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Home My WebLink AboutPermit Electrical 2008-9-18 ZON ~'"L-1 INITlALS l H I A!.. DATE OJ. \.01... ~ ~ SOURCE ~,~ C;--/8-L60f 22~ FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 .rAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number C OW'l ZJ:> 0 ? - (:) (L( 11./ Date !'S""'_.=....XY''''''''''''''''"'''''',='J-."--."--~''~''''I''!wr,"'---~',,,,~"'"''I'-- ~ ~?'" "'.'{;oNTRACToRfiirs.fALf1ATIONf'JirEYt.,i B. sa,," .,. '~lli~W~'ii:ii., 2. ~,"~~,f'"""'i",,,i!!}rt4~"'kY"'''''_'''''''4&'''':.iili1,'''''.,,,~ MeS '~~\\F,iilfl"':.H.li,u':'!!i:sfJ"''''~'U''$fii7J-~~;J:iF, ElectncalContractor (!t'lAIJ/?,II'1I f-.I~l. U~'1'lle~qe\ffilis<;~~\lfs~. I .$;-01)0 7'3- . . ole~O~ 'o'l \~ezR~:5I(lh~~l9"tl\)~ 1}j"ps $ 83.00 ' Address JQ/3:i?~.tV 4N~.S'r..~.'",r\O?W \~O<;e I~ CA~\~t\'J'i~1i~mps $138.00 p:.\~~ \uW" c.el'\e~'Cl\~IO~R~tA>~atrnPs . $180.00 ' Phon~o:~~l~~'o\i\1' ~oW~\~~~~~~NOlts $413.00 ' ~" 01>-\'1:;- II (\\0.1 I'\el. ~ O~'el!o\\'ksf\~lTly $ 55.00 Il'r:f"Cl. 0 \~e Ce oleg ()_~~~. , . . 11Or:J .21'~ \01 \~e. ,:DCl W!;,~~pl;it,i'.'1!l!1!~Il!'-j'Fl,ll!Jiii"i'I!ilm!Jill)ji~t11~~?[Lli!'Jf~ Supervisor LIcense Numb,er 70 7'~)"Ie~ .;-~e~ ,S ,~. f!i~~B:9J2![~.f:.~Jr~~~~~~~~~1fIL~i'~~r~'~ (\\,)v' v~.. . Expiration Date / D /0/ /Oq . . . /1{9S'"q. ,Constr. Contr. Number ~D -t/R.;i C.; , Expiration Date / / .I i... .I I!II#I a!J 1.~JEOeAii7oNJOEilNST.ADI'E1,T10Ntf'Ji/ii;j.~.',..'ll1'l.!.: ~(2i"tidY"~~~&HltH'j.i;:;"'iC;;;;.~iIt;'"1,~:g;~JRi.i. , 261 S 18+1A S, LEGAL DESCRlPTJ,ON: _ 170s JI;>:>D JOB DESCRlPTioN: =::':-transte a::~:~:::: . not started within 180 days of issuance or if workis Suspended for 180 days. OOS-ob City FllbGj./':: Owners Name r:;JJ;~ . Cr.f-.. ...tS P':=~ S+I...... ~t- Phone 7U' J7 Y S Address z:z. ~ 51> F) City OWNER INST ALLA nON The installation is being made on property lawn which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 \ 3. ~. '~N~~f~ia~.qf,mr~~~~t~t~p~~'a~liI~gi~'j'u'n'f(~ . ~!ii:,?';;;Z;;;<j,;~""117'Jt%iil",,,:QJ.it'tr.i'%~-~e~.G;g'.t;il":G;';':j'''':;2\i;Ji.W.~.....'''''~ ~-"..,<,.",.s~x Service Included 1000 sq. ft. or less Each additional 500 sq. ft, or portion thereof ". Each Manufact'd Horne or . Modular Dwelling Service or Feeder $117.00 $ 21.00 $55.00 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400,Amps ,,' 401 Amps to 600 Amps $ 55.00 $ 76.00 $110.00 Over 600' Amps or 1000 Volts see "B" above. . i:D. ~$~~EhT~Ii';a;~~~~~~t~~fi~,~0)Ki'.3--Wi;;t~JW;~~~~~ , ~)<.wt.M<:;~i~1~~1.;,;i=h;_;3E'=~1b~1kYZhjJ~ZfiHP~~!}~~~ New Alteration or Exten;ion pelc.~'j\~ .' "., . One Circuit ,~""IVI _ ,Co ~(:) $ 48.00 , Each Additional CI~~~ith~\ I :"'Cr7 S l{ u S{~:ce or ~~'t.1\l'o.O<-\-?-\S \'~~~'i) '{\ys . $,It.00 ~\)1\lMht~J11;\~~~~~~~o1:1.;~{~lin~l~jif'~f~i'W;i;ill'r.1't'1i!i . , \i~' CI{\\~'C"~'(),?\,~~<>~,"""':a- ~:;rd&:illG:"" __w,,*,,~ ~ ~ ~\J1>t~~wtt\O'ii-"'~ - $ 55.00 c,\Sl1f\~~ff.lghting $ 55 00 ~Ited Energy/Residentlal . $ 28.00 . Limited Energy/Commercial $ 50.00 M;inimum Electric Fee is $50.00 + Surcharges 113 I"3Sb 1/70-:- Sbr 4. 8% State Surcharge 10% Adrninistrati ve Fee 5% Technology Fee TOTAL /43 ~ Shared Drive(T:)/Building Forms/Electrical Pennit Application 7-07.doc Status Issued CITY OF SPRINGFIELD , Building/Combination Permit PERMIT.NO: cOM2008-01434 ISSUED: 09/18/2008 APPLIED: 09/18/2008 EXPIRES: 03/18/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: . 201 S 18TH ST ASSESSOR'S PARCEL NO.: 1703360000500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: 200amp feeder and 8 circuits Owner: CITY OF SPRINGFIELD ,. Address: 202 S 18TH ST ATTN SPRINGFIELD UTILITY BRD SPRINGFIELD OR 97477 I CONTRAC,TOR INFORMATION I Contractor Type Electrical Contractor , ,. License J\!ipiration Date CON RICH ELECTRIC LLC 1495~Q?leS '10, l\i\I\'111102/2011 I BUILDING INFORMl\TION,t,e~:~se\\~~:;. , II ~ d"' illeS 9o~- "',' -, o:,r!" \o?\e ose I" o[>..?- is v, p#'"of'S~&ries::~\\\el. :'(\ '(\Ioll~'(\ 0\ \'(\e III \\tlSiie: \J!eight,?J(Struc~~e()~ co?le\e \€lie? \ti'f\lst Floor: \",1ypf,~\;#..ft?~ o'oW\\\,,-o\e', ~I\'l \,,-O\I\i~q Ft 2nd Floor: iWat'l;} l(~p@1> ce\\\el. ~o<;l \l\\_2~tl,tl,). Sq Ft Basement: itaR~el\~.l'me \'(\e ole_~_~'2i . Sq Ft Garage/Carport Ene<r~\)l!;lffpl leI IS'\ Sq Ft Other: Sprllffil~d iNalling: 'nla Occupant Load: !' " Phone 541-607-3447 # ofUiIits: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION , REQUIRED PARKING' Front yard Setback: Side I Setback: Side 2 Sethack: Rearyard Setback: Solar Setbacks: T~, ~~~ ed: ~\. ~<?~~~\lI~~ ,t)\lI : -)r~:. .:.. c,~~ f~ ~",n\l~fr;; I PUBLIC IMPRo~~~I~~ \)~~~ \>-,,\"'~' I"~ ,-"\,, J'_~~_\r:..'il. .- \>-\)~ ~'~S~c,,,,,~,~'O..II<"Type: " c,\)~ '\ 'O~ <i:l1>tiownspoutslDrains: '\>-~'{ , " Overlay Dist: ' # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvem'ents: Storm Sewer Availahle: Special Instruction : Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage 'or BidAmount Value Date Calculated , " Paee I 01'.2 ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726"3769 Inspection Line Fee Description + ]0% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid $]1.30 $ 13.56 $5.65 $40.00 $73.00 Total Amount Paid $143.51 Total Value of Project Fees Pai~ . Date Paid 9/] 8/08 9/18/08 9/]8/08 9/18/08 9/18/08 Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2008-01434 ISSUED: 09/18/2008 APPLIED: 09/1812008 EXPIRES: 03/18/2009 VALUE: Receipt Number 1200800000000000978 1200800000000000978 1200800000000000978 ]200800000000000978 1200800000000000978 . " 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. I Reouired 1~,s'lec~ions. ~ Rough Electric: Prior to Cover Electric. Service: Approval required prior to utility company energizing service. Final Ele"Ctric: When an electrical work is complete. " By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shan be done in accordance with the Ordinances of the City of Springfield and the Laws of th~ State of Oregon pertaining 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 an required inspections are requested at the proper 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 an times during c~nstruction. . Owner or Contractors Signature Paee 2 01'.2 Date 225 Fifth Street ~ Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008~0 1434 COM2008~0 1434 COM2008-0 1434 COM2008c01434 COM2008-0 1434 Payments: Type of Payment Check cRcceintl 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 CONRICH ELECTRIC INC City of Springfield Official Receipt Development Services Department Public Works Department 1200800000000000978 Date: 09/18/2008 2:08:00PM Hem Total: . <":heck Number Authorization Received By" Batch Number Number How Received Amount Due 73,00 40.00 5,65 13,56 11.30 $143.51 Amount Paid djb 3056 $143,51 $143.51 In Person Payment Total: Page 1 of 1 9/18/2008