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Home My WebLink AboutPermit Electrical 2005-8-25 .~0~}'6~\c. ,- I!" fl0 'V'O e? .. iY~.y,GFI '0(,\ !I.. ,\0. O~~ (\0 i)' ,,,' 225 FIFTH STREET' SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-'~o0 ,'-::C: '.: ~\~~ ' ELECTRICAL PERMIT APPLICATION "\,,0'~..."~ ,<'~ --- City Job Numberl"C>Ao1 ",-00 ').c. C:> I { ~ 3. Date "~:'I<;e- Z '}"Q I. . LOCATION OF INSTALLATION 3. :CO.ll1PLETE FEESCIIED~~o.\'" ?/Oc.; !:,/tk-W;:J 'f .s/'e~1 r>'<' , . LEGAL DESCRlPTlON -:d ;7/9" A. New Rcsidential- Single or Multi-Family per dwelling unit. 17D:l2-Z-z.0 03ocO Service Included . r~~, II CITY OF SC)NGFIELD, OREGON (--) . JOB DESCRIPTION 1000 sq. ft. or less o J / Each additional 500 sq. ft. or J::e~/)""/ f" (' drfi. 5fJ;<lC'-€..-. portion thereof Permits are non-transferabl{ and expi;e if work is NOTlCg~ch Manufact'd Home or not started within 180 days of issuance or if work is THIS PEl)1p,1,~I"SD:velling Service or $50.00 Suspended for 180 days. AUTHOffi~e~Br U HALL eXPIRE IF THE VVUt11\ C .r. ~ NDER THIS-PERMIT 1<: MOl .... - 2 CONTRACTOR INSTALLATION ONLY OM~B:NrSeE\"ic" or F,eederbOInst.,lIation, Alterations or Relocation: ~lectriCal Contractor0(;z; f~~/~at?/41I11u;~;z:02~0~!p~~~~~':'''' J~tU rUH ( $ 63.00 6> ~ 18 r //1 C' .Jf / . 201 Amps to 400 Amps $ 75.00 Address /!;;;;;, /1' o.?r~C/r-- 401 Amps to 600 Amps $125.00 .----;-:: I", 6,,0-- 601 Amps to 1000 Amps $163.00 City ~~#( tI"'Phone 0"5-o/p-3126J\"er 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 $106.00 $ 19.00 Supervisor License Number ~DR / <: r .- "- -.- - _. .._.- - -'- C. : Temporary Services or Feeders IC-IL~ t-l ~c:>-4 r-n-./-.;~~ . Address 1St{ <)C SW ~6"""'lr"" ~ City lA-k ~c c> Phone neb - ~ g ~ .r , / n _ / - 0 +- Installation, Alteration or Relocati\\'%s '101.l.~~ \ ~ {eO: (\ \.l\i}) /IOpj2-'- 200 Amps or less ~le~O(\ a: . ",AnO l' 0 /t. /~ ~ ~?": T 201~'(OClb\) ~d'o~\nel.l\o...e.les,:,~_~~ '"7 ; -. . 40f~'&J'!lD\ijo6i R1!\'i 1'\Ose Inn Op.?- ';;l";l\l&fllijO .-f - '" - 0 B \0\ . (\ cen . ~C\ tnlOU" It"'" ,.1 ()~b~~~~~Il2_e()~c1O\)\~'l{tto~EIB::~&~'l)Q~e n- --- . ---- - D. ~lI)lI:fI.t~\rc~ 0'0 I~O\e'. \\. ~\f\ca\lO O,'(ou - en\el.- \ \.l\i\i~~O' ----- -- NeJl~~~J\~ ~~~~_I3S~~44). One Cir<.'llh'oel \01 tel is "\_\'>00 $ 43.00 Each AYilrtional<em:U1t or with . . C) Service or Feeder Permit )?i ...-$ 3.00 .s Expiration Date Constr. Contr. Number r---- '. - -- --. --- _.~---- -~'---'---.- - -... E. : Miscellaneous (Senice/feeder not included) -Each Installation f _. .._..___. .___, __.' __, --- -.---- OWNER INSTALLATION Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited EnergylCommercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee ~3 h51 ?,'J 0 /C8'f7 Owners Signature: 4. . SUBTOTAL OF ABOVE Inspection Request: 726-3769 TOTAL Shared Drive(T:)fBuilding Fonns/Electrical Permit Application 1-03.doc . CITY OF SPRINGFIELD Building/Co m bina ti9Jl>.p~rmit .~'{\0 ",S0 PERMIT NO: COM2005-01153 ISSUED: 08/25/2005 APPLIED: 08/25/2005 EXPIRES: 02/25/2006 VALUE: . , Status: Issued .' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection 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 requIres you.~ .J'.R'lS.~':Y!'fR4tfPn la~ne Oregon Utility ~%'o't !l glt:bY settorth talloW r ~nt: Those rules a~ 952-001- .._.\I;"atlon C _ _",,,...,nlloh Of>: ,-- ....1 . t' . ~ - --.. ....1...-.~~.; iesOl\"Q'....._~ IPUIJLm~RQY.E~ffS'P. e telephone UV::1U'.' - - t r \I'l~te. th .\. ;oIinn \ling the cen e . Uti\~ii Ji:..ype: ca the Oregon ,,-""'44\ number lor ',sl_800-33'1i'owiiSjxlUtsIDrains Center Owner: KKMH PROPERTIES LLC Address: 15450 SW BOONS FERRY #9-140 AlTN MICHAEL HUMMEL LAKE OSWEGO OR 97035 Contractor Type Electrical I CONTRACTOR INFORMATION I CoramW8!::, c . , ." 'lPIRE. IF nlE. "1J?~icense VIIqNP <;;9l'!~!M€TORSr!~~, Dt:RMll \5 I1n0827 ~U1\iOR\110 '1::ilUiiriiNGiINFORMATIONI OMMHICE.O V"'- C N'{ 1 BO DI\'{ \,tRWl);'fStories: 1\ R2 Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled #ofUnits: Primary Occupancy Group: Secondary Occupancy I'rimary Construction Type Secondary Construction # of Bedrooms: VN nla I DEVELOPMENT INFORMATION I :. Front yard Setback: Side 1 Setback: , Side 2 Setback: , Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: I Valuation DescriotionJ Description $PerSqFt or multiplier Square Footage or Bid Amount Type of Construction 1 of 2 Phone Number: 541-726-8895 Expiration Date 02106/2008 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 . . CITY OF SPKli'ltJ1'1~L1J Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01153 ISSUED: 08/25/2005 APPLIED: 08/25/2005 EXPIRES: 02/25/2006 VALUE: Total Value of Project F~~s Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $9.30 $6.51 $30.00 $63.00 8/25/05 8/25/05 8/25/05 8/25/05 1200500000000001244 1200500000000001244 1200500000000001244 1200500000000001244 Total Amount" $108.81 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. win be made the following work day. ~'Iirpd~ Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 fnrther 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 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 541-726-3759 Phone Job/Journal Number COM2005-01153 COM2005-0 1153 COM2005-01153 COM2005-01153 Payments: Type of Payment Check .. " - '~. " '. - ';\ " 8/25/2005 . RECEIPT #: G~ ~- . ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000001244 Description Penn ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By VIKING ELECTRICAL Recei ved By djb I of I Date: 08/25/2005 Item Total: l:heck Number Authorization Balch Number Number How Received 6548 In Person Payment Total: 2:11:31PM Amount Due 63.00 30.00 6.51 9.30 $108.81 Amount Paid $108.81 $108.81