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Home My WebLink AboutPermit Electrical 2006-6-27 ZON L...D'L:- INITIALS N tv\. ~ DATE CoI:n/~~ ' ~'" SOURCE7Y1O. 'j ~/Z~{~ 3 cOMPiETE PEE SCHEDULE~ BELOiiFrv;t) ~;;:~,j:~~?~;"jJ ...Iw.'v~~ I:~- ? ""J~-J.4~_'~ ><_.t,,""',,::'_"i ~~~~"$;~t"",,1~ =-~~_~'!nw~~;;~i:t'..1";~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726,3753 . FA:\. (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number ~ ZOO," - C:> = 'ifc> Z- Date 'l-t >.",1':< a.j<~".,"t 'j'- ",~.. !'I.-~ "~r-""/l'},"" V'(\-~:- 1 -LOCATION OF INSTALLATION" ", '~'1 ,f; ~-'"'~^'~~ 'l:''U'1....''ir',,1 ,k.",...P;'t''''~~v'.._b..~ 20~f' CeoA~~',4-( ~(vJ. ...." "","..~!r..","'1 ~fl~"!"",~1t-~~,,,[1:':), "Z~J.'";'~';,(i'x.oii!JZ'tl-;;;~.Jr{,> ';J~~~~\ A ""~~~~ ~(,~~ld!nR~!,.T3 ~I~~gl~.. ~!~~l~~~l!~~~~~e!:.$d'i;II~~lg ~~1/i~ LEGAL DESCRIPTION /70"l Z'S'-f"5. JOB DESCRIPTION Kt::,( /Ju:.- ZCV,4-~ SiLVL I Permits are non-transferable and expire If work IS not c;tarted wlthm 180 days of ISSUdnce or If work IS Suspended for 180 days ~/200 SerVice Included 1000 sq f1 or less Each addItIOnal 500 sq f1 or portIOn thereof Each Manufact'd Home or Modulal Dwelhng Service or Feeder $10600 $ 1900 $50 00 ~l~j, '~T% A':A.~ f~:~~';~ "">';'''''~,,/ "'1f~:l:;:{~-s.,;~w1""'l-"''' :>--\ 'i!>~~'"'1th ~~JJh )(;';~ B ~ Ser.vlces or Feeden ~IInHJlldtJon. AlterJtaonlf or Relolatton ~~ \_7 ^"",,; d'",,~~ ~(,.,,,,;;; ':!'~, """I,..;:"~f%"c ~~..\.~ l- ~'04~v.:- ~'?f!,,-,,* ~ _<~ --({ *"",,:rf;~ ~ ;',/'''';;'''<1",2'' /..,~k-,,- 1., ,,L~ '\1:"-~'-'0 ~"'~~ft'H'~h:"".t"-> , CONTRACTOR INSTALLATION ONLY_ :lec~:I::; ~:~~::~t::. A~;;:~ r;;] '~~&':;;'2- - 0 Addms (J, U 780)( --:z.. u L( CIty Wl4-t-f-tIW~~ Phone 74L(-070) '1:'1'i0'i bJ ~T' $ 63 00 $ 75 00 $125 00 $16300 $37500 $ 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 Amps/Volts '~~ r"" l"es \frill ~^ Reconnect Only rdJon Ilt.r,ty ~'"' '~O,,"I\~"~~~ Irj"~;~ ~;~~J.)~f:.~?J~J<<sel (qrth{1'~\\;'\r-~~~t~~~ In (e rR:{~5mp?(~~~~i&~sf<~lif*!~ta2mO~~~ti~~1~~~& 0090 Vou may obtain caples of the rules by caIIIii~tall'lIoniWlte~attQl) or1Ee\9.sa~!~8ne nUI1'20if A9Ii~~gr<il:',ggon Utility Notification 20 I c;,,%'IWI6S40oSRRi~'32-2344) 40 I Amp> to 600 Amps ~c CaG-s SuperVIsor License Number 10/10 In g I (' Con'tl Contr Number 20 --:Lcr"t ~ ExpIratIOn Date '5 ( '3 I, 0 I I SIgnature of Supervlsmg Electllclan ExpiratIOn Date $ 50 00 $ 69 00 $100 00 Over 600 Amps or 1000 Volls see "B ' above '''-''l;. ^ ~~i\-" A'"t"'j;V~!,,?, a!,,1'V\ t\1.."x.;'" rl>~J"'1.~>":[f~"'i"~i;f'~~~ D 'hBranch,~)rculb~"~{,;f~\Sl o/?~'7~;"s~1trl~~~~'th'~:J.~,,- "L't~~;',:2J.;1,,~ I~ z; J~ "",,",,"^~bI<~ ,,~~-:.h,". "Ie (r~ik",:..m;t:.-.,A_\Zl_ ~ '" 'J.\.>iI,~f;Q",S~'~,,^"'''''''''-rl>>;;a~,,4-'&~ New AlteratIOn or K"\tenslOn Per Panel One CircuIt Each AddItIOnal CIrcuIt or With ServIce or Feeder Permit ~-- ~~ Owners Name IJMt'rfr r\-Wt~ Address be;;<; ~/Tbt( ~J CIty ~ k L~.....J $ 43 00 $ 300 """~~pJflZ'67frJ4>:..'t(<,~~' "",",~J~ ,,~y,,>r<t".j"~~ !:f\~1iiq~"::t r'~~"'~~~'l E ~l\hscellaneousJSel \lce/feeder uot mcIuded) -Each InstallatIOn' P;.~.Jr;..; f;;~..J.. ~,{ 1~f-m.q,)" ~~ ",_i,\ _i.~ '4 ~'5'1I.\~,.,w..:~,1~,{,.~1.p "'-Io.<,(;e..,..J.--.:&....d....lu.::.._h !lOTlCE,pump or 1mgatlOn, $ 50 00 ;'!:CIS PER~~Jrn/Outhne Llghtmg $ 50 00 OWNER Il\ST ALLA nON Co THORI2tYJu~Wtrt.leF>:{ffres1dentIaI ~ 25 00 The mstaIlatlOn IS bemg made on property I own WliJ~.tyMl~ENCE!tyrl/fliiiieT'f(!f1;,fnlrfefflt Wo $ 45 00 IS not mtended for ,ale, lease or rent' ~.W'fIltkltd:{vlr4lVfJI'J/i~lIrre~8?~ ~r. IS $45 00 + Surcharges 1\" ". ,"' IOD'dild'">'+- /YED'FnN .~[,,z "~',,"~9, If I Owners Signature ~~ LSUBTOTAL'OF ABOY'f!I;~E,"...;~,;;'V1j';t1;::~ 0 ") ~l~_~~,,\ "~.;~$:~-14,,,~,*t~ tkMt..~J:,...":".../r~, .nr"~:.L.i~z 5-<>'i' ". 8% State Surcharge ., ....~. 10% Admm1stral1ve Fee ; 6:1.:> ~V <! 7c( ?l( -J TOTAL Phone InspectIOn Request 726-3769 ShJred Dnve{T )/Buildmg Fonns/Ekctm..al Penmt AppllcJtlon I ~06 doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' COM2006-00802 ISSUED 06/27/2006 APPLIED: 06/27/2006 EXPIRES: ]2/27/2006 VALUE' 225 F,ftb Street, Sprmgfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 InspeclIon Lme SITE ADDRESS 2068 CENTENNIAL BLVD ASSESSOR'S PARCEL NO 1703254307200 SprIngfield TYPE OF WORK Electncal Work Only TYPE OF USE Repair Resldent..1 PROJECT DESCRIPTION Replace 200amp or less servIce Owner Address W ANET A HAZARD 655 REITEN DR ASHLAND OR 97520 Contractor Type ElectrIcal I CONTRACTOR INFORMATION I \0 _ . ,~C\\Nes '1~~ lIt'/. Contractor Llcense."O\\E'i~W~lIOn Date GLEN A CAMPBELL 73995 . 3 ale s~~ ~;i~412008 BUILDING INFORMATION 1,1\ O\\~e";;es '0'1 0\-l18S 0 hO\\6 # of StOrIeS " v\ali\ ~ote th6 16\6\ )..~~e He'gbt of St~,usturC'1 ~ 0\\ \JIIII\\} \,\otl I~q Ft 1st Floor Type of H~at \\160\69 0332.,2.344), Sq Ft 2nd Floor Water'TY~~~nI61 IS ,-80 ' Sq Ft Basement Range Type Sq Ft Garage/Carport Energy Patb Sq Ft Otber Sprmkled BUlldmg n/a Occupant Load Phone 541-744-0705 # of UOItS PrImary Occupancy Group Secondary Occupancy Group PrImary ConstrucllOn Type Secondary ConstructIOn Type # of Bedrooms R-3 VN I DEVELOPMENT INFORMATION I REQUIRED PARKING Fronlyard Setback SIde 1 Setback SIde 2 Setback Rearyard Setback Solar Setbacks Overlay Dlst # Street Trees Rqd Paved DrIve Rqd % of Lot Coverage Total HandIcapped Compact Street Improvements Storm Sewer AVdlldble Spec,allnstruclIon .~~ Ie 'n.lt \NO~~ I PUBLIC IM1Ra>\\E~ENiIiStlr>.\..\.. \:J'.~I~'?t\'l\'!lIi; I';) ~w ' ,\-II;) 'O~\'IlltO \J\,mt~i~~o fO f\\Jitl 0 0\'1 \~Ip; CO\'!l\'!lH\Ct :1 ?t\'l~nspoutslDrams f\~'/ '\\)() 01\ I , Notes , ValuatIOn DescnotIOn I DescnptlOn Tvpe of ConstruclIon $ Per Sq Ft or mullIplIer Square Footage or BId Amount Value Date Calculated Pa2e 1 of2 -~~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO. COM2006-00802 ISSUED 06/27/2006 APPLIED. 06/27/2006 EXPIRES: 12/27/2006 VALUE: Status Iss u ed 225 Flftb Street, Sprmgfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Total Value of ProJect Fees PaId I Fee DescrIptIOn + 10% Admmlstrahve Fee + 8% State Surcbarge Perm Serv/Fdl 200 amps or less Amount PaId Date PaId Receipt Number $630 $504 $63 00 6/27106 6/27/06 6/27/06 1200600000000000975 1200600000000000975 1200600000000000975 Total Amount PaId $7434 I Plan RevIews I To Request an mspectlOn call the 24 hour recordmg at 726-3769. All mspectlOn requested before 7.00 a.m. will be made the same workmg day, mspecttons requested after 7 00 a m will be made the followmg work day. I Reolllred I nsnectwns I ElectrIC ServIce Approval reqUired prIor to uhhty company energIZIng servIce By signature, I state and agree, tbat I bave carefully exammed tbe completed apphcatlOn and do hereby certify that all mformatlOn bereon IS true and correct, and I furtber cel tIfy tbat any and all work performed sball be done m accordance wltb tbe Ordmances oftbe CIty of Sprmgfield and tbe Laws of tbe State of Oregon pertammg to tbe WOI k desCrIbed berem, and tbat NO OCCUPANCY will be made of any structure wltbout permISSIOn of tbe CommuDlty ServIces DIVISIOn, Bulldmg Safety I furtber cerhfy tbat only conlractors and employees wbo are m comphance wltb ORS 701 005 Will be used on tbls project I furtber agree to ensure tbat all reqUired mspectlOns are requested at tbe proper tIme, tbat eacb address IS readable from tbe 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 times dUfmg constructIOn Owner or Contractors SIgnature Date Page 2 of2 225 FIfth Street Sprmgfield, Oregon 97477 541-776-3759 Phone ~P~lHGF:l2LD"""1 II, IlL C Jf Sprmgfield OffiCIal Receipt ur~lopment ServIces Department Pubhc Works Department Job/Journal Number COM2006-00802 COM2006-00802 COM2006-00802 Payments Type of Payment Check cRecemt I RECEIPT #. 1200600000000000975 Date. 06/27/2006 Descnptlon Perm Serv/Fdr 200 amps or less + 8% State Surcharge + 10% AdmInistrative Fee Paid By GLEN CAMPBELL Item Total Check Number AuthorizatIOn Received By Batch Number Number How Received dJb 3901 In Person Payment Total Page I of I 11 5021AM Amount Due 6300 504 630 $7434 Amount Paid $74 34 $7434 6/27/2006