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Home My WebLink AboutPermit Electrical 2004-5-28 :;'f,:'~ ',' " :.'Crry6F':S'J.~.l@GRiELi:)" OREGON ." (') : 7" ." r.' . . '. --". :.' .'"jf "..'" '"'--1" ", :. I" !I OJsct as submitted has the followmg 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (S,<bh)~ipM68lbes not reqUire specifIc land use ELECTRlq,pLPERMIT APPLICATION _11 approval 1 ~ CltyJObNUn00~l1Jl(-()(J~3-rsate 5/a'l5/iJClJ/.j Data Zomng f5~IOU 1 'h07iATIONOFiNsiAiLATION'7~.1I{. 3 I COMPLEiEFEI!TstiWBii~B1'-;.n'itr'W:.:k.-o - - ~ 7;~i:~7'~1Z;7.Il 'rd'" L'l__~,,-""""_~~~~_"_4~=':: _-~-~'_-._~ " LEGAL DESCRIPTION A Ne", Residcnti~I'- 'Smgl; or'J\1ullI.Famllv per d",ellmg UOlt '1/02, .::2c, '-1-'-1 cosol se~::~I~c1U';dJ~ ;r~gon\a~;;~q~;re~youto~'~' --. All c."" 0 on UtlulJ.. JOB DESCRIPTION 1000 slb.\bW~~"'S adopted by the reire-sJiImv /I /I Eachafl511\,onalcJ\~<Olq1'ftlrorThOSe ,,,1,,0 Q01 Vd UJ(JJU d (()J?~ port1d~~W~52_001-0010thrOughOAR95~istlQ I btaln caples UI ",.. ,u e y - ~erm.: are non-transferable and expll'e I ork IS Each lGIleIifa'1l'P/!ImID'e<6r (Note the telephone not started ",.tbm 180 days of ISsuance or If \\ork IS ModuIar~lJllg,~~[I!llft Utility Notlfl~ 2sus:~c.~odeN.dT.f~:'CT8:~OaR~:'IL';:;C>T.';; ,uT:.7"'TI' 'Oc;;N~';'OT;; ";,',1 ~ee~er nU~b~r~:~::I~~~Q~~~~~ ~,' \Y :---~, v' Ad H'" .N,LLift HLr, 1 B I~Services or Feeders -lnstallatlOn,.Allerdllons~or Reloeahon : L '.. 0(i.....'~.....J.,.-'.,::;u._h '1Y "",",_ ;,._ "'m ',)11.1'1'1 L+~~ ~'/. ~\ ~". ~ -e' ~,,_~_t ' d;...-:tL...__~___~ __~ ~ J ,A /J Ne", AlteratIOn or ExtenSIOn Per Panel A ~ 1I1.1rf19J/~/" One CIfCUlt {/ /J C\ Each AddltlOna' CirCUIt or With ~ ~ ~ ServIce or Feeder PermIt A:::ss NG /7 s . F ~~ Il~ r}1~~ll~>N~~s:~s1Fi?~'<;Idr~ii'(~~~<!)'"-E.;~b,:i:ji~I~~ilO~ City ~ 61J Phone Pump or ImgatlOn $ 50 00 SlgnJOutl1ne Lighting $ 50 00 LImIted Energy/ReSldentla' $ 25 00 LimIted Energy/CommercIal $ 45 00 ElectncaI Contraclor ~ ~C Addre" (9'10 D 2firH :;r. CIty:{lf( I tvb R t:$>Phone 74-7-226 I Supervl'iOr License Number 24~.-- 5 ExpIratIOn Date I CJ- ( - 0 cr Constr Contr Number _I ?,,-,'7 Z- ExpIration Date S -l 1.--93'0..<). L. , /~ Signature of Supervl<;mg ElectncIan OWNER INSTALLATION The installatIOn IS being made on property I own which IS not Intended for sale, lea'ic or rent Owner.., Signature InspectIOn Request 726-3769 200 Amps or Ie" $ 63 00 201ti.trf~,\.'t:100 Amps $ 75 00 401frl1S!~~00 tSl'iALL EXPIRE I~ 71 fE~;;Skqp 60I~9~o'Rl~ t~\IDER THIS rcn:/,:T I I~Ubp Over:1'6QQ~m ).~ 0 ~, IS ABAN~:1.I'~'1 r 2,7500 __') Rec~AJJ:fc!JI~'j It 11 Uj."..u, 11;000 <..50 .l.l~ ANY 180 )AY PERIOD c 5i~~~~fy~~i~~I,~,;~:r~~'(ijt:'l:~:~:~~lr ~f Installation, Alteration or Relocation 200 Amps or less 20 I Amps 10 400' Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 V olrs see "B" above D $ 50 00 $ 69 00 $ 100 00 ~~. 1k1./ $ 43 00 $ 300 Mmmlllm ElectriC Permit InspectIOn Fee IS $45 00 + Surcharges 4 k'lSuBroT~~1)' !l:j!tm!>i'J~*("ht;YiL;ltf41~P& ()0lJ ,? .be) ~.CtO J1. 6g'. 60 7% State Surcharge 1O% AdmInIstrattve Fee TOTAL Shared Dnve(T )!BUlldmg Forms/Electncal Permit ApplicatIOn 1-03 doc Status Issued CITY OF SPKll~\..d:<lELD" Building/Combination Permit PERMIT NO. COM2004-00634 ISSUED: OS/28/2004 APPLIED: OS/28/2004 EXPIRES: 11/28/2004 VALUE: 225 Flftb Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 2633 CENTENNIAL BLVD ASSESSOR'S PARCEL NO' 1703254400501 Springfield TYPE OF WORK ElectrICal Work Only TYPE OF USE RepaIr ResldentlUl PROJECT DESCRIPTION Reconnect NnTlCE' ~(Drng<niWd~au'rps ,,- , 'C THIS PERMIT SHALL t)l,t"Ht I~ I Me vvunl\ .Nt~,r$ iB6~\ttJDJ 6R' 97477 ' '., AUTHORIZED UNDER THIS PERMIT IS NOT 1M 3 -1-- Th~"o" dps P,:" ::" 1 ",,,,,,,c~l('~n m~ 1<:' ARANDONED FOR flOtlllt,;i:I.\IUI1 ...... -.. I -, _ - - -. In OAR 952-001-0010 throug'l O,~ ~ON;~CTOR INbO~tfu^N' ~ERIOD '0090 You may obtain copies 01 ' . ront Hllole the'" ' ContractortIW~ the ~'Onw:aetl[w'\I\V N (h ,. I LIcense EXpiratIOn Date Electrical number for ~~fIt~J;;I,;JI!V;;J\'iC 12772 OS/22/2005 \,I""'''' .w I .-.. I BUILDING INFORMATION I I Owner Address Phone 541-747-2213 # of Umts Primary Occupancy Group Secondary Occupancy Group Primary ConstructIOn Type Secondary ConstructIon Type # of Bedrooms # of Stories Helgbt of Structure Type of Heat Water Type Range Type Energy Patb Sprmkled BUlldmg Lot SIze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Otber Occupant Load nfa I DEVELOPMENT INFORMATION' Front yard Setback SIde 1 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' Storm Sewer Available SpeclUl InstructIon SIdewalk Type DownspoutslDrams Notes I ValuatIOn Descrmtion I DeSCriptIon Tvpe of ConstructIon $ Per Sq Ft or multIplIer Square Footage or BId Amount Value Date Calculated Total Value of Project Pa~c 1 of2 . -~-'- .-.' ;;' -I l CITY OF SrKll'lut'lJ<.LD' Building/Combination Permit PERMIT NO: COM2004-00634 ISSUED: OS/28/2004 APPLIED: OS/28/2004 EXPIRES: 11128/2004 VALUE: Status Issued 225 F.ftb Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769Inspechon Lme I Fees Pmd I Fee Descrlphon + 10% Admmlstrahve Fee + 7% State Surcbarge Servlcc Reconnect Amount PaId Date PaId ReceIpt Number $500 $350 $50 00 5/28/04 5/28/04 5/28/04 3200400000000000085 3200400000000000085 3200400000000000085 Total Amount PaId $58 50 I Plan RevIews I To Request an mspectton call the 24 hour recordmg at 726-3769. AlImspectton requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will he made the followmg work day. I ReoUlred Tnsnectionsj 1 Electric Service Approval reqUIred prior to uhlIty company energIZIng servIce By sIgnature, 1 state and agree, tbat I have carefully exammed tbe completed applIcahon and do bereby certIfy tbat all mformahon bereon IS true and correct, and I furtber ccrhfy tbat any and all work performed shall be done m accordance wltb the Ordmances of the CIty of Sprmgfield and tbe Laws of tbe State of Oregon pertammg to tbe work described berem, and tbat NO OCCUPANCY will be made of any structure wltbout permissIOn oftbe CommuUlty Services DlVlslOn, BUlldmg Safety I furtber cerhfy tbat only contractors and employees wbo are m complIance wltb ORS 701 005 wIll be used on tb,s prOject I furtber agree to ensure tbat all reqUIred mspechons are requested at tbe proper hme, tbat eacb address IS readable from the street, tbat tbe permit card IS located at tbe front of tbe property, and tbe approved set of plans will remam on tbe sIte at all hmes dUring cODstruchon -J ~.:",,~~t~:"~\ I ~ ,f' W 6 J~i ) OL(- N I'- Date Pa2e 2 of2 225.Flfth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00634 COM2004-00634 COM2004-00634 Payments Type of Payment CredltCard 5/28/2004 RECEIPT #: Description ServIce Reconnect + 7% State Surcharge + 10% AdmmlstralIve Fee PaId By STEVE/ALERT ELECTRIC &r~!!'IQ~I~D I - t u..., ~.il I':ty of Springfield Official Receipt velopment Services Department PublIc Works Department 3200400000000000085 Date: OS/28/2004 Item Total Check Number AuthOrizatIOn Received By Batch Number Number How ReceIVed I1Jm 000398 028574 In Person Payment Total Page I of 1 9 34 46AM Amount Due 5000 350 500 $58 50 Amount Paid $5850 $58 50