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HomeMy WebLinkAboutPermit Electrical 2010-7-20 This permit I,; i.'5ued under OAR 9]8-309-0000, Permits are nontr"i'sferable. Permit. expire if work is not started within ]80 days of iss,," "ce or if work is suspended for 180 days. JQ.,SOefl_ ~ 'L C CAL' GOVERNMiENT APFiROYAl:, ..>",;" , ." i ,', "ii,;:'?:"!'!~,'I,,':I,i~;;'i:i':i"'EE:'.:S!O:REOUl!Er;;;~'i.;itr;,~i!;~(",~i,i;Yi(t\I~::ii Zoning approval verified? DYes 0 NONu~b.r'ofin,p~cfion,per,;t~~:(.)' Qt)'. i ~~t ,~~~J "C\TEGOR'r!::Of;"CONSTRUCl'ION',~ ' o Residontiai 0 Govemrnont 3 Commercial ,t1f~""I.j;~'i,w Ei:;(S lIE :INFQRMifTlctNfANtV"QCJ\TlbN::",,;,;.,ti; Job site adme,.,;: i:>u .....L>-... GL-\e.t>'\L ~ City: Stare: t> a- ZIP: '''1'1 11 Electricd Permit Application , ~"$':"- ~;1; €IJ. It. . ..",.""" ". . . ::;;,:;':;'.';:;.~..~,' " - ,- , 225 Filth Slm!! :;priH~ll,ld, OR 97477.PH(S41)n6.3753+FAX(S41)726-3689 \ PhOne: E-mail: This mstallllrion is being made On residential or farro property owned by me or a mef!lber of my immediate family. This property is not intended ior sale, exchange, lease, or rent OAR 479.540(1) and 479,560(1), Signature: ,CONTRACTOR INSTAllATION .\- G:~ City: Phone:'5 E-mail:' CCE license no.: Signing SUpervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: c.. fI-0," \\ S'lt-' ~\..\~ lD ~ "ilJ~i1l2.- ~tB\" 440.2584-) (91D8/COM) W 39\1d al3I~9NI~dS ~o Al18 ~~ DEPARTMENT USE ONI.Y {ViJ- C;G2 Pennit no.: Date: Residential. per unit, service inclu.dcdj 1.000 sq, ft. cr less (4) Each additional 500 sq, ft, or pOrtion thereof . $134.no $ $ 25,00 $ Limited energy (2) Each manufactured home or modular dwelling st:rviot: or feeder (2) $ 32.00 $ $ 63.00 $ . Services or r",~d.,r:il: installation. alreration, reloc~eion 200 amps or l.ss (2) \ $ 61.00 s ~~ eoD $ s .... $ $ $ 20 I to 400 amps (2) 40 I to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 emps or volrs (2) Reconnect only (2) $ 95,00 $15B:OO $206.00 $469.00 $ 63.00 Temporary aervicclS ur foc:dcn: instaltafl'on. alterQ#Dn, relocatiON 200 amps or loss (2) $ 63.00 S 201 to 400 amps (2) $ 67.00 $ 401 to 600 amps (2) $126;00 . S ... OVer 600 amps or 1, ,QOO YOlts, see services or f~eders scction abov!: Branch drcuits: n.ew, alteration, e:ttensicUl pel' panel e.. Fee for branch circuits with pu~chasc of a s~rYiQe or feeder fee: Eoen branch circuit 2.( $ 6.00 S \'U.." b. F~e for branch circuits without purchase of a'service;: or fl;':l;Odcr fee: first branoh cirouit (2) S 55.00 $ Eacn additional branch circuit. $ 6,00 .. $ Miscellaneous fees: service or feeder (Jof'l'nal1.ld/1d .: Eaoh pump or irrigation cireie (2) Each sign or outline lighting (2) Signal circuit or i1limitt:d.en~rgy piU1el, u.lteration, or extension (2). Eacn additional in'peetion, (I) $68.00 S , :(,,,,, '''i"Yo''l1'l(\',:, ""~"''';;A .''';;;'''I'''''IiI'';''''''''S~'''' i"'''''''''';'' .,.:"",';' ,:, .;.'" , ~;,i,,~,,:(,,*lj:.;~;~"\'H!Jlt,,;""~'~'~!,'.<i.;~-1-'(. "1.':1:::";' ~'Ml'C~;J~:~,~';Oi'I:":;..,it,,:.. ":" J,""~~",,"<'ff:~,:'.:,I.:. .; '. . $ 63.00 $ 63.00 S 5; $ 63,00 $ (A) Enter ,ubtotal of above fees . (Minimum Pormit FeeSSS.OO) (B) Enter 12% ,urcharge (.12 x [A)) (C) Technology Fee (5% of [Al) TOTAL fee. and .urcharges (A through q; $.;1<>,',,,.. $ o1<J;e-l $ I':>.~ $ 2'-\2., ~q 'lL'lE'l1:L ~~:L9 RIRZ/~RIIR '~:JN~j:~ ;~};~l~I~~~~~j~' . : ~-.} . ( ~,:Z;::;. ,,' w, . ~,;:, , ~, CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00962 ISSUED: 07/20/2010 APPLIED: 07/20/2010 EXPIRES: 0112012011 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ..."1 J, SITE ADDRESS: 3680 JASPER RD ASSESSOR'S PARCEL NO.: 1802061202700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Public PROJECT DESCRIPTION: Electrical for bioler replacement Owner: Address: SPRINGFIELD SCHOOL DISTRICT 19 525 MILL ST SPRINGFIELD OR 97477 t~/~l' 'li:~'):' I 1 'H/'O"'i .1'Ii~., ~,;., '" T\ON' Oregon law re4U t .w.... ,~~ _ T~ -':, . ATTE~Ules ~dopted by the Cjne0N~d\l;OR INFORMA nON ~ follow t Those ruh\1. __ ,--- I .J>lotification Cen eL hOAR 952-001- Contractor ~~~R 95~otmHlrhrO~;g " of the rules by License Electrical 0, YoUIlR1.TONt'E~,~ C\~lephone 164857 \ling lev Ill...... ," .." -.., .,... ca ber for the Oregon Utili Y UlL G INFORMATION num Center is 1-800-332- # of Stories: Heigbt of Structure Type of Heat: Water Type,' '" , , ' ',. ',-I 'RangeType,'-" , 'ri-J"EiJergy Pitt~i Sprinkled Building: Expiration Date OS/25/2011 Phone 541-484-9800 # of Units: , Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Storm Sewer Available: Special Instruction: Downspouts/Drains: Notes: , , DescriPtion' Type of Construction I Valu~tion Des'Ci'iption I (,'.'. .. $(p~/Sq Ft ," Square Footage or multiplier or Bid Amount Value Date Calculated Paee lof2 Status Iss u ed S:-:::,';T "'1>', CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00962 ISSUED: 07/20/2010 APPLIED: 07/20/2010 EXPIRES: 01/20/201 I VALUE: '~i~~tf;' . '.t_; 225 Fifth Street, Springtleld, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~-". !'};' Total Valne of Project Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ServrFdr 200 amps or less Fees PaidL. "':~}J" ',,' ';." .;....,:'"; . . .. k . Amount Paid. Date Paid Receipt Number $24.84 $10.35 $126.00 $81.00 7120/10 7120/10 7120/1 0 7120/10 2201000000000000846 2201000000000000846 2201000000000000846 2201000000000000846 Total Amount Paid $242.19 I .i:ijn,R~~iews ~ ",,}.:"'o) f,.!:';', (~~; ;' 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. I Reauired Insoections I Electric Service: Approval required prior to'litilitYc~,",~a:h en~rgizing service. . ',,'j '.' . .., . '.' ..,,~'. Rough Electric: Prior to Cover \, ~ , ,:i . . 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 Springlield 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. 1 further certify that only contractors and employeesjYho"ar,e.in.compliance with ORS 701.005 will be used on this project. 1 further agree to ensure that all required inspectioiisiare'i'j!qti~sted'atthe proper time, that each address is readable from the . ~._,I\.tl' _.",.~ I' .. , , ;::;';:1/J::ii'"""'" "","0< "if~'ro'",,; '"' ", ."ro~ ":"'(: rom.', ." ".""" ." Owner or Contractors Signature Date , J':' ~, . ~~tH;,' , P~ee 2 01'2 .! 225 Fifth Street Sp.ringfield, Oregon 97477 541-726-3759 Phone. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1, \ ,; . ',~ ~, '.'" 2201000000000000846 ....i'..;t'. "", .....- , Date: 07/20/2010 10:49:24AM Description 3'i~;:'.::;:;~ . "...:.}~,',,; Penn Serv/Fdr 200 amps or less .;:; " Add, Alter, Extend Circ Eo Add + 12% State Surcharge + 5% Technology Fee Paid By SCOTT LISTER Item Total: Check Number Authorization Received By Batch Number Number How Received cjc 04598d In Person Payment Total: Amount Due 81.00 126.00 24.84 10.35 $242.19 Job/Journal Number COM20 I 0-00962 COM20 I 0-00962 COM20 I 0-00962 COM20 I 0-00962 Payments: Type of Payment CreditCard Amount Paid $242.19 $242.19 ;1'0, '~"'n \. I .\ I., ,'!\t;U~, '~ILflH){)I);')' i_.: ; ~ ~-" ,';-.';' J''''',~.. ,...."".1... i'A-:'- ~';'. .,-.', 1l ,t,,~ " '. ".. ~;~:i'fH~, iIO:q:_f't~\); "., .~ ""~~ :"),'j-, \'" ',' .. cReceintl . Page I of I , , 7/20/20 I 0