HomeMy WebLinkAboutPermit Electrical 2003-12-10
Cl as ~i1b'niltted' has' the following
not re.quire specific land use
;.. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX1~g~~26-3689
ELECTRICAL PERMIT APPliCATION Zoning
City Job Number COWl ZOOs - 00 9 D9 Date 17/;0/0 .1 Date
~ ,,,.
'... , '0 CITY OF SC .lNGFIELD, OREGON ,<-~!
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JOB DESCRIPTION ._. --' .". - . -,- '1000 sq, ft, or less $106.00
Each additional 500 sq. ft, or
L. 7Uvl- h ~ portion thereof $ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or If work is
Suspended for 180 days.
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50,00
Electrical ContraWlfGON ELECTRIC SERVICE
PO, BQt2!JI
Address EUGENE, OR 97402
City
Phone...:l,I1~\ \0)( I
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only'" "
$ 63,00
$ 75.00
$125,00
$163,00
$375.00
$ 50.00
Supervisor License Number \ ~Q,~S
,',:' ?;:::'~ " :.C '.;'.
C:~~~~~~~~
.',... .
I .,.
Exp~ti6n Date \'f) - 0\ -'--\
.,.
.;. ., ~. ,j I
Installation, A1teratiqn or Relocation ,
,. . . 'l. ., ."
200 Amps or l~s~ ..
201 Amps to 400 Amps
401 Amps to 600 Amps
,'''. I:
Expiration Date
O,-t'-\-04
$ 50,00
$ 69.00
$100.00
Constr, Contr, Number' . .':l.,<g no \
Signature of Supervising Electrician "
71A'hU'vW~j~
I' ~?~""at-I"Y\GI+~I-7
Owners Name ~ IJ ... _ ') ~ i:A::;t-,
I '6 10 Is--I-I..... s t-
. . ~Q
City s>P A Phone \i ~~"i\l91gation
. ~ t'l-\'\\\\t\\\~~~line Lighting
OWNER lNSTALLATI01~\)1\t~. '''.\' ~~t>-\\\ ,~\~ "o~~ea Energy/Resi~"!ltial
" ~W" ~Q ,tl.o.t>-~'v L' , dE .nrC'4U ...." I
The installation is being man.'>\'c,: ;""d\, .w1,l;:,,1f''' lImte nergy, ommerCla
-\~u' ~Il'>-"'":: ,t' '\'" ,,'\I ~"'''' <:xOII ~ \Qt'
is not intended for sale, lease '!N<;n.. c._lc,t\) C.\\\O\), Mininiij~Electric(hrmil'Ihspection Fee is $45.00 + Surcharges
. +.- ~I\~\..\'" r\'(?\.o 11,l'O'('=''a. k'-I \H';"" ,,_~ 111''"''':, ...0,.-,-)\.1 ,
COl" "Inn Or' ....\.o('\O\~. 01 ...,Lh! " I' ~~"jk III,.., j~'ll Ii'. ''"
Owners Signature: :i ..I> ~€I-l I 9.0'4, 'S !J1(i)il1.'m' ~ '
.':C' ..."L.'T.. -~ ,.._p>.\O~{i.l\~Sce{\\e,~o"" \OS'" \0~~w" {\
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~o,... c 95?-- "D'i'I\O~~~ \\,,~~!'l: '"",. . NOE'"
Op..p ~a;, '0 waIDISuatlve ee
, '{OU e(\'''' 0(\ v' '2.'3ti'" I"
0090. X(\Q \\".8 C\'l~T0~,ll::;'3'2:
ca.' 'ne( \O( ~.r';c '-' .
(\U~~ r -,- Shared Drive(T:)IBuilding FormslE1cctrical Permit Application t.()J.doc
Over 600 Amps or 1000 Volts see "B" above.
D.~~~~~~
New Alteration or Extension Per Panel
One Circuit I
Each Additional Circuit or with
Service or Feeder Permit
$ 43,00
4...3 6-{)
'.J.. 7 0..0
C?
$ 3.00
Address
E.
$ 50.00
$ 50.00
$ 25.00
$ 45.00
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In .
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Inspection Request: 726-3769
.
. Lu t OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00909
ISSUED: 09/17/2003
APPLIED: 09/16/2003
EXPIRES: 06/10/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 12221/2 Kelly Blvd
ASSESSOR'S PARCEL NO.: 1703274402700
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Upgrade service and wire house
"
Owner: R P INVESTMENT REALTY
Address: 1810 15TH ST SPRINGFIELD OR 97477
Phone Number: 541-726-2400
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
OREGON ELECTRIC SERVICE
License
38001
Expiration Date
09/14/2004
Phone
541-343-1681
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Siructure
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:
R-3
'\
SETBACKS
I U'" "-LOPMENT INFORMATION ,
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Total:
Handicapped:
Compact:
Rearyard Setback: % of Lot Coverage: .
Solar Setbacks: NO~'~~~. "T cunl' FXPIRE IF THE WO~~
. ~UTHORiiEO UNOER ni~llrc,~~oVEMENTS l"""'ENTION:Oregon law requires you to
. NeEO OR IS ABn'w'C \\.J . \I I '0 Ufrty
Street ImprovemeifluMME follo""S.i!!e!v.alk,T~p'e:d by the regon II,
MN 180 OAY PERIOO. 'f . "M ron''''' Those rules are set fOf'
Storm Sewer AvailanlE!: ~Otl IC'DownsjloutslDrains: hOAR 952-00
Special Instruction: ,n OAR 952-(;01-0U1 U mro~g
0090. You may obtain COPIEl~ of the rules I
Notes: calling the center. (NOt3: tne tel~~hol~e
nllmber for the Oragon Utility Notification
"
I, Valuation Descriotion I
r -' ~....~ '-.'jlll-,'j." "-~..,,.t'1'j.
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pa~e 1 of 2
.
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-00909
ISSUED: 09/17/2003
APPLIED: 09/16/2003
EXPIRES: 06/1012004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
"
I Fel's P'IidJ
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 200 amps or less
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt Number
$6.30
$4.41
$63.00
$7.00
$4.90
$43.00
$27.00
9/17/03
9/17/03
9/17/03
12/10/03
12/10/03
12/10/03
12110/03
1200200000000002145
1200200000000002145
1200200000000002145
1200200000000002577
1200200000000002577
1200200000000002577
1200200000000002577
Total Amount Paid
$155.61
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 Reouired Insnection'iJ
1 Electric Service: Approval required prior to utility company energizing service.
2 Rough Electric: Prior to Cover
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 readahle 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
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00909
COM2003-00909
COM2003-00909
COM2003-00909
Payments:
Type of Payment
Check
,)'
__~.,.u G..!'I_._. m,' _ ",'..
~-!~.. ,
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Receipt #: 1200200000000002577
Description
Add, Alter, Extend Cire
Add, Alter, Extend Cire Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
OREGON ELECTRIC SERVICE
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Departme~t
Public Works Department
Date: 12/10/2003 8:54:llAM
Amount Paid
Item Total:
43.00
27.00
4.90
7.00
$111.9U
How Received
In Person
Payment Total:
Amount Paid
$81.90
$1I1.9U
.
.