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Home My WebLink AboutPermit Electrical 2005-6-16 ..\<i-~ . o ,o~~C;,e ,,"S' ,,0 "<i-'I> ~O .\0 . · ~'O ' . "~f ~ lis FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)72~~\ ,0 _ ELECTRICAL PERMIT APPLICATION ,... O\\o"i~~ 000" -- City Job Number CDWlvo'5"-oo75( Date b- tb ~C \_\"<i-e:\,,~.:\, ,,,~ ,0'- ~o" ",of:i. . 1- ()' Y 3. [~()~"ilil"-~;"i~!e.HE.J' ' 1.1' \)'3-\0 f......1-00 A ,MN"'!.I..: "R -'d"" IIItl' jl~ I, 'S~I" I'!I~\)~M" '1IIli'.II F' III ;'\' ~.~. "d '''1"1'. ,.,~iII" "tW o ~ ..:,es~1 _~n,.!! - IDg~O.h U -ism. y. p.~!1 . w~ . ~g om . 1. "E@eA-Ti(jNiOFliNSTMillA:j;i@N~ .;~ ,';;:- "it <;~l,A~l~ LEGAL DESCRIPTION )70 Z"l..1$ 4. "1 00<::;00 ServIce Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder JOB DESCRIPTION AdA I.{ $106.00 c..\rc......~~ $ 19.00 Permits are non-transferable and expire if work is not started witbin 180 days oflssuance or if work is Suspended for 180 days. 2. ~~~;~,~:~'~C{>~.!~~!JiJ,~~eM'~~~~Y" $50.00 SCOFIELD ELECTRIC CO. Electtical Contractor 200 Amps or less 20 I Amps to 400 Amp,s 40 I Amps to 600 Amps 601 Amps to 1000 Amps 686-8612 Over 1000 Amps/Volts ReFolUlllCl~!i>nlyequlreS you to ATTENTION:U ":~' "t e Oregon Utility, follow rUles.-'lI-W.~"'~"'J,,'<. "", ""',L""'''' . Ci:' I'J!!PP.rml"-""",ces,,,..,reenet5 NOlulvolion e . 010 through ~Ak"'o!-JJ'. in OAR 952-0<\\&i!fIl\,\%~!Wllfio\iro..tR~iilC!l.'llon OU::lU. You ma)/g9 ~p l<lole:sthe telephone calling the ~~el~l!lI1400~!ptilication nUlllu"'~~~&r i~'1'm(l(j 6lfO?A?hli!4). Over 600 Amps or 1000 Volts see "B" above. D. (Bra~cht'~~'~t~it~ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 PO BOX 2765 Address City EUGENE, OR 9740:Phone '. t~..: ..... .1( ;/~"'~ ~. .~;' -:" ,'" Supervisor License Number 508-S Expiration Date 10-1-2007 $ 50.00 $ 69.00 $100.00 38702 Constr. Contr. Number Expiration Date 12-21-2005 ~:g:Z;~ New Alteration or Extension Per Panel I One Circuit ' Each Additional Circuit or with Service or Feeder Permit 'Is 7 $ 43.00 $ 3.00 '3 Owners Name S ~N' clA"t..( ~Ht::;- Address 51.{ ~\ tf.~iA(,n...j..,,- ~ City <; P ,..: (\ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 25.00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. ' Minimum Electric Permit Inspection Fee Is 545.00 + Surcbarges Owners Signature: ~~~!~EE~M\T SHALL EXPIRE4~ 'SUiJ,1fo.T~ (:)FtlBo/~ 5 Z. AUTHORIZED UNDER THIS PE IVII "" ,,' ,--'". bY _~"~ M 'f' ABANDONE'Y.;S~t,eSurcharge 5 vUIVIIIJIC\'iVLU VI' ...J . r'Zo ANY 180 DAY PERIOD. 10% Administrative Fee .> Inspection Request: 726-3769 TOTAL 60 8'( Phone Shared Drive(f:y:Building FormslElectrical Pennit Application I-03.doc Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY 01' ~rKli~uNJ<.,L1J' . Building/Combination 'Permit PERMIT NO: COM2005-00751 ISSUED: 06/17/2005 APPLIED: 06/17/2005 EXPIRES: 12/17/2005 VALUE: SITE ADDRESS: 5495 HIGH BANKS RD ASSESSOR'S PARCEL NO.: 1702284300500 Springfield TYPE OF Electrical Work Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Add 4 circuits Owner: SEAN CHALElTE Address: 5495 HIGH BANKS RD SPRINGFIELD OR 97478 Contractor Type Electrical # of Units: PrImary Occupancy Group: Secondary Occupancy P'rlmary Construction Type Secondary Construction # of Bedrooms: Front yard Setback: Side 1 Sethack: Side 2 Sethack: Rearyard Sethack: Solar Sethacks: Street Storm Sewer A vailabie: Special Instruction: Notes: Description Phone Number: 541- 'CONTRACTOR INFORMATION I Contractor SCOFIELD ELECTRIC License 38702 Expiration Date 12/2112005 Phone 541-686-8612 , BUILDING INFORMATIONI R-3 # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled nla VN Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n-;:-:;~-;-;~!J. 8.~~~..Lu ......._:._.:.l~;~: follow rul,,~i>E\{ELOrMii,jliti~ilQ~ION I Notification Center. Those rules are set fortn in OAR 952'OOI'OO~rraYg)IR:AR 952-001- 0090. You may obt#stNeiq~dsthe rules by calling the cente'Pa',VedtDrl"~ Rqil;Jhone number for the Oro/~ofillDt:C:jlverage3tion Center is 1-800-332-2344). 'PUBLIC IMPROVEMENTS I NGTlCE: Sidewalk Type: THIS PERMIT SHALL EXPIRE IF THE WOD~wnspoutslDrains AUTHORIZEO UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. REQUIRED PARKING Total: Handicapped: Compact: I Valuation Descriotion I $ Per Sq Ft or muitlp6er Square Footage or Bid Amount Type of Construction Value Date Calculated 1 of 2 . . CITY OF SPRINGFIELD. Building/Combination Per~it PERMIT NO: COM2005-00751 ISSUED: 06/17/2005 APPLIED: 06/17/2005 EXPIRES: 12/17/2005 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 Fl'P.s~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Clrc Ea Add Amount Paid Date Paid $5.20 $3.64 $43.00 $9.00 6/17/05 6/17/05 6/17/05 6/17/05 Receipt Number 1200500000000000854 1200500000000000854 1200500000000000854 1200500000000000854 Total Amount $60.84 I Plan Reviews , To Request an inspection caD 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. wiD be made the following work day. 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 nnd 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 wiD be made ofany structure without permission ofthe Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 wiil 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 wiD remain on the site at all times during constructiolL Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-7~6-3759 Phone ,.j Job/Journal Number COM2005-00751 COM200S-00751 COM200S-00751 COM2005-007SI Payments: Type of Payment Check " " 6/17/200S . RECEIPT #: ~ Wit, . .Jif..ity of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000854 Description Add, Alter, Extend Circ + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Ea Add Paid By SCOFIELDS ELECTRIC Received By djb 1 of 1 Date: 06/17/2005 Item Total: l.:heck Number Authorization Batcb Number Number How Received 29916 In Person ' Payment Total: 10:11:27AM Amount Due 43.00 3.64 S.20 9,00 $60.84 Amount Paid $60.84 $60.84