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Home My WebLink AboutPermit Electrical 2008-6-13 225 FIFTH STREET . SPRINGFIELD~ OR 97477 . PH (541)726-3753 . FAA (541)726-3689 ELECTRICAh ~ERMIT APPLICATION --1 CIty Job Number lDn1 ') 1"'\I) K - ('In g B ( 1 . LOCATIONOFINSTALLATION (5& 'z;3I~ ~ LEGAL DESCRIPTION ,,02,?i.tJ 1~()Cj{n(11J JOB DESCRIPTION ~~,~ ~~SfC~7~:r::~r:,r not started wlthm 180 days of Issuance or If work IS Suspended for 180 days ~~.,. ~t --~;-~ 2. CONTRACTOR INSTALLA nON ONLY o < _ Eleetneal Contractor , ) t< (-? c-I fcC'Yl u -:-r70G Address 71""1 U!"'n <;~ vP r f CIty ~r"')':J~pld Phone '5LJI-i41oL/IcD/o SupervIsor LIcense Number '-t1:l~ s: ExplfatIOn Date 10 - 1.- I i) Constr Contr Number <.i :S' I 2..'1 ExplfatlOn Date .q - L '-f- -I U SIgnature of SupeTVlSmg ElectrIcIan ~ OwnersNam~lJ/I(.u ( ~i7 S~ Adnre:;Z,-Cj~~<2D ,'>1 U 0 Clty&w_ <Y22Phone ~ OWNE~~:~ALLAT10N ' The mstalIatlOn IS bemg made on property I own which IS not mtended for sale, lease or rent Owners Signature InspectIon Request 726-3769 3 COMPLETE FEE SCHEDULE BELOW r-- A !'Ten llc"J(luthaI- ~mglc or l\-fultl~FalmI) pcr dncnlIl~ umt Scn'U..e Included 1000 sq ft or less Each addItIOnal 500 sq ft or portJon thereof Eaeh Manufae\' d Home or Modular DwelImg Servlee or r ceder $\17 00 $2\ 00 $55 00 B Scn KCS 01 Fu'dcrs - In~t;llldllOn. Altcl~ltlOn~ or Rdoc.ltlOu' 200 AmPAff~TION Oregon low rp.q\JIriS79~ to 201 AmPfo'i\'o'Wh:mlll"adopled bv Ihe Ore~oo Wilily 40 \ AmffdR~Wl16enler Those rules ~~orln 601 AmifdoIl00il5\'nqQ1-0010 Ihrough UAR~~~f(t\: Over IOlfiO.8.\h ~Ii\lay oblain "~r.."'" -:.IIMl >>lShQ~ ~Ilfng the center (N",," tL.I~tlM>>lS\ Reconnect """1" h 0 - "I,'..\.-Nbi1ft&I(;,n number for I e regvn -' ...., Cp.nter IS 1-800-332-2344). C T<.mplH tn Scrl"it:Cli or I"ecden InlltallatIon, Alteration or Relocation crO 200 Amps or less I $ 55 00 S::') 20 I Ant~o.l'~bmps $ 76 00 401 Anii1'11s i/Il9R'M@SHALL EXPIRE I~ "ih1fuWKI\ Over6O'lJJiJih\QB}ZIOfulililli\fJ3el~I{),~~MIT IS NU I D BradUhlti\WiillCED OR IS ABANDONED FOR New ArW:r;ll~grl}1Ye~s~(m~p. Panel One Cucmt Each AddIuonal Clfcmt or Wlth ServIce or Feeder Penmt $ 48 00 $ 400 E "Mlllccll m(otn (Sen Ice/lecdLl not lJu.Juded) -EdCh Indal1ahon Pump or ImgatlOn $ 55 00 <;Ign/Outhne LIghung $ 55 00 Limited EncrgylResldcnual $ 28 00 Limited Energy/Commercial $ 50 00 Mmlmum Electric Permit Inspection Fec IS $50 00 + Surcharges 5S()O ri<D CD -ltJn ,=",=r) J! it/A.. - KS 4 SUBTOTAL OF ABOVE 12% State Surcharge 10% AdnunIstratIve Fee 5% Technology Fee TOTAL Shared Dnve(f YBulldmg FormslElectncal PeITIllt Apph~bon 1-08 doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00857 ISSUED' 06/13/2008 APPLIED. 06/13/2008 EXPIRES' 12/13/2008 VALUE 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 756 23RD ST ASSESSOR'S PARCEL NO 1703361209600 Sprmgfield TYPE OF WORK Electncal Work Only TYPE OF USE New ReSIdential PROJECT DESCRIPTION Service change out Owner GREGORY SYLVIA J Address 756 23RD ST SPRINGFIELD OR 97477 I.CONTRACTOR INFORMATION I Contractor Type Electncal Contractor J K GUCKENBERGER ELECTRIC INC LIcense 45129 ExpIratIOn Date 04/24/2010 Phone 541-746-4656 BUILDING INFORMATION I # ofUmts. Pnmary Occupancy Group Secondary Occupancy Group Pnmary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms # of Stones Height of Structure Type of Heat Water Type Range Type Energy Path Sprmkled Buddmg Lot Size Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other Occupant Load nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback Side 1 Setback S,de 2 Setback Rearyard Setback Solar Setbacks Overlay Dlst # Street Trees Rqd Paved Dnve Rqd % of Lot Coverage Total HandIcapped Compact Street Improvements Storm Sewer Available Special Instruction I PUBLIC IMPROVEMENTSfrrENTION Oregon law reqUires you to , _ _ en by the Oregon Utility follovl Slilewa~e les are set forth Notlflcs11on Center hose rUh OAR 952-001- ~o~~R !o~~:o~:;~:~I~S of thle rUh'OenSebY t (Note the te ep nC:~I~~r tro~ f~; ~;egon Utility Notllicatlon Center IS 1_800-332-2344). NOTICE: THIS PERMIT C::UAI' "'''r -"--- AU fHORIZEO UN -.." Ir.~ 'I . MJ;: ':~'L:KI: COMMENCED OR ~~R THIS PEIN~aliBttl61tT Descnohon I ANY 18 ABANOONtu t-UK o DAY PERinO $ Per Sq Ft Square Footage DescnptlOn Type of Construction I I B d A or mu tip lef or I mount Notes Value Date Calculated Paee 1 of2 -iiiC CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO. COM2008-00857 ISSUED' 06/13/2008 APPLIED: 06/13/2008 EXPIRES 12/13/2008 VALUE. Status Issued 225 FIfth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme Total Value of Project Fees PaId I Fee DescnptIon + 10% AdmmlstratIve Fee + 12% State Surcharge + 5% Technology Fee Service Reconnect Amount PaId Date PaId ReceIpt Number $550 $660 $275 $55 00 6/13/08 6/13/08 6/13/08 6/13/08 2200800000000000896 2200800000000000896 2200800000000000896 2200800000000000896 Total Amount PaId $69 85 I Plan RevIews .1 To Request an inspectIOn call the 24 hour recordmg at 726-3769. All mspectlOns requested before 7;00 a m. wIll be made the same workmg day, mspectlOns requested after 7;00 a.m. wIll be made the followmg work day. I Renuired Insnect~o~..~ I Electnc ServIce Approval reqUIred prIOr to utIhty compdny energIZIng servIce By s.gnature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certIfy that all mformatlOn hereon IS true and correct, and I further certify that any and all work performed shall be done m accordance WIth the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and thM NO OCCUPANCY will be made of any structure WIthout permISSIOn of the Commumty ServIces DIVIsIOn, BUlldmg Safety I further certIfy that only contractors and employees who are m comphance WIth ORS 701 005 WIll be used on thIS proJect I further agree to ensure that all reqUIred mspectlOns are requested at tbe proper tIme, that each address .s readdble from the street, that the permIt card .s located at the front of the property, and the approved set of plans wIll remam on the SIte at all times durmg constructIOn Owner or Contractors SIgnature Date Pa!!e 2 of2 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00857 COM2008-00857 COM2008-00857 COM2008-00857 Payments Type of Payment Cred ItCard cRecemtl RECEIPT #. DescriptIOn Service Reconnect + 5% Technology Fee + 12% State Surcharge + 10% Admmlstratlve Fee ~~ CIty of Spnngfield OffiCial ReceIpt Development ServICes Department Public Works Department 2200800000000000896 Date' 06/13/2008 Item Total Check Number AuthOrizatIOn Paid By Received By Batch Number Number How Received JACK GUCKENBERGER (JKG) nJm 015540 Phone Payment Total Page I of I 1013 46AM Amount Due 5500 275 660 550 $69 85 Amount Paid $69 85 $69 85 6113/2008