tr 1~~~1Ules uy $ 87.00 $ r ~dBi;tV1RR'M'~l~?;l;atio n $126.00 $ 1-1l3er~~!4~.1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per pane/ a Fee.for branch circuits with purchase of a service or feeder fee: - -'~Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit S' $ 6.00 $30 Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extensiori'(2f' ':'011: Each additional-iDS~fcl ~1 $58.00 $ .,. c.\-\r>.\.\. Lf~:.T'. ?t1<1liilll t/' NT USE &">>tfQ"~9tty.I\9 \ ees $30 r 'I'~\ll'iln\im ermit Fee $58.00) ~) ~ surcharge (.12 x [AD $':?bU (C) Technology Fee (5% of[AD $ I~o TOTAL fees and surcharges (A through C): $ 3S~ Phone: e E-mail: Notifioation Cent P This installation is being made on residential or bIrQ~01- 0 owned by me or a member of my immediate fanOQed:hltou may b property is not intended for sale, exchange, lease, 'lI'EIJmtg~en e 479.540(1) and 479.560(1). number for the 0 Signature: Center i CONTRACTOR INSTALLATION Business name: eAST SID f: EL EtT{I1G Address: ~ 'ii).5' 3 150 S (/I G- E t. N ' ''''. ..., .~ City: 5 P f c..D State: 6 R. ZIP: 9 7 1./ n Phone: .7l{/-1'{'19 Fax: -73b'Y960 E-mail: RKKOS75/i>E YAHo6, (0/11'1 CCBlicenseno.: }lj'7jO BCD license no.: )0 ,YO!)c "/71.75 o G- U( l-1 Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: "~~~.\\ ~ \\)' 440-2584--) (9108/COM) /C)IVe- ~ ,\_\t)'\O ~:~ N01\Cf.: 1\-11S I'E\'IWI 1\1.\1\-10\'111- GOMME\'\ .'~'{ '\ 30 '!,: " ~[~~ .tt':~~}~~~- ~J;fjr.:5 , '0 ..;J!Jlol-' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00621 ISSUED: 05/17/2010 APPLIED: 05/17/2010 EXPIRES: 11/17/2010 VALUE: .r.o Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 7i6-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1067 CENTENNIAL BLVD.,,:-, ASSESSOR'S PARCEL NO.: 1703264412800'; ,".'. Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace service and 3 circ Owner: SHATOLA CHUCK Address: W 25TH EUGENE OR . .31-:'~ . '1 ."~'., , I CON;FRA'CTO'R'INFORMATlON I ~i.;-o., ","-~;_ . Contractor Type Electrical Contractor ___.~-. License .- EAST SIDE ELECTRIC INC 117770 ~,-- I BUILDING INFORMATION i ~U\O # of Units: leo.\l\leSo ~~'es: Primary Occupancy Group: Q,Ofl \ll.'Il\ne 0le9 .Structure Secondary occupanCl,kI:(!lltJ.:0199'ed '0':1 l\l\eS al~. 9 at: '. Primary Constr~\t~p !-d~el. "("OS~\lQ," Oll'~ ~u\Il':e e:" ' , . Secondary cons~~IlIrl.\~ell-OO\O\"~~\eso\ ~)\W::,,,...: # of Bedrooms: "o\\{~ gfJZ-OO\ o'O\a\fll'\o\9" ~".e ~\P-"th:. . . \fI 00, '(OU (\\a~fI\el. ~ ofl \l\\\~~kled B~ilding: \ ~. ce: ",'Oe1 \01 ~el \& \- DEVELOPMENT INFORMATION ~U'" cel'\ Expiration Date 10/04/2011 Phone 541-915-9828 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla REQUIRED PARKING Frontyard Sethack: Side I Sethack: Side 2 Setback: Rearyard Setback: Solar Setbacks: Description Type of Construction Overlay Dist: Total: . # Street Trees Rqd: Handicapped: Paved Drive Rqd: c,o~pact: .~_o of ~uo.!- <:?:e~ag~: ,'~J,i..'i:.}1;."'pc'" . 'j . :., -, .,,, "<",i'~V"" :~\\)\'-.'{,. ,:, ."::-;;::':.~ -_::T':"';~~" "r"" ".(~-:~....... ~~. I PUBLlCIMPROVEMENTS I _~~~\'-.t lv.~~ ~\)\'-.'J;';:: ~\C~. ~ ~,,~\.\.~~~~ , " ~~\S ?t~~t~ \\~~~ce~~outslD':;i~S: 1>-\)\\'\~~~()t~ ~t~\\)~' ()\)~ '\ '?:,'U ~~ 1>-~'l , I Valuation Description ~ . o' "";'.' .t, ,t,. ~ . . $ Per Sq Ft . " .: Square Footage or n\~lfjp'lier' . ,,' or Bid Amount Value Date Calculated Street Improvements: Storm Sewer Available: Special Instruction: Notes: ~ Paee I of2 " ii ~..".,l;.. .. "," CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00621 ISSUED: 05/17/2010 APPLIED: 05/17/2010 EXPIRES: 11/17/2010 VALUE: Status Issued ".{ 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ":"~~'''';'' . >,' f I ", tW.,t-:~1 " jy{ ~ .t~S'il! . Total Value of Project LFees Paid _ Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Amount Paid' . .. : ..'.... Date Paid Receipt Number $11.88.;" · $4:95"': . $18.00 . $81.00 $3.60 $1.50 $30.00 " 5/17/10 5/17/10 5117/10 5/17/10 7/12/10 7/12/10 7/12/10 2201000000000000514 2201000000000000514 2201000000000000514 2201000000000000514 2201000000000000820 2201000000000000820 2201000000000000820 Total Amount Paid $150.93 , ' 1"~lllD Re~iews I i.:..:..... . 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. LReouired InSDec~ ", Rough Electric: Prior to Cover . . .,' . . , ~ . , Electric Service: Approval required prior,touiilily company energizing service. Final Electric: When all electrical work is complete. By signature, 1 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 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 inspectio~S\~re 're9'~ested at the proper time, that each address is readable from the street, that the permit card is located at the front of..the'!properly, and the approved set of plans will remain on the site at all times during construction. -'\~,::~'., ' . ( Owner or Contractors Signature Date Paee'20f2 Ill. 225 F;ifth.Street Springfield, Oregon 97477 541-726-3759 Phone i{~ ",",-_,_"""~,"".' .j. ." City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000Q00820 Date: 07/12/2010 2:15:41PM Job/Journal Number COM2010-00621 COM2010-00621 COM20 I 0-00621 Description Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee " Amount Due 30.00 3.60 1.50 $35.10 Payments: Type of Payment CreditCard Paid By ROGER KING Received By Item Total: Check Number Authorization Batch Number Number How Received Amount Paid djb . . 037775 In Person Payment Total: $35.10 $35.10 I ji\." 1 ,.'.H ~n> Ii.!',) ';. ':.' .<./-0 'Ii .!", cReceintl Page I of 1 7/12/2010