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Home My WebLink AboutPermit Electrical 2005-5-18 'oj SPRINGFIELD 1 . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ ~ . ELECUUCAL;ERMlT APPUCA110N ;J;- _ _... City Job Number t-()(v12.D05 - OOS7Lf. Date~'f11lr~? '.. .... 1. !fLoCA'TIoNOF.;iNSTji'T;i?',tTIi.IM''':~!i 3. ~];,MP~EIS":~i~~REi(OW~~~m!li ~_,,_~,~_,~.. . "Jl!i:.1i/A . ~~"'l.<""-""',~~ ~~O Hfl<'hJ (~l;Vl:-:- It <::.'/)1-0 t;7'17? ~~Q;~-~",-,..;;;~~;!\w.r~~~~ "'. LEft)~JdLf OOlrfX) . '\e;;;~;~;$ ,~:" Ul1i~F~\t~~g~~~ JOB DESCRIPTION . . ~ 100q&f!o~ f\!il~adopted b the eJ Ut$.ffii~~ . ,^Ar\ fA" ^ (~ Eaf~~l\1E!\.'?IBiH991~!lJtft.l;Mse" ~]~s,tfo~Ff-~ f.cfLvru- P,"~~ l1f . '~6i&9'5f2_001-001?throuat1~52., ~9.00 . Permits are non-transferable and expire ifwJrk is \ladll:iinlnufal;t1(!1Hi>mll1b1'n copies 01, e ~~ "not started within 180 days of issuance or if work is Modu@!r~llin8'SClVic& dr"lote. the telt,. hone . Suspended for 180 days. Feed~umber lor the Oregon Ut;'.';' ~1"t,fLr~..s5Q.00 . - . " < ""Q-;~;i;l~\ ~R-~'~~~AU",,,,,,,,,,~n.,Itl.~'"""~~;':~"""'HOffl'~,,,,,"!f"~ ,,_i~~~~JfY.il'~~.;J:;'J',ii:ffiy ~" " ,.'ms;;O:lt)il'~&1""~.~~~l'~i 2. ~!lt!f.fAC!!OR7I1'fST.A'!.~~Nk'X~ B. ser;Vi~es.or,~e~e;;~~.!!i'=~~t~~~!~1f~~!~~eloca!!6n~ Electrical Contractor Jhi:h:Jf< 'fU= :r {)ok 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 $163.00 . Over 1000 AmpsIVolts $375.00 Reconnect Only $ 50.00 Address 2li D ~}.:w-.~,:/" City lS./(4~ Ooff- Phone q2./-<;"..<;rO Supervisor License Number .q /7;)" S Expiration Date i 0 - c 1- D I Constr: Contr. Number f Y (,71.J,,- ExpirationDate OJ - W- 0 I Signature of Supervising EleClrician . ~-'~V-- oLName f--Au'. / ().;h~^J Address .6L IJ i>lAOi"v-- &"05 f' ()/Aer- City <:.,/)f.vv2 97';77 Phone ~- ,7 ''IIZ- &6&5" OWNER INSTALLATION The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: .726-3769 C.l~!~!~~rY1.~m!i~~F;~~~~~~~1b~ Installation, Alteration or Relocation 200 Amps or less $ 50.00 ~20ifA'mPs to 400 Amps $ 69.00 T~o~ AmPs,l<?~6QJl~!:sEXP'RE IF $100.00 ~'c\W~o6~~P's'~rPOOi"))!\Ss,~e..~.\1[b~~!~~ ",. D4ImB,,,,',,wli~G,..ffi_...ts. ...,.." '.'.<' '\~.'" ~,t!',"''''''$;.::t\\>j ANAFf~~cA~rcu~RI!Jn '\; ..; rL~:<""~~~~':'f'~~~:~~ New Alteration or .Extension Per Panel One Circuit J Each Additional Circuit or with ? .--- Service or Feeder Permit ~ .., $ 3.00 $ 43.00 . 43.00 (05,00 1.$\~',-w~cs.".::K~""-~'" ,~':V':"?>il~',I..'..V~VI"'~"'~ ._<~.,,-ri_._ ..-..~ '''''':; -\.....',.'.1"li>."""""........='l!'....~oI.Jl'~., E. "MiSceiIaiteoust(SerY;'ceJfe€der;iiot'liicj'1id~i1)''''EaclDfnStallilllon~ ~"",",~r.'l'~~~"'_~'~'r~=~~4:.".....""""" ...;!l.":.:'_...."UI..".:::....~..,~ Pump or inigation Sign/Outline Lighting Limited EnergyfResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ~UBfOTA1~OF:~o~j:,;~~~,-"."'J.p. :"s~.i~~~. "'~..t"".;t,-"""1t<i,,,.~,~~~cr~1t-i~ /4-~. 00 10.3(" ~n 113. ilo 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:YBu;lding FonnslElectrical Penn;t Application 1-Q3.doc . . UI l' OF SPRIrljul'lJ<..LD Building/Combination Permit PERMIT NO: COM2005-00574 ISSUED: 05/16/2005 APPLIED: 05/16/2005 EXPIRES: 11/16/2005 VALUE: \ requires you to ATTENTION: Oregon a~, _ "_nnnn IJtili1V ,f,...lInv.I ruleS aaut'l-=-..... .., 1 .' ~ . _ _ ;.".,... C'ot fnrth SpringfieldomEr6{.'wORK:~Eh;~t;.i;~I- iv.orJ{Oolf]01- in OAR 952-0?1-~Ut~~n'~~V;~~ of the rules by OUtI,uJj,IOF, USE:b Rep*. the telephrRilSldential calling the center. \I'i~ ~ti\ity Notification number for the Ore~~~ "",,_')'\44\, l"enLt;1 1.oJ , _f. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRES.S: . 660 HAYDEN BRIDGE PL ASSESSOR'S PARCEL NO.: 1703262100600 PROJECT DESCRIPTION: Replace Panel. - Owner: Address: CARLSON GARY J 660 HAYDEN BRIDGE PL SPRINGFIELD OR 97477 I CONTRACTOR INFORMA nON I Contractor Type Electrical Contractor MITCHS ELECTRIC INC License 146745 Expiration Date 01118/2007 Phone 541-747-4483 I BUILDING INFORMA nON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structnre Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Tyji~';lTICE: Sq Ft Garage/Carport Energy PatliiS PERMIT SHALL EXPlrsq Ft O'tiier:'UKK Sprinkled:J,l.!l!I~!!g:IZED UNlw8\ THISOcc'ilp~'Jt 'Co~diT __, ___ .....-......... an...U"""I,t\ rnn . ,....."". .",.. ., ,.,. ." ,......" ......... .-- . - I DEVELOPMENT INFORMAHON)llD. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDralns: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pae.e 1 of2 . . Ul l' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00574 ISSUED: 05/16/2005 APPLIED: 05/16/2005 EXPIRES: 11/16/2005 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 Fee~ Plli!U Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $14.80 $10.36 $43.00 $105.00 5/16/05 5/16/05 5/16/05 5/16/05 Receipt Number 1200500000000000628 1200500000000000628 1200500000000000628 1200500000000000628 Total Amount Paid $173.16 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 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 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 aU 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 aU times during construction. Owner or Contractors Signature Date Pal!e 2 of2 225 Fi~fh Street 8,p?ngfield, Oregon 97477 541-726-3759 Phone . ~...................'.".>o . ,~. .......'.'..... ..,.............,. J. .d....,: I:' l; ro".' ; " . '-'^_%'-, ," - .... .City of Springfield Official Receipt evelopment Services Department Public Works Department Job/Journal Number COM2005-00574 COM2005-00574 COM2005-00574 COM2005-00574 Payments: Type or Payment CreditCard 5/16/2005 RECEIPT #: 1200500000000000628 Date: 05/16/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By MITCH'S ELECTRIC Item Total: l:heck Number Authorization Received By Batcb Number Number How Received ddk 133560 In Person Payment Total: Page lofl IO:49:58AM Amount Due 43.00 l05.00 10.36 14.80 $173.16 Amount Paid $l73.l6 $173.16