HomeMy WebLinkAboutPermit Electrical 2004-4-8
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225 ~H in STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F"tbh/ri'I1'dM'ifo'tl!l'~ot require specific land use
ELECTRICAL(f,~~~~ approval., LW(2..
City Job Number \1 ,Zomng.
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200 Amps or less $ 63,00
201 Amps to 400 Amps $ 75,00
ATTENTIOM!1rW8~~0,60~ Amps $125.00
/Jr=, fo"o~rules &~J'3l3 iWlO~~!es YOU!0 $163,00
-"'~ ?,('94'C;!tian C(J.V.~ef,oqqltl~gifVlg&egon Utility $375,00
- In OAR 952-0rff't95'l1jttR%Z ru es are set fan l S 50,00 .5P.C10
0090. You ma . r ugh OAR 952-00
calling thfcl_~~wlsflifi~~~~~~~
number for the Oreoon U!.,. I I '? one
Expiration Date /1;-6/-6 t/ Installatlon,,~~~~;~~~r.Rttollation
n// 200 Amps or less .
Constr. Contr. Number Il t 7. '1"6 201 Amps to 400 Amps
A / ',.-- NO 401 Amps to 600 Amps
Expiration Date ~/'-6,> 7;'1. rIC/:: Over 600 Amps or 1000 Volts seeOOB" above.
\-l \ {\Jt ,,~ _ OD, 'fJfr;fU Q ,. rmit . $ 3,00
I t ~ "'P""t'""~~,,,,',"""'~'1l,~,~~~'il:';'1\'Jlil!1,\li!f,~
. E, i~~M~J.\\\!~JJ~~~~~~~~n2~~p!~!.:~~a.~Al}ns.t~IJ..aB.g,.1!1
Pump or irrigation $ 50,00
Sign/Outline Lighting $ 50,00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
1. ~LOCAtldN'oBINsLJNt;miO~~
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LEGAL DESCR1PTI~ f\ A1'I\
\:1~~,,:")-ln\.l }
KOB _DESCIliPTION'.
~orl ~'ffiWf)
PermitS are non-transferable and expire if work is
not started within I~O days of issuance or if work is
Suspended for 180 days,
2 . ~.,]TOlliiNSTAEmTIONONBW;
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Electrical Contractor
Address ()n;]& {}J1
City f yt',<;l..X I L Phone
Supervisor License Number L; ,( q /) c)
City
OWNER INS ALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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Service Included
1000 sq. ft, or less
Each additional 500 sq, ft, or
ponion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106,00
$ 19.00
$50,00
~"""'!!"~"""'--"""'l!;'~'''''''''''.'..,-,,,,-j''r.''''-''''''t'I
B. i~~~~1!~~i~~~~;[~~~!!i,~JJ8~~-~=J!:~---
$ 50,00
$ 69,00
$100,00
MInimum Electric Permit Inspection Fee is $45,00 + Surcharges
~*~.loO-~t;'!!:ot,.;:~~~,.,..:';".:~--_.
4, ~S'(j'BTOTAL~F;-AB. O,VB.
~~">F~,- ,',
""~{) pO
-~.50
s -
~.OV
!5lh !f/J
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:YBuilding FonnslElectrical Pennit Application l-Q3.doc
.
-ri-
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3875 KATHRYN AVE
ASSESSOR'S PARCEL NO,: 1702304304000
~,
. CITY OF ~rtUl'\i~J<u'LU
Building/Combination Permit
PERMIT NO: COM2004-00388
ISSUED: 04/07/2004
APPLIED: 04/07/2004
EXPIRES: 10/07/2004
VALUE:
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
PROJECT DESCRIPTION: Reconnect Electrical Service from Tampering
Owner: JONES FAMILY TRUST
Address: 6022 THURSTON RD SPRINGFIELD OR 97478
Repair
Residential
Phone Number: not listed
I CONTRACTOR INFORMATION I
'lOU ~.r BUILDING INFORMATION I
o.U\~aS U\\\,.,
# of Units: (\ \~"" la Ola90{\ Sa\ \Of. # of Stories:
Primary Occul!.~!5Y~~j \~a ,as ~~a 9~'l.-OO Height of Structure
Seconda~~ceUP1\~,>\~o,&.;a ~u ~ Op..?> ~u\aS 'Type of Heat: .
Pr'~eoMtt.w{io~\f~""IOU~ 0\ \"a ....o(\aWater Type:
~'I"'., I~'.: ~"(\", ~\\. 'as 'an" ,,..,
Sec~lIllry ,'it}'.'Istru\t}8l) . 'R"6oQ\ :l\a \0' :~\C~\\U<ange Type:
# oln$llf8d~~~_OO O~\~\\ ~0\0": \\'l ~O\\ Energy Path:
Op..?> U ({\~'l {\\al, ~ (\ U\\\ "!"1,,,ft.\,
\(\ _ '-/0 _ r.e _ _....nO _("Jr')-.
Ou"'~~\\\(\g '\~~ \"a:::, ct"" , DEVELOPMENT INFORMATION I
j;:~~CKS '
(W'"''-
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Contractor Type
Electrical
Contractor
BEAR MOUNTAIN ELECTRIC LLC
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Rearyard Setback:
Solar Setbacks:
% of Lot Coverage:
I PUBLIC IMpROVEMENTS I
Street Improvi1\e~', II t~PIRt If i~{ I~ N01
Storm sewe~"~~if~W,^I1 5\1P-. R 1\115 PERt-/l OR
Special Instr~ 11~\\'ORI1.EO \J~O\ p..'i\P-'~OO~EO r
p-'\J ~CE\) OR Iv
Notes: CONlNlE Of>,'{ PERIOO.
~~'{ ~ BO
I Valuation DescriDtion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Total Value of Project
Pae:elof2
License
136298
Expiration Date
08/06/2005
Phone
541-895-8833
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutsJDrains:
Value
Date Calculated
.
. CITY OF ~rKll'1L..l'l~LD
Building/Combination Permit
PERMIT NO: COM2004-00388
ISSUED: 04/07/2004
APPLIED: 04/07/2004
EXPIRES: 10/07/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F....s PfoIirl I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Service Reconnect
Amount Paid
Date Paid
$5,00
$3,50
$50,00
4/7/04
4/7/04
4/7/04
Receipt Number
1200400000000000449
1200400000000000449
1200400000000000449
Total Amount Paid
$58,50
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.
L.R..olJir..d lnsn..dions I
I Electric Service: Approval required prior to utility company energizing service,
By signatu.re, 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 witb
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 aU
times during construction,
Owner or Contractors Signature
Date
Page 2 of2
225 Fifth Street
......... ,
Springfield, Oregon 97477
541-726-3759 Phone
...
Job/Journal Number
COM2004-00388
COM2004-00388
COM2004-00388
Payments:
Type of Payment
CreditCard
'.'0.
"
4/7/2004
RECEIPT #:
Description
Service Reconnect
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
BEAR MOUNTAIN
ay of Springfield Official Receipt
Wvelopment Services Department
Public Works Department
1200400000000000449
Date: 04/07/2004
Received By
Item Total:
Check Number Authorization
Batch Number Number How Received
llh
000348
073654 Phone
Payment Total:
Page I of I
1:33:45PM
Amount Due
50,00
3.50
5.00
$58,50
Amount Paid
$58.50
$58,50