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Home My WebLink AboutPermit Electrical 2007-11-21 c' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO"""" 'Z..CO 7 - C>/ S 88 Date #A (2.~(J e.. LEGAL DE.e"CRIPTION 18043023"3- JOB DESCRIPTION 1000 sq. ft. or less $106,00 .../ 'Each additional 500 sq. ft. or S{LvL \2t=-u:i.,V~~-r..r ;" S c., ru\7 J~portion there<}(TTENTION: Oregonlaw requi$elSl~u.t.O Permits are non-transferable and expire if work is Each Manufl~I(il'Md'M~ adopted by the Oregon U~hti not started within 180 days of issnance or if work is Modular D~tifws~~e1I1ter. Those rules are set or h Suspended for 180 days, Feeder in OAR 952-001-001f\thrnI10h O$J{l~-001. . . fthe rules b .-cJ () .' Ii . nurn er or t ~ 200 Amps or less Center is 1-800-332-~~1)6 -'7/_<'. y, ~ ~ 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 I ~O )" 1. J ?Ol htL 05300 2, Electrical Contractor City 10 crz ~ (j /70.-(5:00 Phone (~I Address pt(~~s 1011/07 I I b~ (37 ~///o~ I I s;gna~;ngEl;tn ~ if Supervisor License Number Expiration Date Constr, Contr. Number Expiration Date Owners Name ?1'rW\.~1 A ~,4t1' ~ }/;\ R. ~O<L Wt... Phone 97'177 City ) 91) 1 S:~F ~ Address OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 3, A, Service Included B, c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50,00 $ 69,00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D, New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $}OO IZ ~ E, Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4, b7 53~ b 70 '3 1 $" fZ If.L NOTICE- THI~ F -- . , 8% State Surcharge AUTuHO~7z'VEID'1 SHALL EXPIRE IF THE Wem1\Administrative Fee/ S% 'i:?1I- ffl" UNDER THIS PERMIT I Inspection RequQCMMe;re'fD OR IS AS S ~1fAL ANY 180 0 ANDONED FOR " , , AY PERIOD, Shared Dnve(T:)/BUlldmg Forms/Electncal Permit Application I.06,doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1901 HARBOR DR ASSESSOR'S PARCEL NO,: 1803023305300 Springfield PROJECT DESCRIPTION: Service reconnect and 3 circuits Owner: DAVIS PAMELA L Address: 1901 HARBOR DR SPRINGFIELD OR 97477 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO:COM2007-01588 ISSUED: 11/02/2007 APPLIED: 10/23/2007 EXPIRES: 05/02/2008 VALUE: TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor RALPH W BROWN I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: , # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: R-3 VB License 63137 Expiration Date 0211512008 Phone 541-729-1500 n/a 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 Downspouts/Drains: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-001-001 0 through OAR 952-001- Uu:;1U, YOU may amain caples ot me rules by calling the center, (Note: the telephone number for the Oregon Utility Notification Square Footage Center is 1-800-332-2344)r BOd A t Value Date Ca culated or I moun Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ~Hi\ , I PUBLIC IMPROVEMENTS , itJ'lJ! THeE: Street Improverne,Ilt:;';ER /11/.) ~ MIT SHALL EXPIRE IF THE W Storm Sewer $.tjf;'~~I~aZED UNDE ORK Special Instru~,tionllnENCED OR SR THIS PERMIT IS NOT vUIVI/VI I ABANDONED FOR Notes: ANY 180 DAY PERIOD, I Valuation Description I Description $ Per Sq Ft or multiplier Type of Construction Pa2e 1 of2 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01588 ISSUED: 1]/0212007 APPLIED: 10/23/2007 EXPIRES: 05/02/2008 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 Add, Alter, Extend Circ Ea Add Service Reconnect Amount Paid Date Paid $6,70 $3,35 $5,36 $12,00 $55,00 11/2/07 11/2/07 11/2/07 11/2/07 11/2/07 Receipt Number i200700000000001667 2200700000000001667 2200700000000001667 2200700000000001667 2200700000000001667 Total Amount Paid $82,41 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 Insoections I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete, 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 Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01588 COM2007-01588 COM2007-0 1588 COM2007-0 1588 COM2007-01588 Payments: Type of Payment CreditCard cReceint I RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001667 Date: 11/02/2007 Description Service Reconnect, Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By RALPH BROWN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 115218 In Person Payment Total: Page I of 1 1:47:46PM Amount Due 55.00 12.00 3.35 5.36 6.70 $82.41 Amount Paid $82.41 $82.41 11/2/2007