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HomeMy WebLinkAboutBuilding Electrical 2008-9-16 ZON ,\t\n/' . INITIALS~ . DATE. 3..-\\..D.o'O SOURCE \-'-~o- ,-/r-26c:::.:s- 22SFIFI1I STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COWl z..o 0 g- -0 ( l.{ C g Dale 1. l7t!iiti!fiiJt7jfi@Nl(fjFJINs~aN!Jr}!ji~'ls7[l:~~ 3. lr&]m~,"j'''("'''''''''''''''''''~1f'''~.'Sjtwi''iC_~d'''~Qilire:'''~""'H:li1ii0!\,iR%lND. 153"5 )LeJ/ Y 31 U () . c""'"'~'~'<!'0if.m""ill*.""",,,,_,qpC"~C/_""'''''_\Ilii$''''~~. LEGAL DESCRIPTION: A.' l~~mes\ile,jj.@J"",~.!.,!gl.~IP'r~lS'I;i1.wlliim!Im!.~.Ili.i1,~![lJ~gl!in\ " " ( "7 c'> 27 q ( 0 "3 7 DO' Service Included Permits are non-transferable and e,xpire if work is not started within 180 days ofissnance or if work is Suspeniled for 180 days. 1000 sq. ft. or less ' Each ailditional 500 sq, ft. or portion thereof Each Maoufact'd Home or Modular Dwelling Service or Feeder $121.00 JOB DESCRIPTION: fAP)Clk/rf.pfo.ce Br-fu.w jJc'f\ltl $ 22.00 " $57.00 ~"'!'!0"'01M1N'1;1;.>i;\jyrWi" X'"tn>lm;.;;WI1lM\T?P';"P:.'**,+'WHP"h'!"'"'H+:_:""'''''':,"'''~__nd '(?ONiFIDfGT:@R*INS:FAlJP!AU01'i,ONI:;Y!f{, 2. CkW;if,",i%llI!HI1Wi"""''O'-:0iw.;;$~mll~:\Ijiill\iiiib0i&idijii12f70~7'''A"9'1V';~;;'f',fi);';'8#.1&'. mftV0E1#&%0i$~"jiliJ:A,tti8)'H,^;>04&'t",d1;,'Wt",w"/)""YY$iim~!@Th'WimW!i!ii%MM::i'i!nItw&!&'#'0W1mmi'Wl1I'%!'lW"f ' B '8--", =, -vvm'-~"d'Y"'""',' .rP'~l"l~".,ti'i"-~],t,~,','..,'t'-''''''''n.~l~,.t' ' . ~..<e~lfj~!j!,.a~ee~~fldL~nsJ,Q ~ o!!,~"er,~"J(",!s;otf~e oca},on:F& City Phone .\-:r::rlTlON: or~8BmR!clWes you to )( $ 73.00 follow rules ado~IlP1!!'a~iUtility $ 86,00 Notification Cente4.orIitGaJlsndMll.r.ertlJjlforth $143,00 In OAR 952-001-0@~~1i!l.l52,~1. $186,00 0090.. You may olvl~n ~ ~ 0 !]lJ'es ~ $426.00 rOil" the cent r. N,. iplfone nu er for the 1lfI"€It, :tJollfication $ 57.00 ~vl' Center is ~m~800~;23U)._,,~__..__~.....,. '" C. 1F~'Dl"'ra-'Sefu1ices'lli-~~eed-e'rs ,',Wfi .~' ,-liY'.!'_'NI, . '. . -. PO.,...!'Y..," ...._.. ...J Nl1111 ,.lii!I., -j OJr / /' 71 Electrical Contraclor Address Supervisor License Number Expiration Dale Installation, Alteration or Relocation 200 Amps or I~;s 20 I Amps to 400 tunps 401 Amps to 600 ~ps $ 57.00 $ 79,00 $114.00 'Constr. Contl.. Number Expiration Date , L Signature of Supervising ectriciao Over 600' Amps or 1000 Volts see "B" above. D. oWners Name .~ ld- ~k!,!__ "- ,Address IS 35 14./( '! Sf () D f'!"TIC~' . City ~'1IoP"e(cJ Pbone $"/q-~cxJ~ PERMt;yij~JREIHHEWORK .. $57,00 v AUTHORIZ~QJ:INQ.6IHijlSnPgERMITlS Nu 1,-.. '. $ 57,00 OWNER INSTALLATION . COMMEN~Q@1ffieMMQQhl~QFOR.. -"$ 29,00 . The installation is being made on property I own whi~Y,180 Qt\Xi.m!Q!;l~/Commercial " $ 52.00 ..., is not intended for sale, lease or rent. Minimum Electric Permit Inspection' Fee is $52.00 + Surcharges New Alteration or Extension Per Panel One Circuit Eacb Additional Circuit or with Service or Feeder Permit $ 50,00 1- $ 5.00 10,00 Owners ~~ ~/'-.....V'\. 4. . 12% State. Surcharge 10% Administrative Fee 5% Technology Fee S3- -<<- ""'(1 }T7c , 'i'r f /O~ '!l- Shared Drive(T:)/Building FormslElecbical Permit Application 7-QS.doc Inspection Request: 726-3769 TOTAL Status, Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01408 ISSUED: 09/15/2008 APPLIED: 09/15/2008 EXPIRES: 03/15/2009 VALUE: . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspectiou Line SITE ADDRESS: 1535 KELLY BLVD ASSESSOR'S PARCEL NO.: ' 1703274103700 Springfield TYPE OF WORK: Electrical Work Only " TYPE.OF USE: Repair 'Residential PROJECT DESCRIPTION: Upgrade panel Owner: SCOTT MCLENNAN Address: 1535 KELLY BLVD SPRINGFIELD OR 97477 Phone Number: 541-514-3005 " r CONTRACTOR INFO~ATlON 1 Contractor Type Electrical Contractor OWNER License Expiration Date Phone BUILDING INFORMATION 1 # of Units: # of Stories: Primary Occupancy Group: R-3, Height of Stru8trtt'l Secondary Occupancy Group: '.Ty~l!lit~ uti\i\'l Primary Construction Type V~. Olegon ~%~Owlt?nse' IOn" Secondary Construction TYP'Ji,'\TE';-\\\O ~ ~clO?'ecllR'gggti\lll" II 952..()0'- # of Bedrooms: lo\'.O'<'J ILI\e'Cel\181. \"'€~5~ : IU\esn., ,,\o\il\C'i\\IS~_OO~ _001 0 'S'~ffll~61 el' e . _" n 0.:"1_ _""H\\f\ . \'hPl\ ._ _~i.nn 10"090, '\oU,.:'JrbEl'l"ELPP,KDENT1NfORMATION , \' 9'" '" / 11 '~IIr. ca\ Il\ 101 \l\", ~ _800-,:)""- umbel tel IS 1 l\ cel\ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ftlst Floor: Sq.Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: , n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: -REQUIRED PARKING Total: Handicapped: Compact: Street hriprovements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS ~ ,_;, .. ',...-'" _.~ . .---------:-Sidewalk Type: '/.. , ;'D~,,~~),Iffi~V ~~~~~~~i~ ~:ii~~~~~~~~g f~: b.\litlQ~~, en O~ \s r>:, i "'1.......:1:. --"'\,10. I \.IV .\-- nll.1 P'", V aluatitilll\1)1te&mfIon " Notes: ...~ Description Tvpe of Construction $ Per Sq Ft . or multiplier Square 'Footage or Bid Amount Value Date Calculated Page I of 2 _~~IIoI<lI"'I:IlI"C\i ~ , , CITY OF ::'lrtuNGFIELD Building/Combination Permit PlmMIT NO: COM2008-01408 ISSUED: 09/15/2008 APPLIED: 09/1512008 EXPIRES: 03/15/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726'3769 Inspection Line ,., < ... ,,' ,,... Total Value of Project Fees Paid 1 Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid $8.30 $9.96 $4.15 $10.00 $73.00 Date Paid .I, 9/15/08 9/15/08 9/15/08 9/15/08' 9/15/08 Receipt Number 2200800000000001390 2200800000000001390 ~200800000000001390 2200800000000001390 2200800000000001390 Total Amount Paid $105.41 I 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 ~equested after 7:00 a.m. will be made the following work day. ' I Reouired 1 nsnections I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Fin'al Electric: When all electrical' work is complete, By signature, I state and agree, that I have carefully examiued the completed ap~lication and do hereby certify that all information hereon is true, and correct, and 1 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 Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the l:;ommunity 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~ 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. . ~J1t~ ': 9-1S-0'j{ Owner or Contractors Signat~re I, Date I Page 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 1408 COM2008-0 1408 COM2008-0 1408 COM2008-0 1408 COM2008-0 1408 Payments: Type of Payment CreditCard cReccintl RECEIPT #: Description , Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee . + 12% State Surcharge + 10% Administrative Fee Paid By SCOTT MCLENNAN City of Springfield Official Receipt Development Services Department Public Works Department 2200800000000001390 Date: 09/15/2008 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 194608 In Person Payment Total: Page I of 1 II: 17:32AM Amount Due 73.00 10,00 4.15 9,96 8.30 $IU5.41 Amount Paid $105.41 $105,41 9/15/2008