The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2007-9-10 ZON L- c:::a.-- INITIALS t-.J Y"-"-. DATE C\.......\, ~cr1 SOURCE ~{)fV 225 FIFTH STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION r- City Job Number (OW\ z.c>o 7 - C> ( "3 7 S JOB DESCRIPTION: 1000 sq. ft. or less ') .) /. ,f I ({ Flach additional 500 sq. ft. or ~ ~ )' d-vL ? 't'Pl ~ C, r~ dortion thereof Per~i'ts are non-transferable a~ expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 1. 2,c. ')- C ST :>./J c.../J CYt<r L~7~D1S3&I(~ 2?(0L::> 2. Electrical Contractor tJ1 ,'~ We f" f- U~ L- Address 2:7 x~ ,1\.1 AM>....c.... 0<.- City<;PUJ Phone 3711" ~ H"c" <10 Supervisor License Number t17i ), ~ Expiration Date /0 - DJ' 07 Constr. Contr. Number j4t7'4S- Expiration Date J- ( g--- D Y Signature of Supervising Electrician /d~---,- , ~ W~ ~ ..-::, Owners Name ~ b........... \ \ ..... . \ c:........^-t Address ebb}' C sf- S"~A City Phone OWNER INST ALLA nON The installation is being made on property I own which is flU1fr:l? for sale, lease or rent. oJ~ fl~ff: SHAll AUTHORIZED llN EXP'~ IF, THE WOR~ (;OMMENCED OR~~R nlls rfRIVII, IS NOf ANY 180 DAY PERlotBANDONEfJ fOR" v Inspection Request: 726-3769 Date 0'7- } f)' 2J7 3. A. Service Included $117.00 $ 21.00 $55.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 70 c. AW~tifi~WVai ~6ff.ioYou to foll~~pted by the Oregon Utility $ 55.00 Notj~QeIll_A~ rules are set fOrtb1l76.00 In QMJ~~sQg~~~ough OAR 952-001-$110.00 0090: YOU-may obtain co 'es of the diRm 1 " Ji))J New Alteration or ExtenslO~ er~anel One Circuit + $ 48.00 Each Additional Circuit or with Service or Feeder Permit t $ 4.00 L( E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited EnergylResidential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 4. 7'1 S~~ 7~ 7?D W~ 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01375 ISSUED: 09/10/2007 APPLIED: 09/10/2007 EXPIRES: 03/10/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2665 C ST ASSESSOR'S PARCEL NO.: 1703361422100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace service and add 1 circuit Owner: ROBIN HOLLOW A Y Address: 2665 C ST SPRINGFIELD OR 97477 Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MITCHS ELECTRIC INC License 146745 Expiration Date 01/18/2009 Phone 541-521-5690 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: StrefJtwl'(;E~ments: ~~::~~t~~~"All EXPIRE IF THE WORK X\H1fu1ff4~d:UNDER THIS PERMIT IS NOT NottGPMMENCED OR IS ABANDONED FOR ANY 180 DAY e.&B!O.O. I PUBLIC IMPROVEMENTS tlTENTJON' Or ol/ow~~ eg~n faw requfres you to Notification Ceo I!)Rfa by the Oregon Utility In OAR D8~-'b1ff_t~~aM rules are set forth 0090. You ma ob . ro~gh OAR 952-001. calling the ~nte~a'"(NCOtPJ.es of the rules by nUmb f . 0 e. the teleph er or the Oregon Utility N ' one Cantsr I, 1 @ge __~~fication I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01375 ISSUED: 09/10/2007 APPLIED: 09/10/2007 EXPIRES: 03/10/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $7.40 $3.70 $5.92 $4.00 $70.00 9/10/07 9/10/07 9/10/07 9/10/07 9/10/07 1200700000000001176 1200700000000001176 1200700000000001176 1200700000000001176 1200700000000001176 Total Amount Paid $91.02 I Plan Reviews 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. I ReQuired Insoections I Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 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 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. Owner or Contractors Signature Date Paj!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01375 COM2007-01375 COM2007-01375 COM2007-01375 COM2007-01375 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000001176 Date: 09/10/2007 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MITCHS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 003123 In Person Payment Total: Page 1 of 1 12:04:24PM Amount Due 70.00 4.00 3.70 5.92 7.40 $91.02 Amount Paid $91.02 $91.02 9/1 0/2007