The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2008-2-21 ZON JY...- INITIALS N "^'- DATE :.::J. :::l\ - ()~ SOURCE f'r\ppU Date c?/D//drnr 225 I'H HI STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELEL1KICALA!ERMIT APPLICATION CIty Job Number ( y)lV!dlnJ f(" - OOdSh 1. LOCATION OF INSTALLATION: (PO ~ _33re~ 50- LEGAL DESCRIPTION: _J /n~,:? Q4();), <ffl) - , JOB DESCRIPTION: ~ SeJ\YC V- 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor ~\A ~~~ c, So [;7 -ra 6+' Phone 5/7-3oScr Address I 80 C;ty 1m7/.f.J SupervIsor License Number sc.fLfS S ExpiratIon Date \0 \ '" L..c.OIO Constr. Contr Number ?A _ <.f ~~ L Expiration Date Signature of Supervismg ElectrICIan L/ \ }, ,~_ l\,,-.~ ~ '"/ Owners Name (D{JIr<.y r.JU;S:S Address q &0 (;if f'J5 -rh ~ City &. t1iV/vLR / Phone tr () it- OWNER INST ALLA TION The mstallation IS bemg made on property I own which is not mtended for sale, lease or rent. Owners Signature Inspection Request: 726-3769 3. . COMPLETE l'l!,l!, SCHEDULE BELOW ... A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq ft. or less Each addItIonal 500 sq. ft. or portion thereof $117 00 $ 21.00 Each Manufact'd Home or Modular Dwellmg Service or $55.00 Feeder ATTENTION Ore~lon la'fl ren'JIr0S VOU to follow rules a~~h ' y . lJ<jl'tu B. Servie.es4u'.EapileliS.,:;- s~ :ti e t4r' Kelocation: ~"QUnC"dllUH \,1<.7 :T. . IO~ es set lorth In Q,\R 9-::'2-001-0010 thrCL!\.J, OAR s~2-Q.01- 200 AmO~!)oJe~u may oLnarn en;'I': .,l9!-t.h~ mt8~ b~i 201 AmpsClal40QjbOOpsenter. (I\1ote' he t~I~~dXb 401 AmP~~wr~I{!:e Oregon Utility NO$fl138~ 601 Amps to 100gX9J~~ IS 1-800-J32-2344)$180 00 Over 1000 AmpsN olts $413 00 Reconnect Only $ 55.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Ab\'pItfr Fe;s '. -~.,$ ~?rf1, 201 AMp~fiF4~CVtUn~~:A~L EX::F.~ .I~,I.~~%\ K 401 klipstQ600~~J~l::tS 1 h'S r'L"'~'liT_$_r~~. ~ D. o;~\\ li'f~~l,;'ii-'Ua~~;"O New Alteration or Extension Per Panel One Circuit Each Additional Crrcuit or with Service or Feeder PermIt 5 $ 48.00 $ 400 E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigatIon $ 55.00 Sign/Outline Lightmg $ 55 00 Limited Energy/Residential $ 28 00 Lumted Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 4. SUBTOTAL OF ABOVE '. . '9' () . (J1 12% State Surcharge <f . 5 cJ 10% Admmistrative Fee j t) . Yt) 5% Technology Fee q . -0 () TOTAL J// /Lf 30 Shared Dnve(T )lBuIldmg FormslElectncal Permit ApphcatlOn 1-08 doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00256 COM2008-00256 COM2008-00256 COM2008-00256 COM2008-00256 Payments: Type of Payment Check cRecemtl RECEIPT #: 3200800000000000118 Date: 02/21/2008 DescriptIOn Perm ServlFdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstratIve Fee Paid By DMH ELECTRIC CO Item Total: Check Number AuthorizatIOn Received By Batch Number Number How ReceIved nJm 1305 In Person Payment Total: Page I of I 1:21:57PM Amount Due 7000 2000 450 10 80 900 $114.30 Amount Paid $11430 $114.30 2/21/2008 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00256 ISSUED: 02/21/2008 APPLIED: 02/21/2008 EXPIRES: 08/21/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 603 33RD ST ASSESSOR'S PARCEL NO.: 1702312402300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Service Change Owner: CROSS GARY P Address: 460 W 25TH AVE EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DONALD MARVIN HORTON License 116021 Expiration Date 07/25/2009 Phone 541-726-9021 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Tm!@T~C\E: Sq Ft Basement: Range Typ~~S PERMIT SHALL EXPIFSiIIFtbltrd~W'<RKport Ene.rgy PtY :[ ~ORIZED UNDER THIS ~m~~~:NOT Spnnkledr.Bcf~,!~it1~CED OR fSa ABANlS\sf-R..Pdqt(J.Rad: I DEVELOPMENFI'I'llfH~@RMAtlMll~D. REQUIRED PARKING Frontyard Setback: Side 1 Setback: SIde 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: -, # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: --~- Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: i 1:1'1"1 IUIII. UII:I~UII iavv 1\:.I.fU;'.... yvu 1.:- I PUBLIC IMPROVEMEN~ W rules adopted by the Oregon Utility Notificati~~i@lfi-t.lose rules are set forth In OAR 952-001-00TOftirough OAR 952-001- 0090. Y~<m!l,mwtta~oopIGS of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa\?:e 1 of2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00256 ISSUED: 02121/2008 APPLIED: 02/21/2008 EXPIRES: 08/21/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid-1 Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ServIFdr 200 amps or less Amount Paid Date Paid Receipt Number $9.00 2/21/08 3200800000000000118 $10.80 2/21/08 3200800000000000118 $4.50 2/21/08 3200800000000000118 $20.00 2/21/08 3200800000000000118 $70.00 2/21/08 3200800000000000118 ,----" \ '-...1 I ( Total Amount Paid $114.30 I 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 Reouired Insnections , Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover . Final Electric: When all electrical work is complete. 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 Date Pal!e 2 of 2