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Home My WebLink AboutPermit Electrical 2008-4-11 ZON L..O(L, INITIALS \k"\ ~ DATE ~-\4.-0~ \1iIlJ1! SOURCE U. ~ ~F' . ~ ,,' / , COMPLETE FEE SCHEDULE BEWW ..:'.,. -i< H ' ~ v 225 I'll' ul STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number C-~ ~ 2.C>c:> g>- DO S- D 7 <<' " 1. LOCATION OF INSTALLATION: ~" ,~ ,,~, ,> ~ ~ ~O ,fYl fu r(\ ::J- if ;:) / LEGAL DESCRIPTION: 17l'L 5:Cf3 I o 5"06~ . ;J:ViL~'IL t Cc.' (:"^- ds Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. <ii>' 2. CONTRACTOR INSTALLATION ONLY .J , ' <~~j,' Supervisor License Number ExpIration Date /n / I /; f) . . Constr. Contr. Number )) 7 ~{}6 Expiration Date ,r! / 2J::> I ?- (D(p 1 SIgnature of SupervIsing ElectrIcIan ~ J-..~rL )~J ~."~ Owners Name \f c ~E:..Ve:-LO (/ ttV\ ~ S7Z 5 mAtN City Sft"-'2b Date 3. ',~ ~ " ~, > ~ " A. ,,~e~ Residentlal- Single or Multi:l!~~!ly pe~,dwelli~g unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwellmg ServIce or Feeder $117 00 $ 21 00 $55 00 B. Ser;y!~es or Feeders - Installation~ Alterations or Relocation: \" , , , , , New Alteration or Extension Per Panel ( One Circuit Each AdditIOnal CIrCUIt or with Service or Feeder Permit $ 70,00 $ 83 00 $138.00 $180.00 $413.00 $ 55 00 $ 55 00 $ 76 00 $110.00 7 $ 48 00 $ 4.00 {(~ Zr Electrical Contractor IVI \1 f \ oct-Y"\ \'(' j'A-U fP:J-C 200 Amps or less I 201 Amps to 400 Amps Address S' d ~ l b (,' \ e \.J ( ~ _ 401 Amps to 600 Amps I ' ATTENTrON: 6ll'e~ra~ ~ooo Amps City r 6iiOuP C~ Phone SilI-l~~~~S a~w89 .ffi@~~~ you to - (j I , Ion Celll@eo~t9nJM regon Utl!lty ~ n OAR 952-001-0010 th es arc sat fOlth ,0090. You mBJ( o:hnlJ'l :,?&~gh".Q~R ',." , ~ l/;)."'S ..) callinq the c'e. t-ftm~Flii!)1 *ilMW eders "q, number for then ~;. (Not~, the.tcl(~pr")(~e ., Center j!nffi~1!Wg~~~liiOJliQl)ij.elocation 200 Amps or fess ). 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D. Branch Circuits Address rwt 6 ..fa z- E. Miscella~eO'~s (Service/feeder not included) -Each Installation 'H>> "~, ~ > ~ , Pump or irrigation $ 55.00 SIgnlOutlme LIghting $ 55 00 OWNER INST ALLA nON LimIted EnergylResidentIal $ 28.00 The installation IS bemg made on property I own WhICh LimIted Energy/Commercial $ 50 00 IS not mtended for sale, lease or rent NOTH~E: Minimu~ EE,~~t~~spection Fee is $50.00 + Surcharges lH\S ,PtR~IT SHA~~:~i{lf)WfiMf~VE ' 7 b {\1I1 :1CRILED UNO n?iI''''~5\)'SQPge '12 [" \I} ',,~i=NCED OR IS ArJHN vU I Ilv.~ .J 10% Admmistrative Fee 760 ANY 180 DAY PERIODS% Technology Fee :3~ 0 76~ Phone Owners SIgnature: Inspection Request: 726-3769 TOTAL Shared Dnve(T )/BUlldmg FormslElectncal Permit ApphcatlOn 1-08 doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00507 ISSUED: 04/11/2008 APPLIED: 04/11/2008 EXPIRES: 10/11/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6330 MAIN ST APT 27 ASSESSOR'S PARCEL NO.: 1702343103003 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Add/ alter 8 circuits Owner: V-E DEVELOPMENT Address: 5729 MAIN ST PMB 302 SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor " .-,..._ MY ELECTRICIAN INC License 87506 Expiration Date 11/20/2009 Phone 541-729-1454 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB I BUILDING INFORMATION. ATTENTION. 0 fol1~ ~ffifieS'~ regon raw requires yo ,",ot Size: NO~ihbrw~lIffi by the Oregon U~I~~lt 1st Floor: In ~gii\r~~~~' Those rules are set f(~r9;lt 2nd Floor: 009&Y~ ~Re:ob 1 ~ through OAR 952-0~fFt Basement: CaJ(~Yfl9Yl!lhte~am Copies of the rufesSt)qlt Garage/Carport nUlEberm;rt>>~: . (Note:, ~he telephon~q Ft Other: Spri~tbRw9~rnqpon UtIlIty ,i'n1.alfleJ:ltl~Occupant Load: r,~ 'f-d~( -332-?~LlA,\ . ,,",,'.y,'l' ., I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: 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: N01U;E: Downspouts/Drains: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOr COMMENCED OR IS ABANDOf\lFn I=nR '\!~'f ~-&D DAY rEnlGu. ., Valuation Descri tion Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of 2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00507 ISSUED: 04/11/2008 APPLIED: 04/11/2008 EXPIRES: 10/11/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $7.60 $9.12 $3.80 $48.00 $28.00 4/11/08 4/11/08 4/11/08 4/11/08 4/11/08 2200800000000000446 2200800000000000446 2200800000000000446 2200800000000000446 2200800000000000446 Total Amount Paid $96.52 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Reouired Insoections I 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 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 Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00507 COM2008-00507 COM2008-00507 COM2008-00507 COM2008-00507 Payments: Type of Payment CredltCard cRecemtl RECEIPT #: 2200800000000000446 Date: 04/1112008 DescnptIOn Add, Alter, Extend Clrc Add, Alter, Extend Orc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Admmistratlve Fee Paid By EDWARD GUIDRY Item Total: Check Number AuthorizatIOn ReceIved By Batch Number Number How ReceIved dJb 05522A In Person Payment Total: Page 1 of 1 1O:21:4IAM Amount Due 4800 2800 380 9 12 760 $96.52 Amount PaId $96 52 $96.52 4/J 1/2008