HomeMy WebLinkAboutPermit Electrical 2007-12-12
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54t)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPliCATION
CitY Job Number ~ ~ -O/'ilZ5 Date
Supervisor License Number 4 7 ,~ ) .:5
Expiration Date / 0 / I 0
Conslr~ Contr~ Number J 3 & tjLJ Lr
Expiration Date / D J J D
,
6~ gn~atureUtLof Supervising ~ctri'IJ\JI.}J.cian ,
New Alteration or Extension Per Panel
~ "'''Ad One Circuit
fI r I ~ Each Additional Circuit or with
ownersN~mOec ' ~~,2 ';:!:J ~ ufE S;;~~'lrF:~se.r.:.. ::~.~~~.'.'~~tl,,",I'lli\i;;E::~h. :r.''!'Fllq..~.t'~. .'1..
Address--V '-> .5. .:..:>'Y'''....>I .,-- ~ 'l!li~~:~~~~~~~JJ!W~ili~=~~.!i
City ~d~ Phone J-,:j) - 3 ~;;'1 Pump or irrigation $ 55,00
, tJ J/ Sign/Outline Lighting $ 55,00
OWNER INST ALLA nON Limited Energy/Residential $ 28~00
The ins~Nl_'<mlHl\lIlO~,lj; 'Yltial1o Limited Energy/Commercial $ 50~00
is not int81fl5<<,IffiM~'aem~R!"C!<jIjy the Oregon Utility Mini.m. urn Elec.tric Permit Ins.pe ctio.n....Fe .e.. i.S $.50 .O.O+.S urchaies
~'Ifi at' Ion Center Those rules are set forth r's."'Jii'.".~:r:.-'''''-..'Y''~-'.'._~~!!i1!'}''illl!l~.~3'sl!'11ll; ~!V!W.' 0 -
O . 1 4" c/BT<!/'E.... ~n'~@~N:~:'" "~I" ~illt,...,
wne n \l52-001-001 0 through OAR 952~OO. . !Ji.iWJj*",..i"..,.,. 1It:'F:~ .,~ .~;/ ,;", \,0", '''111
gggn V~" ",o~!-.toin "Doles of I;le rules by 8% State Sur jl'e . _, -lS:;k12........
calling the center. (Note: the telepllolle 10% Adminis IfV~~MIT SHALL EXPIRE IF ,r1.: 7JBo
number for the Oregon Utility NotliiCalion 5% Technol~lJifUORIZED UNDER THIS PEKIVIII$}.!#t)
Center is 1-800-332~2344). COMMENCED OR IS ABANDONE[J.I;OR !D
Inspection Request: 726.3769 TOTAL ANY 1 Rn DAY PERlnD _ ~0.
Shared Dilve(T)713UJJdmg FonnsJEfectrical Permit Application 7.07.doc
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)..fOAL DES~RlPTION: I
:J-((v/l'f rf{)Oi)f
,
JOB DESCRIPTION:
110).:53 (JoO Id (JlJ
Permits are non-transferable and expire if work is
not starlet! within 180 t!ays of issuance or if work is
Suspended for 180 t!ays.
ael'kU~il'rt-j~0;,,,,~,1101~."'::lI1ji;r;ur0:;;U~Jlj{m;,,l1;;
'(ZJ:iNJlm'Jt(JH:(;):B.;lTNSfRi\'T~m. - l1.l i@ .. ~
2. , " M.!t:M,~4t$tV"i;t~;G:ki11'iM1AJ10;'j#;W4'lG'" w , ' ""
Electrical Contractor
BUAAEllBAOS. ELECTRIC:
Address P.O. Box 697
WQlt8rvllle, UH Y74fW
City 54Jh~11-2724
3. mfe;7MiiiJiIiP"iikTir........GlifJJD'iJiBjiJlBEil@JV:,illll'Jlil!!ii\l!,lm. .'1I!i_'\;.~~5 i!1!1Ji0!~~1j!
V1k~fJjj_-.,,"'.'""",._""'~~$P'l~i'il$.~~J
;/
A ~~R~'Mtl"'i!'jt'I"'::.lt1!!1f<3~-S.r.,,*~\ffi'iI~W11!'!!1 .", ""j~[ITt.'~"jmt""'I'..j-!tl"if"'I.'I"""'~:~.
. ~'Y.*;,;5t~!~"'~~~tl1~;y1'P~~~i,}}:.t}r~g~l!m,:' ',:
Service Includet!
1 000 sq~ ft. or less
Each additional 500 sq~ ft~ or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
/' $117.00
$ 21.00
$55~00
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 70~00
$ 83~00
$138,00
$180,00
$413,00
$ 55,00
c.
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
$ 55.00
$ 76,00
$IIO~OO
$ 48~00
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01825
ISSUED: 12/1212007
APPLIED: 12/12/2007
EXPIRES: 06/12/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 205 S 54TH ST SPACE 3
ASSESSOR'S PARCEL NO.: 1702330001200
Springfield TYPE Of WORK: Electrical Work Only
TYPE OF USE: Alteralion
Residential
PROJECT DESCRIPTION: Service Repair
Owner:
Address:
HUEBNER JOHN D & JOAN C
205 S 54TH ST #3
SPRINGflELD OR 97478
Phone Number: 541-741-3824
I CONTRACTOR INFORMA nON I
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC
License
136446
Expiration Date
08/20/2009
Phone
541~ 747-2724
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:
Lot Size:
Sq ft 1st Floor:
Sq ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INfORMATION I
frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS ~
Street Improvements: Sidewalk Type:
Stonll~I'fnCl\......ffilb~:m law requires you,to Downspouts/Drains:
Speelith.f),s]iolltilJj\~pted by the Oregon Utility NOTICE:
N~iification Center, Those rules are set forth
N<lffSJAR 952-001-0010 through OAR 952-001-- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may Dbtain.~opiesc ~f.t~~~~~:..bY AUTHORIZED UNDER THIS PERMIT IS NOT
calling U1t:lI"'"\"" \..'t,'~',t:, - N' ~ 'I" t'M vUIVIIVltl~vtu U~ '" fo\tlfo\NUUI~tU rUH
b lor the Oregon Utility Otl lca I . .. I ANY 1
num e~enter is 1-800-332-2344). ValuatIOn DescrmtlOn 80 DAY PERIOD.
$ Per Sq ft Square Footage
0" multiplier or Bid Amount
Description
Type of Construction
Value
Date Calculated
Pa2e I on
_6il'!'R'....-iiiii.'..
.~~.......
.'--,..' "
-- ~...-- '''''''"'" ", ,,"
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01825
ISSUED: 12/12/2007
APPLIED: 12/12/2007
EXPIRES: 06/12/2008
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 I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps nr less
Amount Paid
Date Paid
Receipt Number
$7.00
$3.50
$5.60
$70.00
12/12/07
12/12107
12/12/07
12/12/07
2200700000000001823
2200700000000001823
2200700000000001823
2200700000000001823
Total Amount Paid
$86.10
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 Rellllired lnsnections I
Electric Service: Approval required prior to utility company energizing service.
By signature, 1 state and agree, that J have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and] 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, aud
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
J further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
J 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
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/JournaJ Number
COM2007-01825
COM2007-01825
COM2007~01825
COM2007-0 1825
Payments:
Type of Payment
CreditCard
cRcceintl
'l'i
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200700000000001823
Date: 12/12/2007
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+~8% State Surcharge
+ 10% Administrative Fee
Paid By
JOSHUA BURRELL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
DDK 00570B Phone
Payment Total:
Page 1 of 1
3:13:53PM
Amount Due
70.00
3~50
5~60
7~00
$86.10
Amount Paid
$86~10
$86.10
12/12/2007