HomeMy WebLinkAboutPermit Electrical 2005-2-1
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)720J~qo"" ~~ ~ L~"
ELECTRICAL PERMIT APPliCATION . () Ob~~ ~"O' 't!~ ~ '"
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Service Included"'" ''19
1000 sq. ft. or less ~ $1 00 '
Each additional 500 sq. ft. or ~ ^':- "
portion thereof $ I~
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
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LEGAL DESCRIPTION
I 70 S Z2. 5,1-{
o Z. 2.00
JOB DESCRIPTION
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c./ (2.(.,t..A \ r
Permits are non-transferable and expire if work is
Dot started within 180 days of Issuance or if work Is
Suspended for 180 days.
2. f:do.jV'iRACTOiiINS'f~.d4PONONLY 1
Electrical Contractor
Address
BURREll BROS. ELEaRlC
F.0. bOX OY/
Walterville, OA 97489
C;Lll_ "1Iqn.270~
City
Supervisor License Number 41-7. i '"
Expiration Date J I) - () ') '. . .'
Constr. Contr. Number
70 -UL.i7(1
In - (f.,
Expiration Date
~:""~M>1l. J
Owners Name 'i?I I( b(Z.., Jr=-
Address b S-O 1-//1 (L \ Ol....J ~6
City
'S, ?IC.~
Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
OwnetslSi~<l:
.lI"".IV".
THIS PERMIT SHALL EXPIRE IF THE WDRK
. "-"~f"~rD ''''n~r. TI "<' rr-n"IT IS NOT
f'\U IIIU lU...L. VIU.-I.... ....... t..ll;u
COMMENCED ORIS ABANDONED FOR
IDspeehoI1:'ReQueS't:\'17iIi3169D.
$50.00
B. L'~'r:V~c~,:or:F~fMe~s..;. ~nsbi~lation, AJt~raiion; or Re.~o'cation:
.'- ..
200 Amps or less . . $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps'l0600Am s Q eI$125'00'
60IAmp!l'1m m ~.~. Jar
o I lP. adopted III1iy
R::nn 1Mce~~:=;
952.co1oOO10U.._~. .
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C. 'temlf/f~i~~jt~~~~lf'.r:::ti;;;::'"
InstalIati~lmlm.tf1t.l ~&mLJtIIitYNotL!,..,J. '.
200 Amps or less (:enter Is 1~~O.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D. I ;Brl!n~1i Circuits. I ,
New Alteration or Extension Per Panel
One Circuit / $ 43.00 L/ 3
Each Additional Circuit or with
Service or Feeder Petmit $ 3.00
E. rMi~~e!biD~~~s (Service/feeder not iDcIuded)":Each Ins.taila,ion I
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee~~ Surcharges
4. [SipfX':*OE~QrE'] 'I S-
'7/r
7% State Surcharge /
10% Administrative Fee If .n::>
Cz b_"
TOTAL ....>
Shared Drive{T:}lBuilding FormslElcctrical Pennit Application 1.{,I3,doc
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY VI' ~rKll~uN~LD
Building/Combination Permit
PERMIT NO: COM2005-00I30
ISSUED: 02/01/2005
APPLIED: 02/01/2005
EXPIRES: 08/01/2005
VALUE:
SITE ADDRESS: 650 HARLOW RD APT 249
ASSESSOR'S PARCEL NO.: 1703223402200
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Add 1 circuit
Owner: BILL GRlLE
Address: 650 HARLOW RD APT 249
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION 1
Contractor Type
Electrical
Contractor
BURRELL BROS ENTERPRISES INC .
Phone
541-747-2724
# of Stories:
Height of Structure
Type of Heat:
....... ',' -, Water Type:
Range Type:
Energy Path:
_.... f'l-J _Sprinkled Building:
1 L ..'.........11.." n""l1..........
foUow.....I~(@:.fiN1l~li'GRMATION .:,: . ," .'. . .
.........._~ ... .. .,.. "" "" r I.,.. ".. ....'-"~ . REQUIRED'PARKING.
~""'UIiIIil 'll,~ '.............."....'.'-, ....'.'
tnOARIJ52.OOt.OO10[:l ~t-
CI09O.lbumayOlltaln~ lUleaw.:: Total:.
caIIlng Ihe CIOf8t e 00: HandIcapped:
fID1\berforlheOlegon 't Compact:
. Centlr18 t~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Sethack:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
License
136446
Expiration Date
08/20/2005
BUILDING INFORMATION I
nla
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I PUBLIC IMPROVEMENTS 1
Sidewalk Type:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORl(Downspoutsmralns:
AUTHORIZED UNDER THIS PERMIT IS NOT
. COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
I Valuation Descriotion ,
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Paeelof2
-
.
. \...11 t OF SrKll'l~l'u'LD'
Building/Combination Permit
PERMIT NO: COM2005-00130
ISSUED: 02/01/2005
APPLIED: 02/01/2005
EXPIRES: 08/01/2005
VALUE:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fp.l's tlWU
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid
Date Paid
$4.50
$3.15
$43.00
$2.00
2/1/05
2/1/05
2/1/05
2/1/05
Receipt Number
1200500000000000131
1200500000000000131
1200500000000000131
1200500000000000131
Total Amount Paid
$52.65
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.
I Rp.nuirp.tf \jUpp.p.tions I
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 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 ofthe 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
Paee 2 of2
, 225 Fifth Street
~riIig'ii~ld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00 130
COM2005-00 130
COM2005-00 130
COM2005-00 130
Payments:
Type of Payment
CreditCard
2/1/2005
.
RECEIPT #:
"'~AIN""'IILD ,
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JiJ,.,ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200500000000000131
Date: 02/01/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Minimum! Adjustment Electrical
Paid By
BURRELL BROS
Item Total:
l:heck Number Authorization
Received By Batch Number Number How Received
djb 078125 In Person
Payment Total:
Pa/(e I of I
1I:22:57AM
Amount Due
3.15
4.50
43.00
2.00
$52.65
Amount Paid
$52.65
$52.65