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Home My WebLink AboutPermit Electrical 2005-6-22 1 he TOllowlng project "s~ul.Jm tea lIi:1~ lilt:! IUIIUVVII'Y laning, and does not r uir ~~fjc land use . '. VfiftfY . ~ ingr~t~~1~lFJ(~.... , {.::<,;oi'/./":(~ ...........'. ..'.':i{,{/ '..i."..'.Y'-'.....".....i........."..,..'......: .,~"'.~,.-~--_:,~----- 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)i2g-3o~ ~~o~~:~~~~;;I;L:CQ3riS Date ~ /~;));"~5 1. LOCATION OF INSTALLAl1()N ;j(Olq rf\s\1e Dl\~~ v LEGAL DESCRIPTION II ().5 d'S 30 5 d c.J0 JOB DESCRIPTION ~()~~ ~(Le {ll~J- Permits are non-transferable and expire if work is " not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor fn. y ?..J . \c..l (g, ~ l\j(' , Address ~~~\ (~ 'Z~) e\j l~ - , City Co\~~~ PhonelQR 14SQ Supervisor License Number 3q;:.;~ S Expiration Date to/:JCO 7 - Constr. Contr, Number ~S<()b -, Expiration Date II 20 :JOD S" s~:w;n~~ Owners Name f) n(9f\'\)\\J ~~'Df'cD ~ Address ..) A rn? CL~ tbC&'1-\<oI\J . Phone -.!JA0 :14.D~ City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 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 $50.00 B. ION: Ore 209 f.rH.f5'Yor~ ado gon law reouirps ~8~'00 20.l1X~P&:WGW(t)~~ted by the Oregoo ~iffff~O 40:{ '{:fu.... ~.. Ifs f(f6Df);~~'1 oThthose rules are ~eTtl~O , ..')i - rough OAR luno 601 Am. p. ,s..'.tt)1 1'0110/ ~- " 95 "IlIIl!A..oO ,. '" - ..../Yra!n COPIE. &'VI:#,. Ovpr IOdoA~ps7Vdl~r. (Not . t~ 01 the rUI$s715y>O Reconnect 9nlythe Oregon ~'/ It: re/.~ho$-}~O.OO l+.'rer i _ tl f,y NOtlftcat" c. ~n, ().:) Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Arri.ps.or :1 000 Volts see "B" above, D.';;~,:r~~~ItfQii . . . .... ..~':~"'r~"-",~.::,r'~: New Al~~~ttoil~r'Eite~W()Ii-p~1 Pa~~icH:,:j r iSi:] T One Circ~lt, '""~. 'j., L ~),'!i~;,; ,; t 1$ 43JOO Each Add'i~bn'ar ti~c'tilt l)fwitlr L) . Service or Feeder Permit $ 50.00 $ 69,00 $100.00 $ 3.00 E. Pump or irrigation Sign/Outline Lighting Limited EnergyfResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. .tL en,~ 350 SCPo SBSO 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03.doc Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2005-00785 ISSUED: 06/22/2005 APPLIED: 06/22/2005 EXPIRES: 12/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2619 CASTLE DR ASSESSOR'S PARCEL NO.: 1703233305200 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Raise service mast. TYPE OF USE: Addition " you to _ --"~'\!"Oregon law' reqUIres 'I'W ~. ",nntp.rl bv the Oregon Uti'. . ." "0 . Those rules art: ~ta l..,.d-: (:1 ~'.Jnter. OAR 952-001- . -'2-001-0010 through _v btain copies of the rules by . 'hU may 0 I h ne ,'-"~ 't,~+".thptp.eo 0 ,':~ ,:,q me l,;t:lIlvl. t,-, " Notification I CONTRACTOR INFORM-AU€>N;I,' '::Jon Utility . ' . ,,- -' ,0 332-2344). Gentel \~ -80 - License Expiration Date 87506 11/20/2005 Commercial Owner: Address: OREGON STATE OF 2619 CASTLE DR SPRINGFIELD OR 97477 Contractor Type Electrical Contractor MY ELECTRICIAN INC Phone 541-729-1454 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: . Range Type: " . : . : . Sq Ft Garage/Carport Ener Path' ,J, ~ 0, '" S Ft Oth . gy ._, 'Ie: PL'-'T ~I:-iALL E'ilql'-l~ II--twr: It/ORK Sprinkled BuildIng: L h I \/lt 'n/a 'OcciIpant 'r..oad'~ l)i,-r.-!i,!~'i;:~:J Ili\Wd=q TI-J1~ Pr-l=lI\/tIT I~ I\lnT I DEVELOPMENT INEORMAiIIONLli IS ABANDONED FOR AI~Y 1 ~u UAY r'tRIOD. REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation DescriPtion' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00785 ISSUED: 06/22/2005 APPLIED: 06/22/2005 EXPIRES: 12/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 6/22/05 6/22/05 6/22/05 2200500000000000812 2200500000000000812 2200500000000000812 Total Amount Paid $58.50 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 . 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 · t~: during con trT~~ h /;)d / D ) Owner or Contractors Signature Date Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00785 COM2005-00785 COM2005-00785 Payments: Type of Payment CreditCard 6/22/2005 RECEIPT #: Description Service Reconnect + 7% State Surcharge + 10% Administrative Fee Paid By EDWARD GUIDRY .~- WIt. f'ity of Springfield Official Receipt .velopment Services Department Public Works Department 2200500000000000812 Date: 06/22/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received njm 031314 In Person Payment Total: Page 1 of 1 2:55:24PM Amount Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50