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Home My WebLink AboutPermit Electrical 2008-2-27 LEGAL DESCRIPTION' .2 t C11 lV--'<- JOB DESCRIPTION: 5~L Ctf-A,v,~e I Z 0"'6-\1 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ZON \ it-V INITIALS () m ~ DATE }_-~-o'T 225 FIFnI STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 .,, SOURCE(Y\;{X$ fY.V ELECTRICAL PERMIT APPLICATION / '"7 /. \ city Job Number (~2eJoF- 00211'7 Date 'C/Z~ O~ 1. LOCATION OF INSTALLATION: 3. COMPLETE J:<1:!.l!; SCHEJULE BEWW 2(b lJ' 'b' &""'~f " S-+- D A. ,'N~"::,,~~~~~~tial- Single or Multi-Fa~!ly pe~ dwelling unit. Service Included 1000 sq. ft. or less 1-- Each additional 500 sq. ft. or J \ portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $1l700 $ 21.00 $55.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 ~~s ~~~ U\\\\\'I ..\. Ote90t' \\'Ie Ote9 et \ottn .. "') f r ( .ftN1\O\"~' te9 'o'Y ~'eS ate1c.t)J\()'\- SupervIsor LIcense Number J LP LR 1p..,.,.1!y, ,,\eS aCO? ~nol',;.,l.lD"~"I'J'~~~9r Fet;ders 10\\0'" t - t' centet. 0 t\'ltou9l\ ~ t\'le tu\e ( / Q " \ ca\\o 0\-00\ a\eS 0 ~nQne 10 I () tJ '( NOlI ~~ 952-0 o'o\a1fl~Qna~~ ~i~\\\\~t!~~r Relocation I ' \n 0'0' "{ou ff\a'Y t'\et2~Q~'t\l\}f ~~n 2 C; C; ,...-{)09. \\'Ie Ce !O~IJ~' r'W Constr. Contr Number { ..J 1 ('7 - r:a\\\n9 \ \ot t\'le.o . ~i1'~ 0 Amps i) / ~ (! nuff\'Oe cen\ef \5 01 Amps to 600 Amps Expiration Date \ ( iJ (') 1 I Over 600 Amps or 1000 Volts see "B" above. I '" '" SIgnature of Supervising Electrician D. Branch Circuits ' 2. CONTRACTOR INSTALLATION ONLY ElectrIcal Contractor r ~W t:.~<- \ ~ 0 1 ~~ L G If CIty \.N%- \.J,J~ ,fCe. Phone 7 ~ 4 r 0 V) ~ ~, , , B. Services or Feeders - Installation, Alterations or Relocation: f $ 70.00 $ 83.00 $138.00 $180 00 $413.00 $ 55.00 7D Address Expiration Date $ 55 00 $ 76.00 $11 0 00 New Alteration or Extension Per Panel One CIrcuit $ 48 00 Each Additional Circuit or with e..t. "2- f' Service or Feeder Permit "t ~~~ . _ $ 4.00 . ~~~ok~~~Q\ . ~\ cf!; MiS~\.~~~Uf~~\i~lot included) -Each Installation ~O \ i~ S ~\\ \~ ()~t.\1 \~\S?t: ~~~~~~U $ 55.00 (l>.~\~O '~~'M~ting $ 55 00 OWNER INST ALLA TION CO\J\\J\~~'lI ~~ergy/ResidentIal $ 28.00 The installation is being made on property I own which F\~'{ '\ 'i~ted Energy/Commercial $ 50.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $50.00 + Surcharges /c1-e- SfrUf Owners Name IloC/' -, ItI'J {- / ,Of;;, I ..sf- CIty s? A Phone Address Owners Signature: 4. . SUBTf!TAL OF ABOVE 12% State Surcharge 10% Administrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL l~ 7Y</ 3?o '1/ ~ Shared Dnve(T )/Bulldmg Forms/Electncal Permit Apphcatlon 1-08 doc CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00287 ISSUED: 02/27/2008 APPLIED: 02/27/2008 EXPIRES: 08/27/2008 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 216 W D ST ASSESSOR'S PARCEL NO.: 1703352306400 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Service change and 2 circuits TYPE OF USE: New Residential Owner: TANG HOD Address: 1906 I ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor GLEN A CAMPBELL License 73995 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 'Setback: Rearyard Setback: Solar Setbacks: Overlay ~ist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ~ ~ ,~', ~ Phone Number: 541- Expiration Date OS/24/2008 Phone 541-744-0705 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: N C IMPROVEMENT _~ THIS PERMlT NOER TH'S PERM\l~~' Type: AUTHORIZCEEOOUOR '5 ABANOONEO mm\spoutslDrains: COMMEN ANY 180 DAY PERIOD. Notes: I Valuation Description' Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Pae:e 1 of2 Value Date Calculated Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00287 ISSUED: 02/27/2008 APPLIED: 02/27/2008 EXPIRES: 08/27/2008 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 J Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $7.80 2/27/08 1200800000000000184 , $9.36 2/27/08 1200800000000000184 $3.90 2/27/08 1200800000000000184 $8.00 2/27/08 1200800000000000184 $70.00 2/27/08 1200800000000000184 Total Amount Paid $99.06 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. L. Reouired Insoections , Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 Pa2e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00287 COM2008-00287 COM2008-00287 COM2008-00287 COM2008-00287 Payments: Type of Payment Check cRecemtl RECEIPT #: 1200800000000000184 Date: 02/27/2008 DescrIptIOn Perm Serv/Fdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmInistratIve Fee PaId By GLEN CAMPBELL ELECTRIC Item Total: Check Number AuthorizatIOn Received By Batch Number Number How Received dJb 4178 In Person Payment Total: Page 1 of 1 11:54:15AM Amount Due 7000 8.00 390 936 780 $99.06 Amount Paid $99 06 $99.06 2/27/2008