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Home My WebLink AboutPermit Electrical 2008-7-15 ZON INITIALS i''{'Y"'. .A!.. DATE\ ''''\If '0j., \Oi8J' SOURC~~2J yf~OOg ~ COMPLETE FEE SCHEDULE BELOW Date 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number Lc>vV\~Og-- DO 7Z'!: I Lf 86;ION OA-INST~tTION: LEGAL DESCRIPTION /702..:>24 ( 4gb C'i '';A <:::.r/Z.t:E T JOB DESCRIPTION 3 o {l( 00 A. New ResJdenhal- Single or Mulh-Famlly per dwelllug UUlI. Service Included HE'ff3(2. esTATES LoT$7 1000 sq It or less Eacb addItIOnal 500 sq It or portIon thereof $11700 $2100 Permits are non-transferable and expire .fwork IS Each Manufact'd Home or not started wlthm 180 days of Issuance or If work IS Modular Dwellmg ServIce or $5500 Suspended for 180 days Feeder \ )/(,1lq~~~~.Il~. 2 CONTRACTOR INSTALLATION O~:W. QregOR lar ~ ~.=.;I"(fl1U\ - InstallatIOn, AlteratIOns or RelocatIOn ",ii€\'li~es ~dopted bY ruleS ale se\ ~1. ElectrIcal Contractor lo\\OW rU_r ~p,nter i\1~~>>~~M\~~ 'a'I $ 70 00 l'lotl1\GR95i_o01.001~~~]QIt\\Ilto~s $ 83 00 \~_Q{>; 'lourna'lOb\a.W:d/ ~.w\ll,p~~~ $13800 uv:lQ, \1e center. \'~ II ~~ callIng \or \\18 oregllll) :jlIlO Amps $180 00 nurnb8r^'ll\\8l \a 1 00 AmpsNolls $413 00 . Reconnect Only $ 55 00 Address CIty Phone SupervIsor LIcense Number C Temporary Services or Feeders ExpIratIOn Date \tt'- } 0" InstallatIOn, Alterahon or Relocahon 200 Amps or less"""""- 1(. 201 Ampst0400AmJl~~\N~i C~.401 Amps~~~ ?~,,\S',I ' "01\ ~~~ .'1h\~~,fk9 iQ\\" above i\'\\S 90~_ c~~ f>.\Ii\,\on r~.' t'I. CQ~~~\t t~i\\Q;'fJ'r ExtenSIOn Per Panel ~'l ~ ~ IrcUlt t>i Each AddItIOnal CIrCUIt or WIth ServIce or Feeder PermIt ( $ 55 00 $ 76 00 $]]000 s-r Constr Contr Number ExplfatlOn Date SIgnature of Supervlsmg Electnclan 120 DO '1 ---rP roTA Owners Name I-IflJbfTftT ~/Z..l-IuHA'" rrt Address PO. i?,tJ)< 499, CIty SfPJ ()/L Phone 7.1/-1-/707 $ 48 00 $ 400 E Miscellaneous (Service/feeder not mcJnded) -Each InstallatIOn OWNER INST ALLA nON The mstallallOn IS bemg made on property I own whIch IS not mtended for sale. lease or rent Pump or ImgatlOn $ 55 00 SIgn/Oullme LIghtmg $ 55 00 Lumled Energy/ResIdentIal $ 28 00 LImIted Energy/CommercIal $ 50 00 Mmlmum ElectriC Permit InspectIOn Fee IS $50 00 + Surcharges Ow~,I 12% State Surcharge 10% AdImmstrallve Fee 5% Technology Fee 5j- 4."" 5.50 C:7J b 7 ~;: 4 SUBTOTAL OF ABOVE InspectIOn Request 726-3769 TOTAL Shared Dnve(T )/Buddmg FormslElectncal Penmt ApphcatlOn 1-08 doc -~ .1iiI Status Issued 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlOn Lme CITY OF SPRIN&J:<lJ<.LD Building/Combination Permit PERMIT NO: COM2008-00725 ISSUED. 07/15/2008 APPLIED OS/22/2008 EXPIRES 01115/2009 VALUE: SPRINGFlETYPE OF WORK Electncal Work Only SITE ADDRESS 4869 A ST ASSESSOR'S PARCEL NO 1702324101400 ResIdential TYPE OF USE New PROJECT DESCRIPTION Temporary Electnc Only Owner HABITAT Address POBOX 458 SPRINGFIELD OR 97477 Contractor Type Electncdl Contractor OWNER # ofUmts Pnmary Occupancy Group Secondary Occupaucy Group Pnmary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms Front yard Setback S,de 1 Setback SIde 2 Setback Rearyard Setback Solar Setbacks Street Improvements Storm &ewel AvaIlable SpeCIal InstructlOu Notes DescnptlOn Type of ConstructIOn Phone Number 541-741-1707 I CONTRACTOR INFORMATION , License ExpiratIon Date Phone I, BUILDING INFORMATION' ,I :' 0 - C~ law reqUires you to i # of Stone"tc rl by the Oregon Utility Lot SIze 'c HeIght of Struct!!~~ rules are set forth Sq Ft 1st Floor Type_ of Heat J through OAR 952-001- Sq Ft 2nd Floor Water Type Jln copies of the rules by Sq Ft Basement ^ Range Type. (Note the telephone Sq Ft Garage/Carport "c" _ Energy Path 'gon Utility Notification Sq Ft Other SprmkledSlluildiiIgl32-2344).n/a Occupant Load I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay DlSt # Street Trees Rqd Paved Dnve Rqd % of Lot Coverage Total HandIcapped Compact 'r ,\OIl'\I).'f I PUBLIC If\\\~~iME~Ui"'\.\, tf-?1t\E \~~11 IS ~Oi ililS :;~lEO \It.mtt\S;ll~6g~fOt\ j\.\.l~'MtNCtl) Ot\ IS ~ownspoutslDrdms COWl 00 l)j\.'; ptRIOO, j\.N'; 10 I ValuatIOn DescriDtion ~ $ Per Sq Ft or multiplIer Square Footage or BId Amount Value Date Calculated Page 1 of 2 CITY OF SPRINGI'lI'.,LD Building/Combination Permit Status Issued PERMIT NO ISSUED. APPLIED' EXPIRES' VALUE COM2008-00725 07/1512008 OS/2212008 0111512009 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Total Valne of Project Fees Palll I Fee DescriptIOn + 10% AdmmlstratIve Fee + 12% State Surcharge + 5% Technology Fee Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $550 $660 $275 $55 00 7/15/08 7/15/08 7/15/08 7/15108 2200800000000001081 2200800000000001081 2200800000000001081 2200800000000001081 Totdl Amount Paid $69 85 Plan RevIews I To Request an mspectlOn call the 24 hour recordmg at 726-3769 All mspections requested before 7 00 a.m. WIll be made the same working day, mspectIons requested after 7:00 a m will be made the followmg work day I ReQUIred' nsn~ctlOns I Temporary Electric Approval requlled prior to Utlhty Company energlzmg pole By signature, I state and agree, that I have carelully 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 perlormed shall be done m accordance With the Ordmances of the City 01 Springfield dnd the Laws of the State of Oregon pertdmmg to the work desCribed herem, and that NO OCCUPANCY WIll be made of any StruCtUl e Without permiSSIon of the CommuDlty Services DIVIsIOn, BUlldmg Safety I further certIty that only contractors and employees who are m comphance With ORS 701 005 wIll be used on th,s project I further agree to ensure that all reqUIred IIlspectlOns are requested at the proper lime, tbat 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 dunng constructIOn ow"~~hi, 7 -1,:;,--88 Ddte Pa~e 2 of2 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00725 COM2008-00725 COM2008-00725 COM2008-00725 Payments Type of Payment Check cRecemtl ~.. R'NQFI~ ; .... ~ art: - CIty of Sprmgfield OffiCial ReceIpt Development ServIces Department Public Works Department RECEIPT # 2200800000000001081 Date. 07/15/2008 DescriptIOn Temp Power 200 amps or less + 5% Technology Fee + 12% State Surcharge + 10% Admm.strat.ve Fee Paid By SPFD EUG HABITAT Item Total Check Number Authorllatlon Received By Batch Number Number How Received DJB In Person Payment Total 1598 Page I of I 1 24 18PM Amount Due 5500 275 660 550 $69 8S Amount Paid $69 85 $69 8S 7115/2008