HomeMy WebLinkAboutPermit Electrical 2010-7-26
225 Fifth Streett Springfield, OR 97477tPH(541)726-3753tFAX(541)726-3689
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DEp'ARTMENt USE ONLY'
COvV' ZOfO rOc,:) (.(
Permit no.:
Date: 7- C6 '/0
This permit is issued uuder OAR 918-309-0000. Permits are uontransferable. Permits expire if work is uot started within 180
days of issuance or if work is suspended for 180 days.
'. " :(OCJl.L::GOVERNI\IIEt-IT"'/f.f1F'ROvA15:;i",~'i,)'tyi'i
Zoning approval verified? D Ves D No
'.:~'.CATEGORY:;6f:.C.ONST:RUCTION;':~',
City: '"
Reference:
Name:
Phone:
E-mail:
479540(1) and 479.560(1).
Signing supervisor's license no::
Print name of signing supervisor: .-:--
Signature of signing supervisor:
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Number' ofinspectio'ns per item{.)
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Residential, per unit, service included:
Total
" cost
$134.00 $
$ 25.00 $
$ 32.00 $
$ 63.00 $
1,000 sq. ft. or less (4)
Each additional.500 sq. ft. or portion
thereof
Limited energy (2)
Each manufactured home or modular
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
20 I to 400 amps (2) $ 95.00 $
40 I 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) '-J!>-"~.", $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
$ 63.00 $
$ 87.00 $
$126.00 $
tJ
IohBe~g;ow'l9ffl
B ~~4~. $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch e'ircuit (2)
Each- adCiitional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder ':lot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
$ 63.00 $
$ 63.00 $
$ 63.00 $
Each additional inspection: (I)
$58.00
$
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NOTICE: '\~t,%j''',. ;:::::~::::.:'~~:,])
THIS PERMIT SHAll EXPIRE IF THE W~~T (C) Technology Fee (5% of [A])
AUTHORIZED UNDER THIS PERMIT IS ,.TOTAL fees and surcharges (A through C):
COMMENCED OR IS ABANDONED FOR ;;!i;'
ANY 180 DAY PERIOD.
440-2584-1 (9/0B/COM)
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
,:.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00984
ISSUED: 07/26/2010
APPLIED: 07/26/20]0
EXPIRES: 01/26/2011
VALUE:
Status
Iss u ed
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SITE ADDRESS: 1431 LINDEN AVE
ASSESSOR'S PARCEL NO.: 1703273202500
Springfield TYPE OF WORK: Electrical Work Only
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PROJECT DESCRIPTION: Repair mast and repiilce,meiet,',:
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TYPE OF USE: Repair
Residential
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Owner: ULMER JOAN E
Address: 54655 MCKENZIE RIVER DR SPACE
BLUE RIVER OR 97413
I CONTRACTOR INFORMATION i
Contractor Type
Electrical ' ,
Contractor
MY ELECTRICIAN INC .
License
87506
Expiration Date
11/20/2011
Phone
541-729-1454
I BUILDING INFORMATION ~
e uiteS yoU .\V ,
# of Units: ON' Otegon laW t 6i~~ti6t\Jti.\\'l.
Primary occupancy~UIlI ~do~i\l:l bY th~les'llligb~\'\~,ip~cture
Secondary OccupanlQllc:>>tl';.i\'6: centel. 1\'1OSe 9h (jMlt9ijj?~~~
Primary Constrncti)llJl~fgt}~5~-OO~-00~t\'lt~~ieS ~Intly~~:
Secondary Constru411~6\i may obtain c ate', thi~~Rl\n
# of Bedrooms: 0090., the centel. {N Uti\iWilllF~ql\j\'n:
ca\\I~gt tol the Ole9~~.33'2.-~i\lkled Building: nla
nu{O. Be L....iQ.~~6 .
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I DEVEUOPMENTINFORMATION ~
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
""OverlafDi'st:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
. ;c:':lW"~ ",.~, i'
Notes:
I PUBLIC IMPROVEMENTS ~ .' 1'1" ,.
I . . 'NO,,!' ,;
. Sidewalli\:J:.vo\'f 1\-\'E. ,e. ~'OI 'i'
-r\ct: ~'E.'/-.\'\\'Ie ~l1 ,,, \. ,":"
~QI .. "\1 S ~\O\SS~ :"O:\'. ."",.'''''
.... . S ?ERw\' ....c I D O"f T', "
,;" ; :' . . ".'\\&\ 'R\IED \)~\J<- fl-'\)l\~D ,. .."
~\.n\10 ED OR \5 '.,
COW\W\t.~~l\'1 PER\OD..
, \)
,y": '
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Street Improvements:
Storm Sewer Available:
Special Instruction:
,.
Valtiation Descri tion
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
t;J~~~:..'":~,,:t~-;~A~'~.' L:,~~. ,
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Pa!!e 1 of2
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Status
Issued
225 Fifth Street, Spr1ngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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'. Total V'alue 'of Project
~Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid
Total Amount Paid
$7.56
$3.15
$63.00
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$73.ir'.,~; ::i:'
I PI~n Reviews I
Date Paid
,.".~.: .
7/26/10
7/26/10
7/26/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00984
ISSUED: 07/26/2010
APPLIED: 07/26/2010
EXPIRES: 01/2612011
VALUE:
Receipt Number
2201000000000000875
2201000000000000875
2201000000000000875
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.
ReQuired Insnectio~s .
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Electric Service: Approval required priod'o"uiility 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 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.
1 further certify that only contractors and employee~,w~o~re,.i,n.compliance with ORS 701.005 will be used on this project.
1 further agree to ensure that all required inspectionsi~re'reqiiested at the proper time, that each address is readable from the
street, that the permit card is located at the front or-th'e' property, and the approved set of plans will remain on the site at all
times during construction. ..tr-': . ~""""""", --'
Owner or Contractors Signature
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1-1
Paee 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
RECEIPT #:
2201000000000000875
Date: 07/26/2010
II :49:56AM
Job/Journal Number
COM20 I 0-00984
COM20 I 0-00984
COM20 1 0-00984
Payments:
Type of Payment
CreditCard
cReceintl
Description
Service Reconnect
+ 12% State Surcharge.
+ 5% Technology Fee
Paid By
MY ELECTRICIAN
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'7' ~
Amount Due
63.00
7.56
3.15
$73.71
he!" Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
$73.71
$73.71
023271 In Person
Payment Total:
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