HomeMy WebLinkAboutPermit Electrical 2007-12-19
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)7263689
ELECTRICAL PERMIT APPLICATION.
CIty Job Number (' AJ W7 11)0 t - 0 1 Zq If-
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J~ DESCRI;TlON
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I
Permits are non-transferable and expIre If work IS
not started wlthm 180 days of Issuance or rfwork IS
Suspended for 180 days
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Address Po 00)i.. (p q 7
CIty tU fI) f -( ( V; J }y Phone n7 - XJ") t.j
47J}S
Supervisor License Number
Expiration Date J () J J 0
Constr Conlf Number /3 (; Y If ~
ExpiratIOn Date / () / / D
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A r~i~~i(e~,ld~tw~~~l,m!l~lMfu~~;WlJ~~~~~~iT!lig~~~m~
Service Included
1000 sq n or less
Each additIOnal 500 sq n or
portion thereof
Each Manufact'd Home or
Modular Dwelhng Service or
Feeder
I $11700
$ 2100
$55 00
B '.S~'I~~%f~~~t:iliil'~;sJ~t~~st~Rclmiti;~~
.. ~, ~_'""'.c,,.~ ~1'Mj~""hlU"f.r"""",<,,~~
/ $ 70 00 7 0
$ 83 00
$13800
$180 00
$413 00
$ 55 00
200 Amps or less
201 Amps to 400 Amps
401 Amps 10 600 Amps
60 I Amps to 1000 Amps
Over 1000 Amps/Volts
Reconnect Only
c iiI[rifM~r~JYt~t;~%.(!r![gJr~;_~~i
Installation, AlteratIOn or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
$ 55 00
$ 76 00
$110 00
Over 600 Amps or 1000 Volts see "B" above
3nature ofsupervlslblectnclan G D ~~j:a!f~"'<~lrc~~lQ~~:~
\/\ I I AI. I , ^ ^ A I New Alteration or ExtenSIOn Per Panel
Y J WlIAJ \, VV IJ \I\- One CirCUit $ 48 00
. / .Ii. ._ ^ ",J ~:ch AdditIOnal ClICUlt or with
Owners me .fl1/(J--(r5or; fUl!.~,:XlU~rvlceorFeederpenmt $ 400
Address \;Q b?x'- \o~V I E M'(s'c"clI~?;:I~~(S~Fv;~~7f~~'d;;'r1it3tM~[J1fci~J!Erlll"I1f~i\:W~1\!~
clty~fJn(.nf'e 7 '2..t -057. 5 Pump or lIf1gatlon $ 55 00
.;) ted b q..hfffl..., yvu (0 .
Notification Ce t y the Oregon Utility SlgnlOutlll1e Llghtmg $ 55 00
ow9M ~T~I.l1{.I~hose rules are set forth Limited EnergylReSldentlal $ 28 00
(]Q(:l~ y art1 if/i rOUOhQA8.oc~
Tne rn taliillibms'Jl<OOJjd1l'jde6i\\ pi05fiXE I'<>WnCWII.ch Limited Eneffji{c;q'il~erclal $ 50 00
IS n8f\ \QiilItlaEfatESIli<ll/Jeaa;;-Sfeg'g'i t e rules by MIOImum Electrlc~PMJ.il ~spectl.on Fee IS $50 00 + Surcharges
number to th I" ine te/eph ' I ~"l ,,- .
r e Oregon Uti lit one 4 JilSUiffbt':" .. 0 ''''''ea l!' III ',lrin~
Owners SIiY\atun.r IS 1-800-332 ! NotIfication 1!ir."'M_'-'" ';1 "~f~~
- 344) 8% State S~har~f;I\JcED 0 VIII ~~/~o
. 10% Adml'A1VthY~OeDAY R IS ABANDONW ffifl. 00.
InspectIOn Request
TOTAL
g"./D
Sharl..d Dnve(T )/Bultdmg ForrnslElectncaJ Permll ApplicatIon 7-07 doc
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO. COM2007-01894
ISSUED. 12/20/2007
APPLIED, 12120/2007
EXPIRES 06/20/2008
VALUE:
225 Fifth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
SITE ADDRESS 205 S 54TH ST SPACE 85
ASSESSOR'S PARCEL NO 1702330001200
SprmgfieJd TYPE OF WORK ElectrICal Work Only
TYPE OF USE
Repair
ReSIdential
PROJECT DESCRIPTION ServIce Repair
Owner
Address
ANDERSON EDWARD EUGENE & DIANE LOUI
PO BOX 660
W AL TERVILLE OR 97489
Phone Number 541-736-0575
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC
License
136446
ExpiratIOn Date
08/20/2009
Phone
541-747-2724
BUILDING INFORMATION I
# of Umls
Pnmary Occupancy Group
Secondary Occupancy Group
Primary ConslructlOn Type
Secondary ConstructIOn Type
# 01 Bedrooms
# of Stones
HeIght of Structure
Type of Heal
Water Type
Range Type
Energy Path
Sprmkled Butldmg
Lol Size
Sq Ft 1st FloOJ
Sq Ft 2nd Floor
Sq Ft Basemenl
Sq Ft GdragelCdrport
Sq Ft Other
Occupant Load
nla
I DEVELOPMENT INFORMATION'
Frontyard Setback
Side I Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
Overlay DIst
# Slreet Trees Rqd
Paved Drive Rqd
% of Lot Coverage
REQUIRED PARKING
Tolal
Handicapped
Compact
~WHllIErovements
slb~a. Smfllfv3~L<L EXPIRE IF THE WORK
~1l.'Jiji~m~~tt9flmER THIS PERMIT IS NOT
.COMMENcED OR IS ABANDONED FOR
lA1W 180 DAY PERIOD
I PUBLIC IMPROVEMENTS I
ATTENTI&ea'rJ~6rtfEfw reqUires you to
follow ruleD~SM).u'-\<i\Dregon Utility
Notification Center Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090 You may obtain copies of the rules by
calling the center (Note the telephone
.....IIUt::1 IUI lilt:: UIt;i8U1I UlI;UY ;...'.HIi.........~I""'1I
I ValuatIOn DescriDtlOn I Center IS 1-800-332-2344)
DeSCription
Type of ConstructIOn
$ Per Sq Ft
or multlpher
Square Footage
or BId Amount
Value
Ddte Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01894
ISSUED, 12/2012007
APPLIED, 12/20/2007
EXPIRES 06/20/2008
VALVE.
225 FIfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Tolal Value of ProJect
Fees~~,id I
Fee Descrlphon
+ 10% Admmlstratlve Fee
+ 5% Technology Fee
+ 8% Slate Surcharge
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
ReceIpt Number
$700
$350
$560
$70 00
12/20/07
12/20/07
12/20107
12/20/07
2200700000000001881
2200700000000001881
2200700000000001881
2200700000000001881
Total Amount PaId
$86 10
I Plan ReViews I
To Request an mspectlOn call the 24 hour recording at 726-3769. All mspechons requested before 7.00
a m will be made the same workmg day, inspectIOns requested after 7 00 a.m. Will be made the followmg
work day.
I Reomred Insnecltons I
Electnc Service Approval reqUired prior to ullhty company energIZIng service
By signature, I stale and agree, that I have carefully exammed Ihe completed apphcatlOn and do hereby cerhfy that all
mlormatlOn hereon IS true and correct, dnd I further certIfy thdl any and all work pel formed shdll be done 10 accol dance With
the Ordmances ofthe City of Springfield and the Laws ofthe State of Oregon pertamlllg to the work described herem, and
that NO OCCUPANCY Will be mdde of any structure WIthout permISsIOn of the CommuOlty Servlles DIVISIOn, Butldmg Safely
r further cerhfy that only contractors and employee, who ,1/ em compliance WIth ORS 701 005 wII' be used on t'", proJect
I further dgree to ensure that all reqUIred mspectlons are requested dt Ihe proper time, that each address IS readable from the
street, that Ihe permit card IS located at the front of the property, and the approved set 01 pldns WIll remam on the SIte at dll
times dUring constructIOn
Owner or Contraclors Slgnalure
Dale
Pa2e 2 of2
225 Fifth. Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
"P.RINQI'IIlI,!! ~
".... - ,
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City of SprlOgficld Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-0l894
COM2007-0l894
COM2007-0 1894
COM2007-0 1894
Payments
Type of Payment
Cred,tCard
l,Rt:celOtl
RECEIPT #.
2200700000000001881
Date 12/20/2007
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Admmlstratlve Fee
PaId By
JOSHUA BURRELL
Item Total
Check Number AuthonzatlOn
Received By Batch Number Number How Received
ddk
015703 In Person
Payment Tolal
Page 1 of 1
103455AM
Amount Due
7000
3 50
560
700
$8610
Amount Paid
$86 10
$8610
12/20/2007