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Home My WebLink AboutPermit Electrical 2008-3-7 Date zo~~ INITIALS N'r-1 DATE 3~-;1-'( SOURC~ \>~ rs/-,16i' . 2251'0. ul STREET ~ SPRINGFIELD, OR. 97477.. PH;(541)726-3753 .iAx: (541)726-3689 ~LE~~lKlC~iEM~~~'ArPtIC4TI,OlV,' . City J9b N~ber (/:rt1:1250!J fr' - (J 0.3 ~ '2 1. 2.00 Lci6c;-r IS 5T. LEGAL DESCRIPTION: li03 sS 32.1') ':S'llJ'O JOB DESCRIPTION: "R ~ fCN...E e:~,l Sill\) c;. 'S e!<.\.J ((:,6 S Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is SuspendedJor 180 days. . 2. Electrical Contractor (VA Address City " Phone Supervisor License Number 4. 02..-3 5 Expiration Date ( 0 -... { - '2.. 0 \. 0 Constr. Contr. Number NA - Expiration Date . c' . Signature of SuperVising Ele((triqian {~-Vn~: n~~P' , .' \1 .. :.~.' ;.;~t.-t ~ ;~. '( . . . ..' ,.~. ":,'.' . .'. " : >.,';>~:~.':<r ,_. :/':' (i.\"'>:. ; O~ers N~~ '\AI i\':CA ~4(;:A~'~E;:., PA Rt::.: DI<5T ' .:- ,. ""'~," .';' if" ..,,~. '\"';~'. '::~',,,;~.(,~:t~-'.,., '!',,'\":'" >,. Address:ZSO :is;'322~~,;i.S \.':;'.. ,;. . . City-S~(~;/A-d~ .~'::~phb~~~;'ij3b'.i4'S-44 . .~.. , ':~:',i.':;/:~~'~:;ik'!,,::.:,:"" ' OWNER'INSTA~LATION' '.,<'',1;;':.;#,,: .',:, . ", ,"', '.',~~,[T ,c_'"_':,': ~':_,_...''} .'~~.'; ~>_::;t~t~~,,~;o:>":;'~':.1,:<. The lltstaIJatiou'ls, bylIlg m~e .?~pf.9i>e~1 own~hich ' is notintended for sale, leaSe oi're:nC~'::;') .... ','~' " ~)- r':~ ~ ~1~ OWners Signature: .... .~. - " ., "1 .,. .' /.: ~. Inspection Requ~st: 726-3769 . .i( 3. A. Service Included 10'00 sq. ft. or less Each additional 500 sq, ft. or portion thereof. $117.00 $ 2 LOO Each Manufact'd Home or Modular Dwening(t,,~~te~-009- ~ S! Ja;~~?j~Ii!O~ Feeder UOI :eO!l!lON Amnn u06~.. a 6u!lreo B. -~,Q.~Z96 'l::lVO 4 nOJ4l . ; 0 \'OI}'S8ILilON 200 AmP,~r/o~s are 58. \n.l ?,.s.:.~q:.",~f,/~I~ ,~JlJ~'QO...;\\CI 201 Amps ^~ ~p'SIO eLlI A..j >'; \',~' 'I,' .~: 8~,o,q.L\:;I 401 Amps tQ'~oownpsnb01 d,S; uw-"v"ii38~00 601 Amps to 1000 Amps I $180.00 \ 80.,C)(;;; Over 1000 AmpsNolts $413.00 Reconnect Only $ 55.00 c. Installation, Alteration or Relocation 200 Amps or less $ 55.00 . MlOtiSi:to 400 Amps $ 76.00 "fitH&\lBlliUqIIJOSr4m EXPIRE IF TII[ ~VO~~o.OO t~tkfJ61J01~SJf~ ~ Wi . n9 .'\ew Al eratI~n ~~nsi~n Per P~riel' , .000e Circuit Each Additional Gircuit or with . Seni~.or F,~~der Permit __y-r' $ 48.00 E. .q O~ 00 $ 4.00 . - ..... ',-, '. ~ ,'- . , Pum~.c;r iITiga~ion", 'l$ 55.00 55~ OD Sigil1'Outlinet:;.ightmg . $ 55.00 't .,-' LimitedE~ergy!Residential .... '. , $ 28.00 . '.,' Limit~dEi1ergy/Cokneicial ,,' . .' $ 50,00 Minimum ElectriC Permit Inspection Fee is $50;00 + Surcharges -Ii L.. 15...00. 33..00 2. ') ~ 50 i 3.75 #3-<q<1.Z6 4.. 12% State SUrcharge' 10% Admlnistrative Fee 5% Technology Fee TOTAL Shared Dnve(T:)/BuildingForrnStElectrical Permit Application I-08,doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2008-00322 ISSUED: 03/07/2008 APPLIED: 03/07/2008 EXPIRES: 09/07/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 200 W B ST ASSESSOR'S PARCEL NO.: 1703353203900 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Replace existing services TYPE OF USE: New iy""C IIOU 1~!Jblic :rTENT\ON: Oregon \a~~:6~'~g~n Utility A. _'..I^" '.'lrlopted by .I~", ",rP set iorth w\lu" [-;- enter. I flU;:'''' ,~. - 952-0U1- ' Notiti~~~~_~o~ -oO~ ~ thrOui~~ ~~~e rules by \n OA v u may obtam cOP. the telephone ' 0090. 10 ter (Note. .t' ation , WI'&' fnP cen ""., ,,'J'Jt"+,\, NoH IC , , '-''''' ',-"'.;. of r the ure'::julI . -2344). I CONTRACTOR INFORMWl'~nter is ~_800-332 Owner: Address: WILL'\MALANE PARK & REC DIST 250 S 32ND ST SPRINGFIELD OR 97478 Contractor Type Electrical Contractor OWNER License Expiration Date 'Phone 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 Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Ene.rgy Path:, NOTICE: Sq Ft Other: Spnnkled BUlldlr~is PERMly/~HALL ~'X19PJ~~~~"~ WORK DEVELOPMENT INFORM~TiBN':J NDER THIS PERMIT IS NU I \..IU VIlVICill OR IS ABAND@tIlfQbm~D PARKING Overlay Dist: ANY 180 DAY PERIOD. Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: %. of Lot Coverag~: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspo.uts/Drains:, Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated 0'c Pal!e'l of 2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2008-00322 ISSUED: 03/07/2008 - APPLIED: 03/07/2008 EXPIRES: 09/07/2008 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 Add, Alter, Extend Circ Ea Add Irrigation Pump Perm Serv/Fdr 601 to 999 amp~ Amount Paid Date Paid Receipt Number $27.50 $33.00 $13.75 $40.00 $55.00 $180.00 3/7/08 3/7/08 3/7/08 3/7/08 3/7/08 3/7/08 3200800000000000151 3200800000000000151 3200800000000000151 3200800000000000151 3200800000000000151 3200800000000000151 Total Amount Paid . $349.25 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 ~ay. Reouired Insoections-I 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 informa'tion 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. , f Owner o'r Contractors Signature Date Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00322 COM2008-00322 COM2008-00322 COM2008-00322 COM2008-00322 COM2008-00322 Payments: Type of Payment Check cReceintl RECEIPT #: Description Perm Serv/Fdr 601 to 999 amps Add, Alter, Extend Circ Ea Add Irrigation Pump + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee' Paid By WILLAMALANE City of Springfield Official Receipt Development Services Department . Public Works Department 3200800000000000151 Date: 03/07/2008 1 :47:32PM Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 180.00 40,00 55.00 13,75 33.00 27.50 $349.25 Amount Paid njm 71626 In Person Payment Total: $349.25 $349,25 Page I of I 3/7/2008