HomeMy WebLinkAboutPermit Electrical 2007-12-11
I'
, CITY OF SPRINGFIELD, OREGON, '
, .
SPRINOP..u.o
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INITIALS \...1't-1\
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)72~3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number COM z..oo 7 - 0 I g Ii(
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
;\TTi::N nON' C40_LAomosto 600 Amps $100.00
" ., -'i,! ",,,w reqUl~e.s.YOu to
.:0iIo\'/ rules adOVerr600JAlnpOl1e~ Mlllu..ee "B" above.
,'''lll!:(,EHlOn Cp.oter, Th" <~"M ,my
in ("Ai' 95? OOD.O Bnulcli'U""""'tjre set forth
~, . -- 1- 010throuflh OAR 952,001-
008~. You may d'!lllll'i~!i!l'b"ft!'a'ffN~!l'B'er Panel (
cadrng the cenOlfe ltb'olil: the telephone
,.y'''U"r for the ~Ild~ fliD!1fjbll'liOOlh
Center iS~S.ee1l~it I
I. LOCATION OF INSTAIfATIOf:
(70( 5. Ir's,:t
LEGAL DESCRIPTION:
/7033. bOOO
JOB DESCRIPTION:
00&:>0
-AM I D
c.r,-,^~ h
Permits are Doo-transferable aod expire if work is
not started within 180 days ofissuance or if work is
Suspended for 180 days.
2.
CONTRACI'OR INSTAlLATION ONLY
lUCri ElLc--IriL..LYlC-
Electrical Contractor
Address
/970
tV Z- ~ -r1" ST,
City S;r~"c,.f;<-(c1
Phone '.)ifI-7 Y7- ~ll ?
Supervisor License Number
so/,;;;. S
Expiration Date
/0-1- 20/'0
Constr. Contr, Number
/2.. 7 7 ;).
Expiration Date
,) -"z.;l. - V CJ
Signatur/Jf~an
/~ ~
Owners Name S (A K
, Address -Z-z.."3 A- \, t
City St:>f~
Phone
OWNER INST ALLA T10N
The ins,!,lIation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Date I Z -11-0 7
3. COMPLErE FEE SCHEDULE BEWW
A. New Residential- Single or Multi-Family per dwelling unit.
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. Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less
201 Amps to 400 Amps
40] Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163,00
$375,00
$ 50.00
c. ;.Temporary Services or Feeders
,;
, ;
(8
$ :Y.l.oo
9 $ j.oo
l(S
"Jb
E. Miscellaneous (Service/feeder not inclnded) --Each Installation
Pump or irrigati?n $ 50.00
Sign/Outline Lighting $ 50.00 '
Limited EnergylResidential $ 25,00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
flJO'ffl,'eu~AL OF ABOVE ~ Y
THISl'P>mrtMl.'lf1l1' , n'
AUm~ 1i1lVe'~/RE fF THE WQ' 81(0
COMM"tN'C:Ebo OR IS A~HIS PERMIT IS N~: (f~
ANY MllrIiAY PERIO ANDONED FOR /03 -
Shared Dnv9r:)/BUildmg FormslElectrical Permit Application 8-06.doc
-~~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01814
ISSUED: 12/11/2007
APPLIED: 12/ll/2007
EXPIRES: 06/ll/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1701 SA ST
ASSESSOR'S PARCEL NO.: 1703360000600
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
Commercial
PROJECT DESCRIPTION: Add 10 circuits
Owner:
Address:
SPR]NGFIELD UTILITY BOARD
223 A ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
ALERT ELECTRIC INC
License
12772
Expiration Date
05/22/2009
Phone
541-747-2213
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type:'fl, "'",~^ I Sq Ft Basement:
. ., ,t}\"I requ'
Range Type: '" cl;J - '" lh Ires J!ilIJlbGarage/Carport
, _ " .... J L / ~ Dreg
Energ, y Path: ,o'-.Ie (, :-'105", onSj!tR/t.Other:
j, ,_~, r:;;) I e rUrAS ar r
@:PlTkleil'&uililingqO throu O/lt e Salfwlll'nt Load:
. You mOH ^~L' gn OA1'l a"... ^g I
I DEVE~iiMEN.T=1NCooQM~f the rUle; by
- .1.10 uregon U T telephone REQU]RED PARKING
Center is Hl00-33t2/lty Notification
Overlay Dist: -2344).
# Street Trees Rqd:
Paved Drive Rqd:
""" % of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC ]MPROVEMENTS I
Street ]mprovements:
Storm Sewer Available:
Specia] Instruction:
Sidewalk Type:
Downspouts/Drains:
Description
Type of Construction
NOTICE: E IF THE WORK
~~.~ ,~~~I~ ~~~~~ ;X~~ PERMIT 18_ NOT
. -.. .....e.. ,LEO OR IS ABANDUNl:U rvn
I ValuatIOn Des&RW~~ ^';{ PERIOD.
/-IWI I wlo"
$ Per Sq Ft Square Footage
or mnltiplier or Bid Amonnt
Value
Date Calculated
Notes:
Pa2e I of2
-ii:tJi
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-01814
ISSUED: 12/1lI2007
APPLIED: 12/11/2007
EXPIRES: 06/11/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54]-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt Numher
$8.40
$4.20
$6.72
$48.00
$36.00
12/11/07
12111107
12/11107
12/11107
12/11107
2200700000000001816
2200700000000001816
22007000000000018]6
2200700000000001816
2200700000000001816
Total Amount Paid
$103.32
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.
I Relluired Insnections I
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, I state and agree, that] 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 he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Com'munity 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 readablc 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 Signatnre
Date
Pa2e 2 of2
225 Fifth Street
'Springficld, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-01814
COM2007-01814
COM2007-0 1814
COM2007-01814
COM2007-01814
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
2200700000000001816
Date: 12/11/2007
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ALERT ELEC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 011492 In Person
Payment Total:
Page 1 of I
".,-1'
l~_.........
] :36:36PM
Amount Due
48,00
36,00
4,20
6,72
8.40
$103.32
Amount Paid
$103.32
$103,32
12/J 112007