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 (' j)m 2.D07 - 0 1 qo I
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LEGAL DESCRIPTION
\l[)L..~Y)
J~ DESCRIPTION
01rVI'r'f 12--f{)O\;r
,
Permits are non-transferable and expire rfwork IS
not started wlthm 180 days of Issuance or If work IS
Suspended for 180 days
2 ~~~~~~mJiJ!<ir~~
ElectrIcal Contractor h V r r Y J J h V 0 S
Address Po ho)l. (p q 7
City vJ ~Jt1YV;/ )-(Phone 7LJ 7 - J7')tj
47;)} s
Supervisor License Number
ExplTatlon Date /0 J J 0
Constr Contr Number /3 U Lj 4 ~
ExplTatlon Date / (j / / 0
6n~"m~~,
Owners Name (1 Oi rn [) by J In \
Addres~L~0A;,: \9\.~
CIty I !t ~h:tJgJi~l{)i?- ~
se ~~-:.JG{f{1{
0090 '\1, 52-00 - 010 throuru es are settor~
OWN1j:R/INSP'..ffiIDAimWlh CO gh OAR 952-001
'" ng the cc~ Pies of th r ,I -
The Iflttal@\J\llJ'6J ~~r \if.d~ontRrojJ\'ettJJ@Wh wRleI)'
IS not mtended eWtsal%, ase(jnr~Jli'Ity N ephone
~ " er IS 1-800-332' otlflcatJon
-2344)
Owners Signature
1I"";';.cr;;-:1.'Yi'E~~"7';;;S'r,.'H.'E--D"~'E,~--,,,,,,,,'.Itlt4ljll!!1!!;!!1ll!K~,'1I w
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ServIce Included
1000 sq ft or less
Each add1l10nal 500 sq ft or
portion thereof
Each Manufact'd Home or
Modular Dwellmg ServICe or
Feeder
I $11700
$ 2100
$55 00
~~~i'!t:r'o/Si'\f~~iiij1iii*WfW:!Si1W;Z~~'~'lW'''N';:k,j~~~,:q~,"1\tii)W'~:~
B ~J1~!~~fu9~~~~~~d1&~!l~~~e~iQ,~*ll.~,tg(~F It ~
/ $ 70 00 7 0
$ 83 00
$13800
$180 00
$41300
$ 55 00
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
c ITrnlf~!HWl%Raif~'lRnC:JiI)if~~~:wcrt14t_k~~~~~~
~!~qtRq<t~J8~*~"~a~~~e.~~P1i.,.tkltfrs I ~~'%~'B.~{;ili:Ji.1iifi:~.ED
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above
D
$ 55 00
$ 76 00
$110 00
New Alteration or ExtenSIOn Per Panel
One ClfCUlt
Each AdditiOnal CITCUlt or with
Service or Feeder Permit
$ 48 00
$ 400
~ '~'""^'", ~~~?pq~dfl*h~'<t;TF1{li$;.'fh,2!~1'""jfi:j~;~@;;Yiif.~~
,lScell nco,us'(Serv'ce;t=~.U~'!e~!l~~l!it@iliE}j:!!SltJ!!I,;~~
Pump or Irrigation $ 55 00
Slgn/Outhne LIghtmg $ 55 00
Limited Energy/Resldentlal $ 28 00
Limited Energylt!o';\,1ife'?cfal $ 50 00
Mlmmum ElectrIC plM/ff mE;~Ctl~n F: ee IS $50 00 + Surcharges
'j}:"
4 S&B!l:(;rr'r.ml i ~~' "i@l ~"--:Il ' --.' '!7t1J. ti>{j), K
~ 8% State Surch'iirge VI CED OR IS ABA en nil/ T
, 10% Admmlst~L1e FglJ DAY PERIOD NDO,vt ,lOO
726-37R~~ t\~'JfA ::::c~nOIOgYFee :z:~T6
~ ~r(\U'- \ Shared Dnve(T )/Bulldlng FormslEleotncal Pe",,1l AppllCalloo 7 07 doc
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Inspection Request
Sta tus
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO' COM2007-01901
ISSUED 12/20/2007
APPLIED: 12/20/2007
EXPIRES' 06/20/2008
VALUE
225 FIfth Slreet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
SITE ADDRESS 205 S 54TH ST SPACE 114
ASSESSOR'S PARCEL NO 1702330001200
Sprmgfield TYPE OF WORK Eleclrlcal Work Only
TYPE OF USE
Rep31r
Resldenllal
PROJECT DESCRIPTION ServIce Repair
Owner CAMPBELL FRANCE M
Address 573 S 67TH PL
SPRINGFIELD OR 97478
Phone Number 541-736-3028
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'
# of UOltS
PrImary Occupancy Group
Secondary Occupancy Group
Primary ConstructIOn Type
Secondary ConstructIOn Type
# of Bedrooms
# of Stories
HeIght of Structure
Type of Heat
Water Type
Range Type
Energy Palh
Sprmkled BuJldmg
Lot Slle
Sq Ft 1st Flool
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft GaragelCarport
Sq Ft Olher
Occupant Load
nla
I DEVELOPMENT INFORMATION I
Front yard Setback
S,de I Selback
S,de 2 Setback.
Rearyard Setback
Solar Setbacks
Overlay DISI
# Street Trees Rqd
Paved Drive Rqd
% of Lol Coverage
REQUIRED PARKING
Total
Handicapped
Compact,
I PUBLIC IMPROVEMENTS I
Street Improvemenls
Sidewalk Type
Stor"l\,Se'rec~vallable AnEH'lmI\P~f~~lfll1flt\v reqUires you to
Specl~J 'r'nsl.cucfion
I HI;' t-'I:RMlt SHALL EXPIRE IF T follow rules adopted by the Oregon Ullllty
HE WORK Notification Center Those rules are set forth
Notes!\UTHORIZED UNDER THIS PERMIT IS NOT In OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ARAMnmlm mD 0090 You m8\1 ohtAI~ r"'1'9f. nf the ""po '"I\,
ANY 180 DAY PERIOD I I calling the center (Note the telephone
V aluation Descn~tlOn number for the Oregon Utility Notification
Center IS 1-800-332-2344)
$ Per Sq Ft Square Footage
or multlpher or BId Amount V dlue Ddte Calculated
DeSCriptIOn
Tvpe of ConstructIOn
Pa2e I of 2
_._....~. ~
.~..
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01901
ISSUED: 12/20/2007
APPLIED, 12120/2007
EXPIRES: 06/20/2008
VALUE:
225 F,fth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769InspecllOn Lme
Total Value of ProJect
Fees Paul I
Fee DescnptlOn
+ 10% AdmlOlstrallve Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount PaId
Date PaId
$700
$350
$560
$70 00
12/20/07
12120/07
12120107
12/20/07
Recelpl Number
2200700000000001888
2200700000000001888
2200700000000001888
2200700000000001888
Total Amounl PaId
$86 10
I Plan ReViews I
To Request an mspectlOn call the 24 hour recordmg at 726-3769. All mspectlOns requested before 7:00
a m. will be made the same working day, IDspectlOns requested after 7:00 a,m. will be made the following
work day.
I Reolllred I nsnecltons I
ElectriC Service Approval reqUIred prIor to ullhty company energIZIng service
By Slgnalure, I slate and agree, that I have carefully exammed Ihe completed apphcatlOn and do hereby cer"fy thaI all
mformatJOn hereon IS true and correct, and I further cer"fy that any and all WOI k performed shall be done 10 accordance WIth
Ihe Ordmances of the City of Sprmglield and the Laws 01 the State of Oregon pertdmmg to the work deSCribed herem, and
that NO OCCUPANCY WIll be made of any slruclure WIthout permIssIOn 01 the CommuOlty Services DIVISIOn, BUlldmg Salety
I further cer"fy thdt only contrdctors and employees who are 10 comphdllce WIth ORS 701 005 WIll be used on thIS proJect
I further agree to ensure that all reqUIred mspectlOlls are requested at the proper lime, thdt each address IS redddble Irom the
street, that tbe permIt card IS located at the front of the property, and the approved set of plans will remam on the SIte at dll
times dunng constructIOn
Ownel or Contrdctor> Slgndture
Date
Page 2 of2
225 Fifth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
CIty of Sprmgfield OffiC131 Receipt
Development ServIces Department
Pubhc Works Department
Job/Journal Number
COM2007-01901
COM2007-0 190 I
COM2007-0l90l
COM2007-01901
Paymenls
Type of Payment
CredltCard
cRecemtl
RECEIPT #.
2200700000000001888
Date' 12/20/2007
Description
Perm ServlFdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% AdmlOlstratlve Fee
Paid By
JOSHUA BURRELL
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
ddk 01570B In Person
Payment Total
Page 1 of 1
1037 54AM
Amount Due
7000
350
560
700
$8610
Amount Paid
$8610
$8610
12/20/2007