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Home My WebLink AboutPermit Electrical 2004-7-30 ,r." Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date. .Signature of Supervising Electrician .se~' .L- - Address City OWNER INSTALLATION ~=_'",~"~''''",",~_~<J:#.''''~.'"~'.~ B. ' .Ser,ilC'es~Feedersi;fqT!istallatil?,Jli~erationsjglliRelo~ation:_ ~~~. ~_~ ~,i"f':-'IPI'1tL~' .....Jt4,~,w.: ~~.~~ 200 Amps or less $ 63.00 20l A~NwrtJQ Amps . $ 75.00 401 "ffll~t~~f~Ss $125.00 60l ~.A'i-f\:Jh92.1 sALL EXPIRE IF TI-f~I~M~K . . . Ove1{)89,QI&!!V Eal I DER THIS PF~MIT~i!)9y. ..... Rec=c;'l'>\i1;l' R IS ABANLl.illJID l'.b'd I ~},U,.J nl~ r Tau DAY PERIOD. . -... C. ~~~s~~~rs . '\>!" i ! Installation, Alteration or Relocation 200 Amps or less $ 50.00 20l Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or lOOO Volts see "B" above. . D. ~llra-'licwCifcliiiS~~)f~~w,~",,~-afillj """..:::.:.J::.-s:..,<..'::.-.....':.......~..~._~ New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Penult $ 3.00 E ~1i ..-ll.""~""('S"""""""'~d';W~t.liJ<~I.d'~d..). ~EF~I.'I. .t.ll.ti'" ._ ~~~~L ~rl~'1c.Cllee .!!i!'2~~~..Ja\:;~J~1!.h1:~9,!!!:~~ _... .' Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00. Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. tSVBTOTA'L:.OF~.;~VE~'1~.,m~ r;..1"\ 00 ~~.w?_ ;JJj :3;sQ. ~.OU ~<t.~ The installation is being. made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 7% State Surcharge lO% Administrative Fee TOTAL Shared Drive(T:YBuilding FonnslElectricnl Pennit Applic<1tion 1..Q3.doc . . \..-11 l' OF ~rKll'\ju1<lJ'..LD Building/Combination Permit PERMIT NO: COM2004-01193 ISSUED: 09/29/2004 APPLIED: 09/27/2004 EXPIRES: 03/29/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 660 HAYDEN BRIDGE PL ASSESSOR'S PARCEL NO.: 1703262100600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Reconnect Electrical Service Owner: CARLSON GARY J Address: 660 HAYDEN BRIDGE PL SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION I Contractor . ~n~&W '~~;~~ate ROBS ELECTRIC INC t>.iTENi\ON~ArI~8>'i the ,_~ ,,9J!1~~ BUlLDI~\oo811": ., N ~"o\>o ,_.. Op.f\ 9o't-uu'- (,Ju.!J! ~J rw \\lro~g: 01 the rules 'o'i # of Slil~f\ 9~~a'/ obtain co~~~ t\1&Ot\sIZ~~e HeighOlf.Str~g~~ center. tNO Uti\i~qlEti'i'st'F2~r: Type of HliSt!ng lor tM oregon aZ_~2nd Floor: Water T~'oercenter is ~_800-a Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nfa Occupant Load: Phone 541-686-5444 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Di~: ~. IIi\<. # Stree ~fFiUiQiI: L EXPIRE It 1HE, '~apped: Paved ~~'V~~iI;\M\1 SHt\L fI 1HIS PEflMI1 '& ~act: . % ofLo o'l-~~EO UNOE B"'OONEO tOfl I . EO Ofl IS t\ "" r.()tv)M:.N~ ,.,. r:.nl."o I PUBLIC IMPR.8VEMENtS I Sidewalk Type: Frontyard Setback: Side 1 Setback: Side 2 Setback:. Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Downspoutsillrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . . CITY OF ~nuNGFIELD Building/Combination Permit PERMIT NO: COM2004-01193 ISSUED: 09/29/2004 APPLIED: 09/27/2004 EXPIRES: 03/29/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Frrrs PllW Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 9/29/04 9/29/04 9/29/04 1200400000000001412 1200400000000001412 1200400000000001412 Total Amount Paid $58.50 I Plan Reviews , 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. Reollired Tnsoections ~ Electric Service: Approval required prior to ntility company energizing service. 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 strncture 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 tbe 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 Springfield, Oregon 97477 541-726-3759 Phone '1' . RECEIPT #: Job/Journal Number COM2004-01l93 COM2004-0ll93 COM2004-01193 Descriptlou Service Reconnect + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard DAVID LAWLER 9/29/2004 ~ --. JiilY of Springfield Official Receipt "elopment Services Department Public Works Department 1200400000000001412 Date: 09/29/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 029834 ln Person Payment Total: Page I of 1 3:03:07PM Amount Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50