HomeMy WebLinkAboutPermit Electrical 2010-8-10 (2)
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Electrical Permit Application
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225 Fifth Streett Springfield, OR 97477.PII(54J)726-3753.~.F~,,~!?~,lp26-3689
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'O,EI'ARTMENT USE ONLY' . ;,
Permit no.:,1I - SI'i<:2-DIO-<XJ<)'.2J{
Date: ? /0 ;0
This permit is issued under OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
;;Y>'~+:\~;'-C-LQCALGOVERNNlENT .APPROVAu,>."... -.
Zoning approval verified? 0 Yes 0 No
:CATE<:;OR'(' OF . CONSTRUCTloW;"'~~-.c
o Government 0 Commer.cial- ,,-
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Job site address: S"3 g +!J. s. ,"'" "
City: $?l2.'''' 'Fla.-I:>
ZIP: '11"'\
Reference:
Taxlot.:
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ZIP:
Name:
Address:
City:
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). -.,.
Signature:
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. CONTRACTOR', INST ~~I:A'TION:~r;;;;EK',~'-:'ri'i
Business name: C. "?
Address: P. tJ.
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State: CJ <"L ZIP: "1 '7 '-I( b
Fax: 5</1_ '/,1{'" - LI5 J. (,
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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BCD license no.: C--3
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440-2584-) (9/08/COM)
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. . -, Cost . "TotalL'
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~~~~~r~'o~t ~nsp:!ct.i~~-s per,;l!.e!",(J ' Qty. "e"a. ~ CO,st);'i;
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R~sidential, 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
200amps or less (2) ( $ 81.00 $lf/
. $ 95.00 $
.201 to 400 amps (2)
, 491 to 600 amps (2) $158.00 $
,.
601 to 1,000 amps (2) $205.00 $
Over 1.000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: instalfation. alteration, relocation
200 amps or less (2) $ 63.00 $
20 I to 400 amps (2) $ 87.00 $
101 to 600 amps (2) $126.00 $
: Over. 600 amps or 1,000 volts, see services or feeders section above
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Branch circuits: new, alteration, extension per panel,
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit ( $ 6.00 $
b. Fee for b~anch circuits without purchase ora service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Mis,~ellaneous fees: service or feeder not included
9a~~ipump 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 extension (2)
Each additional inspection: (I) $58.00 $
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(A) Enter subtotal of above fees $ ff!~
(Minimum Perm it Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $ tJ'?!'
(C),Technology Fee (5% of[A]) $ '1{)J
t,."." .- '7 'j "..z.
:reT AL fees aud surcharges (A through C): $
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CITY OFSPRINGFIELD
Building '-Residential Permit
PERMIT NO: 811-SPR2010-00028
IVR Number: 811164196629
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541.726-3769
Fax: 541-726.3676
permitce nter@ci,springfield,or.us
PROJECT STATUS: Issued
ISSUED: 8/10/10
APPLIED: 8/10/10
EXPIRES: 2/5/2011
VALUE: $0.00
SITE ADDRESS: 5339TH
ASSES OR'S PARCEL NO:
Springfield
1703351304400
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
PROJECT DESCRIPTION:
200A service change
OWNER:
ADDRESS:
WAlSTER JANE
533 9TH ST
SPRINGFIELD OR 97477
Phone Number:
Contractor Type
Contractor Name
RITE ELECTRIC INC
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CONTRACTOR INfQRMATI()Nlflter ~rh~~~';~I~;egon Utility
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,', omn VA~.'C Type.. Ulc)N~h OA ~i
. cal/inn ~,qC~~ul""l mpi~s of the'l'l/il~~o~ '
BUILDlNGINPORMATiON for thlO;~gl~~U~;iJ~~e telephone l
I,HI: . ,,' ' . '-'~I Her IS 1'800'332}3~~tlflcation
# of Stories: lot Size: ).
I Height of Structure: .. Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Phone
541-895-4466
# of Units:
o
'1"
# ot Bedrooms;
Hazmat:
Sprinkled Building:
Fire Alarms:
. "' Occupancy load:
Electrkal speciall):,?IJl'b1ilt~; E IF THE WORK
Springfield Fire Code G~(~QnPERMlT SHAll EXPlR RMlT IS NOT
Mechamcal Specialty 9\'~~'!i~1i\1[:ED UNDER THIS PE
Munici.pall Dev~lopm~tn8,~~'tNCED OR IS ABANDONED FOR
Plu~blng Specla!ty Co fl(:.di~i81\: nAY PERIOD. .
ReSIdential SpecIalty ,iW El.itmrt:'
Structural Specialty Code Edition:
Energy Path:
Site Information
~
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
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CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 81-1-SPR2010-00028
IVR Number:,8U164196629
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield.or.us
PROJECT STATUS: Issued
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ISSUED: 8/10/10
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APPLIED: 8/10/10
EXPIRES: 2/512011
VALUE:'$O.OO
SITE ADDRESS: 5339TH
ASSESOR'S PARCEL NO:
Springfield
1703351304400
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
PROJECT DESCRIPTION:
200A service change
DEVELOPMENT INFORMATION ~
REQUIRED PARKING
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay ~,ist: .-; "/"
# ~treet,Trees Reqd:~
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure to
north property line:
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS ~
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,I
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
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Sidewalk Type:
1;)0wnspoutlDrains:
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Valuation.Oescrip!.ion ~
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Unit Amount Unit Tvoe
Unit Cost
Value
Descrietion
Tvee of Construction
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Descriotion
Services 200 amps or less
Technology fee (5% of permit total)
State of Oregon Surcharge (12% of applicable fees)
Total Amount Paid
$81.00
$4.05
$9.72
$94.77 ,
Date Paid
08/10/2010
08/10/2010
08/10/2010
Receiot #
224411
224411
224411
Deoartment
Permit Issuance
Application Acceptance
Initial Review
Planning Review
Public Works Review
Structural Review
Received
08/10/2010
08/10/2010
08/10/2010
08/10/2010
08/10/2010
08/10/2010
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ComDlete-~.\' 'Result",i ,.;;.,., Reviewer Comments
08/10/2b10-~!t Issued--q . Chris Carpenter
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08/10/2P~O, 5 OveYthe Counter Chris Carpenter
08/10/201'0 Over the Counter Chris Carpenter
08/10/2010 Over the Counter Chris Carpenter
08/10/2010 Over the Counter Chris Carpenter
08/10/2010 Over the Counter ~hris Carpenter
Due Date
08/10/2010
08/10/2010
08/10/2010
08/10/2010
08/10/2010
08/10/2010
Over the counter permit
Over the counter permit
Over the counter permit
Over the counter permit
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Springfield Building Permit
8/10/2010 2:58:18PM
Page 2 of 3
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
CITY OF SPRINGFIELD
www.ci.springfield.or.us
Building I Residential Permit
PERMIT NO: 811-SPR2010-00028
IVR Number: 811164196629
permilcenter@ci,springfield.or.us
PROJECT STATUS: Issued
ISSUED: 8/10/10 - .
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APPLI~~: ~/~0(10,<:
'EXPIRES: 21512011
VALUE:.$O.OO
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SITE ADDRESS: 533 9TH
ASSESOR'S PARCEL NO:
Springfield
1703351304400
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SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
PROJECT DESCRIPTION:
200A service change
OWNER:
ADDRESS:
WALSTER JANE
533 9TH ST
SPRINGFIELD OR 97477
Phone Number:
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CONTRACfORINFORMATlON I
Contractor Type
Contractor Name
RITE ELECTRIC INC
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Lie Type
CCB
Lie No
178518
Lie Exp
09/25/2011
Phone
541-895-4466
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BUILDING INFORMATION ~
# of Units:
o
# of Stories:
I Height of Structure:
Type of Heat:
Water Type:
Range Type:,' . .,. <'
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Hazma't;~ ,." . ,)f in.).
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Sprinkled Building:
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Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Occupancy load:
# of Bedrooms:
Fire Alarms:
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal I Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Stru~~~;~ ~~~~~:~.?~,~~d.ition:
'NTNi sifi{.iff'fMiriaiiOn'. ' ~
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Energy Path:
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
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Springfield Building Permit
8/10/2010 2:58:18PM
Page 1 of 3
5~~IN.G.F...I.E.~.. .
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'.,. -OREGON
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225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541.726-3769
Fax: 541.726.3676
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CITY OF SPRINGFIELD
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www.ci.springfield.or.us
Building 1. Residential Permit
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PERMIT NO: 8t1-SPR2010-00028
IVR Number: 811164196629
permitcenter@ci,springfield.or.us
PROJECT STATUS: Issued
ISSUED: 8/10/10
APPLIED: 8/10/10
EXPIRES: 2/5/2011
VALUE: $0.00
SITE AODRESS: 5339TH
ASSESOR'S PARCEL NO:
Springfield
1703351304400
. .
!':i.~\~l ':<~'~'" . SCOPE:
~:\:;fJ')~ .'f~~!'; ti1:\' ~' ,'(\fORK INVOLVED:
:',0'" '~''-~'iYPE OF STRUCTURE:
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PROJECT DESCRIPTION:
200A service change
INSPECTIONS REQUIRED I
Inspections
4225 Service or Feeder
4999 Final Electrical
By signature. I state and agree. that I have carefully exami~ed the complete~ application and do hereby certify that all
information hereon is true and correct, and I further certify that any and ,alJ,~9rk.p~,rformed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oreg~n pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the,C'om'munity Services Division, Building Safety. J further
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certify that only contractors and employees who are in,c"onipli~ince with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections are requested at the:Rfoper time, that each address is readable from the street, that the
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Owner or Contractor Signature Date.
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