HomeMy WebLinkAboutPermit Electrical 2005-9-12
200 Amps or less $ 63.00
201 Amps to 400 Amps $75.00
401 Amps to 600 Amps $125.00
. -. ' _ 601 Amps to 1000 Amps to $163.0211
.-, <ru-(}70c:. "~<:''ioU 0 v..,,'~
Phone I" 1 J Over bW\IcMDp~olts Utility $375.00 use
~1iEN1\ON: ~~~'ll~IyOlegon t lort\"! $ 50.00
oVIlUles adop e $eJ}I'es ale se ~ nM
'J.r r r c- 'oil r"'~l!f~~"'" ,,'./"00>< >15~,;'"" ,.... ,',' """'.'M;' . ,''''",
Supervisor License Number ...Jlp\Qlr ~ "\"lilication~O~~~~~\~~e~fJ~~s'f.S' .~. J::':' ", ".'r;:".::.'. ;".,<:;-,~''i
in Ot>.R 952- b1ail1 COp\es,_~ :~\E>ohone .
Expiration Date to II oj () b n(\qo. '(ou rnaIh~alIat'{llffl~teratIOn or ~~'e!'i'tlOn
f /~ 7'" "i If ') calling t\"le ~8~~onl~~\ity Not\\\C .
Constr. Contr. Number .a 113 ,...2-0( &Ie nU(l\beIIOliR\ .'1-.:....rtbl400~p~4).
cen~ \~~ - ..
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "8" above.
D. FBt~ij~~~Git~~i~~~~'i"::~s;.~f~~5:;. ;{~:\: '~~~~~~.- ;\',:~.<\
E. f~Mi~~ii~t;~;(i.if(s$~~i~~f;~~.~~filiglmr~d);iE-~~h~igfurfatiiihl1
',. ~._'.',""" ".,'.".:.~.~,,<: .'._.'-'~\\,\\~" .,>..... -....
Pump or ~~ation' 't.'f..?\?S- It \\-\~ \'~ ~9:00
Sig!"'OutlnfeLighting\r>-\..\" .,.,'\S ?t.I"IW \ _~\50.00
.'~' .,~\\I\"\ . ,,,r.'?I ,>, "".tV \ '
Limited;Energ)llResiilential ,0 r>-~\JV\ . $ 25.00
\ ."...... \(\t\\LLU - t"\Q 'CO t'\U
Limiteil\Energy/CofumerciaI" $ 45.00
':-"lo,/\\\~t:\,I..i~~, ot.I'-I\Ju, -
Minimum Electric.t:,ei:niit Inspection Fe..,r.;- $45,.0"0 + Surcharges
",,\\J \ (J t..:._. .
~~ '....v,,:n::,:..:~.;;, ',,;.""",'):$>,;;:;' ....~:. .,.....'j~."*/:.<'\.. ~;.<ctt:4 ~<t -. ~\:j
4. ~'SUBTOTAEOE'ABOVE",'~.i \;o:'.',t.:t'~.:i' J
~~ ':::~~:;:"~f<"'M'"
:i')"bt: TOTAL
1. I. LOCATIoN. OEitNST-;4 i'f':trtofi.:Y ,:;,~. "}
p _. "'~-4""'" .".:.A;~.., "'.... __ ~- --._ .~...:'oJ l~ i
3 I 0 \" G\4-~+. i4.n1 -42../9
LEGAL DESCRIPTION 6 l-7d3z."Zzo
PAc-I frL V:ll ~ ,4.y,i S I 0 '3000
J08 DESCRIPTION t<- CO~
foh,J.( LA.. 0 / rJY1.t 4(~""-, 9v<;~
Permits are notfransferable and expire if work Is
;. not started within 180 days of issuance or if work is
Suspended for 180 days.
:'lec:~:::or:::f21V~~
o
2Gt(
Address fc. cJ ( if; a f-.
City \.J"o4.tJ-t ~ (G
l 0 Ir 0 / r1 C(
f
;;L;:"'c,iIM
Owners Name tt/MH Pr".QEt\-t-i;:"s;
Address / 51.( $0 5W 8oe....~ F~oL'r
City ~C>~r;o Phone :>--c1-7u' - 8t"~1~
.
Expiration Date
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
. ~ i< ;.1' '.j. -. :)",",.~..
<'I" . 'f;:;!%-," .' .,)~:'_'(
, ,I... ~,l ...~. , ':' '''.
3.
A. ~~~1ffil:Fgn;g:i1~~,~i\iilfli~F~liiil~p'''''~;r~;~lih~g:'~m8t~
~~-"-",,-,,t-._..-~_.-;~..., _'_ "--"~O<' .._,..~"..._.........~.~.1 _-,........_........ ._.. "'.- _", '!
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
$106.00
$ 19.00
$50.00
B. ~~:'Se~kJ~{'~~~f~~i-st]'ih~til1~iikn;":A1t~?"atioiis -'~riR(;io~a1r~~;1;vl
~~6,""U~'~'" ~,-_'. ~_.';i:'.--""'.':'''~,,'E ___".."....~.....,;"f,~::N.:;."-.~'ti,t.ft..:., -~. .!:'~-'..,-l." '."";,;"\'",...,,,' '~r,.. .;....
$ 50.00
$ 69.00
$100.00
\ ~\T.~:H
"...,{
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
ifJ
3/)-
ys-o
"\ Z..'..c
Shared Drive(T:)/Building Forms/Electrical Permit Application I-Q3.doc
. CITY OF SPRINGFIELD'
Building/Combination PerIilit
PERMIT NO: COM2005-01153
ISSUED: 08/25/2005
APPLIED: 08/25/2005
EXPIRES: 03/1212006
VALUE:
.
-I
Sta(us: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspection Line
SITE ADDRESS: 3105 GATEWAY ST APT 219
ASSESSOR'S PARCEL NO.: 1703222003000
Springfield TYPE OF
Electrical Work Only
PROJECT DESCRIPTION: 200amp service change and 10 circuits
TYPE OF USE: Alteration
Residential
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
NOTICE:
...... .., ,..... .....,. . '''''''1:: It- I HI:: WUHK
IPUBLIC-IMPROVEMENTS I
"~,, .~;..~__ _:.__.. :..._ ?ERMIT IS NOT
COMMENCED OR IS ABANDONlSjd,errA1k Type:
ANY 180 DAY PERIOD. Downspouts/Drains
Owner: KKMH PROPERTIES LLC
Address: 15450 SW BOONES FERRY #9-140 A'ITN MICHAEL HUMMEL
LAKE OSWEGO OR 97035
Contractor Type
Electrical
'CONTRACTOR INFORMATION I
laW requireS you ~u'
Contracto\\TiENiION: Oreg~bY the Oregohic.leli'Se
VIKING C~~~<rtI!(i)~~...~~o ",Ies arE1I08:i~~h
Notilicat\~q fNllooM)lnoi'lf';y
In OAR 9 btain cop:gr" vr J /! '5
0090. '(ou ma;/ %~\?rt'te: the te\e~hO~e
IU;a\\ing the If~~~ on Utility Notlllcatlon
numberlor fli.p.e ~~ 1>32-2344)..
VN Cenwlt~r TYpe: '
Range Type:
Energy Path:
Sprinkled
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Yrimary Construction Type
Secondary Construction
# of Bedrooms:
nla
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Sethack:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
1 of 2
Phone Number: 541-726-8895
Expiration Date
0210612008
Phone
503-932-3726
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
;
Value
Date Calculated
I'
.
. CITYOFSPRINGFIELD
,?
Status: Issued
225 F1fth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
.
Building/Combination Permit:
PERMIT NO: COM2005-01153
ISSUED: 08/25/2005
APPLIED: 08/25/2005
EXPIRES: 03/1212006
VALUE:
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Residential
Minimum/Adjustment Electrical
Amount Paid
Date Paid
$9.30
$6.51
$30.00
$63.00
$4.50
$3,15
$25.00
$20.00
8/25/05
8/25/05
8/25/05
8/25/05
9112/05
9112105
9/12/05
9/12/05
Receipt Number
1200500000000001244
1200500000000001244
1200500000000001244
1200500000000001244
1200500000000001335
1200500000000001335
1200500000000001335
1200500000000001335
Total Amount
$161.46
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.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work Is complete.
Low Voltage: Prior to cover.
By signature, 1 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 wiD 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 ofthe 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
,'-
2'25 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
v
. Job/Journal Number
COM2005-01153
COM2005-0 1153
COM2005-0 1153
COM2005-01153
~.
Payments:
Type of Payment
C.heck
"
"
t.
o ':
'~
:1
"
.'
1
:j
~
9/12/2005
.
RECEIPT #:
G!""H~... ...gI!1~.. ...._ '.
u.,..;
~.;
.J;ii.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200500000000001335
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Residential
Minimum! Adjustment Electrical
Paid By
GLEN CAMPBELL
Recei ved By
djb
I of I
Date: 09/12/2005
1l:21:39AM
Item Total:
L:heck Number Authorization
Batch Number Number How Received
3738 In Person
Payment Total:
Amount Due
3.15
4.50
25.00
20.00
$52.65
Amount Paid
$52.65
$52.65