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Home My WebLink AboutPermit Electrical 2004-1-15 : !'1...:..t<;"~"~" <';""h!"~l~<,, "~'. .'N)"'.,/. , J"'" '\. _', ,'j', 'd,' ~ ',r<" < .(,.,<,.' .../~"" '. ll, i i\~;<~.":,:' ~,,',., . .," , ': ,CITY ,O;E'sl..._,lNGFIELD~ .OREGON" ".;\ ) "'; I ,.'~~'I'_. ~,.' <. .~.,. "'. '_~./ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753. FAX: fg.ff~1~~-3689 ELECTRICAL PERMIT APPLICATION Zoning City lob Number COm zoo 'i .c....--...n S- 3. Date , - \5 -0 {"I Date - Pump or irrigation $ 50.00 CE Sign/Outline Lighting $ 50.00 OWNER INSTALLATION NOTI. E~~mEf.e~dfFtft1IE W081l $ 25.00 !he in.stalJation is being made on property I own Wh~~H~R1Z~mERrr~&~MI~ ISN(ilif $ 45.00 IS n~} mtended for sale, lease or rent. COM~~~e~~frANfi)Ot'Vl~ma Fee is $45.00 + Surcharges ANY 1 ~ 726-3769 OTAL . ~ ~1~t'~~f~':'W;'\i~"';.~'<<'~'lll~~;~lf::<~?#;.J\ft?'~~W~(ffllt~>..^~';1:";', -...t 1. ~!",Jj;r.' Qlr@;J/1lJ.1,M;,t~'~~W,M;I!!4:r}}J. i illt~. ">-~1r ....il~>O(.'i'3!~"lj~. < ..' . I llO"2, eo""[ltlJd) '~lt\ LEGAL DESCRIPTION SpAtt. it~ j/E{' 1703"3 Lt LI 3 D I~C c. c. JOB DESCRIPTION G,lfA,u.)OOO e V PA~ . ~l V ,"( <t. ~,_ ~y. pt.L DNtt.~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor r --- I I I Address ' I I I Burrell Bros. Electric 40159 Booth Kelly Road Springfield, Oregon 97478 City I ',,-__ .~'\.~~-L-~I....~_' Supervisor License Number ~~ S . -Expiration Date -*~~ Constr. Contr. Number \~ ~,'\~.'-.{l Expiration Date ,'==>\~ ... Signature of Supervising Electrician . , (n ~ 2J "'^^-llv IL.Jt SfU..'S. Owners Name U~ 10 Address 520 se- City tjhtlku vJA Phone , 'OIL Owners Signature: Inspection Request: " ecl as Submitted h not require spe .af,s t,he fOl/owing CI IC and use 3. 1- . A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manu fact' d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 A?1Ps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 ..t:~. 00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps Over6aaI.K~~~Tdf1~ti D.~\I' '. ~ .,ltb OA4:-V New . 2.1.: ~6IOObtOrtbrPll'i'l'l!r , g. ~W~ i'.~ bt'n copies of t~e rules \ One t You .may 0 al .e E h ~IP' ~. hlir.R .~ ~i"L'(Note: lilo te e1Mt9n ac c fl l1W~ ij 1.11. . . .. tion Service or~~ W'ib;rw1S Oregon Utlhtv N&ti3!OO\ nUmDe , _~~2-2344). , "rimq'~""i'7,=.<".r,,~, .).,'w'P"i!l:;;,:;;'.>."",.~, ,~n"'WM". ,,;_;Yltt~!i~~iQ~ _,.;6'fHtt':Xt~\f.i&M%h,."S~~~fili1?~ E. b> Y L{ I b70 737} 7% State Surcharge 10% Administrative Fee .\: \; ~.\' \ i <-~~~J~~J~~I. .. . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00053 ISSUED: 01115/2004 APPLIED: 01115/2004 EXPIRES: 07/15/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1703 CONCORD AVE APT 7 ASSESSOR'S PARCEL NO.: 1703344301800 Springfield. TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: 200 amp service Owner: DAVID VIMONT Address: 320 SE SELLS DR SHELTON WA 98584 I CONTRACTOR INFORMATION I Contractor Type Electrical . Contractor BURRELL BROS ENTERPRISES INC License 136446 . Expiration Date 08/20/2005 Phone 541-747-2724 BUILDING INFORMATION I VN # of Stories: Lot Size: Height of Structure Sq Ft lst.Floor: Type of Held: Sq Ft 2nd Floor: Water Type:. ~f'b~~4Qlent: . Range Type: .oregoO \a'.N reqUS9tF~~,,~/Carport Ener~..rT\ON. ted b'J the orgl}'I?J '\?lJlql15r\ to\\OW r~'~~~~~r. ,.hose r~~e~I(J~2~rface Area: I DEVELOPMk__~A\:fl0N~I;;\;'s ofthe rU'.~ l . I 3. "may~''''''' . thete\ep~lJIRED PARKING Q090. 'foU. eoter. {Note.. Not\t\cati6n OverlaYdAWfJ."\Q the C oregon U\\'\\'i 4 Total: . # Streeh~M~qar ~~?;e 1.Af'O.3~2.234 ). Handicapped: Paved Dnve Rq~""" . Compact: % of Lot Coverage: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Pri~ary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: . Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMP~~W~NTS I . . J _ , 1. t:VDIQ~ : THE WORK THIS PERMIT SHA~dt!"al]{ ~ pe:IT IS NOT . ORIZED UND~ THIS P '\M AU1H ownSDflllt!il/li)Ui~R . COMMENCED OR I Aot\t~1JUT'iL ANY 180 DAY PERIOD. Notes: I Valuation Description' Description Type of Construction $ Per Sq Ft or mul~iplier Squar~ Footage or Bid Amount Value . Date Calculated Total Value of Project , . Paee 1 of 2 · -~"'JiN9.ma~:.. ..... I ' . , . ~ j" Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid . I Fees eaicU Amount Paid $6.30 $4.41 $63.00 $73.71 I Plan Reviews I Date Paid 1/15/04 1/15/04 1/15/04 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00053 ISSUED: 01115/2004 APPLIED: 01115/2004 EXPIRES: 07/15/2004 VALUE: Receipt Number 1200400000000000057 1200400000000000057 1200400000000000057 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 Re~uired Insnections I 1 Electric Service: ~pproval required prior to utility company energizing service. By signature, I state and agree, that I 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 that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the 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 at all times during construction. . Owner or'Contractors Signature Pae:e 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt . Development Services Depaa l&A&ent Public Works Depa..lll.Lent Date: 01/15/2004. 10:51:45AM Amount Paid 4.41 6.30 63.00 $73.71 . Receipt #: 1200400000000000057 Job/Journal Number COM2004-00053 COM2004-00053 COM2004-00053 Description + 7% State Surcharge + 10% Administrative Fee Perm Serv/Fdr 200 amps or less Item Total: Payments: Type of Payment Check Paid By BURRELLBROS Check Number Received By. Batch Number Authorization Number djb How Received In Person . Payment Total: Amount Paid $73.71 $73.71 . .