HomeMy WebLinkAboutPermit Electrical 2010-8-11 (2)
225 Fifth Streett Springfield, OR 97477tPH(541)726-3753t FAX(541)726-36S9
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:'DEPARTIVIENT IJSE ONLY, "',F
Sf'UOIO -OOC~ I
Permit no.:
Date: ~-II-IO
This permit is issued uuder 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.
;" ":~'~'l!.OCALC;O)lERNMEIIIT'APPROVAt _ . -;-
Zoning approval verified? DYes DNa'", 'Lk..
.<. HJ,.;, .CATEGORY'OF ,CONSTRUCTION"':ft~~:,::\;:~'f'
~esidential D Government I D ComDl.e,cial
''4. , ,JOB 'sITE.'iNFORMATION'AIIID '[OCATIOIII' .
Job site address: LI ] 2.. <: 'I f II .s f
City: \; /) II'/'Vl 6, (i-.. j I State:o y , I ZIP:7'7 U-::Z v
Referen~e: \'1 n'i?1\ ~ A I Tax]od'PAr-t'\
\.. 'w:,:.~~:~ DESCRIPTIO'N. OF' WORKb. . ,:i. ,,,.'-"/
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:M" h,' " ',:'~PROf>ERT;Y,OWIIIER:'",,' ~"" . ,"1 ~ , ,
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Name: Cry', /. J_/.,,,~, C",.//c:;t"u'~':'; ,/I
Address:? .s;r,V/ V"J'yo, Jrvt f'e;, i::J;;,,,,
City: \P1T/J,1 h j n. .11~tate: d' v' I'ZIPci::Z I.A -"
Phone: S~/, r/ J",..,....,lFax: - ,
E-mail:
This installation is being made on residential or fann property
owned by me or a member of my immediate family, This. .
property is not intended for sale, exchange, lease, or rem.,.<)AR" ,:.' ,
}79,540(l) and 479,560(l)'j;:0' ''C,:r,t:
~ Signature: G u6! c! q (r//2<- Cc, vi c:T .r-:~~~,::~:-:
, ,:>.,'CONrRAC.IoR\IIIIS'f.!\LtAimoN''':c7.:r,:'' c ,.'
Business name: /""")/ J N E^
Address:
City:
Phone:
E-mail:
CCB license no.:
State:
I Fax:
I ZIP:
I BCD license no,:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
$!,J.
~ ;E~',llt .0
NOTICE:"'"
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED,fOR'., i
ANY 180 DAY PERIOD.,,:':i': T:,'I.
IJ)~" Ci\1'
~O '
~
440-2584-J (9/08/COM)
. ,
FEE SCHEDULE
:!,
Cost
ea.
Total' ,:
co~t., .;
';;~j~~~~e~ oJ ilJspectlons per.'item,() J qty;
Residential. per unit, service included:
1.000 sq, ft, or less (4)
Each additional 500 sq. f1. or portion
thereof :
Limited energy (2)
Each manufactured home or modular
,dwelling service or feeder (2)
$134,00 $
$ 25.00 $
$ 32,00 $
$ 63,00 $
Services or feeders: installation, alteration, relocation
200:~mps or less (2)
20 I ~o 400 amps (2)
40 I to 600 amps (2)
601 to 1,000 amps (2)
Over 1,000 amps or volts (2)
Reconnect only (2)
I $ 8t,00
$ 95.00
$158,00
$205.00
$469.00
$ 63,00
$ g(
$
$
$
$
$
Temporary services or feeders: installation, alteraUon, relocation
200 amps or less (2) $ 63,00 $
201 to 400 amps (2) _. $ 87,00 $
49).to 600 amps (2) . ..., (e~\J\leS ~~'i\\\~126,00 $
Over ~~lllrcv.l'Y\'\l't\tI~*:l1,,'1ltij:e~s section above
~~.t~~~~~~~IM~' '~{
~l\I'S~~i\l;WAIM\'!lS ' ~or feeder fee:
II ~q\rtBlf~~~;' 'l\'\o\~:~~~;;; l-I,b\i\iCF'l:" 6,00 $
Q,\l~\{~~~~C(!jte~ fa service or feeder fee:
~!I~~Elli~M'u' $ 55.00 $
Each additional branch circuit .. $ 6.00 $
Mis'cellaneou.s fees: service or feeder not included
,I . I?ac~'pump or irrigation circle (2)
. ,. .J Each sign or outline lighting (2)
$ 63.00
$ 63,00
$
$
$
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (1)
7"h~,i
$ 63,00
$58,00 $
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APPLICAIIIT, USE . , ',' '~"f"';; ,,'
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C)'Technology Fcc (5% oflA])
TOTAL rees and surcharges (A through C):
$ ~,
$ 97l
$ y~
$ 9","'"
S!~.~N.=~~
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~OREGON
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
Building IResidenti~IPermit
PERMIT NO: 811-SPR2010-00031
permitcenler@cLspringfield.or.us
"
IVR'Nlunber: 811180014530
PROJECT STATUS: Issued
ISSUED: 8/11/10
APPLIED: 8/11/10
EXPIRES: 2/6/2011
VALUE: $0,00
SITE ADDRESS: 43234TH
ASSESOR'S PARCEL NO:
Springfield
1702312409400
SCOPE: Electrical Only
WORK INVOLVED: New
'." TYPE OF STRUCTURE: Residential
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PROJECT DESCRIPTION:
Panel change
OWNER:
ADDRESS:
CARLOS GUADALUPE
3841 VIRGINIA AVE
SPRINGFIELD OR 97478
,,("'" .:' f'~1 ""
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Phone Number:
Contractor Type
Contractor Name
CONTRACTOR INFORMATION ~
Lie Type
Lie No
Lie Exp
Phone
BUILDING INFORMATION I
# of Units:
o
# of Stories:
I Heigh~ 9f~~~~c~~~e.: '! t, .
WR'\RI:~eat:; ..
Water Type:
~. \ '\
.. '.~
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Occupancy Load:
# of Bedrooms:
Range Type:
Hazmat:
Sprinkled Building:
Fire Alarms:
Energy Path:
Electrical Specialty Code Edition:
Springfield Fire,Code Edition:
Mecha~(~~1 s~~~i~i.ty Code Edition:
Muni~1pai?'! O'eV~'9pnient Code:
T.,_ '. ''',
Plumbing Specialty Code Edition:
Resid~iitial Specialty Code Edition:
Structural Specialty Code Erlition:
Site Information
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NOTICE: .,' 'c. ,-,. . ...
TH IS PERM1T SHALL EXP1RE IF lHE WORK .:
~ AUTHORIZED UNDER THIS PERMIT IS NOT ;,:
COMMENCED OR IS ABANDONED FOR <,("':,
ANY 180 DAY PERIOD. "." '
Engineered Fill:
Fill Volume:
Flood Hazard Area:
land Hazard Area:
Retaining Wall:
Soils Report Required:
"
,<1., ~
ATTENTION: O,r.egpn lil\,!,rriluir,es you,t,o
follow rules adopted l:iy'the Oregon Utility
NotificatiotrCei')te'i, Those rules are set forth
in OAR 952-001-li010through OAR 952-001-
0090, You may obtain copies of the rules by
calling the center. (Note: ~he tele~hone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit
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Page 1 of 3
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CITY OEi,$PRINGFIELD
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Building.kResidential Permit
PERMIT NO: 811-SPR2010-00031
IVR Number: 811180014530
PROJECT STATUS: Issued
ISSUED: 8/11/10
APPLIED: 8/11/10
EXPIRES: 2/6/2011
VALUE: $0.00
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@cLspringfield,or.us
SITE ADDRESS: 43234TH
ASSES OR'S PARCEL NO:
Springfield
1702312409400
SCOPE: Electrical Only
': '". WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
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PROJECT DESCRIPTION:
Panel change
DEVELOPMENT INFORMATION ~
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Pav,ed Dr!,v-? Reqd:
% of Lot Coverage:,_
. u', ,'I
Highest point on:.stt~~!.~mr!o, ~,
~"""'''''' ~".1."J.. t'i '.
north property Jme:,~ ; ,~",,:i'; t
t' .j~i'; ; ,: ~;; ,
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBlic IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Special Instructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
;f'l':'.fi
,.' F'
Valuation Description ~
Descrietion
Tvee of Construction
Unit Amount Unit Tvee
Unit Cost
Value
P;":4Z;,::g, ',T'M; -:}0;::~;- ':-[_~;J'~~':--,~D:7-:;-~~;'~<~:i~'~~"~~m~w:,,, 'i' "'; :~},,-'-:r;,w~ ':"" .; ~'::.'-'" tr~'
Descriotion ;njAmountl?aid " ... Date Paid
Service~90 amps or less !~r;-~'~,:: ,~~ ~~$~\O(), 08/11/2010
Technology fee (5% of permit total) ':,:".'>~: $4.05 06/11/2010
:;tate of Oregon Surcharge (12% of applicable fees) . $9.72 06/11/2010
Total Amount Paid $94.77
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Receiot #
224414
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224414
224414
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Comments
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Deoartment
Application Acceptance
Initial Review
Planning Review
Public Works Review
Structural Review
Permit Issuance
Rece ived
OBlll/Z010
08/11/2010
08/1.1/2010
08/l1/Z010
081111Z010
08111/Z010
ComDlete
OBll11Z0l0
08/11/2010
08/1112010
OBlll/Z010.
08/1112010
06/11/Z01D
Reviewer
David Bowlsby
David Bowlsby
David Bowlsby
David Bowlsby
DavId Bowlsby
David Bowlsby
Result
Over the Counter
Over the Counter
Over the Counter
Over the Counter.
Over the Counter
. Issued,
.
Due Date
08/11/Z010
08/11/2010
08111/2010
08/1112010
0811112010
08/11/2010
Springfield Building Permit
, ':'r ~f11f2010 9:33:50AM
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Over the counter permit
Over the counter permit
Over the counter permit
Over the counter permit
Page 2 of 3
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www.cLspringfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00031
IVR Number: 811180014530
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225 Fifth St
Springfield,OR 97477
Phone: 541.726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
5~R'N. G.. f.'.E. l~
..~.
,:~
""~'ORfGON
perm itcenler@ci.springfield.or.us
PROJECT STATUS: Issued
~t: r&it,. ~'~~J.tLt1Li..~~
ISSUEP}:8/11f1;Q' .J
APPLJJ~l?: 8/11110
EXPIRES: 2/6/2011
VALUE: $0.00
SITE ADDRESS: 43234TH
ASSESOR'S PARCEL NO:
Springfield
1702312409400
SCOPE: Electrical Only
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Panel change
INSPECTIONS REQUIRED . ~
Inspections
4220 Electrical - 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 cer{ifyihat any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Buiiding 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 inspections 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 on the site at all times during
construction.
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Owner or Contractor Signature
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".,":'";'::-~ ,. .;- Date
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Springfield Building Permit
8/11/2010 9:33:50AM
Page 3 of 3
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",,;L. OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726.3753
www.cLspringfield.or.us
pe rmitcenter@ci.springfield.or.us
RECEIPT NO: 2010000037
RECORD NO'(SI:j-SPR201O'00031
DATE: 08/11/2010
lDESCRIPTIOilF:j!t;f' ',;;7f7'!fc,f'- ;;7!F~~111'l!ft'r:.il'4cSi/-, : AC.C.o.lfNU90EtS-:';:'c'" ,"",:"'~l'iIo_l.'-NJ~D.UE':'F'l
Services 200 amps or less 224-00000-426102 $81,00
Technology fee (5% of permit total) 100-00000-425605 $4,05
Slate of Or<:gon Surcharge (12% of applicable fees) 821-00000-215004 $9,72
TOTAL DUE: $94.77
t:JPA~M_~NJJgPE;- -~"'. 'RAYOR' ~"CASHIERrr6B()v0lSBY'C.OMME:NJS~';. ,.;., ,,;- .~:; },,;"'~I'iIOLJNL~l\ll:l.~:\ '. {
Check guadalupe carlos delgado $94.77
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