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Home My WebLink AboutPermit Electrical 2005-8-16 The following projecl as yiljlbjilled has Ihe lollowing s not ttn("~pecific land use , gjlb/Or', IJI0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726-3753 . FAX: (~~1J726-3689 I Yla.A25f?(<'-uY)q ELECTRICAl,; PERMIT APPliCATION , / ' AuttJotJzed Signature '-./ City lob Number( r; - 0/ b 7~ Date !if / (~ / ::J(ln c:; , ., I. ~~~ 3, ~;~~~ , ,^:"~~~~~ ~ESCRIPTlON ' ,A. &~~:.1.~_lfiii~'1l't.i~~~lli~1Aili ' -/,n3 -''JV--6.y3---/'d-/(JiJ---------' Se~iceIn~luded------. '. .-.-.---- 'u.".,______ I ' JOB DESCRIPTION 1000 sq. ft. or less $106,00 17 \ Eacb additional 500 sq. ft. or r17/h/.J \.../f r"'U...Ld portion thereof $ 19.00 ,,.,.1::"';1 ':,: .,.:C;, '~€1ffi~~0R~S~~"'- ~@E!Iiffili5E>'.@ltE@(i)N \\..;: :"j;;~~' ":,'S~h N t.~:,,"j(';"1 ...,......~.~):...d,;_:.~l'Jt~: 1~~...~...;,1i Jt<~rjj ),~'.!orQ./"',~.~.'!.11'.;'\-1. '!; ,':"'1',; l;'~ \1~(11.,t.",~j 'i." I' : p{\j "'!'t'.vl-l~~'" '_M ,...........'1... '\"'f ~~.., ...,,;. ,,~.' '. ~ _. Permits are non..transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or, '$50,00 Susp:nded for 180 days.. Feeder ATTENTION: Oregon law requires you,to,." ~j;~V8m'1>"t:m:.@~~~~~;';.-.t;n~ B.. ~~~~, filWS 2.~,?~ &'t'1li'~;,,..,,~~ Electrical Contractor mF-AlE ,: I Efl Tt..lt!. ~P.lllc.€. 200 Amps ~1~R'952-001-001 0 through $)W52-001. 20 I Amps to ~~o.}o~ may obta", wfJles ~ ;~%@Jles by I' ~" Il1 ..,,~.. L: (' - cailll ~ !he center. -\l'U'..ollJelJcl1>nhune Address .,(,u II/O,u<...oCo ~ . 401 Amps toABllriMiPlorthe 0 r'... J> 5:l!IJ' r .. r"'>Jv" '''''''I. ~tificallOl1 IC{ /0 ~. 'e 601 Amps 10 1000 A~nter is 1-SOn ??J 2~ ;00 u - City U wov,- Phone 3'-11./ - 3b'"~ / Over 1000 AmpsNohs $37.00 Reconnect Only $ 50.00 Supervisor License Number .3' 13 S- S Expiralion Date IlJ II / rJ..CJ () +- Canstr, Contr, Number 9 () :J. () D Expiration Date .3 J / T- / () Sf /. &- , c. ~~~~~B~b~ ~ ot Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Sigllaturc of Supervising Eleclrician Over 600 Amps or 1000 Volts see UB" above, D. tllBl~iJS1[~i~l~ ~Jj1 . d/)hk~J Owners Nam~ <::)k' / 1/'0. n _1); AddresPO &2X 7/4- ' .. I City~ Phone OWNER INST ALLA nON New A1ter.lion or Extension[perXPan01 ~ . " ...,.,,, ullML t PIHfj I" ,- ' OneCITCult, ,S:\:~E:O,Ui\!DfR .._ IFT.$f43~00RK tS Each Addlt!o~,~li<;:,lTg~JII~I;tlth TI "" r-tKNlIT IS NOT Service or. Feeder Pennit ,~ A8>\Nnmlc.o$F3.00 ."." IOv [JIIY PERIOn - un OJO The installation is being made on property I own which is not intended for sale, lcase,or renL Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% Stale Surcharge 10% Administrative Fee ;J, ()iJ ~5.VO, . 3./5 , .L./" ~O l ii 5'::2 .~6 Owners Signature: 4. t..., U" ",'0 n ,~; (J ~u,'. 0": ,\ ...t '.. ~_,,-:;",:-~-.." ,.~:::"',\"'~-;;'~:.V't'';'',:~ ~'''.., ','- , J.:: "~";:.','" '.'~~, Inspection Request: 726-3769 TOTAL .~ . ....'. Shared DriY<(T:YBuildioa FoI'lllSiElcclricI Permit Appli".lioo 1-43.doc '-~y ,", " 'I t- . . ,> :}~ :..~.- ,;:. (;,;~' '. ..: {'j J;~"\ ~'~ it,',; ~ : ~. '_ '!u,,:,~."f..:;!, . ,1.. ". r"... i . -:-$WIt?A!~"G~F.I~' , I i \ , .- , " . - -" .... Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01074 ISSUED: 08/16/2005 APPLIED: 08/09/2005 EXPIRES: 02/16/2006 VALUE: SITE ADDRESS: 1475 HENDERSON AVE ASSESSOR'S PARCEL NO,: 1703344312100 PROJECT DESCRIPTION: Fire Damage Owner: SKILLERN INVESTMENTS Address: PO BOX 714 SPRINGFIELD OR 97477 Contractor Type Contractor # of Unils: Primary Occupancy Group: Secondary Occupancy Group: Primary Conslruction Type Secondary Conslruction Type: # of Bedrooms: :' Frontyard Selback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Slreet Improvements: Storm Sewer Available: Special Instruction: Notes: ' ':. Description Type of Construction Eugene TYPE OF WORK: Fire Damage ATmE'5j;iUSE:~OnRepaillquires you teommercial fOl,low ruleo adopted by the Oregon Utility NotJlll\ >'0" Center. Those rules are ~pt Inrt'" '" -:.:": "~~Jl'UUlO through OAR 952,001- OO~o: : J'lnJ.,y obtain copies of the rules by C', ,: e center, (Note: the telephone nL.l. ,r!no(')........,..",...II40TJ. "'-I"" . ". - 'J . ._...........,.~jl I CONTRACTOR INFORMAT~6N"ir is 1.800.332.2344). License Expiration Date Phone BUILDING INFORMATION 1:.- ""0 PEA' # "fSlories: AUTHORI,MIT SHALLot Size: ~ ZED U C "'''''''Ii Height ofSlructurVMMEN ' NDE~qtfUst F!~orHE Type of Heat: ANY18 CEDDRISsqFt-2nd:Floor: WORK O 0 ~ ' "I/VI/I IS WalerType: AY PERIO Sq'lF:t\Basement: NOT f"'l ~V/Vr-/1 ,.r..... Range Type: 'Sq Ft Garage/Gorport Energy Path: Sq Ft Otber: Sprinkled Building: nla Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compacl: Overlay Dist: # Streel Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: DownspoutslDrains: I Valuation Des~rintion I $ Per Sq Ft or multiplier Square Foolage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued 225 Fifth Streel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administralive Fee + 7% Slale Surcharge Add, Alter, Extend Clrc MinlmumlAdjuslment Electrical Total Amount Paid . Amount Paid $4,50 $3,15 $43,00 $2,00 $52,65 Total Value of Project Fees Paid I Date Paid 8/16/05 8/16/05 8/16/05 8/16/05 I Plan Reviews , . .1 CITY OF SPRII~ut<lJ'.,LU: Building/Combination Permit PERMIT NO: COM2005-01074 ISSUED: 08/16/2005 APPLIED: 08/09/2005 EXPIRES: 02/16/2006 VALUE: Receipt Number 2200500000000001110 2200500000000001110 2200500000000001110 2200500000000001110 To Request an inspection call the 24 hour recording at 726-3769, All inspection requested before 7:00 a.m. . will be made the sa!l'e working day, inspections requested after 7:00 a.m. will be made the following work day. Renuired \u~nedinnLl 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 wllh the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to lhe work described herein, and that NO OCCUPANCY will be made ofany structure wlthoul 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 lhal all required inspections are requested at the proper time, lhal each address is readable from the street, thai the permit card is located at lhe fronl of the property, and lhe approved set of plans will remain on the sile at all times during construction, .Jjrn/J )~ Owner or Conlractors Signature Pa!!e 2 of2 fl/{%\ NM Date r 225 Fifth Street ,Springfield, Oregon 97477 541-726-3759 Phone . ~. Job/Journal Number COM2005-01074 COM2005-01074 COM2005-01074 COM2005-01074 Payments: Type of Paymenl CreditCard ;;, '1 ~ .;.. ) , 8/1612005 RECEIPT #: 2200500000000001110 Deserlption Add, Aller, Extend Circ Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administralive Fee Paid By RUSS ROBINS Check Number Balcb Number Received By njm Page 1 of I .' City of Springfield Official Receipt Development Services Department . Public Works Department Date: 08/16/2005 Item Tolal: Authorization Number How Received 016277 In Person Payment Total: 2:50:27PM Amount Due 43,00 2,00 3,15 4.50 $52.65 Amounl Paid $52.65 $52.65