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Home My WebLink AboutPermit Electrical 2004-1-15 . '. " ".. . . r" ',( . .. .' . " :~..' " '~-....' ',.'- ,~ . ~:' '. CITY OF:S~ INGFIELD,.OREGON .;.::,' 1 .....' , " " ',_.', ,'_ '''j.'' i . "t.. ''''' \" '''I',r oLf-OZ Lf oject as submltled has the following 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (~W'l;t~i3'g81Pes not reQuire specific land use ELECTRICAL PERMIT APPLICATION Zonin" [012.. City Job Number CoVVl t-n= 4 -ooasb Date ! - ( ~ ~ 0 L( Date . l-b,[2. '../illtl1n(izadSiol'A\''"o 1- liP -0-+ 3. COMPLETE FEE :;CHbUULI!: .ljbLv 1'1' New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with r- Service or Feeder Permit $ 3.00 E. '.,' M;;nlQ;U~it~~s~ri-I':'~~N~~~~Y;~\r~I.M);\qlaQ~Ol<'stalla.tioil .. THIM'l:n'iYII "~""THIS PERMit I~ N f '. ,'n\-ln~IZED UNDER E<>~ Pump ol"ifrtga~Qh\CED OR IS AB.ANDON ... SignlotfIa~JN~Il\ng ~ PERIOD. $ 50.00 OWNER INST ALLA nON Limited Etl\,~g~}lPesY~niial $ 25.00 A:rTI=NT10N'Ore~on law reqUIres you to . . . The installation H Ming.P.1aoe 9AR~'I!'cir&'ym~"C'j1.!ii.lon Utilitrlmlted Energy/CommercIal $ 45.00 IS not mtendeJcr~jl,'l~'il~~l'renl. Th a rules are ~i.iljpjum Electric Permit Inspection Fee is $45.00 + Surcharges lotiflcatlon Center. os hOAR 952-00' , . , .. .' , .. ,.' "'.. <,., .... . .,' ',.. Owners Sigmltlii\AR 952:001-001 ~ thro~g 4. 1~[lBiOT.A+.:9F..AJidvE'~ ':>+::;'{,t.' , :\ Z ( 0090. You may obtam coplas of the ru~s, .:<.. "<".""-~,>',.,.,,"..-'..,'~.""'" ',':',< ',e'. """,, .. -c. b 7 calling the center. (Note: .t~e tel~~hO~e 7% State Surcharge * '5 number for the uregon UlIln/ Notification 0 ... . .-'. <;; 10 "-~t",. i" 1_l\nn-332-2344). IOVo AdmmlStral1ve Fee " <.> Inspection Request: 726-3769 ...1 j \~ TOTAL ' '7 y 77 ~~\:Jb 'O\~\(1\ Shared Drive(T:YBuilding Fonns/Electrical Penni' Application ).o3.doc I. . .. LOCATION OF INSTALLATION . , . l.( (L{ ~ 3' J\"'" f c:-fL ~ ~ LEGAL DESCRIPTION I '60 Z 05 z.. "3, ooYO.5 JOB DESCRIPTION ~<-<. b ;/ r; C-l a..c.........: .\, I Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended Cor 180 days. 2. j!o.M;Ri&o~'~~'r~I;AfjoJJ.~NLt ~ ." ..' --~~. .'. ..."".' . ..... -.. ,.,.~ -".' .".~~..-". Electrical Contractor JB Electric, Inc. Address 4685 Isabelle Street City Eugene 97402 Phone 687-5770 37587-C 10/1/03 Supervisor License Number 3872-5 10/1/04 104929 3/14/04 Expiration Date Constr. Contr. Number Expiration Date Signarure Of~1!?:::- / ~ Owners Name \c-A.-, , Lf{'-t~ rD/^ City ::> , r-u.J ?h.l(t! <; 1 /l " f" ofC- {Z-d Address Phone A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ct. or portion thereof . Each Manufacr'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 '. . -l~' . ~. . . - .. " <>~ . '. \ ~ , . . ':. . B. Services or Feeders -,Installalion; Alierations or,Relocation: .' ." .,_.. ..::;'- r-' '. .... _ . '_'" 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1 000 Amps Over 1000 AmpsNolts Recol1l1ect Only I $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 {-:; "3 ".~~.:-~ .,r~(,;- :"':-;.<"'" ~'f,t..,... ....~-..,'.~.',~....::-:., <1/'" . ' . . ~ C. ;/Te"mpo'rary Services or Fe-eders ~:;~}'..' /1 y' ;,.-_:'..:'::J,.>':~.':~.' .~>.,'~",J'."'.' :..... . "'''''. ~.._ .. _ ._ _',' _ . .f.'-,,'.!..~":,,_, '. .. . Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Ove: 600A':!ps or.1000 Volts..se~ ::W' a~?"e.., '. ' .. _,k ~~"'...~ :""",1'... . <", ',..:.; .~, . ,,,,:r."'i:,"[' :", .;:: D. "Branch,S~lfcUI~f.....,'~t'-.f)~)...~..y,-'<. ".!..};'..! ~"",,;,_~ .. .'" '> .~'" ~',,".., ....~.~..'o...l. ....,.. ...- t_ .... ~..'-...'_', ...... " '., $ 43.00 ,7 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00056 ISSUED: 01115/2004 APPLIED: 01115/2004 EXPIRES: 07/15/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4145 JASPER RD ASSESSOR'S PARCEL NO.: 1802052300403 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTlON: sub panel and 6 circuits Owner: RAY PHILLIPS Address: 4145 JASPER RD SPRINGFIELD OR 97478 'CONTRACTORINFORMATlON I Contractor Type Electrical Contractor JB ELECTRIC License 104929 BUILDING INFORMA TlON I Expiration Date 03/14/2004 Phone 541-687-5770 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS I DEVELOPMENT INFORMATION I Front yard Setback: Side I 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 PUDLIL l1VIPROVEMENTS I law reqUl'''''' , """' ,- Street ImPAT ""t,,,<:':~N:Oregon 0 Utility Sidewalk Type: , ~.I adopted by the regon , Storm Se~Qt,\I{itafm: Those rules are set fert NOTICE: DownspoutslDrains: Speciallhsti1lCtiOllin C~~HP10 through OAR 952-00 THIS PERMIT SHAll EXPIRE IF THE WORK Notes' ~O~~Ry~~2~~y'obtain'CoPies of the ~1.S l AUTHORIZED UNDER THIS PERMIT IS NOT . ' "RiUno the center. (Not.~:.~~e ~~~'~^~~:n COMMENCED OR IS ABANDONED FOR nulflberfortne urto\jU" ~""., "-, ;';;Y ~8U UAY t'tt1IUU. ron''''''':: 1-8nn-332-2~'Valuation Descriotion , Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee I of2 . . L11 t' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00056 ISSUED: 01115/2004 APPLIED: 01/15/2004 EXPIRES: 07/15/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F~~~ PaW Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $8.10 $5.67 $18.00 $63.00 1/15/04 1/15/04 1/15/04 1/15/04 1200400000000000063 1200400000000000063 1200400000000000063 1200400000000000063 Total Amount Paid $94.77 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 Reouir~d \Iw'~"'ion~J 1 Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 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 Page 2 of2 225 Fifth Street .-;J Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00056 COM2004-00056 COM2004-00056 COM2004-00056 Payments: Type or Payment Check -iftI..d.!!'" .-~,,~ ." Wi.......'....""'.""...'.-..,., ....~." ! , ' ~ J., I .' ... ,-" . " I/I'^,,~' -... Receipt #: 1200400000000000063 Description Perm ServlFdr 200 amps or less Add, Alter; Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By JB ELECTRIC Received By djb Check Number Batch Number Authorization Number h City of Springfield Official Receipt Development Services Department '" Public Works Department Date: 01/15/2004 2:50:50PM l' Amount Paid Item Total: 63.00 18.00 5,67 8,10 $94.77 How Received In Person Payment Total: Amount Paid $94.77 $94.77 . .