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Home My WebLink AboutPermit Electrical 2007-10-1 .' ~pt-- ~~ 07-/ '" \u ~Qz.... s~gGf'urLP . . 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CeJr---n'ZOD1. -DI'tf1l})ate 10 11"/01 2. B. Electrical Contractor(;.<t Y.tl.f' (]~,e E~ ftZ( 200 Amps or less /J L:? / II 201' Amps to 400 Amps Address ro 1':;)0)( '-f I 960 40 I Amps to 600 Amps 601 Amps to 1000 Amps City N6~.e Phone f:cll-/Vb~)47) Over 1000 AmpsNolts Reconnect Only 1. {5:qLD4 ll/!.vU Li1-1./tC LEGAL DESCRIPTION ) {}/lz/1.vJ -( .( 75VZ JOB DESCRIPTION 5t101'Jt: &rno I , \"105:l~ 000 100 \ Permits are non~transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Supervisor License Number )'(7:7-35 Expiration Date /CJ // I' 2.<7 / () Constr. Contr. Number /tbL/S77 Expiration Date Signature of Supervising Electrician /yI~~ ~~ Owners Name -p...-{ i3V ~ Address r.C) ~ 6<OA ILkIt) City ~fU-,) Phone l\.4bl J;.mtON: OJ:~$lp,n 1aw requfres you to OWlf01fOyffthiktl8d~Wa by the Oregon Utility The ~OOifl~BGfi~aJJ1~~~t~ltI is ndniCMeaa2~O~W ~mMQ'h-OAR 952;o()1:' 0090. You may obtain copies of the rules by Ownerg:81lin@Jdha center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Inspection Request: 726-3769 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 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 1)/./5!::9 L ~ $ 3.00 E. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum ElecNlJJICE; Ins ection Fee is $ 5 0 4. + ~EfRtb ITI9K>f tU'lf.vD S,lJ\) .;>. SV -&l--9) g% State &Q~NCED OR I 10% AcinA~~at~P~~Y PERIOD. c;o; ( "[ e4 'fOTAL Shared Drive(T:)/Building FormslElectricaI Permit Application 1-03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2007-01490 ISSUED: 10/0112007 APPLIED: 10/01/2007 EXPIRES: 04/01/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3306 BALDY VIEW LN ASSESSOR'S PARCEL NO.: 1703220001001 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: One circuit for septic pump Owner: PEACEHEAL TH Address: PO BOX 1479 EUGENE OR 97440 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor CAMP CREEK ELECTRIC LLC License 164877 Expiration Date 06/09/2009 Phone 541-746-1471 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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: 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: I PUBLIC IMPROVEMENTS' Street Improvements: Sidewalk Type: Storm~~.e~Q~IPre90n law requires you to Downspouts/Drains: Specia J~Wlntt~ adopted by the Oregon Utility NOTICE o :(ncallon Center. Those rules are set forth : Notes:/n OAR 952-001-001~ thro~gh OAR 952-001- THIS PERMIT SHAll EXPIRE IF THE WORK Oo~~o.;:.:oul.~~~~~tal~ c~p'le~ ~fLt~e rules by ~~THORIZED UNDER THIS PERMIT IS Nor nu;;;i,:, ~~~ th/o;~g~';-Uiii~N~tlii~'u',,,, . .... ']'V1CIMU UH IS ABANDONED FOR Center is 1-800-332-2344). F~m.atlOn DescnPtI~NJ.180 DAY PERIOD. $ Per Sq Ft Square Footage or multiplier or Bid Amount Description Type of Construction Value Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2007-01490 ISSUED: 10/01/2007 APPLIED: 10/0112007 EXPIRES: 04/0112008 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 Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $5.00 $2.50 $4.00 $48.00 $2.00 10/1/07 10/1/07 10/1/07 10/1/07 10/1/07 2200700000000001531 2200700000000001531 2200700000000001531 2200700000000001531 2200700000000001531 Total Amount Paid $61.50 I Plan Reviews, 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 InsDections I 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 ofany 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 Pa2e 2 of2 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 -01490 COM2007-01490 C0j\i12007-01490 COM2007-01490 COM2007-01490 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200700000000001531 Date: 10/01/2007 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received CAMP CREEK ELECTRIC LLC ddk 130096 In Person Payment Total: Page 1 of 1 2:46:36PM Amount Due 48.00 2.00 2.50 4.00 5.00 $61.50 Amount Paid $61.50 $61.50 10/1/2007