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Home My WebLink AboutPermit Electrical 2005-1-23 '" 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (54U:ni~89 Z> ~ ~ ELECTRICAL PERMIT APPLICATION . ;o"'ot-~ ~o~~ City Job Number {'11U12.1H7"'S -t:) ()7-2- 2. Date 2(~-(.')r"0' {,o"'ot: -0< 0 .s- 0 1. ~J;/ie~'!lijN~ijj~iftS!!if~T:iij!i::[_'.,,~~t..,,~ 3. 1....COi!fL.~cLb .!~!~~q"'f[':'~~'t1f~~~~;(;'.""'" 27{)~ fJh-CtV.7P47 r 0r~ €jfet.-hPYI # S-) . ...' ...... . . ",,,,,~'?<r~cc"'~' ..,.,._~:~~O'~c, ." LEGAL DESCRIPTION A'hl'\~1xRe,~J~enti~1:::~i~gle:~r? ... "It!: ...... . y'Ff!,~wellingH~it.,j J~~~?RIP~o;l)O D27bl ~:;::';;c:~:::'~'.< .~~~~:S~~._~' Each additional 500 sq. ft. or '\.. ~~l . ?,()If (3van&/t, GirC-lv,;f- 40V ~'pr~;- portion thereof "<~ ,00 , ", . Permits are non-transferable and 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' = _._""'~_ " ",,,,,,,'~""~_'" __,,," ~_""",,,,,,,,,,,".,.--~ _.,~-,.,V^/- 2. r,'c.o.Ni:BAc.Tifll{'JNSI:-'!tLA}J9l'lJJNLY'j L-'A,..,.,j~J;:;U...~;v~:",,;;&;;...........,.<~,. __Si.:;j~ _,~~>;;"':'.;'__~~n~_.!..,;]2..:;;,'. :.;:'~L'ill~:'":...; ~~ __.y... )}:"i;:"~'_.,.~._~ Electrical Contractor me)) l(Jrml/ Co YJIr& /5 :JIt.t., Address <0>>79 l!wyf'~, City EfA4-fflC- Phone 7-Z6 -/677 . ~ Supervisor License Number ~#S Expiration Date J ~-I - 07 Constr. Contr, Number 77tJZ3 Expiration Date /0- 'Z l/..- t7 b Signature of Supervising Electrician ~ Owners Name C/rz, dr !//A!.I~~etJ Address 22~ S B. S'r" City 'I/J~ Phone 12b -37 n' OWNER INSTALLATION !he iispf~iAA~rll~~ PclW'~eJ~tYch IS nOicm~wM;W~ ~~aplmf By1"fl% Oregon Utility o~~e.\mCenter. Those rules are set forth in OAFf952:001-001 0 through OAR 952-001- 0090. ~.~.L1llayobtaill \;ujJ;es of the rules by calling me cemt::l. (l\iullJ. t;IC t<;:.s~~~ne number for the Oregon Utility Notification Inspection RJq~r ~6-~-332~2344). $50,00 r -~.-;"'\-~. '. ,,~'-.--~-':_"-':-7':^v,",-;,;: ._,,"'~~"';'~T~- ~",y:v___' __' _,~' .. " ',' B. ;,Set:vices or Feeders:i:-InstaIIatioIl' Alterations or Relocation: ::":~fjih1L:L__::!:i:t.>_J::"'.;;:j:..~,~),:Lk,",,:~,,;<;S}~.G,.!d.:"}'.. ':,L::.........._ ~u*kt;:..;..~~~.. :tL<'s^~;._,:.>. ;~.2.<:ts^-_::; . 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63,00 $ 75,00 $125,00 $163,09 $375,00 $ 50,00 <~. ..~_._:.,_..,' . ~"U"'_}"__:_":"........" .,. ~'_":''''''Y<'''-<'''~_'"'~'_;''_:::~"_;~'~ . ~.-;:'~'__.~._ ~,........, c. :t~Il1Poiary S~t'1cesor,Fee~ers,. .....~~h_..,^., ~..",<,'(~""y" ,^,""""'~~o~_",--. ' ,...'.~'" ,~~<" ,,->--,,' ''''.,-< "."_,~,'"";:j);-;;;L:,'~,,,,,,_ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50,00 $ 69,00 $100,00 Over 60~,.A.mp~_t)r!_q9gYo1ts s~e "B" abov~, D.:.B.t~I1Ch.p~clJit$ '. . ,(, ~,y;z<"<,~.;;;,C',,,.._::J~,.,.,-,~.;,;,':""'"": '. .-.,,,--;,~~-,,_. ,,,~,,',,,-;~<,,, New Alteration or Extension Per Panel One Circuit , Each Additional Circuit or with Service or Feeder Pennit l $ 43.00 $ 3,00 1145 ~ ~ ~_.:~v_'__ -~~-c-,:-~~. -'7Y'~~:,~-,:,,-Ir:-:,;:7---,' ~-::-'--"",';" '7'~.'~-- E. : ,Nl1scenaheous;(SerYice/fe~derriht included) -Each Installation :_:::.....:L:..-^-----'~^:~,>::L~-"~j.<:,>:,~,', _o__...+si:'-:~<N\ ;;jC;::;:'.-~:, ..:..~>;,:&.6:;:~":.~~(I~:,_..._.,. ...:,.....L__: - <, ' ::. ,.. Pump or inigation $ 50,00 Sign/~tlvr~Cignting L E\lnInC It: 1\$.~oJOQm.l\ r:'"'I\i1!T ~~~L 1\.".-.. , f Limite(riP.~rgyMes~'dential ER i~:S ~I=RM$\2p:;OOIU , , .i\rllllnO!7r::n UNII . . r.i-" ' Lllmte4~E.ne~!W,(i}ommerOcla1\ S A E!\ ~\\ nO 1\\ E t$ 4.DJ{)0 ~ft'iIlFIENCED Ii MinimU~~lA~~~_{at):J?~1~!P~,~~i!)!:~~~,,~~c~:~0 + Surcharges 4. SlJJiT(jTAL,7JF'ABOVE;;tf;:~C,,;!l,,)"!1,;<"" /J~ eh:J ^:~~~L,E':;"N_~'--;&"'~" <. .:-,,,.__..' ,.~{...".,. .,..-o~ \.~~ ~~ ~ ~2... /J ,"; . 7% State Surcharge 1 0% Adininistrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt elopment Services Department Public Works Department Job/Journal Number COM2005-00222 COM2005-00222 COM2005-00222 COM2005-00222 Payments: Type of Payment Credi tCard 2/23/2005 RECEIPT #: 1200500000000000241 Date: 02/23/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BRYAN RICHARDSON Item Total: Check Number Authorization Received By Batch Number Number How Received dIm 616004 In Person Payment Total: Page 1 of 1 2:02:24PM Amount Due 43,00 3,00 3,22 4,60 $53.82 Amount Paid $53,82 $53.82 . ~_$PRl'NGF' EI-O. ~... .... WiL~- ~T ' -. -, ......... .,..._~,~... ... r'_ "'... " Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2005-00222 ISSUED: 02/23/2005 APPLIED: 02/23/2005 EXPIRES: 08/2312005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 498 Harlow Rd ASSESSOR'S PARCEL NO.: 1703220002701 Springfield TYPE OF WORK: Miscellaneous TYPE OF USE: Alteration Public PROJECT DESCRIPTION: 30 amp branch eirc. for compressor .. Owner: Address: CITY OF SPRINGFIELD 225 FIFTH STREET SPRINGFIELD OR I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MCDIARMID CONTROLS INC License 77023 Expiration Date 10/24/2006 Phone 541-726-1677 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. Front yard 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: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 · .--~,~~!N~~li""~t?)'"."",,,,,,"~ ?; ~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid $4.60 $3.22 $43.00 $3.00 Total Amount Paid $53.82 Total Value of Project Fees Paid I Date Paid I Plan Reviews I 2/23/05 2/23/05 2/23/05 2/23/05 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00222 ISSUED: 02/23/2005 APPLIED: 02/23/2005 EXPIRES: 08/23/2005 VALUE: Receipt Number 1200500000000000241 1200500000000000241 1200500000000000241 1200500000000000241 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 Reouired Insoections I Sign Electrical: After connection is made but prior to energizing 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 accord~nce 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. -~' A~---~ ~ ~~,c--- -- Owner or Contractors Signature Pa2e ,2 of 2 Z-25-t/S- Date