HomeMy WebLinkAboutPermit Electrical 2007-12-12
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22S F1FfH STREET. SPRINGFIELD, OR 97477 . PH:(541)725-3753 . FAX: (541)725-3689
ELECTRICAL PERMIT APPUCATION
City Job Number CO~ 'Z-C> 0 7 - 0, g"! l{
t(7C1n S
!O~ 1- /0
/ / ~ 200 Amps or less $ 50.00
Constr, Contr. Number (0 f 'J ~ '2:j I f,j'JTlON: OreJ%i\l1lPsto 4QOAmps $ 69.00
q IcJIo..W r"'es adoPt"4Q1I:jV~~Il~lg~If6'~\l!r to $100,00
Expiration Date - 07~0.!@I~Center.~",,~' ~,._regOn(Jtilit " "
tilt UMM gb~-0~1 uverf6{)(lhiUUPlim ts see B above.
/1 u -OQ1~""..."r. il' .". -
Signature (!J Supervising Electrician 0090.. You may oL'fllill'~ie "'iJr!ll--- ; Ii,n, , " ,
1. calling the t ' ~. e rilles hv
her cen er.r(~l~I\!i?S1Ilr.l'i'dfe~fon Per Panel
_ num for the Or~1cl;\t.clil .~ ne
Gettler is 1_Mr;,<l.Q.o,L~otlf!cat.ion .
r;aan~~j:I!Cult or W1th
./1. (.~ Service or Feeder Permit "'3
~y ~~r..c,
T.4)~e-tL ~.l
NOTICE:
THIS PERMIT '1:1 ~ E'\lIMIT IS NOT
AUTHORIZED U % \i~'\!DR
COMMENCED OB'Ma-AF'l!eLJ
ANY 180 DAY PERIOD. S {.
TOTAL 100 -
Shared Drivc(T:)lBuilding FormslElectrica1 Permil Application 8-06.doc
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LEGAL DESCRll'TI9N:
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JOB DESCRll'TION:
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Permits are non-transierable aAd expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
ke:omMeFORi1NSTM!mTioNlO~JIl
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Electrical Contractor
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Phone :Jff3-ln7j
Address C%SL{
City srkt
Supervisor License Number
Expiration Date
~
O~Qfl'a[ne -S-~
A):J." 3L9(
City S ?,c/\
Phone .72l> -/07 t(
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
F ceder
$106.00
$ 19.00
$50.00
B.I1~;lrsr4~r~I~~r~~urJ!i!;~~.
7D
I ~.Oo
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
70
C.
Installation, Alteration or Relocation
$ 43.00
I(
$XOO
12
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E. ~~Iis;~~I~a~e~~1~~~€l!~~~lt~lLl!tl~~)4:i~l,l~J@~,~~~
$ 50.00
$ 50.00
$ 25.00
$ 4~.00
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Status
Issued
CITY OF SPRINGFlELU
Building/Combination Permit
PERMIT NO: cOM2007-01834
ISSUED: 12/]2/2007
APPLIED: 12/]2/2007
EXPIRES: 06/] 2/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3854 JASPER RD
ASSESSOR'S PARCEL NO,: 1802061412300
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Service change and 3 circuits
Owner: MEYERS JOE E & CAROL A
Address: 3854 JASPER RD
SPRINGFIELD OR 97478
Phnne Number: 541-729-1074
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
JEM ELECTRIC INC
License
161235
Expiration Date
09/07/2008
Phone
541-729-1074
BUILDING INFORMATION I
# nf Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
I1'rT~~I""""L
f Type ofoneatOregon law requl'r SIFt 2nd Floor:
O"~'" ]'.';',. j es YOU~
N Water'i'ype: opted by the Orego Ut Ft Basement:
Ofifi('~tl -, n I J
in ~,~mlar);1'6i1ler. Those rules are set f r 'It Garage/Carport
00 ~<\! Iill1c0010 through OAR 952-~ '~'t Other:
C ~rl &I<m.J1i1iiilP copies ol'(lIe rU/e~<t'cupant Load:
mo t e CAnter ''''....._. "-Ie .. y
I DE~k'~iN~'tNIu(')~MAliIf~Niitifi~~:;n
! '." .r-,,:;dS44).
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
R-3
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Nntes:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
~ n 'If IF/'f. -- -
-~.... ".. 11 un Iv f\Of\I~UUNtU tUK
I Valuation rMtYriJWoWf PERIOD.
DownspoutslDrains:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amnunt
Value
Date Calculated
Paee I of2
-~~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-0]834
ISSUED: 12/12/2007
APPLIED: 12/]2/2007
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
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps nr less
Amount Paid
Date Paid
Receipt Numher
$8.20
$4.10
$6.56
$12.00
$70.00
12112/07
12112/07
12/12/07
12112107
12112/07
1200700000000001492
120070000000000]492
1200700000000001492
1200700000000001492
]200700000000001492
Total Amount Paid
$100.86
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 Tnsnection.' ,
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 herehy certify that all
information hereon is true and correct, and] further certify that any and all work performed shall be done iu 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 he made of any structnre 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
Paee 2 of 2
225 Fifth' street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01834
COM2007-0 1834
COM2007-0 1834
COM2007-0 1834
COM2007 -01834
Payments:
Type of Payment
CreditCard
cReceintl
SFA1N.G"''''''l.'j).:.:
,i>>~ ':
_~'J
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1200700000000001492
Date: 12/12/2007
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
JOE MEYERS
Item Total:
<":heck Number Authorization
Received By Batch Number Number How Received
djb 164096 In Person
Payment Total:
Page I of I
2:17:32PM
Amount Due
70.00
12.00
4.10
'6.56
8.20
$IOU.86
Amount Paid
$100.86
$1 UU.86
12112/2007