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Home My WebLink AboutPermit Electrical 2005-2-23 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number CoW1Zo'c.>- 002.\ ~ 1 LOCATION OF INSTALLATION '"- _ "" w~ =_ r+/liL[g<:>(L 2062 'f::::,(L LEGAL DESCRIPTION !!S031( Z-Z JOB DESCRIPTION 0'3 )'0 6 SL-(LVIC/F b,k(L..t:rG.-€ AI Pernuts are non-transferable and expire If work IS - not started wIthm 180 days of Issuance or If work IS Suspended for 180 days rv:- - ~~ - - CONTRACTOR INSTALLATION ONLY 2 -~--= ~ ~ , SPRINGF&ELD ~_~~ _ ~, h // ",- Js,'.t\..,- """"~ _ L"% _~ _ } I''''-''J!!r,...". --~' !~ '- '"\"'" ' - - Date 2-2.3 - as;- ,..- ~ ~'~1& "'F--~ --- COMPLETE JoEl}:5~ BEL9~V. ~ Ot- $: i? o ~/ ~O'~..o Ql: 0:. ""0 i6 ~ o~~@w..- - A New ResIden~q; gle ~:IUlff~J~Y pe~ dwelhn~ um~ ~ :9 "'61"6 Servlce Included 190' ""0 ~t. Q). /'-\SI '&. 1000 sq ft orless :9".., ~N 00 << " ~ Each addItIOnal 500 sq ft or '", /~" 00", ;;~:~:~~;~~:;::I~; or "~~ ,-';~'~::"~ Feeder "" -~ q~~ -~- B SenIces or Feeders - Installahon, Allerahons or RelocatIOn 3 Electncal Contractor ,200 Amps or less IreS 'IOU to J ~~\fO"46~~nU\I\\\'/ Address / I n::~n\O~'!\91\~~mro;~w~eset10M / ,\ ,0 'J rIlle - " ~hOS& rU :.....:. 952-00'. t on C(iOI~ ,,;'to ooo.~> . Clly Phone \,')~1;<:;a. ~52"O(}v,!i)Q~ J~~~~ne rules b. / \n v..J< u rn~6il\lml!l81'6% tnetelepnon8" OO~~\\~~ the c~nter t~~ UtIli\\} "'Otl\lcatI~I' SupervIsor LIcen,e Number rnber ~r tU'@ili1!i~~~Feeders , / .'\U center IS . ExpIratIon Date InstallatIOn, AlteratIOn or Relocahon / / Constr CO?NUmber ExpIrahon Date SIg~ ofSupervIsmg ElectncIan ? OwnersName f?o&d .IJf/vt;: Address .J0aJ-hiPdl, CIty 9'//1 Phone 7r:;/-(1S<::J!1 U OWNER INST ALLA nON 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 VOIlS see "B" above "'" - ~ , D Branch CIrcuits New AlteratIOn or ExtenSIon Per Panel One CIfCUIt Each AddItIonal CIrcuIt or WIth ServIce or Feeder PermIt ! $ 63 00 b) $ 75 00 $12500 $16300 $375 00 $ 50 00 -";" -" ~ ~~...-_ -0 $ 50 00 $ 69 00 $10000 $ 43 00 $ 300 N ~l1~ellane~~~ (Se~IC~/f~eder not mcln'fe'd) ~Each I~staii;hon THIS PERMf(SHALL EXPI' _0" - ...,,' AUTP,u}nP,Eu,rliW17gR THIS RE IF THE WORK$ 50 00 COtVSI,,"/011t1m~'I'llmtm~ PERMII IS NOT $ 50 00 DC'. VLV Uii'10 k ANnON ANYIltli1Jt<l9A'f1'rer*JB enha' EO FOR $ 25 00 LImIted Energy/CommercIal $ 45 00 MmImum ElectrIC PermIt InspectIOn Fee IS $45 00 + Surcharges The mstallatlOn IS bemg made on property I own whIch IS not mtended for sale, lease or rent ~~ P '-.---' InspectIon Request 726-3769 4 SUBTOTAL OF ABOVE 6) ~ . " 7% State Surcharge l.( I.{ ( 10% AdmInIstratIve Fee I.., )0 TOTAL 7~71 Shared Dnve(T )/Bulldmg Fonns/Electncal Pennlt Apphcatlon 1-03 doc ._~' --, (;11 r OF SPRIN~l'lJ!..LD ' Building/Combination Permit Status Pending 225 F,fth Street, SprlUgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspecl10n LlUe PERMIT NO: COM2005-00216 ISSUED: APPLIED: EXPIRES: VALUE: 02/23/2005 08/23/2005 $ 220,800,00 SITE ADDRESS 2062 HARBOR DR ASSESSOR'S PARCEL NO 1803112203500 Springfield TYPE OF WORK SlUgIe FamIly ReSIdence TYPE OF USE New PROJECT DESCRIPTION SlUgle famIly resIdence replaelUg eXlstlUg MH ReSldenl1al Owner ROBERT MENTZE Address 2062 HARBOR DR SPRINGFIELD OR 97477 Phone Number 541-741-8599 I. CONTRACTOR INFORMATION I Contractor Type General Electrical Contractor FM SHEET METAL OWNER License 89710 Expiration Date 03/15/2007 Phone 541-344-6002 VN BUILDING INFORMATION I on law requIres you to #,llnEiMl~ON Ore? d by the OregonIL\\l\4lt2e lf~g!Jtlat.SWu~flR.1l e Th se rules are SiIlI1tlIth Floor ~~Mlitoo~enter 0 t~rough OAR ~li1ltl Floor ~~~pi1: 001-001 les of the l'a\iIi'S BVsement ~N ~may obtain cOf the telealIlfiIa:;arage/Carport E;~~III?~tfi1e center, (No e Notlfi&li'/CfAther SPfIDl\ll'Jb~'<thig,?~e~~~$~344).occupant Load . .,.....-. .- I DEVELOPMENT iNFORMATION I REQUIRED PARKING # ofUmts Primary Occupancy Group Secondary Occupancy Group Primary Construcl1on Type Secondary ConstruCl1on Type # of Bedrooms R-3 Frontyard Setback SIde I Setback S,de 2 Setback Rearyard Setback, Solar Setbacks Overlay DlSt # Street Trees Rqd Paved Drive Rqd % of Lot Coverage ~- Total. HandIcapped Compact Street Improvements Storm Sewer Available SpecIal Instrucl10n I PUBLIC IMPROVEMENTS I NOTICE' SIdewalk Type THIS PERMllDllwn,;!t9I[fS}.DFliins: THE WORK AUTHORIZEO UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD Notes Page I of2 CITY OF SPRIN\JJ:<l~LD ' Building/Combination Permit Status Pending 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspecllon Lme PERMIT NO: COM2005-00216 ISSUED: APPLIED: EXPIRES: VALUE: 02/23/2005 08/23/2005 $ 220,800,00 I Valuation DescrintJon I Descnpllon Dwellmgs Tvpe of ConstructIOn V Wood Frame $ Per Sq Ft or mulllplIer $96 00 Square Footage or B.d Amount 2,300 00 Value Date Calculated Total Value of Project $220,800 00 $220,800 00 02123/2005 Fee. Paul I Fee Descnpllon Plan Review Resldenllal + 10% AdmlDlstrallve Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $623 29 $630 $441 $63 00 2123/05 2124/05 2/24/05 2/24/05 Receipt Number 1200500000000000237 1200500000000000243 1200500000000000243 1200500000000000243 Total Amount Paid $697 00 I Plan Reviews , To Request an inspection call the 24 hour recordmg 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 R..omr..d lo.oectioo. I Electnc Serv.ce Approval reqUlrcd pnor to ulllIty company energIZIng service By signature, I state and agree, that I have carefully exammed the completed applIcallon and do hereby certify that all mformatlOn hereon IS true and correct, and I further cerllfy that any and all work performed shall be done 10 accordance with the Ordmances of the City of Sprmgfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and that NO OCCUPANCY will be made of any structure without permiSSIOn of the CommuDlty Services DlVlslOn, BuIldmg Safety I further cerllfy that only contractors and employees who are 10 complIance with ORS 701 005 Will be used on thIs project I further agree to ensure that all required mspecllons are requested at the proper lime, 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 remam on the site at all times dUring construction Owner or Contractors Signature Date Page 2 of2 22~ Fifth,Street Springfield, Oregon 97477 541-726-3759 Phone GPRINGFJaLO ~ rlty of Springfield Official ReceIpt ~velopment Services Department Pubhc Works Department Job/Journal Number COM2005-00216 COM2005-00216 COM2005-00216 Payments Type of Payment CredltCard 2/24/2005 RECEIPT #: 1200500000000000243 Date: 02/24/2005 Description + 7% State Surcharge + 10% AdmInIStratIve Fee Perm ServlFdr 200 amps or less PaId By ROBERT MENTZE Item Total Check Number AuthorizatIOn Received By Batch Number Number How Received dJb 014231 In Person Payment Total Page 1 of 1 8 13 28AM Amount Due 441 630 6300 $73 71 Amount Paid $7371 $73 71