HomeMy WebLinkAboutPermit Electrical 2004-11-10
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225 FIFTH STREET . SPRINGFIELD, OR 97477 .
ELECTRICAL PERMIT APPLICATION
City Job Number LOl4l\v:m'{ - 0 I~ 0)' Date
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LEGAL DESCRJPTION
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J08 DESCRIPTION
0"3400
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
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Electrical Contractor ~4 ~L(
Address (9'70 rJ 2f3TH ~T,
City ~({ I t-..b R fi~Phone 74-7 -ZZ-b
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Supervisor License Number 2.4 '3,.-.5
Expiration Date I D - ( - 0 if ~
Conslf. Contr. Number I ?../1 i
Expi;alionDate S -z..l~A
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Address
Phone
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PH:(541)726-3753 . FAX: (54!)726"i6~%. ~,i"~9
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Each additional 500 sq, ft, or ~
portion thereof 9.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
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200 Amps or less $ 63.00
20 I Amps to 400 Amps , $.15;00
40 I Amps to 600 Amps $125,00
601 Amps to 1000 Amps $163.00
Over 1000 A~@N: Orego"h;:l'6U~~W{RJ t'"
ReconnectfOflbw rules adopted r~tilitl s-U
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, 0090. You may obtain copies of the rules by
Inslalla liofG<l'I'~!J'ffmtll\!rfte19c/lWlte: the' telephone
200 Amps IwiMer for the Oregon Utilitv ~ltill!l.tion
201 Amps to 400 A~ter is 1-800-332-23<mj;.9.00
40 I Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "8" above.
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New A1leration or Exlension Per Panel
One Circu!t
Each Additional Circuit or with
Service or Feeder Permit
$ 3.00
$ 43.00
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Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50,00
OWNER INSTALLATION Limited EnergylResidential $ 25.00
The installation is being made on property I own which Limited EnergylCommercial $ 45.00
is not intended for sale,tlease oPrent. Minimum Electric Permit Inspection Fee is $45 00 + Surcharges
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. THIS PERMIT SHALL EXPIRE IF T~&;.;~""'.!\"'''''''''~'h';L'".''!t;t-->'''', ilii!,~ik~~i.ill
Owners SIgnature? AUTHORIZED UNDER THIS PER~l;~~ifg~~~S?~J..\.'!il1l~lf~_ 50
COMMENCED O~_I~ ~BANDONED 7o/~State Surcharge '35"'"
ANY HIU Ui\Y I"tl"tlU . 10% Administrative Fee 5= <.:>
c.:-Q '.:::.
Inspeclion Request: 726-3769 TOTAL ~ ()
Shared Drive(T:)/Building Forms/Electrical Permit Application l-Q3.doc
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Status
Issued
.
. U 1 )' OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01385
ISSUED: 11110/2004
APPLIED: 11/10/2004
EXPIRES: 05/1012005
VALUE:
225 Fifth Slreet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2412 CLEAR VUE LN
ASSESSOR'S PARCEL NO.: 1703271203400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
Repair
Residential
PROJECT DESCRlPTION: Raise masthead
Owner: FULLER JOINT TRUST
Address: 590 W 26TH AVE EUGENE OR 97405
# of Units:
Primary Occupancy Group:
Seco.udary Occupancy Group:
Primary Construclion Type
Secoudary Construction Type:
# of Bedrooms:
Contractor Type
Eleclrical
Froulyard Setback:
Side I Setback:
Side 2 Sethack:
Rearyard Sethack:
Solar Setbacks:
Street Improvemeuts:
Storm Sewer Available:
Speciallnstructiou:
, Noles:
Description
I CONTRACTOR INFORMATION'
Contractor
ALERT ELECTRlC INC
License
12772
Expiration Date
OS/22/2005
Phone
541-747-2213
BUILDING INFORMATION I
R-3
# of Slories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: NOTICE'. Sq Ft 2nd Floor:
Water Type: Sq Ft Basemeut:
Range Type: THIS PERMIT SHAlSqlll(~iiif!111IYIf"m>qroRK
Euergy Path: AUTHORIZED UNDl&iJ nJW~HMIT IS NOT
Spriukled BuildiultOMMENC"l.'lJ OR 1.9~I\NI3~t:'/j FOR
I DEVELOPMENT INFORMHid~T rctllUU.
VN
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
ATTENTION: Oregon lft"6frmY~MC?t'J!Jl)
follow rules adopted by the Oregon Utility
~r"tifi,..~tit"\n Canto. Th^C'o... ,IOQ ~..a "at f"'.....
In OAR 952-001.4lPtl1HDI~S'
0090. You may ob."" I wfJltlb VI .1,tI furtld L~
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Total:
Haudicapped:
Compacl:
Sidewalk Type:
DownspoutslDraius:
I Valuation Descriotion I
$ Per Sq Ft
or mulliplier
Square Footage
or Bid Amouut
Type of Coustruction
Value
Date Calculated
Total Value of Project
Pa2e I of2
.
.
. CITY OF SPRINGFIELD.
. Building/Combination Permit
PERMIT NO: COM2004-01385
ISSUED: 11/10/2004
APPLIED: 11/10/2004
EXPIRES: 05/10/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% Slate Snrcharge
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$5.00
$3.50
$50.00
1II10/04
Il/10/04
Il/10/04
1200400000000001596
1200400000000001596
1200400000000001596
Total Amount Paid
$58.50
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 I nsneetions I
Electric Service: Approval required prior to ntility company energizing service.
By signature, I state and agree, Ihall 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
Ihat NO OCCUPANCY will be made of any struclure without permission oflhe Community Services Division, Building Safety.
I furlhcr certify that only contractors and employees who arc in compliance wilh ORS 701.005 will be used on.this project.
I further agree to ensure that all required inspections are requested allhe 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 al all
times during conslruction.
Owner or Conlractors Signature
Date
Paee 2 of2
225 Fiftb Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-0 1385
COM2004.01385
COM2004-0 1385
Payments:
Type of Payment
CreditCard
IlII0/2004
.
RECEIPT #:
Description
+ 7% State Surcharge
+ 10% Adminislrative Fee
'Service Reconnect
Paid By
GALE HA TLEBERG
G~.~;R!~,'!!Fl,~', ",""___ :,
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~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200400000000001596
Date: 11/10/2004
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 010053 In Person
Payment Total:
Page 1 of I
11 :25:30AM
Amount Due
3.50
5.00
50.00
$58.50
Amount Paid
$58.50
$58.50