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HomeMy WebLinkAboutPermit Electrical 2005-10-3 .~~ \O~~~GE ~e 0 ~ ",'l>'i:J \'l><<' 0" v .~,\e, ~\ ~'O.' .' "I": ~eo..~ 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~~~ /.~ ." . '-'~", .....,..:.,.~ . ...,...,.,.,.:,.~............~~~'... ..,..,':-...... .."".~.. 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 t. 1. ,:'LiJ61~'~-;;ii-OF~i~fATrpN, " . r.::.:'::~: q 3'0,' "'iJ"...,.Z~-J.r=~~...A-r 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 ~r 'i 'I ~,( ~ f' ..f-' ... t~ -J "\" . 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