The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-6-23 Zoning 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION I. CityJobNumberCOMZc:~ {'"-oo 7~.5 Date b/Z3/f)~ , I [, . . . ~~.r ,__,,".,, ' 1. !LOCATION 0, < n-'-.-, "". ...,~ "i;ic/::" ,~:>'-.,," i""""":'''''_'''~'''''''''~_{S,:',,_,;; 36lflG E;AeA-~ . S {2.d LEGAL DESCRIPTION J g'"Oz.. IOOC;:> 01 Z.OO JOB DESCRIPTION r~ ~ ~\ ~ ~{LII' <..c.:: t FEe- he tL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Electrical Contractor 3. A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. '2- IZ?:' 200 Amps or less 201 Amps to 400 Amps W\~:rti~ tlE:401 Amps to 600 Amps IF THE V'Vno II ER~~lif C.l-H~J I El<PIKt '-'".. THIS P 601 Amps to-l0001'~.mp'sR \11 IT IS i\in T AUTHORlov'ci-lt)&0~~mJ.JM6Itst I ..- . CO\viMEN1S~Bn~'ttkSni~HANUONEO FOP. ANY 180 100. c. Address BURRELL BROS. ELECTRIC P.O. Box 697 WalteNille, OR 97489 541pl~-2724 City Expiration Date til'll s jO ~ 07 Supervisor License Number Constr. Contr. Number 7_0 --447(' (l? ~Db Expiration Date ~~~Si~=~,^_, OwnersNam~ :r-Awt~ ~e-.\ t:.a.( Address Po 150x 2bZZ~ City tcA.c.--€:N~ Phone '188 - Olfll OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Cir~uit Each Additional Circuit or with Service ' ~ ....MAr n- ...~' fa $ 3.00 I'\rYt:I~l!\JIV:'uregon IN requires you to E.~~f 'Y~~~#~i~ll~tionl cfi . 'Ortft,,.cc,, L.. ..J Pu4,B 900JiH&001-o010through OAR~~tf001. sigJI8~E\Dr~~mfflV obtain caples ot tht%f_by Limite~~UrAJ ~"t;dtm~~ {Note: the telef~96~ numo'~r or'ffieor~on UtllllY i~otiticatinn Limited Energw'Corome.r~a 00332 '$"ZI".UO" vemer I~ 1- - -2344}. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges $ 43.00 4. IZb BeL 12 f:tO J47~z.. 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building ForrnslElectrical Permit Application I-03.doc .&PRfNGF,IiEL-It> -~ ~. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00793 ISSUED: 06/24/2005 APPLIED: 06/23/2005 EXPIRES: 12/24/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 36426 BRAND S RD ASSESSOR'S PARCEL NO.: 1802100001200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Install service and feeder Owner: JAMES SMEJKAL Address: PO BOX 26224 EUGENE OR 97402 Phone Number: 541-988-0411 I CONTRACTOR INFORMATION I . r ,HE \Nunl,\ ~C[nt~~to{\1 SHl\ll t~~.~o.E ~~\\J\\I \s NO\" License ~lJ;~I.~IjR~~\'~~J~\RF~~~!N~()t\ 136446 I\U\"~~~NCED - O~ \~iritDl~G' IN-FORMATION' COM 1\'< pE\."{IUu, # of Units: I\N'< "BG 0 # of Stories: Primary Occupancy Group: R-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VN Water Type: Secondary Construction Type: Range Type: # of Bedrooms: Energy Path: Sprinkled Building: Expiration Date 08/20/2005 Phone 541-747-2724 Contractor Type Electrical Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION' REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of LO~Tro~ilMYegon taw requtres you. ~ t~: nates ~~?~te~ n:~I~~:e~~ni~!I~~h I PUBL~~~~~~thrOugh OAR 952-001- tn U1'\n "w~ ....;.",..1\fJHlei.w.~~ by 0090. You may obtain cor; telepWOIie calling the center. (No ~~lW~Btf~ei\ts: number for the. orego~'.l3t~~2344) Center lS 1.aO\r\l · Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction . $ Per Sq Ft or multiplfer Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00793 ISSUED: 06/24/2005 APPLIED: 06/23/2005 EXPIRES: 12/24/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L-Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $12.60 $8.82 $126.00 6/24/05 6/24/05 6/24/05 Receipt Number 2200500000000000822 2200500000000000822 2200500000000000822 Total Amount Paid $147.42 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 utility 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 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 Page 2 of2 2'25 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ii...='~ Gity of Springfield Official Receipt L~*'1+~velopment Services Department Public Works Department RECEIPT #: 2200500000000000822 Date: 06/24/2005 9:09:16AM Job/Journal Number COM2005-00793 COM2005-00793 COM2005-00793 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Payments: ~s, Type of Payment Paid By CreditCard JOSHUA BURRELL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 000936 In Person Payment Total: Amount Due 126.00 8.82 12.60 $147.42 Amount Paid $147.42 $147.42 6/24/2005 Page 1 of 1