The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-11-14 ,':',:,i~' . '-~::!X:,;'C1TY,'O:F,.sf.' Nta~1Eltl; OREGON, -',' ',:,; " \.~.J.:""I.~_~.'I_l.:. ..1-_...........:......'.:!..:",......~~::....'....I.._.. . ......._. '0>- ", ~ . - cf as submitted has the following "225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAXk~~ffl~- not require specilic ,land use ELECTRICAL PERMIT APPLICATION ~ I _ Zoning Lf)~ City Job Number COWl ZOO] - 01/l-l8 Date II N /0 J 'Jate \ 1- A -0 ~ ' I "LOci;110NOF}NSl~j'i5Aljoiv'ii*',,"';n 3coM;;M'7:lt; "EE'S~' , "1",,,~>,ti\'U ' ~"'_.."., ,,,"=~~..~"~,,",,,,,",,,,,,,~lli'.m'~ . . .!..",-",,,.~..cJt,=u=,,,., -....'. ""~<~~~'l.""~~,,,~ Lj ~ S- ~-lA-td6V l? r, J..~e W y , ; LEGAL DESCRIPTION /703,,62.-1 6:3 ZCYD JOB DESCRIPTION ~1oA yYJ~R frS e' Permits are non-transferable and expIre If work Is not started within 180 days of Issuance or If work Is Suspended for 180 days, ElcoNf,RACftORlliVs.'TAl]m"n~o.M()Nl;'W~ 2. r~~tf'.r.:i"''''ltt1Tf'd~:.t.li.t/t.1.t'''!'''''_~__:''~.'M1l$71j,,.:.';''iIl:i~~~ Electrical Contractor . GiS ~ ifdYIC I =r:w::, . Address r 0, Bo'! \ L\ ~ )_ City ..sv{\\~eld.Phone iYI-2261o Supervisor License Number. Lf<:s q L\ S I D-OI-OLj- :) ~ Lj (1 q -/ - o{/ Expiration Date Conslr, Conlr, Number Expiration Date Signature of Supervising Electrician ~~E~ Owners Name 1.41/ Jk:l J~ 0-0 ( ~ d .i!. _ I Address lOt) ~ Sw bIISc.-... . City ~e Phone 520-72N OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. A, 1!'N~.-:';R~ili[jiiilil'!lfsm"il!Yo;!j"'illtr!F.~ffiii1!?'i,iNmr~iim."tffi~I' "~:'~LL.~c.3.~""......,-,.g'''''''m.:-~~.''.;";!:<..",..,,,,'1'''YP. '7"_~""'-'''l-,g-!J'!I"Mr _ . .~ Service Included 1000 sq, ft. or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder . $106,00 $ 19,00 $50,00 B, Ii:sffi.'f~~i'll;!~tcf~j!ij1?;firi~~li;1t ~', " l\ "rllif.fi1';i!iRlm~~;iiil": ~ijd't.~t~"'''~'~ " . , 1.':'lt~:::IIf~ - ~ ~~. _ ~ ~~ . ,1 $63,00 b 3 $ 75.00 $125,00 $163,00 $375.00 $ 50,00 200 Amps or less 20 I Amps to 400 Amps . 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/VoIts Reconnect Only c. Ilf~ili';;a'~"'Sem;lc@Or:F.l,'eaCi!s'''''1.'!'. :~MMill~'!!im~i'l( P;\:~~~.,..,,~..UI'I_...,_..li'''';V.'~ Installation, Alteration or Relocation 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. D U"B',wc'-Ii'r.;-I."r'",r,~', ., "'~~~~!li~'-'" . " ranc '", <CUlts"~ . 'k.... 1'- '(~~~ .~ ~. - ~"'()reOoli 10 1,.. n t\(i(y New A1teratlon:orExtenslon Pe." P.anele orego t 10" 1-\. ,~' . dopteu uy ... ~'p- se " One Cirellit,lIoW rules a _ T"n"P. rule$ 43,00~n "" . Each Addihonal,GircuilorWiill"10 through OAR 'd~-\ "5 \ ,I("\I'''~''- 00 $ 00 u e Service or Feeder Rennit01- '__ ~j3.! r n 0/'\'" ~-- ~~" obtain \;VP'-.-:"^ t<>\eohone E. 1!~~iillfi'W'iij:"st1M'g""~d~'\lI1~~itJtd<ll...t~tlr.fiPJU1i1~fill 1Ii'~=;""'''''r~:i.!lrJr~.,:wo~r,J!l~",~,>~_",.,'.:Il 'n"mberlort eu 00_332-23441' Pump or irrigation I.",-..N if' 1-8 $ 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 $ 50,00 $ 69,00 $100.00 Owners Signature: NOTICE: 4. l'IS.UBTOTALElJEmJOVE~:tli~,~J~ THIS PERMIT SHALL EXPIRE IF THEWt5RP~L~.!iiM"">'j;~ AUTHORI7tD UNDER THIS PERMIT 1S7~te Surcharge COMMENCED OR IS ABANDONED FOllo% Administrative Fee Inspection Request: Afit-3~g DAY PERIOD. b3 LfLtI b';:'o 73" TOTAL Shared Drive(T:}'Building FormslEloctrical Permit Application 1-o3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01148 ISSUED: 11118/2003 APPLIED: 11/14/2003 EXPIRES: 05/18/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 425 HAYDEN BRIDGE WAY ASSESSOR'S PARCEL NO.: 1703262103200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Relocate meter base Owner: MICHAEL WOOGERD Address: 1008 SWENSON LN EUGENE OR 97404 Phone Number: 541-520-7214 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION I Expiration Date 09/01/2004 Phone 541-741-2236 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 SETBACKS I DEVELOPMENT INFORMATION"')regon law requires you to " follow rules adopted by the CR,E;.gl;JIREDiP.ARKING Overlay Dist: 'otification Center. Those ru1totili:e set fort 1 h~^-ac:."f.'\O' # Street Trees ,R-9!!iR 952-001-0010 throug Handicapped: Paved Drive R!Id:O You inay obtain copieS€6mpact:11es \ V.,::1 :, t (Note' the telephone % of Lot Coverage: ling the cen er. . , , , number for the Oregon Utility NotificatIOn _~.u:_ < onn_"l"l?-?::l44\. I PUBLIC IMPROVEMENTS' NOTlc~~ewalk Type: THIS pm9~~~I8>:.!~m.r~~mE IF THE WORK AUTHORIZED UNOER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 160 DAY PERIOD. Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: 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 I of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01148 ISSUED: 11/18/2003 APPLIED: 11114/2003 EXPIRES: 05/18/2004 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 Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $4.41 $63,00 11/18/03 11/18/03 11118/03 1200200000000002484 1200200000000002484 1200200000000002484 Total Amount Paid $73.71 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 Reouired Insnp.ctions I I Electric Service: Approval required prior to utility 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 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 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 Springfield, Oregon 97477 541-726-3759 Phone .' Job/Journal Number COM2003-0 1148 COM2003-01148 COM2003-0 1148 Payments: Type of Payment CreditCard ," Wi..........~~...=_"Ir,~..-.'"'.......... " ' , .', ., .,.,....... ; ',' . - " ~, . , 1 ~'; .i ....""""~.,......,..-,.. .'.'C'''~ Receipt #: 1200200000000002484 Description + 7% State Surcharge + 10% Administrative Fee Penn ServlFdr 200 amps or less Received By djb Check Number . Batch Number Authorization Number Paid By C&S ELECTRIC INC 000222 022645 --= City of Springiield Official Receipt Development Services Department, Public Works Department Date: 11/18/2003 8:36:10AM Amount Paid Item Total: 4.41 6.30 63.00 $73:71 How Received In Person Payment Total: Amount Paid $73.71 $73.71 . .