HomeMy WebLinkAboutPermit Electrical 2007-10-30
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ("O~ ~oo 7 - c> I br ::5
LEGAL DESCRIPTION
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1. LOCATION OF INSTALLATION 3. COMPLETE FEE SCHEDULE BELOW
71? ( So v'tlll 2.. 0-1'" S'f.Jtd 0 ((
Ij A. New Residential ~ Single ar Multi-Family per dwelling unit.
0/00]
Service Included
JOB DESCRIPTION
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.
Permits are nan-transferable and expire if work is
nat started within 180 days of issuance or if work is
Suspended for 180 days.
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
Address ~~'\G\ U\\.YLl ~~ S
- ", \
City ~')\~.J"'.9..- Phone \ ~- \ \0\,,\
2. CONTRACTOR INSTALLATION ONLY , B. ' Senices or Feeders - Installatian, Alterations or Relacatian:
ElectricalContractor ~~~0 cru.Yo\~ 200 Amps or less .x: $;;fa 7D
201 Amps to 400 Amps $ 75,00
401 Amps to 600 Amps $125,00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsNolts $375,00
Reconnect Only $ 50.00
Supervisor License Number ~ ~ DO ~ ~~c. Temporary Services ar Feeders
Expiration Date \'tJ\ \ \~1'\' f tJ /1 II tJ Installation, Alteration or Relacation \0
, ( , 200 Amps or less \a'H tAqW~~~\\\\\.'f
J I 0 ~.3 ~_l,/.. 201 Amps to 400 A~ON' Otegon 'fJ1 ,~e Cl~se\ ,ottn
I . / 401 Amps to ~~i,m&\es ado~t8;os~ tu" ()J\R~2.00~..
-I-e/ Z J4-! oh, I 0, 2 tfi06 Over 600 A1~~' OO~""'~~W~9@n ~ tn' IU\85 gJ
D. Branch Cc oMb!:n9S2.oo~ Ok''''l~ ~?e'e. ~k~e \e\8.~&~~1\
Signature of Supervising Electrician \)"I'\T' '1 1"'- ,\" 1\ \i' ,\ U--V
~ ' /A . New Alterati~~~~:~~~b~ o\\\~~).\
~tf/:/:- .#?~~ One Circuit ~~b81 tot \ne \t ".&~43,OO
, . / Each Additional ~m-il1t oQel$l\8t
Owners Name j2e> 5 a b-tL.<::::> ~~~erviceorFeederpennit $ ~,OO
Address '+> 0 a - yt' 2. 0 E. Miscellaneous (Service/feeder nat included) -Eaeh Installation
S1>rD
Constr. Contr, Number
Expiration Date
City
Phone
Pump or irrigation $ 50,00,
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25,00
The installation is being made on property I own which Limited Energy/Commercial $ 45,00
is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is u(Oo + Surcharges
, 7'~so
4. SUBTOTAL OF ABOVE 70
-G>O
8% State Surcharge :::>
NOTICE: 10% Administrative Fee;f~ ,.t:t.tI-6!i: 7 / J ro
Inspection Request: 726-3769 THIS PERMIT SHALL EXP~fJHE WORK/ ' fB t ~
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONEerfl91te(T:)/BuiJding Fonns/Electrical Permit Application 1-06.doc
OWNER INSTALLATION
Owners Signature:
ANY 180 DAY PERIOD.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 701 S 28TH ST
ASSESSOR'S PARCEL NO.: 1802060001003
PROJECT DESCRIPTION: 200 amp service
Owner: ROSBORO LUMBER COMPANY
Address: PO BOX 20
SPRINGFIELD OR 97477
Springfield
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01613
ISSUED: 10/30/2007
APPLIED: 10/30/2007
EXPIRES: 04/30/2008
VALUE:
TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
MCDIARMID CONTROLS INC
License'
77023
Expiration Date
10/24/2008
Phone
541-726-1677
I BUILDING INFORMATION.
# of Units: # of Stories:
Primary Occupancy Group: Height of Structureil \0
Secondary Occupancy Group: l~iRfr8ltU~es '/~\\\\\V
Primary Construction Type ON~ Ore9 ti9l\ffe'~e90n at 1oftt\
Secondary Construction Type: ~~e8 adopt ~ a~ ~52.00, ~.
# of Bedrooms: N t\1\cat\On Cen\e~ ~JP.~h fU\es bY
o O~ 952..001-0 i6b~~Qtltl~hona n/a
\n "IsO; "'1fIY ob ,"'~'l.t?the\e }oj"'"
OU:'\n9 ~10~~t:W~R:l'T~oN I
IW~ ~\er \, ,-8 .
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS , ~O~~
. Sidew~~~~~~ 'CO ~\)1
~. ~~Vo~n.flp\'~r~~\)~
<<\\\r:.;~. ..t..~ CO~ ~iJt..~:~\)\)~~.."
~'v \'t~\'i\ 'U~'V ~~~~
, ,\"\\'0 Q~\tt'V ()~ \CO ~
~\)'~ ~f'..~C~\) o~~\O ·
f r:.1' "" \.- .~ !\..., l
\ .' ."'1 V'l'
~ ~ .\r~1
Valuation Descr IOn
Street Improvements:
Storm Sewer A vaiJable:
Special Instruction:
Notes:
Description
$ Per Sq Ft
or multiplier'
Type of Construction
Square Footage
or Bid Amount
Pae:e 1 of 2
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01613
ISSUED: 10/3012007
APPLIED: 10/30/2007
EXPIRES: 04/30/2008
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 J
Fee Description ,
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$7.00
$3.50
$5.60
$70.00
10/30/07
10/30/07
10/30/07
10/30/07
2200700000000001648
2200700000000001648
2200700000000001648
2200700000000001648
Total Amount Paid
$86.10
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.
l Reouired Insnections .
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
Pae:e 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
COM2007-01613
COM2007-01613
COM2007-01613
COM2007-01613
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200700000000001648
Date: 10/30/2007
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
JEFF BROOKS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 611392 In Person
Payment Total:
Page I of 1
9:39:36AM
Amount Due
70.00
3.50
5.60
7.00
$86.10
Amount Paid
$86,10
$86.10
10/30/2007