HomeMy WebLinkAboutPermit Electrical 2008-9-5
Date
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22~ FIFTH STREET 0 SPRINGFIELD, OR 97477 0 PH:(541)726-3753 oFAX:,(541)726-3689:
'~ .
ELECTRICAL PERMIT APPLICATION
City Job Nuinber L 0......... z..o-6Y ~ 0 13 l.f S-
1. 1~~~~~Q~~~~r;W 3.
LE~lO:rfl~\
, 200 Amps or, less $ 70.00
201 Amps to 400 Amps $ 83.00
401 Amps to 60Q;Amps $138.00
601 Amps to 1000 Amps $180.00.
r~~'?:~'r:7.,~: (~~(!JJ.v requir~veoJq&o AmpsNolts $41300
tOP~NI /ules adopted by the orerfOf\'l\\1ttV Only: / $ i?oo 5 7 '
S perv' ['so Ll'C nseNum' ber~n'Ooil~f(~7f))'!~?~1n.t;.Or'10ThthOrsOeUr9Uhleos:Rr,,~1..~~~~~m)~~t...~_. ' - ~@ ... ,
u r e ' ,,11, ,.;.<J J) '"' ll:l"<ir~",,___,_..._.l...~~'ilffil .' ,
, 008U, YOU may obtain copies of the rules by,' ,
Expiration Date ) () - {cellirlll ~E/ @nter. (Note: the te!njsOOllltion, Alteration or Relocation
IlUIlO;"'" lv, ,i,,, V'''i,jVIl Utility N~ificalion I
1 ( "7 7C''''liller is 1-800-332-2344 ?lTAlI1pS or ess
Constr. Contr, Number I-TV 0 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D.
() ,) " ' ' New Alteration or Extension Per Panel
I~ ).-1 f"V'""1 One Circuit
. / " I Each Additional Circuit or with
Owners Name M I b;::. N~'!~~';'SliAhLL' r=v",~ ;i~~~Z~:~'~':Y0'0Y-'~"'~~::~'llilli""-"-"'r~fu1
Address 7 ~ C4.~~~aG il~ n\1S,,~~t}I(~~~~~~~J!I!I!~.~~!i!:'!l2!)I~j~1!~l~!!!U@EJJ
City N &tN f"" P~n~Mr.l=n OR IS ABAND9~p or lITigation $ 55,00
ANY 180 DAY PERIOD. 'Sign/Outline Lig11ting $ 55.00
OWNER INSTALLATION Limited EnergylResidential ' $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
$7
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72 '!!.
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JOB DESCRIPTION:
Pe~~~ ~~::::~nd eX~::2k is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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2 'lC'pNTJ?Ael:(}H-l'Q{$.r.~I1!1lJ!iN'ig!f!jKi'f+
. r.; ""'._ . . -!;.0","""'''=",,,,,,,,"''''' , _. ,,. --_." fi:txxt "'-~~'-'-,
Electrical Contractor
&1\5/5 If) f. f,Uc-rf(1 c..
Address 3 '8'" ). S" 3
Bas GA G e: ti,J,
City
S~<.(I...O
Expiration Date
Jo-j-()Cj
Signature of Supervising Electrician
The installation is being made on property,l own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
~X:~~~*Jfi~tiJ~rm~1S0G~~AGt')!.'t%i*WN;i~-=S--'''%lliK'Al1B0''.AMJ'-'iY'''-.''
A. ~N~!I;l~~,t(te,!!,j'!.L;;;;;.~j!!g!~l!!!:i~ifjiij!fp:eft~:!lfel1iJlg~unit3'lii.
Service Includecl
1000 sq, ft. or less
Each additional 500 sq. ft, or'
portion thereof
Each Mannfact'd Home or
Modular Dwelling Service or
Feeder "'
$117.00
$ 21.00
$55.00
B.
$ 55.00
$ 76,00
$110,00
$ 48,00
4.
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Drive(T:)lBuilding FonnsJElectrical Permit Application 7-07.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2008-01345
ISSUED: 09/05/2008
APPLIED: 09/05/2008
EXPIRES: 03/05/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1704 H ST
ASSESSOR'S PARCEL NO.: 1703362106300
Springlield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Reconnect only
Owner:
Address:
Contractor Type
Electrical
WOOTEN MICHAEL B & JOAN C
72A CENTENNIAL LOOP STE 130 'r8S 'IOU \0
EUGENE OR 97401 0 8QOll laW reo,oUleg, oll UtiliW
._"-,,,,'- A~, .. ",hp. f ," -'nt\\,
P;\ I "". ~ies ?r\oP"'~, -.'_^ 'Illes al" :::;.. n<1\-
10110W I, ce'W!:ONT.RAr=>~M1i\'ION I "
\'I \ilica\IOll . ' ,." ,; 1t{f,~; if!l . :.
; 0 ~p. 9S2-OO,-uv \aill caples \eI8p\10lle.
cont'tIRt,i1t'lOU ma'l ob .\,\'10\8', ,\\\8 \'Io\ilica\ilrice~se
EAS1%<I~~,;jI;~~;ffl,'t\Oll U\I\\\Yn AA\ 117770
number ~~~i~mm:;~1~6 iN~?RMi\ TlON,"
I
Expiratiou Date
10/0412009
Phone
541~915-9828
VB
# of Stories:
Height of Structnre
, Type of Heat:
, , Water Type:
Range Type:
Energy Path:
Sprinkled Building:
~ I1tWIkl'ljj;JlI,T.~~I'~ WORK
,A.'UTHOFlIZED UNDER THIS PERMIT IS NOT
COMld~!)IOllIS ABANDONED FOR
tffKv ~~I'l'I/}Ad:
ANY 1, Vd'D{,~e' ltqa:"
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occnpant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
, n/a
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
REQUIRED PARKING
, Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction :
Sidewalk Type:
DownspontslDrains:
Notes:
I V aluation Desc~iD~ion 1
Description
Type of Construction
$ Per Sq Ft
,or mnltiplier
Square Footage
or Bid Amount
Valne
Date Calculated
Pa!!e 1 of2
-~~~~,~~I;,~g~",~,~,,,,!;1"!~
it
f '
I'
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2008-01345
ISSUED: 09/05/2008
APPLIED: 09/05/2008
EXPIRES: 03/05/2009
VALUE:
225 Fifth Street,.Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Liue,
Total Value of Project
Fees Paid,'
Fee Description
+ 100/0 Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$5.70
$6.84
$2.85
$57.00
9/5/08
9/5/08
9/5/08
'915/08 '
1200800000000000944
1200800000000000944
1200800000000000944
1200800000000000944
Total Amount Paid
$72.39
Plan Reviews 1
To Request an inspection call the 24 hour recording at 726-3769: All inspections 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.
Relluired In,snections .
Electric Service: Approval required prior to ntility company energizing s,ervice.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any aud all work performed shall be doue iu accordance with
the Ordinances of the City of Springfield and the Laws of the Siate of Oregon pertaining to the work described herein, a~d
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are iu compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required ins-pections are requested at the prope"r t.ime, that each address is readable from the
street, that the permit card is I?cated at the front of the property, and the approved set of plans will remain on the site at all
times during construction. ' .
Owner or Contractors Signature
Date
Pa~e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
COM2008-0 1345
COM2008-0 1345
COM2008-01345
COM2008-0 1345
Payments:
Type of Payment
CreditCard
cReceiotl
RECEIPT #:
Description
Service Reconnect
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
ROGER KING
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000000944
Date: 09/05/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
04530B, In Person
Payment Total:
Page 1 of 1
11 :42:42AM
Amount Due
57,00
2,85
6,84
5,70
$72.39
Amount Paid
$72.39
$72.39
9/5/2008