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Home My WebLink AboutPermit Electrical 2004-10-20 , , 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54)J.).726-3689 ' ELECTRICAIrf~mf1PtffiJCATION Il '" N ";O"/~;OI/O,,, City Job Number ~""'(.'l Jr/...V\ D Date ~LA.J AJt ' :Oro.~/";~.or%, - D oS,r 'C/q ~"'''''-:;'''''''VY:~'I'..,.~t'.~'r.j'-'1':~p..\';t'.r~{:''~':'''oi~~'''\:;'.''''!!-='':t~fi 4-:".'" "'~~.lI,...~........:....,.;o::.~:..~~~.~:t:~~.r...;.~,""~'IJoi'<.s 1. ~;EOCATION,OF:INST.ALEATIONfli!:";~,& 3. ~.COMPLETE'li'-EK, 'BE ~ 3'~3'^"!A-d~'"~;;;~'Wijl~"'~< """.....,."""'''',.,,.-'''''''''.YlJ5o;;;;; ~.~"""/;:. .- tiMjSCRIPB' or; 0() I tf/. tJF Aj)~1 A. ~'N~~~ife'1r;;~ift;if:'!Sl~$i~~I'; , ~/t ~~~L~~...t..m.>-,<:>.~' ~~ ~~...I: o Service Included JOB DESCRIPTION 1000 sq. ft. or less --1".. (.--...-..J If)' II 1 I A ;..- c: () . r~,t' , , %; ~ach additional 500 sq. ft. or ..v/v';7ltrVL L/tA(CM/t' r{)^ IVCVV ,/portlOnthereof PermitS are non-transferable and expire if work is /, 'loach Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days; Feeder ~"'''t'~'~~'''~i?,''~-~}~~~J.ti''''''l''I;~~ ~~~~t, .ii~\:":~,i.1\.';i,:~~~ " ./;..l"'~d? '.'<<:>>' ,","',.~ "I'.~C-~~ ",~a-.if"u..:~;..mw 9S '" :00(;'1 ~~/IJ .....,;';l<f....:i1("',~Z'P/d~'~..~~\~~'1 'pc&: , It.~"'{r; .. "". l.!J.;,:t;.(l:).~ \9 ..,,'i~ $50.00 . ~~_:.;..tf,.~<::;"~\,~~f,"\..~~-"'h,.;'~.~~""ig'.-'i'U"(<Ll>'\.'~";':"""~~~ 2 l'IGONTAACTOR'INSTAEE'ATJONiONEl'["1 fJ~\~'lec::~:::=:~":~~::=~~:~ B. ~~~,;~~, ,;'0., r",,,-:P~~~~l:'Ifilmlf{f~t~ti~~io~~li~";??~ ;~~~.!",'!IJI~f.t;u;;;.~~~,~jp"'~ . -:'~QM.~~\i1 Address 68 West "Q" Street 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVo1ts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 City Spfld. 97477 Phone 747-6638 Supervisor License Number 4944S c. ~IDJ.s~~~fiFi~m_~ Expiration Date It}/! /07 Installation, Alteration or Relocation Constr. Contr. Number 8699 Expiration Date /;;.j; f /0 Y-, Signature of Supervising Electrician 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps' Over 600 Amps or 1000 Volts see "B" above. :w.~"'~..~".~~, "'I D. ~!!~!H!EJi;S.~.r&~!~;~_~.}~ New Alteration or Extension Per pane/l One Circuit Each Additional Circuit or with Service or F ceder Permit $ 50.00 $ 69.00 $100.00 't Pump or irrigation $ 50.00 Sign/Outline Lighti~ . $ 50.000 . . ^:rTFN-an '~r.e~on law '''4U"''S y'OU f( Llmlte~l1ergy'R1!': 1 e tIa db"'" "'--oV8;00y . . fAllow r~ws a op. e y ...- -'. ~s '"" The installation is being made on property I,own which Llml~otff8'lti'o'noewn'illi'.alThOS(, ., '\00 ~,~slJ;qQrth is not intended for s~le, lease or rent. R~nimum 1H'l9~1li ~!l@ljO~~6Itrlle.e:j~ S45\'00'3PSu?QJ1arges ~01\CE. E.XPIRE. IF lHE. wO f"''''''''i'~Y()~V:i:Ob1atrne",,,,'''~~~!'l;tM!es bY, II - Owners Si?p\~!';l1:ed~M\1 S NOE.R lHIS PE.RM\1 IS NOI4. !k~~.caiU[(9i1t1~~~~~!i~g~rrp'~pne ,.10, , {\\.lIHORl]. \.l IS {\B{\NOONE.O FOR numhFlr for the Oregon Utility NOt\llcauulI 3 ad/) _ _. ...~Ir.~n OR 7% Stare:surCli'= t '\S 1-800-332-2344). . vv",...- RIUU vOln er ,I bD {\NY \ 80 O{\Y PE. . 10% Administrative Fee "I, 53 I 'if;;;;>- I $ 43.00 $ 3.00 ..."'!r"""''''''....~..,.__~''''~j''~W'''''l!'''.~.~,'.M....-'''',.''1'''''"' "'~Mi' ''''TI';''''',~,' '=('S~~" "":','" ,~.".~."" ,d'''''' ,'''0,,'_' t"'''' ""-"'I d'''''d'')'~~'''E'''''''' ti',I" "t"~ II.'...,' ."'On, , '" . ~L~'\L~S~~~Wi";'.I',~m;~~~~~~~~i'~J.~J...I]-.~,!t",,~~~ OWNER INSTALLATION Inspection Request: 726-3769 TOTAL Shared D~ve(T:)lBui1ding Fanus/Electrical Permit Applic<1tion 1.Q3.doc . . CITY OF SPRll"t.t<IELD- Building/Combination Permit Status Issued PERMIT NO: COM2004-01298 ISSUED: 1012012004 APPLIED: 10/20/2004 EXPIRES: 04/20/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 441 Harlow Rd ASSESSOR'S PARCEL NO.: 0000000000000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Street lighting in right of way Owner: CITY OF SPRINGFIELD Address: 225 FIFTH STREET SPRINGFIELD OR 97477 Phone Number: 541-726-3753 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor LR BRABHAM License 8699 BUILDING INFORMATION I Expiration Date 12/1812004 Phone 541-747-6638 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMEN, m~uKJyJATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: A ,....T~,. '-, N tallow rui;~~~'-'J '-~-;. ~.l, I PUBLIC IMPROVEMENTS I otlf:c"JfiO OPted b" t'- .. ~~ r Street Improyements: n Cent"', ~I J lie GregO YV(j tv VGT/CE' Sidewalk Type: ,,,::;'''f'1852-00 ~. lase rUI n Utility . Storm SewerAvaUa!!l!':n 1-0010 thrOU h es are Set ~, THIS PERM/]Down~outsmrains: Speciallnst~uctiil!!;g the % Obta.in COPi:s O~A 952-0~7" AUTHORIZED ~~f\ L I:XPIRE IF THE WORK Notes: lUmber for the 6~r. (Note: theO::;1e rUles b. COMMENCED OR ~ER THIS PERMIT IS NOT Cer,tF>ris 1_~~~nYlilitYNnf~E~0~e ANY 180 DAY p1=Q/~~BANDONED FOR ......J<~~:.."~"'tl --...... I Valuation Descriotion I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa2e 1 of2 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01298 ISSUED: 10/20/2004 APPLIED: 10/20/2004 EXPIRES: 04/20/2005 VALUE: ,- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fp.p.s P3ilU Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter"Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $4.60 $3.22 $43.00 $3.00 10/20/04 10/20/04 10/20/04 10/20/04 1200400000000001487 1200400000000001487 1200400000000001487 1200400000000001487 Total Amount Paid $53.82 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 re,quested after 7:00 a.m. will be m!lde the following work day. I Reouirp.rI Tns~ Underground 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 orany 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. 1 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 of 2 .225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . .~~,', ~ 1a"~"T ~ llllii..ity of Springfield Official Receipt .evelopment Services Department Public Works Department Job/Jonroal Number COM2004-0l298 COM2004-0l298 COM2004-0l298 COM2004-0 1298 Payments: Type of Payment Check 10/2012004 RECEIPT #: 1200400000000001487 Date: 1012012004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By L R BRABHAM INC Item Total: Check Number Authorization Received By Batch Number Number How Received dim 31219 In Person Payment Total: Page 1 of I 2:58:21PM Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82