HomeMy WebLinkAboutPermit Electrical 2007-12-12
Date
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. SOURCE~5\'?~
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225 FtFTH STREET. SPRINGFtELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERlYIIT APPLICATION
City Job Number COlA-A'Z.oO 7 -Of Y 37
AP'[ .
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::::> f'" ,.. .' C. "'Tempor."17V~V'tCes;w.',Feetlers,,,,,,,S,;-,,,;;fj:-"!f"'--,~\'li,"~f',,",,,,J;i"'i'
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I --' .. ,-,1:1''-'1-'' C.J Dy t1l 0 - -
~eluflce.tl[;n enrte _I, e reg on Utility
In OAR 95')_CnI~st~llhti~ft~Al~Eillll:l\!tlMlllI:ation
- ~ - Vel u thrau,gh OA '"
vV"~'. You maY20<1~mR'j6)5illf~s R 952-001_
r: cadmg the Ce.!jjll~Plo\ 4f1Rc:.1J!(~ rules by
>~er for th~o:?rftl ~. 6 TeRiphone
Center IS 1-8~ 3~~jcation .
Over 600 ~mp;f@4f&o Volts see "B" above
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~Y",;_~_'iC':.~-"".o:___.~<J;;";;_....,,,1d"I'--:--;;-__'__, -- ",",.___":____,__><W''''';i__,__>;:,,?~,__-",,,;e;;r:;;l'';*):d,,,*,",'-C~,,--::.?.:,,,,':;I;;;__'fk)l__\\__~~b<"'__:&~__
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
I / I J I I Service or Feeder Permit $ 3.00
Owners Name A/"",~.;'/n'" -I-""....~ i-b-\.JS-
Address "J-' 't?r r- (J A ).[ '^' " I E. ?;~1U'g;;t\i1l~~lft(~~~i~~if:d~'fJrf~i'H{rilld~);'!Jf}~~1h~1;If~t'i~t
__ J 0..> .J J~ L) r~-'~ -t:o";&'i~';.l:-M-tJ."'"'D;i;,;,c;O:-io.,t.,,,;t.(j,:A~-:k'-';,'&!,j>,,,,__~,.,;.\-'-t--^;~\'[:4;d,__?C~jb;;:~~--.;Nit..."t-~E\~,;~-:H.:.~~",:rk~~:.:.o..'l'!?,;'
City Et.-t&~' Phone NOTlCE:ump or irrigation $ 50.00
THIS PERiM~~E~~FlE IF THE WORK $ 50.00
OWNER INSTALLA nON \, AUTHOR!zmlJt~m!l~~RIvIfT IS ~t:T $ 25.00
The installation is being made on property I own whichCOMMENG/D[Iee~rtSgb;l9/rtOO'Nfb FO!'! $ 45.00
IS not mtended for sale, lease or rent. ANY~IR~@lf.ermit Inspection Fee is $45.00 + Surcharges
4.
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LEGAL DESCRIPTION:
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JOB DESCRIPTION:
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Permits-are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
'P;!'?;''':'r''-#-'''iir<-J--J;ic0~,':2-,"if<rt'et,;;,'2,'P/i'0<-~t:.!A~-t?:-A';:li<-\::~~';'\':"', -t>\~'ll'~~'r'i~,~:~?,\'h
::::.CONTRACTOR1INSTALLATION.DNbYt!.
2. ~;;:';;',l;i,;..:~,::,,,:i;,~~.';')1;:'~;;'}i~'-:--'i:__~-'i;;1--4_';:i"ii;;',~i:';$L~;~Xi~ij?J~~,""it;.~m
Electrical contractor~, r-~' f~'~
Address (9. () t< 1/1/ c..> ~ iJ vv. j oJ C-
, r
City P.. U7 ......, Phone (::, 877'113
Supervisor License Number
79/~
Expiration Date
/ff IO-/J 6f
Expiration Date
I!)~ '3.>2..-
1- 1-0'0
Constr ContI'. Number
Signature ofSupex:vising Electrician
Rd~;-p :r ",JAb
Owners Signature:
:J.-
Inspection Request: 726-3769
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3. ,,"COlI1PLETE Ji'EE'SCHEDULEBELO,W ""';';''i::;\Jl~,t,,O:\H'''''\'!:
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~:-:".(';~j;;,;;<'>~4'~'(<~<1f;t>',t:~--'C'il'';'-,;~f;7'j{';\1';?fi1-~t%;(-!_!yftif:-:f,~\~,~--\~';;$,t?"':;>FI~.'\~Z';ii~;i','!~-
A. ~.i~e,vReSidentj~l;:-; Single. or. Multi-Family per."dwclliiig"unii::tzt:.
-:,~"""~Af"",.;:1ji!r.""~--,,,'i:W . ,."",-,,,,:..;....'1., ,.._~,-,'-'.... "'. " '-. ".-." '~~_~:"1r\.--,~"",.'-",:. ",-,."--,,.._ -:~~,t;:-,;c',.,;"';_.-~'><---o-;~""':'Y.:.\','l!:~,;~
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof'
Each Manufact'd Home or
Modular Dwelling Service '01' .
Feeder
$106.00
$ 19.00
$50,00
~@~i;\:ff:;t:~~~f1_~;----~~':~E:r;;il:01:u.i~~:!?'~!::t:~:"?_tf~3f1'%<B~{i;;;;"t.0y,;:tf~~~,*.~~~1;'fty~~~~t\i;" .
B. ~_Servicesor,__Feeders'_;''lnstalla'tio.Ii~tAlterati6ns:or~Relo~cation:~ht~ . --
~~G~,,'4;r;0i;'';;J$i1'~f0i~ID-'~';~\:-_\:1:ti;;:';)G':o:;:;'.;:';;4'~i.;,'':'i\i>--_~t'>>,,:";;//'-\..i.;:;i;.;i-~, ~.ii:~I}f~~ir:J1ili.~{i1P"~,'::;';f;--;;~ .
. . ,( 70
200 Amps or less ::2- t f $ 1-' .00
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 $ 50.00
IC(D
$ 50.00
$ 69.00
$100.00
$ 43.00
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If~
1'(
7
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8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Drivt:(T:)/Building Fonus/Electrical Pennit Application 8.06,doc
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: cOM2007-01837
ISSUED: ]2/12/2007
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
SITE ADDRESS: 137 38TH ST
ASSESSOR'S PARCEL NO.: 1702314200900
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: 200amp service and feeder
Owner: NORTHVIEW INVESTMENTS INC
Address: 33855 V AN DUYN RD
EUGENE OR 97408
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor License Expiration Date
BOB FISHER EL.ECTW~(\1'\lCoreaon law reql9il"~~~.~,? 01125/2008
I, I BUILDING'IN~&OO'~#~'~et~~~h
, ~\:~,.; ;:-:;;~-0010;hrOughOAR952-00b1.
, , J.""#'of StOri"ln copies 01 the rules y
"If) '~0" r.1?V 01)
R-3 V - . ... ~eight 8f~ !r\l'lUtt;!! the tele~ho~e
(. "'IJngT.y~ec~,j,j'''at'on Utility Notification
VB nu ncer f." lh' v,ell )
" ~e~lfJr ~P/\:aOO-332-2344.
Range Type:
Energy Path:
Sprinkled Building:
Phone
541-689-7973
# of Units:
Primary Occupancy Group,
Secondary Occupancy Croup:
Primary Constrnction Type
Secondary Constructinn Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION'
Front yard Setback:
Side I Sethack:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
No~JCl~;~:v<<~(EXP\RE If THE WOR\(
TH~ PER~\~ ~Mn~R THIS PERMIT_~S NOT
,.""."f,~I",_L -ai"DUNt.U rX
I PU,IlMlif,!~QlNIENfflc'"
ANY 180 DAY ~I:hluu. Sidewalk Type,
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Availahle:
Special Instruction :
DownspoutslDrains:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amonnt
Value
Date Calculated
Paee I on
-~~
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-0]837
ISSUED: ]2112/2007
APPLIED: ]2/]2/2007
EXPIRES: 06/1212008
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 or less
Amount Paid
Date Paid
Receipt Number
$14.00
$7.00
$11.20
$140.00
12112107
12/12107
12112107
12112/07
120070UOOOOOOOOl494
1200700000000001494
1200700000000001494
1200700000000001494
Total Amount Paid
$172.20
I Plan Reviews ,
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 Reouired Insnectio~~,'
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 he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaiuing to the work descrihed herein, and
that NO OCCUPANCY will he 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 he 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 Cnntractors Signature
Date
Paee 2 of2
225 Fifth Street
Spri~field:Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01837
COM2007-0 183 7
COM2007-01837
COM2007-01837
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
". ~RI:~Ii..'.IW>"^....~.......... ...'l.....
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,^'.-~----.- _.~..
City of Springfield Official Rcceipt
Development Services Department
Public Works Department
1200700000000001494
Date: 12/12/2007
Description
Perm ServlFdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
BOB FISHER ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
554191 In Person
Payment Total:
Page I of I
2:36:16PM
Amount Due
140.00
7.00
] 1.20
14.00
$172.2U
Amount r"id
$172.20
$172.2U
] 2/12/2007