HomeMy WebLinkAboutPermit Electrical 2008-2-4
Date
ZON l::U2-
INITI ALS ____1-,.:1/\'\
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541!726-3753 . FAX: (541)726-3689'
ELECTlliCAL PERMIT APPLICATION
,City Job Number CJ:-uA Z-=C:::; g~ 06 / )" i
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~~~.ft~d",.~i\tf~;~~~~~~~~~-:!1tf!fh~~~,i;j;??t~;#:ij.~t~l~~~~~
B. ~ Services or<Feeilers'~lnstallabon;l\lteratlOns or:ReJoc'lfion:;"\\j'
t'?:m~l;;#...:::i;:~~.;;~;.'~""'Z~~~,'iJ~"~;MS:"..;:,oM~"S.~; 'i<el>....:i~~~~,~~j
! 70
. $.91.00
$ 75.00
e~U\les ~~~~:: :: ~~~;~~s ~ :~~:~~
\ Phone *--%A~~~ Ole90n.qt~tlOOO AmpsNolts $375.00
,..1i~~i\O adopted '" ~ luleS ale ~~~t Only $ 50.00
o'll luteS tel, lnos 9n Op,.? ...leS '0'1 .
\0\\ .~\ n cen ~..o \nIOU, o\\ne ~'"5"'''''''l'""",'~,ff'''"''-'''''"''1ir.'''''''''''""''''''''''''''''tB''-'- ";
Supervisor License Nu~ucl\\ICa: ;:mr\~0 'n copIes .f'j3J.mi or,lln: SerVices ~r .,Feeders, :"i.." '~R:,Jt;"''"l~:\~:~~~~ ,":;~
H~~ ^ "00\ \"e \-8\ .~<l\t .t.i.~<~ru>iNrbR.;r." ~>::N~'" ~~...""~- iM,$k="(...,,,,,"~ '1'J<~
_ ~ \n 00_ _'{OU ma'j entel. \~O\~i\\\\\'j ~0\\\IC
ExprratlOn Date \to -viW~ :Iinq \ne c nle90~ n n.2s4~stallation, Alteration or Relocation
~ - '0\ ~.c .. "'.v-~'3..
IIU(l\'Oel ell\el ill 'V- 200 Amps or less
Constr. Contr. Number /1-11. 74 ,,- C 20 I Amps to 400 Amps
40 J. A:mp~ to 600 Amps
New Alteration or Extension Per Panel
One Cire'uit
Each AdditionalCircuit or with
Wlc..c... AvLe::--,... Service or Feeder Pe~t $ 3.00 -
b s l- I E.~:~~~_,*~~~;f~dW~;~i\;~~~i~)~E~~h'J~1t~~1rO~~
_ \. ~'-:'~{i~~~ ""-"" ~r.;",; ~.oM+ 1-.r4'~~;t;; ~ =<-..- u>SiJ"-.n,;~'_S>i:<"",,,,:;\...~...bh
Phone l\01\~;~~\i ~:;~W\'\i~J;.~JP\\ $ 50 00
\\"I~\\Cl\\\lt.\J 0\\ \S_~lme Lightmg $ 50.00
OWNER Ll'ISTALLATION [:>.1,) ~~t.~Ct.~ pt.\\\(\.'ibllted EnergylResidential $ 25.00
The mstallatlOn IS bemg made on property1~~9fl' Lunited Energy/Commercl3! $ 45.00
IS not mtended for sale, lease or rent. , , Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
,Owners Signature: 4. f!kst~2r~:[r]:1l?J1S~il~~;~!~li:ti 70
,;g"1o State Surcharge ,~ 'tv
..10% Administrative Fee r
5% Technology Fee -:s.re>
88~
. '
~"'.'~^'~~V'., "'~Y':;',......'~~,~,~ ,\'.',".' C ,; ,.'-:c', "''". ,.."'JI:;'~i'.;r. ~,l.:.-_,: ."",:,., '~l~'~'ffi;:i$:@
1. ;"LQCATION;.oEINST.4LLATION:0i'!iiJ'fiff.~~.l'
2'b'G7,-'~m"""'"~+-""."'""~~_iIt
LEGAL DESCRiPTION:
/70'35. {,/Cf!
, JOBDESCRlPTION:
12006
S ~v'L c....t#N6-~
Permits are non-transferable and expire if work is
not started within 180 days'of issuance or if work is
Suspended for 180 days. '
1i-\,,-::''l,~if1(,~ql~'(';l~~~\W'::~,)>@;~~1H!i}iti',~;5i-;'"'r-''. ~~~',t~~~
,',CONTRACTOR'INSTALLATIONONL1:'1',
2. ~~~;i,1;~,':!$1.~{tM,~'a0iG::t'j;;",;)&:U1lE;::i.~~i,~~:t''''''.~~;:';~~~;i~i;:
, '
Electrical Contractor lb..ltiR r::(i" ,'T\.l.:-
Address 'f27.~ ~ \&. _~ '~
City (, 5ll~
Expiration Date
1-~~9
S4~~-:-
t/ ~
Owners Name ~W~
2'b (
5\=> f-\.
Address
City
Inspection Request: 726-3769
3. rs5lliltLlii~~~l11~~Z~y;<iw.t~!iit~!~S"
, '
" '
~:{~~'&,~;,v,~o~~~~~~rBit;A';;7{~:~%~t'i-1'*fFt~'l?4'~~:'mi??;~'A~~~~~_~1:1'~
A. :,;N.W ResideIiti:ir,:;'Sirii;leor.Multi;Familv\~e;:ilwe]]jh'i;iiillf';,;p';
:~~W1tiil.&2;.;~.~~I:!~;",W'U;:;:'-:'.:, ,~.,,,;,,,,..,;:,:,""'+'::;C~!!,,',,,ld~;~'<.,"..,,;.';,:;L~..\'.H-L~'~~,,,,,.~~::i~
Service Included
JOOO sq. ft. or'less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home' or
Modular Dwdling SerVice or
Feeder ,
$ 106.00
$ 19,00
$50.00
200 Amps or less
, 201 Ampsto 400 Amps
70
$ 50.00
$ 69.00
$100.00
Over 600 Amps or 1O00 Volts see "8" above.
l''f'.A'i.;:,'r'' J','rx-:l!;U.~"_~~~':-!-i~"'-~~~a~;'.;i~;;'~._ ,i.' ". '~~.;(~~~~f.,1ijJf.g,''ie~:~^>~-->r~.''''
D. ~~Bra~ch: ,E:ii~tlififi~~~fw~t&1\~]~~~,<'i, ",~~~y{f:j~l.ii;;~l~~~'f~li+.
",,,",,~,,,,~-,,""'",-""li...w.,;.m,-'.\~i,-~,~',,,"...;;{"""''';!;.;<:<'''':::~;''' . ;"'W!"""'\J\';<J;"'.o-.i~~;..~~~~=".
$ 43.00
TOTAL.
Shured Driv~T:)/Buildjng FOl1ns/Electnc;J] Permit Application 3-06.doc
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2008-00159
ISSUED: 02/04/2008
APPLIED: 02/04/2008
EXPIRES: 08/04f2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2661 D ST
ASSESSOR'S PARCEL NO.: 1703361412000
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Service change
Owner: MCCAULEY BRADLEY SCOTT
Address: 2661 0 ST
SPRINGFIELD OR 97477
Phone Number: 541-
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
MITCHS ELECTRIC INC
License
146745
Expiration Date
01118/2009
Phone
541-521-5690
I BUILDING INFORMATION I
# of Units: # of Stories:
Primary Occupancy Group: R-3 SYCll1'fl:tucture
Secondary Occupancy GroWIO\l!', oregon \a'H~e MPrt'\l\I\\W
Primary Construction~ lell adl5\liled by \ ~I 'tIAJ~~.
Secondary constructilSll\~K~on center. ThOlleUgtlb;~~
# of Bedrooms: Notl~ 9S2'()01.oo10t\'lrople~a?lI",,1 .
In OIlO YoU may ob\alnl~te: ~8\atllilmlt."ing: nla
nn. 4-.....'. ,.. "/. . .._tlfleatrciK
caI~~'; the Or~~~BNT INFORMATION I
1\11"""" c;en\er 1& 1~" rr
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dis!:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
C~. E \f 'Tl'IE WOR\C. Downspouts/Drains:
~1:i~~~1 ~~~~::!~~:~gf~:Ol
('nMWlE~CEO ~-:.f.;gf\
~~'( 180 ulfd-h" . J
I Valuation DescriDtion .
Sidewalk Type:
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
Status
Issued
CITY OF ~t'J:Ul~GFIELD
Building/Combination Permit
PERMIT NO: COM2008-00159
ISSUED: 02f04/2008
APPLIED: 02/04/2008
EXPIRES: 08f04/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
" .
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
.Date Paid
$7.00
$8.40
$3.50
$70.00
2/4/08
2/4/08
2/4/08
2/4108
Receipt Number
1200800000000000094
1200800000000000094
1200800000000000094
1200800000000000094
Total Amount Paid
$88.90
, Plan Reviews I
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 Reollired Insnections I
Electric Service: Approval required prior to utility company energizing service.
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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 tertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of tile Community Services Division, Building Safety.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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 Signatnre
Date
Paee 2 of2
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-00 159
COM2008-00 159
COM2008-00 159
COM2008-00 159
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
1200800000000000094
Date: 02/04/2008
Description
Perm ServlFdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
MITCHS ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 054656 In Person
Payment Total:
Page I of I
II :49:48AM
Amount Due
70.00
3.50
8.40
7.00
$88.90
Amount Paid
$88.90
$88,90
2/4/2008