HomeMy WebLinkAboutPermit Electrical 2008-9-5
SPRINGFIELD ZON ~
L~ :~S ~o...u..~
.225 FIFI1I STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726..3689 .... ~ , SOURCE ~() )
ELECTRICAL PERMIT APPLICATION ' :; ,I. _ / . . V r
City Job Number ' (' Ow\ Zc::>o.. r - 0 I 5, L( b Date 7 ~/ 0 ~
1. liJJil(j(ffJffj:IoNtOEriNS1M!i!Aiifi(jN?!~Q~,:: 3. WeoMPIJm;E~EiseiiE1i~BEOOW)rJl!j~_
~"',""',""''''HiOOJX^0,,.w;M"'''fk~r&Wii\'~'''' . .~"U',' ""'0.' it~!;l_"'''''''~''l<\'''Mjj'-'' "''''"''= """""'~ ~rz~__ '".~""~"" "'~~
17~ Z. h- '::>'
, 200 Amps or less $ 70,00
201 Amps to 400 Amps $ 83,00
401 Amps to 600 Amps $138,00
601 Amps tOtlOOO Amps $180,00
Phone _7 \.f (:( Y,,1n~on laW r((1j\il!fEj!bO'6:~Nolts $413.00
I\T1 t.N \IV'" d~pted by thER;leWR~WRiM.h I $ 5~0 ' "'.,
tollQW rules a Those rules are , 01- .' , -
Y,ICZi!2'azoR,_ce~~g;lothroe9111v.t~~~~:~~~!Et7amli!~_' _,,' 11-
",,0 ~<'" 00 , ple~~~~,~J~--- -~~-- -~ - _
':' -;:;.0 YOU may OOlaln ~~te: the tele~\1O~e
) () - I - ~(q\"liIQ; the cen~~'ecion U~\I~dlliiilll(fjlQration or Relocation
number tor ~II~ is 1-800-3~~S or less
1 ( 7 7 '7 0 Cen er 201 Amps to 400 Amps
, I 9 401 Amps to 600 Amps
)0- -()
Over 600 Ampsor 1000 Volts see "B" above.
D.
, New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with \<.
Owners Name 2#'\ ~..... /,t.Je>D,+-61( rN~l~~~S:~i.C~~:i:~'WKr~!!~~}t~i~~lfr~;~~
:= tu~'vE ':.:-~"'- \~~f~~, . ,"' ~,... '
OWNER INST ALLA nON Limited' EnergylResidential $ 28.0.0
The installation is being made on property I own which ' Limited Energy/Commercial $ 50,00 ,
is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
SI
bl1..,
srg
Zlll.
72~
LEGAL DESCRIPTION:
17033.bZ(
06 JOO
JOB DESCRIPTION:
~ t;c:..o "'- v\?-:.--c....A-', 0........\....
Pe~mits are non-transferable and expire if wJrk is
not started wilhin 180 days ofissnance or if work is
Suspended for 180 days.
eiTIDr'"eTORtlNsTMr~TION,DNIJR~l B.
2. . ""'.,"'" ..tBXli'0+<fA;di!-WliJ20&~""s&~'"tffdll;r''{jK'0ili1Eij0i%Fi0'1ffi);8*tdifu;;1
Electrical Contractor
61\Si51f) f c<.CC7"f(/C
Address :, '8" ). S- 3
605G/\ Gt.- L /J,
City
S~~c..O
Supervisor License Number
Expiration Date
Constr. Contr, Number
Expiration Date
Signature of Supervising Electrician
~
~
Owners Signature:
Inspection Request: 726-3769'
~~_~:~1JL!!~1'-"$rl!::40~AW;~ltJI~~~'~"'Pi0Rk:':-~1ij0~~W'~'0.
A. ~.s,~IP...t'!.~i!E!.!t"t~!~!!gt~l!!.r~M!!L!;Fa!J!.!!Y4!!,5f,i!~,"!!.!.l!g;)l11~'.'
Service Included
1000 sq. ft, or less
Each additional 500 sq. ft, or
portion thereof '
$117.00
$ 21.00
,
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder
$55.00
$ 55.00
$ 76,00
$110,00
$ 48,00
4.
8% State Surcharge
10% Administrative Fee
5% Technology Fee
, TOTAL
, Shared Drive(f:)lBuilding FonnsIElectrical Permit Application 7..()7.doc
CITY OF SPRINGFIELD
Building/Combination Permit
Status' Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: cOM2008-0I346
ISSUED: 09/0512008
APPLIED: 09/05/2008
EXPIRES: 03/05/2009
VALUE:
SITE ADDRESS: 1732 H ST
ASSESSOR'S PARCEL NO.: 1703362106500
Springfield TYPE'OF WORK: Electrical Work Only
PROJECT DESCRIPTION: "Reconnect only
TYPE,OF USE: Repair
Residcntial
Owner: WOOTEN,MICHAEL B & JOAN C
Address: 72A CENTENNIAL LOOP STE 130
EUGENE OR 97401
I CONTRACTOR ~NFORMATlON I
eClU'\les Vol.l,~,~,
contract\!f oregon laW I oregon Ijt\ h, License
J~'ASTSiP:f!:;.It~mR'rtt \1?!.<rlAS ale se~ \~~~ I 17770
- .
10\lrJ" ,-" tel' "X= - '>~"'\ - '~-.
~ lIon Cen ",BI.JljN1)'1N J1I',li't!}ItlWA TlON I '
NO\\\\viJ. 52001-00W "'11'" '" ,,; '~'
in 01\1'1 9. obtain OO\'I~V~- te\ephOn '
# of Units: 0090, ,<ouma)! ntel. tNOll'I' ~,\~~i\Cat\On
Primary Occupancy Group:ca\\\ng ttR-{~e oregonR\ll. 4'jlructure
Secondary Occupancy Gro'\lUmbel \~:n I is 1.800 e of Heat:
Primary Construction Type CVHe Water Type:
Secondary Construction Type: Rauge Type:
# of Bedrooms: Energy Path:
Sprinkled Building:
Contractor Type,
Electrical
Expiration Date
10/04/2009
Phone
541-915-9828
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
.,Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT I~FORMATlON I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
,u.Street Trees Rqd: t"\f 1\-\t 'NOtl.',(. .
N01\ClP-..y4 H~\.~<Etl.?\?- R\'J\\I \S ~Oi
1HIS pf1l,tIlh"'~~ffl\Jl<\\S PE fOR
I\UlllO~"\~!-On nR \S I\BAt-mONEO
WirlfLi r".L WJl.~~NTS
hit. KtiWi' , " ,
, Sidewalk Type:
DownspoutslDrains:
i '
Street Improvements:
Storm Sewer A vailablc:
Special Instruction:
Notes:
I Valuation Descri;.tio? 1
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page 1 of2
Status
Issued
ZZS Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-716-3769 Inspection Line
Fee Description
+ 10% Administrative Fee
. + 12% State SUl-charge
+ 5% Technology Fee,
Service Reconnect
Total Amount Paid
J
....
Total Value of Project
~ Fees Paid ,I
Amount Paid
Date Paid
CITY OF ~rKINGFIELD
Building/Combination Permit
, PERMIT NO: cOM2008-0I346
ISSUED: 09/05/2008
APPLIED: 09/05/2008
EXPIRES: 03/05/2009
VALUE:
Receipt Number
1200800000000000945
1200800000000000945
1200800000000000945
1200800000000000945
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a;m. will he made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
$5.70
$6.84
$Z.85
$57.00
9/5/08
( 9/5/08
9/5/08
9/5/08
Electric Service: -Approval required prior to utility company energizing service.
$72.39
Plan Reviews 1
I R~I,!,ui~ed I~s~~ct,io~sl
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information h.ereon is true and torrect, and I further certify that any and all work performed 'shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregou phtaining to the work described herein, and
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 in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the prope'r time, 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 remain on the site at all
times during construction.
Owner or Contractors Signature
Pa!!e 2 of2
Date
'>
225 Fifth Street
Springfierd,Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM200S-0 1346
COM200S-0 1346 '
COM200S_0 1346
COM200S-0 1346
Payments:
Type of Payme~t
CreditCard
cReceintl
. 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
12~0800000000000945
Date: 09/05/2008
Item"-Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
045308 In Person
Payment Total:
Page I of I
11 :43:34AM
Amount Due
57,00
2,S5
6,S4
5,70
$72.39
Amount Paid
$72,39
$72,39
9/5/200S