HomeMy WebLinkAboutPermit Electrical 2008-7-16
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22<; F1F111 STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number LOllV\e',OO g- -0/0 6S-
] I LOCATION OF INSTALLATION:
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-ST
LEGAL DESCRIPTION
170>"55,(
JOB DESCRIPTION
l::>2~OO
p~!:t;:e a:-tr=~~(a:d ex~ I~:lS
not started wIthm ]80 days of .ssuance or .f work .s
Suspended for ]80 days
2 [C~I:'!{RACTpilNSTAL!:ATION O~!~
Electncal Contractor If\.}1 ~I e ctY' ; ( 11\ ~ \ l\) G-
Address '3a31 ~ R~\e\J ll4l'Je
CIty Cb1fli.~e~f' Phone 7J.Q -{ 45~1
V
Supervisor License Number :3 q 'J..:S 3
ExprratlOn Dale I'D I (O
,
Constr Contr Number 1'!J7 ,<)1() b
Exprratlon Date
Jl I t/i
?:o'~:i5't.~'C~
Owners Name Jvf,c-~~( C,oc...lU--L
SCf; S 6ai-t- fL
~ +>F~
Address
City
Phone
OWNER lNST ALLA nON
The mstalIatlOn IS bemg made on property I own whIch
IS not mtended for sale, lease or rent
Owners SIgnature
InspectIon Request 726-3769
Date
3
A New ReSIdentIal c. S.ngle or MultI-Family per dweIlmg uniL
..-" =~ ~ ~ --~--"
Serv.ce Included
1000 sq ft or less
Each addItIOnal 500 sq ft or
portIOn thereof
Each Manufact'd Home or
Modular DwelImg ServIce or
Feeder
$11700
$2100
$55 00
B : Servtces o~ F;eders -. InstalIatl(~n, AlteratIOns orRclo~t~n---
,>> .:0 ',,- _>>_ _>>_ _ ,_ _>> ~_
New ~lteratIon or ExtenSIOn Per Panel
One Crrcmt
Each AdditIOnal Crrcmt or WIth
Service or Feeder PermIt
TOTAL
$ 70 00
$ 83 00
$13800
$18000
$41300
$ 55 00
,>,
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts \Q
Reconnect Only ~U\t~ 'IOU 11'rt I
tI \aVl ta allOtl \)\\ "h
'tJ.. Ot~~go- - ~~~..~o" "
.t'r\O'reD/ e 1" \-. '.
"'"E.\..... 'SaD ~a -OJl.~ ,.,-
1o\\OVl t,:,\a Q~~~~U1!~Ug" ^fJQ.~1~~
tlot\\lcat\IlI\~~ ~'CO~\(/'t~~f
Oil-I'> ~:~::u:,'1l ~m\o\a" W9 ~ o'Uf.I~\ot\
\~(), ~i~tl~. \~ \i\\t~AJ,).
ca\\\l\':J ":'~. e .'~
~ i\&l\i ps
till c;e
Over 600 Amps or 1000 Volts see "B" above
~ ~I""'''''~- -~~~-
D, Branch CIrcuIts'
L.~
-- ~~~ - ~~~-
E MlScellane~~s (Se.y~",feeder.n.o,tI~f!;~~~}~S!a!latlOn ~
Pum~-Giim S\\r:..\.\. ~\1l.~~~~\l~ ll\91
SIgn!'t'/\\e~~ \l~tl~? i\\\tl Do~i~Olf{)8Jo
Llmlt"fi.'lJ' ~I't IS ABt-N $ 28 00
LImite pal.IOO. $ 5000
MID,mum EI~c ~\1Jl nspect.on Fee .s $50 00 + Surcharges
4 [SUJJ,!()T~OFAnOVE - ~~-~~ Ss-
12% State Surcharge 660
10% AclJmmstralive Fee .5 JO
5% Technology Fee -Z 7'
67 ~.
-.
-.
$ 55 00
$ 76 00
$11000
$ 48 00
$ 400
Shared Dnve(T )/BUlldmg FormslElectncal PermIt ApplicatIOn 1-08 doc
Status
Issued
225 FIfth Street, Spnngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn LIDe
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2008-01065
ISSUED: 07/16/2008
APPLIED 07/16/2008
EXPIRES. 01116/2009
VALUE.
SITE ADDRESS 1133 J ST
ASSESSOR'S PARCEL NO 1703351102300
Spnngfield TYPE OF WORK Electllcal Work Only
PROJECT DESCRIPTION Replace servIce mast
TYPE OF USE
Owner MICHAEL CROCKER
Address 549 S 68TH PL
SPRINGFIELD OR 97478
Contractor Type
Electncal
I CONTRACTOR INFORMATION I
Contractor LIcense
MY ELECTRICIAN INC 87506
BUILDING INFORMATIONJ
# of UOItS
Pnmary Occupancy Group
Secondary Occnpancy Group
Pnmary ConstructIOn Type
Secondary ConstructIOn Type
# of Bedrooms
Front yard Setback
SIde I Setback
SIde 2 Setback
Redryard Setback
Solar Setbacks
Street Impl ovements
Storm Sewer A vadable
SpecIal InstructIOn
Notes
DescnptlOn
# of Stones
R-3 /_-,.,_ HeIght of Structure
1 {' '-Type o,f Heat
.... 10v/ I U' ~,..,.'"'
VBNOI' I UIM;ater Type:J law r
111('at qt. Jhl"'-:;',.J eqUJ
In OAR lorRll.!I,g~e7Yiie:'Jy the Or res You to
0090 y;62 Elg~r1W ltJiise rUles egO" Utility
_ cal/lnp t~~WHaln ~~dg~O';~~~t ~l'ih
-'~"\!E,,-,:ritiP~q~fi&Mi"fllI1l~;
!, ,,~ns 1 ~ -!. Utility N -',erfJ1Ie
-800-JJ2 OtlflcatJO
Overlay Dlst -2344). II
# Street Trees Rqd
Paved Dnve Rqd
% of Lot Coverage
I PUBLIC IMPROVEMENTS'
Repair
ReSIdentIal
ExpIration Date
11/20/2009
Phone
541-729-1454
Lot SIze
Sq Ft 1st Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Gdrdge/Cdrport
Sq Ft Other
Occupant Load
REQUIRED PARKING
Total
HandIcapped
Compdct
SIdewalk Type
NOTICE: Downspouts/DralDs
i~~~E~1~~ ~~~i~ ~~~R~E'~J~E/tZ~:
liMY "~r IN,' ;-~r.;.,~BANDONED FOR
I Valuation Descflotion I
$ Per Sq Ft
or multIplier
Square Footage
or BId Amount
Type 01 ConstructIon
Page I 01 2
Value
Date Calculated
-ri...~
Status
lss u ed
CITY OF Srl(lj~uFIELD .
Building/Combination Permit
PERMIT NO: COM2008-01065
ISSUED: 07/16/2008
APPLIED, 07/16/2008
EXPIRES, 01/16/2009
VALUE:
225 FIfth Street, Sprmgtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Total Value of ProJect
F~es PaId I
Fee DescnptlOn
+ 10% Admm,strdllve Fee
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount PaId
Date PaId
ReceIpt Number
$550
$660
$275
$55 00
7/16/08
7/16/08
7/16/08
7/16/08
1200800000000000782
1200800000000000782
1200800000000000782
1200800000000000782
Total Amount PaId
$69 85
Plan Reviews ,
To Request an InspectIOn call the 24 hour recordIng at 726-3769 All inspections requested before 7:00
a m, wtll be made the same workIng day, InspectIOns requested after 7'00 a m. WIll be made the folloWIng
work day.
I Relllllred Tnsnechons I
Electnc ServIce Approval req mred pnor to ullhty compauy energlzmg servIce
By sIgnature, I stdte and agree, that I bave carefully exammed the completed apphcallon and do hereby cerllfy tbat all
mfnrmatlOn hereon IS true and correct, and I further certIfy that any and all work performed shall be done m accordance wltb
the Ordmances of the City of Sprmgtield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and
thdt NO OCCUPANCY w.1I be made of any structure wIthout permIssIOn of the CommuDlty Serv.ces DIVIsIOn, BUlldmg Safety
I further cerllfy thM only contractors and employees who are m comphdnce w.th ORS 701 005 WIll be used on thIS project
I fUl ther agree to ensure that all requIred mspectlOns are requested at the proper lime, that each dddress IS readable from the
street, that the permIt card IS located at the front of the plOperty, and the approved set of plans WIll remam on the sIte at .11
hmes dunng construction
Owner or Conll actors Slgnatnre
Date
Paee 2 01 2
225 FIfth-Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0 I 065
COM2008-0 I 065
COM2008-0 I 065
COM2008-0 I 065
Payments
Type of Payment
CredltCard
cReLetntl
RECEIPT #,
Descnptlon
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstratlve Fee
PaId By
MY ELECTRICAN
l~QA~
II&:
CIty of Sprmgfield OffiCIal ReceIpt
Development ServIces Department
Pubhc Works Department
1200800000000000782
Date, 07/16/2008
Item Total
Check Number Authorization
Received By Batch Number Number How Received
dJb
015542 In Person
Payment Total
Page I of I
9 08 33AM
Amount Due
5500
275
660
550
$69 85
Amount Paid
$69 85
$69 85
7/1612008