HomeMy WebLinkAboutPermit Electrical 2008-8-22
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225 FIFfH SlREET . SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
CIty Job Number L 0,#\ z-o c) lr - 0 \ Z. 7 f
1 L/ijjCATi6jii6FiNSTAT:r.ATi6N;&{:~l(: ':li
f,,--y---'S'-j+l..- .':S:-F"'" .,
200 Amps or less $ 70 00
20 I Amps to 400 Amps $ 83 00
Bas GA G t::. L /J. 401 Amps to 600 Amps $13800
ATTENTION ~'~R~to 1000 Amps $18000
Phone 7 If (- (Y,'l'f c"l' rUles ae.yf'l!e!9~/.ooIl'1f~ you to $413 00
"VUII~atlon CeRllqoI1JlF.~ 'Dregon Utility $ 55 00
10 OAR 952-001-0010 " les are selforth
0090 You m"" ~_~~~ . , , ., ,.
n~~~:~ ~~~ t~~~'i~=hO~ aI~ii1>ihG[,,:
Center 19s~Ji~3~llIltJ~R;9Ii&,locatIon
200 Amps 01i~44J.
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600
New AlteratIon or ExtenSIOn Per Panel SO
One Crrclllt I ~OO ~-o
Each AddItIonal Crrclllt or wIth r / A 0
SeTVIce or Feeder PermIt Z $ /00 ~'-' {
rs OTI CE 'rlJi"-"""""""'''"''''' ,'.'.' .,....",.".",,-, ,.","".n~_" """~ """~.
. ;j~- 1m" ~rr '''''''''''a'' ~,,,n ;r; jm""" ~ ,,~j;r; ~~",~~~1'" "'f"'''''-~~"''i,'''.#n'''=f?S,:'''ru~>'%W;f '"'" ~^'^'f41 1
THIS P~' [~~te!x~~w5Wi~S!~,~,!',~llf!ll,SIl;!!1.:'!lIUationl.
~UTHORI~tV~affilS PERMIT IS NOT $ 55 00
(,OMMENISfg;lJalihI&A~IdOONED FOR $ 55 00
OWNER lNST ALLA nON ANY 180 1l~I!'eIi~/ResldentIaI $ 28 00
The mstallatIOn IS bemg made on property I own which Lnlllted Energy/CommercIal $ 50 00
IS not mtended for sale, lease or rent Mmlmum ElectriC Permit Inspechon Fee IS $50 00 + Surcharges
4 ~~Uii~OTALVF3UfOl;E~""'l~~lr~ 6 ()
Owners Signature ~~;;' ~:~~:;~~ b.~", ,~w~,m1p_~b;;t1 7zD
10% AdJmlllstratlve Fee b
5% Technology Fee -r
7b~
LEGAL DESCRIPTION
17uZ 331(
OS (00
JOB DESCRIPTION
-JrJ.i ') Cl"'c.~\h
Permits are non-transferable and expIre If work IS
not started wlthm 180 days of ISsuance or If work IS
Suspended for 180 days.
!rCONfRAcrORINSi;;.a;tTIbNONLQ~
2 ~->"~~";:~Md-J~~".m;c,/",,;:;jA'F't0h0"J /. ,,;_ "''''~''m"",.~,i ""-trb-"01!
ElectrIcal Contractor
t;' !\ST5 (0 (. c(cGTf(IC-
AddJess 3 ~ ). S' 3
CIty
s~o;r(o
ExprratIon Date
Y717.s
}()-f-J,DIO
117770
)0-1-09
Supervisor LIcense Number
Constr CODtr Number
ExprratlOD Date
Signature of Supervlsmg ElectrICIan
I~
Owners Name 7-;....,~... G.:.e-
s 71-l-. ~ \--
~[>-A
Address
1117
S::Pf"::~
Phone
City
Inspection Request 726-3769
Date
3 !;CO.MPLKifi,EEiJ:'SCliED'tJi1;;BEijjWVi;JI!i!!l!t{f!!:!.~r:.'r':: r'i 'I
~;aji._' _._ ,._ ~._i._.,_",,""i.v>"_"". _J;"~",",_M~~ "'''"'0.-",,,__< ~~m mm~_li_~m4'_0.&'\~;:':;;,_, ",__.
A ~N=tii~iidtiit~i3:4SiD'#;i;:tMrirti!F1lfiil~~elli~;;i;;it.)~r",,'~
...,.... _ u.,..... "'''"...._ .. _.,"",:o1,"'.m .,.,~___ '._~ "''___ _~m_..~~u Y~iP=....","",,~ g, ._. ,",1. '.
Service 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 ':S~~~fr~j~~~ri:: id;;';IY;1ii:~~..trtr.l~l=r,~~~l;~d!~~j:l.
L1drJ)W302iV'M441if["-L01;.u'k ~"' ""',JY::~ ',_ ~~~1U:1 ~~.,'" ~di""'110W0WVl:&iillil%Ai@1Th1'"w_,=A""h<kl ~
$ 55 00
$ 76 00
$110 00
D
TOTAL
Shared Dnve(T )/Butldmg FonnsJElectncal Permit ApplicatIOn 7-07 doc
-~ -"--
Status
Issued
225 F,lth Street, Spnngtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO. COM2008-01271
ISSUED: 08/2212008
APPLIED. 08/22/2008
EXPIRES: 0212212009
VALUE'
SITE ADDRESS- 1117 57TH ST
ASSESSOR'S PARCEL NO 1702331105100
Spnngfield TYPE OF WORK ElectrICal WOI k Only
PROJECT DESCRIPTION Add 3 CirCUIts
TYPE OF USE
Owner RANDY CLINE
Address 1117 N 57TH ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Electncal
Contractor
EASTSIDE ELECTRIC INC
License
117770
# of Umts
Pnmary Occupancy Group
Secondary Occupancy Group
Pnmary ConstructIOn Type
Secondary ConstructIOn Type
# of Bedl ooms
Front yard Setback
Side I Setback
SIde 2 ~etback'
Rearyard Setback
Solar Setbacks
Street Improvements
Storm Sewer AvaIlable
Speclall"'tI ulllOn
Notes
BUILDING INFORMA nON I
# of Stones
R-3 Height of Structure
Type of Heat Ires you to
'" 0 (,.1la'aW requ
VB f"' '] \T\:)Wateloll~l-'~ h Oregon Utility
, R ,- .",,(1 hy t e f rth
f , ,,( ~ ange.. Jye' 58 rules are set 0
t 1" L "t'~nEncr'gY Pltl~ hOAR 952-001-
" f'H r.~1 II
In O/\I'i 9!)2SpnnklWB Wd\~~ of the rul<B'i,oy
"_ .......:H/('\htalnCOP . \._.........^
vv X.~D.I'J\(EllJOPMEN-M&flh;IlM~lirooo.lfn
',Il. , "Ii I.'
num08' IV' ,,,. -, 6"00-332-23"'1).
Center IS ,-
Overlay Dlst
# Street Trees Rqd
Paved Dnve Rqd
% ot Lot Coverage
I PUBLIC IMPROVEMENTS I
AdditIon
ReSIdentIal
Phone Number 541-
ExpiratIOn Date
10/04/2009
Phone
541-915-9828
Lot Size
Sq Ft 1st Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft GaragelCarport
Sq Ft Other
Occupant Load
REQUIRED PARKING
Total
Handicapped
Compact
SIdewalk Type
DownspoutslDrams
",nTIr.I=' , oL'ftJ'
- .l'lAttiXPIKt: If '1'\,[ \~". r..
I va~{Fnrn~ "HIS PERMIT IS NOT
~~ENCEDIi~~BANDONED FOR
$ PelV3ll\l'I" a oO/age V I
or muMJllitWO DAY ~ mount a ue
DeScflPtlOn
Type of ConstructIOn
Pal1.elof2
Date Calculated
SPRINGFIELO
-I
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO. COM2008-01271
ISSUED: 08/2212008
APPLIED: 08/2212008
EXPIRES, 02/2212009
VALUE:
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769InspeltlOn LlDe
Total Value of ProJect
Fees Pmd I
Fee DescrIptIOn
+ 10% AdmmlstratIve Fee
+ 12% State Surchal ge
+ 5% Technology Fee
Add, Alter, Extend CIrc
Add, Alter, Extend CIrc Ea Add
Amount Paid
Date Paid
Receipt Number
$600
$720
$300
$50 00
$10 00
8/22/08
8/22108
8/22/08
8/22/08
8/22108
1200800000000000902
1200800000000000902
1200800000000000902
1200800000000000902
1200800000000000902
Total Amount Paid
$7620
I Plan RevIews I
To Request an InspectIon call the 24 hour recordmg at 726-3769. All InspectIOns requested before 7:00
a,m. wIll be made the same workmg day, mspectIons requested after 7:00 a.m, wIll be made the folloWIng
work day,
I Reo III red InsoectlOos I
Rough Electnc Pnor to Cover
FlDal Electnc When all electncal work IS complete
By SIgnature, I state and agree, that I have carefully examlDed the completed apphcatlOn and do hereby certIfy that all
mformatlOn hereon IS true and correct, and I further cerhfy that any and all work performed shall be done ID accordance with
the OrdlDances ot the CIty of Spnnglield and the Laws of the State of Oregon pertamlDg to the work descnbed herelD, and
that NO OCCUPANCY will be made 01 any structure without permISsIOn of the Commumty ServIces DIVIsIOn, BUlldmg Safety
1 turther certlly that only contI actor; and employees who are ID comphance wIth ORS 701 005 wIll be used on thIS proJect
I lurther agree to ensnre that all reqlllred mspechons are requested at the proper tIme, that each address IS readable from the
street, that the permit card IS located at the front 01 the property, and the approved set of plans will remam on the site at all
times durmg construction
Owner 01 Contractors Signature
Date
Page 2 of2
225 FIfth Street
SprIngfIeld, Oregon 97477
541-726-3759 Phone
~P"'NQFI""" ~
~
City of SprIngfield Official ReceIpt
Development ServIces Department
PublIc Works Department
Job/Journal Number
COM2008-0 1271
COM2008-01271
COM2008-01271
COM2008-0127l
COM2008-01271
Payments
Type of Payment
CredllCard
LRu..elOtl
RECEIPT #
1200800000000000902
Date 08/22/2008
Descnptlon
Add, Alter, EXlend Clrc
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State SUlcharge
+ 10% AdmlDlstratlve Fee
Paul By
EASTSIDE ELECTRIC
Item Total
Check Number AuthorizatIOn
Received By Bdtch Number Number How Received
dJb
05570B In Person
Payment Total
Page 1 of I
9 56 46AM
Amount Due
5000
1000
300
720
600
$7620
Amount Paid
$7620
$7620
812212008