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Home My WebLink AboutPermit Electrical 2007-12-12 ZON LI\A-r INtTlALS d-' rv-....- DATE lot 11'2./0, SOURCEIvy'5' '2." - , 225 FtFTH STREET. SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FAX, (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ~O.+'\ ~..:>~ 7 - 0 I g .J! Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 q _ 0 i\,.~,(f:n c: 40 I Amps ~o 600 Amps $100.00 Expiration Date l~i:~~~~~;;~~ne~th~g~~~*~l~yolts see "B" above. Supervising Electrician NoW,cs!'oll Center. 'P.Hi~rlUlW.alI'!:'!l.HtJarttL'___ 1 i~l OAR 95.2.0Q1.001 0 tlNj;Wt;\Iit~~~-~QM.sion Per Panel //~ .. ~O. You may ol.tain O?~ics otthe rules by I . n~~':rL~~~ t~h3;~;~ci~~;~~i~1~~"~r with J\-!A..,.d~ (.o!..'fje~~rtSl-80t)~3'9~-i3~~r. j,' ^ _~",",.,.....,~."..""_,',,,,",~'.~,,~.,,-,""." ,,~~.~,.,.-..,::~ ",,'~~'-~,-,'''r'~., 'flfSX S L. E.Mis~ellaneous(S~rviCe/f~ede~l1{)fincl{)ded)J.t~chIl1stan~tiol1 '....''-'-'M'' ~.., .,,'.',.:;,_'~..~;:,.;.;.i, ~~ ,:,~.-,-,~",~:;_.;..c'~_~.;;;';;':,,,:>:,,,,,..':-";::;;;;';; -,:, ".~.,-'- "-"~. Phone 7CfI- zel3 NOTICE: 4. THIS P1=RMIT SHA 8% State Surcharge AUTHORIZE lLE?XPI/llEI?F~ COMMENCE~ ~~~~R;'{#I&W~M/f~rs 'N~: ANY 180 DAY PERIOJ.~120NED FOR . Shared Drive(T:)/Building Fonns/Electrical Permit Application 8-06.doc 1. LOCATION OF INSTALLATION: >'Iz..~ 0 (V.-4.-1.. / f LEGAL DESCRIPTION: 17D2503t.( OO)'CC JOB DESCRIPTION: S~IIL. c.c+MG-E Permits are nOD-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. CONTRACTOR INSTALLATION ONLY 2. ,,~ .__ _ " Electrical Contractor ~ UM. [(-ec.L-Jc , \rL"'V2.c. r Q-l I . Phone :J$-/07j Address 5~'L( City 0pkl Expiration Date t/7Cfn S I{)~/-IO /fo f /J~~ Supervisor License Number Constr. Contr. Number City OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Date /2 -1'2 -0 "7 3. COMPLETE FEE SCHEDULE BELOW 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 .~r'Feedet~'-jnstanati()ll,A)t~rations.or~eIol:atiori: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only / 70 $,.81.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 70 C. Temporary Services or Feeders I _'. ._, . '_' -. ._c.; $ 43.00 $ 3.00 Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial Minimum Electric Permit $ 50.00 $ 50.00 $ 25.00 $ 45.00 Fee is $45.00 + Surcharges 7D 5bO 7 y.:> f5b ~ Status Issued U 1 )' OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2007-0]833 ISSUED: ]2/]2/2007 APPLIED: ]2/]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 SITE ADDRESS: 3425 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1702303408601 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Service change Owner: HAMILTON ROBERT R ET AL Address: PO BOX 52 SPRINGFIELD OR 97477 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 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # nf Bedrooms: VB # of Stories: Lot Size: Height of Structure 1Ft 1st Floor: Type:li"lGhJt:: Oregon law requires yo 0 t 2nd Floor: " ,,-, ,'j . th 0 gon U I' fWater{~;w-"adopted by e re g ~ Basement: NB:~;;g~Jl'yp€lenter, Those rules are set t Garage/Carport irE;;~gYJ;p:at1l01-001 0 thrO~gh OAR 95 \",,0 II~Other: . :. . . . dlbtain caples pI the ru 'E:~ or oSptLDk'le<IlBiJiI lfg:- Nt. tl'l~"teleph6l\eupant Load: _ _11:........ tho ....~ntfr. foe. 1 DEVEItmRM~N'f1~NPOkM'Ailu~\,~~):"""'M' ~.\,,! . REQUIRED PARKING R-3 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: 1 PUBLIC IMPROVEMENTS I Street lfuprovements: Storm Sewer Available: Special Instruction: Sidewalk Type: NOTICE: THIS PERMIT SHAll fflYt-\f!'W'l'AF~RK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR 6~IV 1Rn nAY PFRIOD. I Valuation Des~riDtion I Notes: Description Type of Construction $ Per Sq Ft 01' multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 2 Status Issued CITY OF SPRINuJ:<1J!,LIJ Building/Combination Permit PERMIT NO: cOM2007-01833 ISSUED: 12/12/2007 APPLIED: ]2/]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 Pai~ 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 $7.00 $3.50 $5.60 $70.00 12/12/07 12/12/07 12/12/07 12112/07 1200700000000001491 1200700000000001491 1200700000000001491 1200700000000001491 Total Amount Paid $86.10 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 Insnedions I 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 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 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 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 ,l.. ,- Sprmgfield, Oregon 97477 541-726-3759 Phone j~ .... City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01833 COM2007-01833 COM2007-01833 COM2007-01833 Payments: Type of Payment CreditCard cReceintJ RECEIPT #: 120070000000QOOl491 Date: 12/12/2007 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JEM ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 085665 In Person Payment Total: Page 1 of I 2:13:06PM Amount Due 70.00 3.50 5.60 7.00 $86.IU Amount Paid $86.10 $86.10 12/12/2007