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Home My WebLink AboutPermit Electrical 2005-2-25 S:A:Q~~ 125 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . F~: (54I)'ht9"~o' :-. - '.A!,. "'l 6 ~ 0$ 9~ ---....,. ELECTRICAL PERMIT APPLICATION, y~o ~~. '" "o~t~", , " ..,.- I"'" "'^ ? ~ . CityJobNumberl.o.,^"Zoo..r-OoZ:Z.-~ Date Z-e.\ -c::> "'., ~ '"., ~6' 1. "I!@GA::F~o/,~i@Fl1!Y~~~I~'~J4!Fl~ 3. l.~d1!":P;:~jf~~:&~~~''*?::t.j~{1J /577 LA-v"vz.v4- :::""1''''''''''''1"'''.' 1('.1,',,, ~~~)i:~"t1.-c , LEGAL DESCRIPTION A. New ~es!de~.~"I,...! SlOgle'o" 111- oe" ij 170 J 271.(( O')ZOO Service IDcluded J08 DESCRIPTION 20 0 ~ SC<WtC.c! Cr:H~N6-~ 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufac!' d Home or Modular Dwelling Service or Feeder $50.00 , Permits are DOD-traDsferable aDd expire If work Is Dot started wit hiD 180 days ofissuaDce or if work is SuspeDded for 180 days. 2 ~e@JY;FRA~~ ,;....,iNsT,Ar;mWFIeN{@7.~~ B. Ser;v!ces onFeeijers . "- ....j' ,.. '7\"" otlo' -NT/ON'n ,,~" . -, , Electrical Contractor ~,,<;p LD r Di'\(Va.:t'(Z$"~s a;ro'6~fcliless >-- \ in OA.Ftlion Cenr.7Rt~fi1PJy?~6fJ~ Address 90Q f'] lJ ~, ~-001.':w. itinp!lf'666JMoo{J~~to ~. I Ca/t 'uu rn~ o~~r.CA~&g~1!66 il.1UJ!fet ~lity City " I Phone lO~4Im'tl~~~t,QV@ RIfJ9j&'l~6'r~5<-oOrtl, -. ur the o1ec!Gnnff!tSJr,,19 the 1lJ~ 01. Center is 1 egon ((';" e te~~I'l.~ es b \ S ~ If\S C: '.~ \1',.' '. .....,cltl:E \ D II I :l-6D 'I IDstaUation, AI~;ratioD or RelocatioD 200 Amps or less f\ L/-tf,~ \ 201 Amps to 400 Amps l I 40 I Amps to 600 Amps Expiration Date C\ (~(). ()'6l\,l4 Over 600 Amps or 1000 Volts see "8" above. Signature of Supervising Electrician D. ~ D New A1teratioD or ExtensloD Per PaDel tL---k-:~A~ NOTICE: One Circuit $43,00 IHIS PERM/"~~Mp?itJ-o~~I,Circ~~torwith ' r AUTWOR/ZEUSelVlceor FeooeT)l'.errlllrHE WON $ 3.00 '::'~(..r:Ci;(e UNOFR TWI~ Wn,,'- 1\ ',.4 I UUIV/1I1ENCErO M'''''''VlI.III'h~/(~S''''"""''''''d''''lflh I'" l'd'd.)'E' b'IIII' "ll" ..'. L. <--\ a.A- ~NV 1 . ISC~ a eOllS . er:vIC .Iee er.'not IDC u e _ - ae nsta ahon 80 DAY t't 100 . . " ,',. Pump or imgation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 I b'J $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Supervisor License Number ~ - "; ~" .... ..... ;, " " . ,1 . !"r.. ._' ... l ,,-' Expiration Date Constr, Contr. Number $ 50,00 $ 69.00 $100.00 . .~~ - , . r ,_ .<" ~ : " ~,' . .' '. '..' ,:. . ',.. Owners Name ~ f.o.-lLlA- Address J~77 ~?~~ Phone City OWNER INSTALLATION The installation is being made on property [ own which is not intended for sale, lease or rent. MiDlmum Electric Permit Inspection Fee Is $45.00 + Surcharges Owners Signature: 4. '~CW'~' .' ,. ~ ... - ~ 7% State Surcharge 10% Administrative Fee b> I.jl(( 6;;; 0 1]7~ IDspectioD Request: 726-3769 TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Pennit Application 1..o3.doc Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . . CI1 t' VI< SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00229 ISSUED: 02/25/2005 APPLIED: 02125/2005 EXPIRES: 08/25/2005 VALUE: SITE ADDRESS: 1577 LAURA ST ASSESSOR'S PARCEL NO,: 1703274105200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: 200amp service. change Contractor ATTENTION' 0 License Expiration Date ROSE CORPORATION 101'01'1 ru/,,~ ~',,_~:r~~3JW requIres ~1~!l/2005 BUILDINGiNF@RMA:TrON~"e Uregon Utilily , , .. , ~v,,'uul.dbl 0 th rules are set forth ~C{,fSt,*lesmay obtain c~o~gh OAR asot'SIl':f.; H~~gi\~Of Str,I\W,I.%r. (N Pl,es of the ISQ;tit8lJt Floor: t'yp'elof3H~at~he Ore ote,. the telepllorID rnd Floor: Water T~\!!ne' gon Ut,II1y NOfjli~rghBasement' Range Typ~; r IS 1-800-332-2344). Sq' Ft GarageJC~rport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: Owner: PATRICIA SEAGROVE Address: 1577 LAURA ST SPRINGFIELD OR 97477 Contractor Type Electrical #, of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction R-3 I CONTRACTOR INFORMATION I Phone 541-686-0905 VN I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: 'fn-. ~ # Street/Trees Rqd: Handicapped: Pa;;ei:l'Driv~'Rqd:^ Compact: .- . , 'lIVI / --HAL %~,!!,Ii?6firl~tage: L EXPIRE IF THE COMMENrr:n ~~O,~R THIS PERMIT ,:v.?~~ I PUBLICiMPROVEM.El'iis;foM,vUUNED FOR' -. Sidewalk Type: DownspoutslDrains: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00229 ISSUED: 02/25/2005 APPLIED: 0212512005 EXPIRES: 08/25/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR ,541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line' Total Value of Project Ff'f'~ tlWU Fee Description + 100/0 Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 2/25/05 2/25/05 2/25/05 Receipt Number 1200500000000000250 1200500000000000250 1200500000000000250 Total Amount Paid $73.71 I Plan Reviews , 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. IRf'OIJ~ Electric Service: Approval required prior to utility company energizing service. 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 ohny structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are incompliance 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 c'ard 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 Springfielp, Oregon 97477 541-726-3759 Phone . ." Job/Journal Number COM2005-00229 COM2005-00229 COM2005-00229 . ,Payments: Type of Payment CreditCard l' , 2/25/2005 RECEIPT #: ii~'~"!!"!!".'!'-'>.' "'~.""." ......... .' " , . '---~ . ~ . -..... .,' JIlty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000250 Date: 02/25/2005 Description + 7% State Surcharge + 10% Administrative Fee Penn ServlFdr 200 amps or less Paid By PHIL ROSE Item Total: Check Number Authorization Received By Batch Number Number How Received djh 035812 In Person Payment Total: Page 1 of1 8:40:18AM Amount Due 4.41 6.30 63.00 $73.71 Amount Paid $73.71 $73.71