HomeMy WebLinkAboutPermit Electrical 2005-10-3
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225 FIFTH STREET. SPRlNGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (S4~~~
ELECTRICAL PERMIT APPLICATlbN " . '{'\\(:~'}<0~?>
,City Job Number CO~'2-0o.S'- D J '3 L/ b '. " Dat~~~ /.~
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3. '~~COMPLm:E FEE'SCHED:ULE'BELOW/" "".
.0. . ': . I. '. '.. ",' ". :. :':.. ":.. '" '. .. .:.....,'.j " :' . '.h. ;." r...,. . ..' ::.: ';. . :.~ '.~I...~':::'
Pump or irrigation $ 50.00
~ Sign/Outline Lighting $ 50.00
OWNER INSTALLATION Limited Energy/Residential '$ 25.00
The installation is being made on property l00ltCl.: Limited Energy/Commercial $ 45.00
is not intended for sale, lease or rent. THIS PERMl1\fMl.hlR WJa~ ~~HC~~~" Fee is $45.00 + Surchar<les
AUTHORIZED ~NOE6 THIS PER ., : Vii..., ' ' " ..
COMMENCEOOft1~mR&e.,~. ,,' .- ~'. '.' SO
Af'!'1 180 DAY PEWOOate Suroharge ' 3 $"0
" 10% Administrative Fee J ~D
S-B~
OS/23/2005
07:44
7253579
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LEGAL DESCRIPTION
170~ Z?lfc.{
JOB DESCRIPTION
Kel'At- J?IA~+ vV'€- k:tt.-
,
Permits lITC non-transferable and expire if work is
not started wIthin 180 days ofissuanc:e or if work is
Suspended for 180 days,
'::.~CONTiaCTOR 'INsflLl;;ATloiV 6Niir'
2. ,',,~, " .......",.', ,,:, " ..', ,',,",'.' "':,:. "" " .,'. ..;..., '.,:, , ' .' .";_' ","',':,
E]ect~'cal Contractor' '.L.'~" " (fV)"0~
Address ~~ ~ )l, .
C;ty ~l~d Phone~1
OZf::,oO
Supervisor .License Number
~bOl.. 5
Expiration Date
I 0 - I - 1-00 .,
Expiration Date
l~3~
LL-~-D(
Constr. Contr. Number
Signature of Supervising .Eleotrician
, / ~ Q<<____f? __
J '" . / 1'/'
Owners Name A-(,c..~ 1f.,..1I
Z7~Z- L\lAy~,~f." uti
~ PI~~ Phone '7'16 - 11 , 3
Address
City
Owners Signature:
Inspection Request: 726-3769
!",
CITY OF SPRINGFIELD
.
A.: ,~~:R~,i~ie~~A~ s.i'~gl~.,:~:~~~!rl~f.~~J~~~~~~elii~~~~k:. ,..,
Service Included -s \~~(\O \}se
1000 sq. ft. or Jess
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. ~...s~ti~~frJ~~~i.g~"~Vkfti~~.:W~~ i.el~'~~ti~ll;'~ ~.~
Pi. I ~ adopted by the Oregon Utility
20~f?t)% ~ ft:~ss. t Those n IIp.~ are selltd~.~
2~~~~b>ijo<c1~~d1 0 through O.AR 95f;(3~1r
4ffi {.i1hlFs!i~60Q ~~fb\ain copiec: nf the ru1~~~
6d:}CWIrlr~fbl\BOijYAffi%l (Note: the tele~w~oo
overCl~~MP~ifPtbregon Utilitv NotiflC$3tt~.r~O
Reo~~nt9r t e. 1 800-33" ?~.:1\ $ 50.00 e:::;:-O
Center IS - - - . ,
.hi" \.:', ,.~,::-...." ~..".':.I"i~'"::-,,, . ~. ':-""r ,....,. .:U:' ..~;:"l~:..:..
c. · 'Temporary SetYice:ii or Fe(jderS:'~:'
.... '" ,. .~,}- .... '..: ..' ..... . ''';'.''. '~"'.' ..
Installation, Alteration or Relocation
200 Amps or les:ii
201 Amps to 400 Amps
401 Amps to 600 Amps
O~er ,6~0 Amps or } 000 Volts see "B" above.
:; '~-' 1. c'.-:' ~ '~":~~:'i" ,.....~.?r.:~:;;t:~..:::~:.:.:~I: .
D. ..' Branen u:CUJtS.., .', .',' .:..,'.~,',',., :,' ;'"
~ - .. . : ..It ~, .." . '. .::~I.~.:,' ~.' :':',.'1':'
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Pennit
$ 50.00
$ 69.00
S100.00
$ 43.00
$ 3.00
."~ :.'0. ~ '-:., ::./.:....;:'1 ,.....".~'..~.......... ",: . ''''~:''~':V'.:''::.:.:-.~'.' ....:.'-;..::.. .w.":..... .,.:.,..... ",', "-:0;' ......
E. ;~i~~ell~e~us (~,erVic:o/.tee.~ef ,~~(i~~]~ded)~E:a~h Instalhi:tiQn :::
, .. ..... .\.. .... '. '.: ...... ,'I'..:.. ......,. :...::;........,'.: . ",.;,'
TOTAL
Shared Orive(T:)/8uilding FormslElc:c:tricnl Pc:nnit Aptlli~tion I-03.doc
06/23/05 THU 08:45 (TXlRX NO 5616]
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGfilELD
Building/Combination Permit
PERMIT NO: COM2005-01346
ISSUED: 10/04/2005
APPLIED: 10/03/2005
EXPIRES: 04/04/2006
VALUE:
SITE ADDRESS: 439 W CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703274402600
PROJECT DESCRIPTION: Repair burnt meter t
I W requires you 0
.. ~."'r-~ IT,,....t-,. nrP.oon a . '~:O:+'I
,.{. I L-f . b the Ult::\::jUIl ""....-J
follOW rules adopted Y I are set forthPhone Number:
Notification Center. Those rUhe~AR 952-001-
2 001-0010 throug b
in OAR 95 - '~i;~ Mripc; o1the rules Y
0090. YOU IlIay J-:._- I~\~to.; thp. telephone
~CfIDWPOR'INFO~r!lON.,ation
numbertor llll:l. -:",v~-0_332-2344).
Contractor Center IS 1-80 License
L H MORRIS ELECTRIC 01838
~ Owner:
Address:
ALICE HUFF
2732 WAYSIDE LN
SPRINGFIELD OR 97477
Contractor Type
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
Front yard Setback:
. Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Springfield TYPE OF
Electrical Work Only
TYPE OF USE: Repair
Residential
541-746-3193
Expiration Date
06/08/2007
Phone
541-747-0811
I BUILDING INFORMATION'
R-3
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
n/a
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
N PU IMPROVEMENT 1'Kt WO~K :
1H\S PERM\1 SH~ R "CH\S PERM,"f;~llQt Type:
A. U1r\OR\2EO \JON~t.\S ASAttt)DNEDIf~pouts/DrainS
MENCEO n ,-,
~~~ 180 DA't p~f\\QD.
\,
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated .
1 of 2
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2005-01346
ISSUED: 10/04/2005
APPLIED: 10/03/2005
EXPIRES: 04/04/2006
VALUE:
Total Value of Project
Fees Paid I
:. Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$5.00
$3.50
$50.00
10/4/05
10/4/05
10/4/05
1200500000000001448
1200500000000001448
1200500000000001448
Total Amount
$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.
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
2 of 2
225 Fifth Street
Spring11eld, Oregon 97477
5~1-726-3759 Phone
'!
Job/Journal Number
COM2005-01346
COM2005-0 1346
COM2005-0 1346
Payments:
Type of Payment
CreditCard
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10/4/2005
RECEIPT #:
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Service Reconnect
Paid By
LH MORRIS
City of Springfield Official Receipt
~velopment Services Department
Public Works Department
1200500000000001448
Date: 10/04/2005
Item Total:
t:heck Number Authorization
Received By Batch Number Number How Received
djb 073358 In Person
Payment Total:
I of I
9:29:27AM
Amount Due
3.50
5.00
50.00
$58.50
Amount Paid
$58.50
$58.50