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Home My WebLink AboutPermit Electrical 2004-12-3 "" " , . ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . P8:(541)726-3753 . FAX: (541)'1-16- R',' '~"..., . ~ ~ l\ ELECI'RlCAL PERMIT APPliCATION . ~~ ., ',. ..0-;: ,,' City Job Number (1)y112J'ff/1-(lilB~te /2/0& <>0';9"<'1, ~" >~~~<> ' I. ~iX!ATIbN:OEJiNST.),Tii;--iA:jij(j'''~ 3. ~eOMPiiliii';;1ffEESCHEiJ.-iJiJErfftEr,.z:i,-,~q"",*,>",~~~ . ~__"'......"_~,..,..,,..~_~_._ H'~"_""'_'~~";l'J,~ ~.._-...",_............iti::-'-~'ri-"--'-'- "_'':'''---:':'~. "M'.....-r.~!\y...."'~.;l!-:~ .... (o.~I?~ J J/ w ' . ~~ '<'''0';01& , .r..:::-.1tl:~Slii':''''~'::5i,..il't;,rc...,~.;.>:~;r>il'''''''~-~'''''''~ -.{;,-., '.-.&- ~.,~~ A. :Ne~.Resii!ential-~i"gleio"'lI1ulli;f.al)1ily" :~. elli ,un~"",, LEGAL DESCRIPTION /002. t'J,,"<: I~ 1'Jt9 '7oe JOB DESCRIPTION ~J ~f5P<~~l////./~C/ Permits are non-transferable and expire If work is not started witbln 180 days of Issnance or If work Is Suspended for 180 days. ' ~_"';"'''-'''''''''''~__~>-1'''__~''~'''f''''''~''''"'O'''to<e:_.......~ eONTFR:AeTORJINST:ATJ:1A'FIOMONLY; 2. '.A!>.1!1o'J<_!"'l~~..lStjtf.1~-'~'~"'.:I",~_...,,,,,,~~~.~,tr;,,.;JJ!,'oom.,.. ;0 Electrical Contractor ~/ Address City ~.- A.TTENTION: Oregon law r ulres you to 'S"fle~t\ful>i~~ e Oregon UtilIty to w Th e rules are seUU1l1I N~?r~~~~ter. rnuoh OAR 952-001- In If,\,! ma 0 ain copies of the rules oy oe~Rfitr,'tiP.%' &'i!' (Nnte: the telephone . ca mg r the Oregon Utility Notiticatlon e~!fef IS. 1 enM1::I2.2344). Signature of Supervising Electrician ,-. Owners Name ~ 1\1 0 \ f'I-' L. \ Address ""<?;-O~. \, v(.. I . v ~ i City ~'~G~.Q\r\ Phone 7).,6-11 OWNER INST ALLA nON )<l. The installation is being made on property I own which is not intended for sale, lease or rent. ~p o Inspection eqnest: 726-3769 Service Inclnded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $19.00 $50.00 '~~"'W!o'.l~f"'~~\i:ifi~;~~~""'~~~~.~:IW-!1IJ~'~ B. ~e1;ri~esto2r.~~eede~'-.Jn~tiilla~i~D:r'A1t~ration~~~~~;~,tio.if:Y: , 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V oIls Reconnect Only ~ $ 63.00 $ 75.00 S125.00 $163.00 S375.00 $ 50.00 bs ;~. ,,~ ",,','~, c. ~r~P6"Fa~.$~~r1~1fd~.' Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 S 69,00 $100.00 Over 600 Amps or 1000 VOlls see ''8'' above. D. ~~4t€~~i~A- New Alteration or Extension Per Panel One Circuit $ 43,00 Each Additional Circuit or with /-' Service or Feeder Permit ..., $ 3.00 Je;- 'O(~-I,-;,j;>W~~'~"~~!f<D.'o:ft;.1;;4':dit~~~ilfl.:\.I.f:~~;'1!~:'~~~~.~ E. M~cella!!!!I~,(~~S~f~~~~.lit~~~~lJ!.~l~.!t~~ Pump or irrigation S 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential S 25.00 Limited Energy/CommerciaI S 45.00 Minimum Electric Permit Inspection Fee Is 545.00 + Surebarges 4. ~~~~-mTOWh~'- -"79--..00 ~~"'(~~~-_' .,',.-' rll.,- /r-/ 7% State Surcharge 'OOI\:l3d AVO 08 ~ ANV c:;. +p 10l@Adilil/rlSlf.ilivelF~eSI \:10 038N3\1'J\1'J08 '7.'Pr6 10"~"'-\ ~\:I3d SIHl \:l30Nn 03ZI\:IOHlnV C} · ~ ')\\:l~~T~~h :II 3\:11dX3 llVHS 1\\1'J\:I3d SIHl ,/- 2- Shared Drive(T:)lBuilding FOrmslEleclr;1~Hc'nQtt..:pplication l-03.doc . . CITY OF SPRIr~uNELD Building/Combination Permit PERMIT NO: COM2004-01483 ISSUED: 12/03/2004 APPLIED: 12103/2004 EXPIRES: 06/03/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726.37691nspection Line SITE ADDRESS: 6808 IVY ST ASSESSOR'S PARCEL NO.: 1802031400900 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Add elect. distribution panes & 5 circuits Owner: DIAL JAN & DONNA Address: 6808 IVY ST SPRINGFIELD OR 97478 f1ruo '\'l}O I CONTRACTOR INFORMATION I 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: 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 I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: Storm Sewer Available: Special Instruction" , ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those fules are set forth _. _ ___ __. ("\r\a....r-llr>rn nn If' ^nAh.lnrH..lcn enD fnUAM.::rOIlC::.-lIUI-UVIVUllUU~II"~"."'L Uu. ...........:..~,.~__ _..._. -- -- ~ -- 0090. You may obtain copies 9f "alu~tib~WDescriDtion I ANY 180 DAY PERIOD, calling the center. {Note: the 'V'V>" ovo.~ Description numlJ-ylit%~~nqlfil:WJ Utility< $!~eii~~l Squa.re Footage . Center is 1-gUU-g32-2~'1J1ulbplier or BId Amount DownspoutsIDrains: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT Notes: Value Date Calculated Total Value of Project' Page 1 of2 . . CITY 01' ~t'.K.ll~l.1'lJ'.,LlJ Building/Combination Permit PERMIT NO: COM2004-01483 ISSUED: 12/03/2004 APPLIED: 12/03/2004 EXPIRES: 06/03/2005 VALUE: " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , F....~ Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid $7.80 $5.46 $15.00 $63.00 12/3/04 12/3/04 12/3/04 t2/3/04 Receipt Numher 1200400000000001691 1200400000000001691 1200400000000001691 1200400000000001691 Total Amount Paid $91.26 I Plan Reviews I 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 ~,:,~ujr..d Tn~,n"dion'l flrlllUiiiii 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 herehy 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 descrlhed herein, and . that NO OCCUPANCY will be made of any structure without permission of the 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 tlmesdurinO~O IL-.~ ~~o4- Owner or cont~ors Signature Date / Paee 2 of2 .225 .Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . i514 .aJty of Springfield Official Receipt ~velopment Services Department Public Works Department Job/Journal Number COM2004.0 1483 COM2004-0 I 483 COM2004-01483 COM2004.0 1483 Payments: Type of Payment CreditCard 12/3/2004 RECEIPT #: 1200400000000001691 Date: 12/03/2004 Description Penn ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By JAN P DIAL Item Total: Check Number Authorization Received By Batch Number Number How Received dim 150321 In Person Payment Total: Page I of 1 3:05:53PM Amount Due 63,00 15.00 5.46 7.80 $91.26 Amount Paid $91.26 $91.26