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Home My WebLink AboutPermit Electrical 2008-4-17 1. LOCATION OF INSTALLATION: L--~ lA-- L~ ZON ~ INITIAL; U\. .9) ~ DATE ~.~Vl,;' ~"I SOURCE ~,........... 0;h ,8 COMPLETE FEE SCHEDULE BELOW Date 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number r...6 uA ZOO 8' - DO 5 3.s- 3. (O~O v LEGAL DESCRIPTION ISOl OLfCf Z C> 0(00 A. New Residential - Single or Multi-Family per dwelling unit. Service Included JOB DESCRIPTION 1000 sq ft or less f) lit!. I II ~ I\n ' Each addItIOnal 500 sq ft or R.f 11::1:.- Y"-J fC{.fJ ~ i) <!. '-t....L/~ ~ WVI ~rtlOn thereof Permits are noJ-tran~ferabIe and expire if work is Each Manufact'd Home or not started within 180 days of Issuance or if work is Modular Dwellmg ServIce or Suspended for 180 days. Feeder $11700 $ 2100 $55 00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: Electncal Contractor C'fItv\-.o'vJ. f ~~ 200 Amps or less $ 70 00 7 D () () .. ~ It" cl\fT10N: ~ 1aW~Yt'flifo.mps $ 83 00 Address -r I 0 , 0 ~ 1-- .LW~ rules adopted by t~ PA~qit~~mps $ I 3 8 00 . Notification Center. ThO::!. ~eA~~loo<1-Amps $180 00 City lV\4-l-te"U I (le Phone=~~~~lItw!l~bfolts $41300 caliing the center. (Not9}ttM1~pblo~e $ 55 00 uJi\ber f~r the Oregon Utility Notification SupervIsor LIcense Number "3 ~ C7(P-Gehter Is 1-80~~tary Services or Feeders ExpIratIOn Date !OJIO/(O " , /l:J 19 ~ tol {()/, 0 . , Installatton, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D. Branch Circuits $ 55 00 $ 76 00 $11000 Constr Contr Number ExpiratIOn Date SIgnature of SupervISIng Electnclan Owners Name /iL- C\ ~ ~v(A T ~ c..~- ~ c5(\- t:.. L__J.4- ~( New Alteration or Extension Per Panel One CIrcUIt Each Addlttonal CIrcUIt or WIth ServIce or Feeder PermIt $ 48 00 $ 400 Address / CJC( '0 s~rb E. Miscellaneous (Service/feeder not included) -Each Installation CIty Phone Pump or lITIgatIOn $ 55 00 Slg""N01f~C15ghtmg AI~ EXpm~ ,~11\1 WQ~~ Llmlt'f~$1tFWM\,1In R ,.H\S PERM\1$~~g Llmlt~IM~&~JtJ(fRI' AB~nONEO fQ~o Mlntmum IU@MMi~PI~!llmtr. Fee is $50.00 + Surcharges 4. SUB~A1&~P~OVE · -? C2 -kl(O -7 Trr..? 88'0 12% State Surcharge 10% Admmlstratlve Fee 5% Technology Fee OWNER INST ALLA TION The mstallatlOn IS bemg made on property I own whIch IS not mtended for sale, lease or rent Owners SIgnature Inspection Request: 726-3769 TOTAL Shared Dnve(T )IBUlldmg Forms/Electncal PermIt Application 1-08 doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00535 ISSUED: 04/17/2008 APPLIED: 04/17/2008 EXPIRES: 10/17/2008 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1040 LINDA LN ASSESSOR'S PARCEL NO.: 1802044200100 SPRINGFIETYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Service change TYPE OF USE: Repair Residential Owner: DOAK JOYCE Address: 1070 LINDA LN SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor GLEN A CAMPBELL License 73995 I BUILDING INFORMATION I # of Units: . ra oltRf~w~"es yoU.t~ Primary Occupancy Group: ATTErR1JPN. ~ re~~egazmuW'hty Secondary Occupancy Group:follow rules a op Tl\m~qti9tJ8lftre set forth Primary Construction Type Notlflcav~n_C~~~~10't'itb\JgriYti)AR 952-001- Secondary Construction Typetn OAR 902 0 btaiR-~~pUhe rules by # of Bedrooms: 0090. You may 0 1il~ IhaIl~'epho~e calling the cen~r~dIl1i\it~Rli~tlon n/a number ~or ~~,e;... r, C€~ ~.,1)_"'U4\. ve1 DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Expiration Date OS/24/2008 Phone 541-744-0705 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrail\l: ~~~I~~~MIi SIl~iWf~I:~~~~J ~~~l AU1HOR\Z~~ UN~ Ie, ABANOONEO fOR V aluatf6M~w~:~~1 :L~;rf \00. Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal!:e 1 of2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00535 ISSUED: 04/17/2008 APPLIED: 04/17/2008 EXPIRES: 10/17/2008 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 Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $7.00 $8.40 $3.50 $70.00 4/17/08 4/17/08 4/17/08 4/17/08 1200800000000000370 1200800000000000370 1200800000000000370 1200800000000000370 Total Amount Paid $88.90 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. l ReQuired Insoections I 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 cel.tify 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 Pa1!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 COM2008-00535 COM2008-00535 COM2008-00535 COM2008-00535 Payments: Type of Payment Check cRecemtl RECEIPT #: 1200800000000000370 Date: 04/17/2008 DescriptIOn Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 12% State Surcharge + 10% AdmlDlstratlVe Fee Paid By GLEN CAMPBELL ELECTRIC Item Total: Check Number AuthOrizatIOn Received By Batch Number Number How Received 4213 In Person Payment Total: dJb Page I of 1 l:13:llPM Amount Due 7000 350 840 700 $88.90 Amount PaId $88 90 $88.90 4/17/2008