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Home My WebLink AboutPermit Electrical 2006-3-2 L\:)'Z- _ 3t~F~Cap '. he 0 ,!njJ J t a5 submitted h9. Mw~n~ . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FA~;,(~)i1o.l>..M>Il9not require sped! ':[2.,-~ ELECTRICAL PERMIT APPLICATION approval, , - City Job Number ~ J c'"'\r'Y /J --- ()b =< 53 Date zo~ - ~ - z..O"Vc,.... - Date ,t) CITY OF S(~mGFIELD, OREGON r:\ . . I. LOCA~F INSTALLATION \ ~ '20 {'(lI'N' V I v,..:) LEGAL DESCRIPTION '"n? @, ?-, '";\ 01J \ io (? JOB DESCRIPTION ~O f7 III (. L (' J\atY\ ~f- pe~~it~ are non~transferable and eXPi~ if w~rk is not started within 180 days of issuance or if work is Suspended for 180 da)'s. CONTRACTOR INSTALLATION ONLY 2. Electrical Contractor G ~(lJ/ lAJ4 €A:1 Address :>f C8'} Supervisor License Number 3 /' :s- /., ,<::., Expiration Date J oj all) b :7 Constr. Contr, Number IS R' k-O .y" , .:?) .2v;/D C- Signature of Supervising Electrician ~1JjJ Expiration Date The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. COMPLETE FE.K$GI:llkDJQilllBFTflw 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 Each Manufac\' d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50_00 B. Services or Feeders -Installation, Alterations or Relocation: 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps I (o3.O-V $ 63,00 $75,00 ;' ~ " "-C$125,OO " ,-.,....., :;1';: 'UI'.i$ hll 601 Amps to 1000 Amp,s ,3: I ;8'" ,~$163.00 , . _ ' ,-, "."'''udP.: Ov;;r'100,o AmpsNolts.'cn ~L1;'ly ;""::;:~::~,o~375.00 Reconnect Only IS l-I:JOO-3:';2.23"" $ 50,00 T C. Temporary Senices or Feeders Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 0,'.:,& ~?tt\llPS or 1000 Volts see "B" above, D. TBr,anchRi':irC/lits , " u r C i1VIII SHALL EX . N'JJ.TNifefM!oJl B'ivt'!!rrrog,~ iFaJUE WORK, 0he^itii~[uiiCED OR IS AR~IS PERMIT IS f'iOtIl,OO 13U\l-Nlg;t&~tl &irswtkl'Wlfl!,DDNED FOR Service or Feede'r p/iHl{JtI. $ 3,00 $ 50_00 $ 69,00 $100,00 E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25,00 Limited Energy/Commercial $ 45,00 Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4. SUBTOTAL OF ABOVE 03 . (j7) 8% State Surcharge ~ ,0 L-/ 10% Administrative Fee (0 , 3 tJ TOTAL -t{ /'7' ~r Shared Drive(T:)lBuilding Fonns/Electrical Permit Application) -06.doc c ( 22s.Fifth Street , Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00253 COM2006-00253 COM2006-00253 Payments: Type of Payment CreditCard i~J f '; Ii J " t, f 3/2/2006 . RECEIPT #: .P~.~I-'!...q.~~ .~.."___. ',., ~' ;' : --.r . . ': , , - .-,-- , "~,.,.,,,. '.'~., ' Jii..ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200600000000000234 Date: 03/02/2006 Description Perm ServlFdr 200 amps or less + 8% State Surcharge + 10% Administrative Fee Paid By HOLLY MCHAFFEY Item Total: L:heck Number AuthOrization Received By Batch Number Number How Received njm 174583 In Person Payment Total: 1 of 1 1:36:11PM Amou nt Due 63.00 5_04 6.30 $74.34 Amount Paid $74.34 $74.34 . . CITY OF SPRINt:.n~LD ' Building/Combination Permit PERMIT NO: COM2006-00253 ISSUED: 03/02/2006 APPLIED: 03/02/2006 EXPIRES: 09/02/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1420 FAIRVIEW DR ASSESSOR'S PARCEL NO.: 1703273200166 Springfield TYPE OF WORK; Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service Change Owner; RUPP DENNIS J & CARA L , Address: 1420 FAlRVIEW DR SPRINGFIELD OR 97477 , I CONTRACTOR INFORMATION' ' Contractor Type Electrical Contractor GROUNDED License 158804 BUILDING INFORMATION. Expiration Date 02/24/2008 Phone 541-726-6858 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION. REQUIRED PARKING Front yard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion , Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00253 ISSUED: 03/02/2006 APPLIED: 03/02/2006 EXPIRES: 09/02/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fees Paid I Fee Description + 100/0 Administrative Fee + 8% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $5,04 $63.00 3/2106 3/2/06 3/2/06 1200600000000000234 1200600000000000234 1200600000000000234 Total Amount Paid $74.34 I Plan Reviews , To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Rerwired InsnectiOlW j Electric Service: Approval required prior to utility company energizing service. 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 Page 2 of2