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Home My WebLink AboutPermit Electrical 2004-11-17 "/.:1 ~ O'~.o 225 FIFTH STREET · SPRINGFIELD, OR 97477 0 PH:(541)7-26-3753 0 FAX: (fNI)726-3l'iS9 O'o~/"% -~1. ~ "'.I' "I ELECTRIC~ PERMIT APPLICATION . "1vl-? $ 0,,//.:1 "Ot :&&(,-6 City Job Numb~J~\J -0\ <-fL.-I Date L I - \ -, -OLf o/j~$O' ~,/ &9v/,;, ~/i.-o~ ~ ' ~ ~"$& ~ 1. 3. L~3~ -'A::{A(tL 1Y~ LEGAL DESCRIPTION t/'~-~S-'-?3 .O-gOc:JO------ ~ DESCRIPTION. " t~i:'}?~~t:*/W~kiS not started within ISO days of issuance or if work is Suspended for 180 days. ~/e SEeVIc.t 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps $125.00 ....' -, "(1 (' r-- , "I.. ,~. 601 Amps to 'lOOO'An!ps ~ ~ ...$~e~t\qQ 1/ Over 10ob.l[.(rJP.~;v.~M SHALL E.X:.~n~rl~ IS ~~.bgri \ Reconn~8t1<DfilyRIZED UNDER Thl0 nJi~ 6~o OT OlVlMEI~CED OR IS AtlAI'-WUI~tD FOR f'''1:~.~t?; ~ . c. ~frte1l! ~.-."'i~."",;;a. 2. Electrical Contractor rUt. t:NE Address /20 !J1t)/I!12.iJ6 ~. City &u); tAlE Phone :3 '-It.! - 3b~ / Supervisor License Number 3 1- 3 ~ S IlJ / I /~DO+ . 9(,I:J () D -31/ ?-/ () ;;- Expiration Date Constr. Contr. Number Expiration Date Sig~ature of Supervising Electrician Oc:-.J/A ~Lu,~' , , CI, ~ Owners Nam rA y..oro-I rnM AddtessLj25 ~ ')(' t2l,cll , W ~ City ~V~ L1iY" OWNER INSTALLATION Phone The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: Inspection Request: 726-3769 1000 sq. ft or less . $106 Each add~'trt!it50d~ttQ!'~90n law It::YUIlt:i::' you. ~o portion tlferl~fV rules adopted by the Orego'$ Y~I~W , .N~t'fiC~ji~ Center. Those ruies aft:: set forth Each M;!n ~ ~~~0010 through OAR 952-001- Modula e a ervlce or. . f th ~by F d 0090 O'u may ootaln copies 0 e$.!lWAA} ee er . . e: the tele hone B. OD Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps . Over 600 Amps or I 000 Volts see "B" above. D. ~~~\~~f $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 0.6U d E. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergyIResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges laC! " tJO 4-. g-3 ~ ~q;(). 80 ' 7.d 4. 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuikling FormslElcc:tricat Permit Application toOl.doc: . --Wi.t- CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01421 ISSUED: 11/17/2004 APPLIED: 11/17/2004 EXPIRES: 05/17/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 435 CASCADE DR ASSESSOR'S PARCEL NO.: 1702353308000 Springfield TYPE OF WORK: Electrical Work Only # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: TYPE OF USE: Repair ATTENTION: Oregon law requires you. ~ J L ~R QFeS...... 1'''hN TOIIOW rUlt:l~ aJv....lv 1 e - ' - Owner: MORGAN RAYMOND KENT Notification Center. Those rules are set forth Address: 435 CASCADE DR SPRINGFIELD OR 97478 in OAR 952-001-0010 through OAR 952-001- J. l' - .,- "",-'f ,.~... ....loC' hu uu~u. YOUIIIC1Y !.JQII'..,WI"'._.....,_It. ' I I CONTRACTOR ~emei (Note: the tel~~ho~ number Tor l.ne vflegon Utility Notification Contractor, ClehtOO~ 1.80~~Mffi:&tU.Date Phone EUGENE ELECTRIC SERVICE INC 90200 03/17/2005 541-344-3561 I BUILDING INFORMATION~T~CIE: I HIS PERMIT SHA~L EXPIRE IF THE WORK ~~[g~~o;~e~~ructure ~~~~E~~~~ ~~ltmlM~f:ERMIT IS NOT Type of Heat: ANY 180 DAY MrF~lMl~~OONED fOR Water Type: ~ij~sement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Residential PROJECT DESCRIPTION: Fire Damage/Repair Contractor Type Electrical I DEVELOPMENT INFORMATION I 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 I 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 Total Value of Project Paee 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01421 ISSUED: 11/17/2004 APPLIED: 11/17/2004 EXPIRES: 05/17/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line LFees Paid-' Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.90 $4.83 $6.00 $63.00 11/17/04 11/17/04 11/17/04 11/17/04 Receipt Number 2200400000000001425 2200400000000001425 2200400000000001425 2200400000000001425 Total Amount Paid $80.73 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 Reouired InsDections . Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-01421 COM2004-01421 COM2004-01421 COM2004-01421 Payments: Type of Payment CreditCard 11/17/2004 RECEIPT #: Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Cire Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By RUSS, ROBBINS -~ty of Springfield Official Receipt ___evelopment Services Department Public Works Department 2200400000000001425 Date: 11/17/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received NJM 017058 Phone Payment Total: Page 1 of 1 2:2S:30PM Amount Due 63.00 6.00 4.83 6.90 $80.73 Amount Paid $80.73 $80.73