HomeMy WebLinkAboutPermit Electrical 2008-1-30
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225 FIFTH STREET _ SPRINGFIELD, OR 97477 - PH:(541)726-3753 - FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION
City Job Nnmber ~ Wl 2. 60 ~ - C')O 13 '-7
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LEGAL DESCRIPTION: 17 6~ 21ft. :r) 0 ~ 1t!JlY'.,
~f #.~ ( ~ ~ '" e...,~ Es/....-/.-..s Service Included
JOB DESCRIPTION: 1000 sq, ft, or less
Each additional 500 sq, ft, or
portion thereof
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Permits are non-transferable and expire if work is
not started within 1 80 days of issuance or if work is
Suspended for 180 days.
2.
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Electrical Contractor ~ \ :.~ ~-c;...e-
~ ------
Address ft' ~4 r ~ i~l
~ ~
City /
Expiration Date
'Sign ure of Supervising Electrician
Owners Name
rlM-Sc........-\.... H.,\AAL-S
&:, """S 4.",,=- ~
Phone ' 9 S-'!,~.L.3-7 2.
Address
?'2.../n
City
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OWNER INSTALLATION
The installation is being made on property 1 own which
is not intended for sale, lease 0
Owners Signature: ~
y ,
Inspection Reqnest: 726-3769
Date
/-30-?, ,
$117,00
$ 21.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$55,00
B.
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 70,00
$ 83,00
$138,00
$180,00
$413,00
$ 55,00
ou
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Notification Center. In
Instaill1Uo'lP,- ~lt;;hit\biPQt 'RtWi~J.'6CnOAR 952-001.
flOl)O IOU may obtain copies of the rules bV
200 AlilIi~I~lil5't'he center. (Notp. thdtPI'lp$t~M)(}
201 A'l'RMIbgpqcJf.m OregonUtilit\[ Notifiil~
401 Ampst06~sis 1-800-332-2344). $110,00
SS-
Over 600 Amps or 1000 Volts see "B" above,
D.
New AIteratiolllltl:"IlM'>liIsion Per Panel
TIV f'"ilji:'.
One Circuit J~IS PERMIT SHAll EXPII$EI$fOQ'HF WnR~
~:~~d:;~~~:fetifj,1tJ.~mi8'uNDER THIS$P~\l~AiT ~S_N9i'
COMM~NCED OK I;:' flDf\NDONED f'~"
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E. ~iJIiWt~~~j~~if~~r:/:i!r,t\IR~i~~d;[j~~~i'h~[I~~~il~t'i~,~'1
:\"",..
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Pump or irrigation ., $ 55,00
Sign/Outline Lighting' $ 55,00
Limited Energy/Residential $ 28,00
Limited Energy/Commercial $ 50,00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
4.
<s frO
12% State Surcharge -- /.-? ",0
10% Administrative Fee S-, ro
5% Technology Fee 2...7 r
TOTAL ~ /..,/, 2;S
Shared Drive(T:)/Building ForrnslElectrical Permit Application ].08.doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-00 134
COM2008-00 134
COM2008-00 134
COM2008-00 134
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Temp Power 200 amps or less
+ 12% State Surcharge
+ 10% Administrative Fee
+ 5% Technology Fee
Paid By
MARC W GRAS SAUER
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000000086
Date: 01/30/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dim 00574C In Person
Payment Total:
Page 1 of 1
12:08:34PM
Amount Due
55,00
6,60
5,50
, 2,75
$69.85
Amount Paid
$69,85
$69,85
1/3012008
-~;:4iiI
WIr
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2592 17TH ST
ASSESSOR'S PARCEL NO.: 1703243103100
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2008-00134
ISSUED:
APPLIED:
EXPIRES:
VALUE:
01/30/2008
07/30/2008
$ 283,878.00
SPRINGFIETYPE OF WORK: Single Family Residence
PROJECT DESCRIPTION: SFR Residence Legacy Estates Lot 6
Owner:
Address:
CRESCENT HOMES
2210 COMSTOCK AVENUE
EUGENE OR 97408
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Iustructiou:
Notes:
Description
Type of Construction
R-3
U
VB
TYPE OF USE: New
Resideutial
Phone Number: 541-344-2010
I CONTRACTOR INFORMATION I
Overlay Dist:
# Street Trees Rqd:.
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
I , Valuation Descrintion I
$ Per Sq Ft
or multiplier
Square Footage
or,Bid Amount
BUILDING INFORMATION'
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Patb:
Sprinkled Building:
License
Expiration Date Phone
uta
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION'
I~.OO
5.00
9.00
33.00,
9.00
Page I of2
2
No
31.00
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Value
Date Calculated
CITY OF SPRINGFIELD
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
54]-726-3753 Pbone
54]-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2008-00134 I
ISSUED:
APPLIED:
EXPIRES:
VALUE:
01130/2008
07/30/2008
$ 283,878.00
A,C. - Residen
Dwellin2S
Garage
AC - Residential
V Wood Frame
Garage
$5.00
$105.00
$28.00
2,401.00
2,401.00
706.00
$12,005.00
$252, I 05.00
$19,768.00
$283,878.00
01/30/2008
01130/2008
01130/2008
Total Valne of Project
Fees Paid I
Fee Description
+ ]0% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Plan Review Residential
Temp Power 200 amps or less
Amonnt Paid
Date Paid
Receipt Number
$5.50
$6.60
$2.75
$833.0]
$55.00
1130/08
1130/08
1/30/08
1/30/08
1130/08
1200800000000000086
1200800000000000086
1200800000000000086
2200800000000000125
]200800000000000086
Total Amount Paid
$902.86
I Plan Reviews I
Plannine: Review
01130/2008
01/30/2008
APP EMM
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Insoectioos I
Temporary Electric: Approval required prior to Utility Company energizing pole.
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
tbe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed herein, and
that NO OCCUPANCY will be made of any structure witbout permission of the Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliance witb ORS 701.005 will be used on this project.
I further agree to ensure tllat all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located- the front of the property, and the approved set of plans will remain on the site at all
times during construction.
/ /
I // 1-3o~e
'-" .
Owner or Contractors Si Date
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