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Home My WebLink AboutPermit Electrical 2008-9-26 -~.. Date ZON . \0''/ INITIALS )-.Iv 'DATE q-'1..-/1" ol SOURCE MOC,~ / q /' Lv, oi 225 FIFTH STREET . SPRINGF~LD, OR 97477" pH,(541)726-3753 . FAX, (541)726-3689 , . ELECTRICAL PERMIT APPLICATION . City Job Number cqW\ 'Z..C>o~- CJ /l{ b i 200 Amps or less, 201 Amps to 400 Amps, 40 I Amps to 600 Amps , I 60 I Amps to 1000 Amps Phone 9fl fd57-r;;-r7Q Over 1000 AmpslVolts . .0\1 \0" 'Reconnect Only" ' . teo.\1ites'l \)\\\i\:f Supervlsor Llcense Nu~. ole9~ ~~_e~,~e\ \a~~. c. p.'r\t.\fi\..sj aop?,e :\~ose 1\1I"Of..? g5'(,,'0 b':/ ' ExpuatlOn Dat~IIO\IJ t'l~~ ~tf\tlQ" \\'Ilo\19~ ^\ \\'Ie t\1\e~e Installation, Altenition or Relocation NO\i\19'''g'S'2..'00'' V' in cO?l"~:!\e \e\e~\\a \\0\\ 200 Amps Ol less ",011?- ....."" dllli' .....Not\\e..' "a\\\\Ca , Constr Contl \N~I\tl'e1<(o\1 II'\:J'..';I\l;1.e;\!'" \ I\W\\'1~ 201 Amps to 400 Amps oog '. ~e V~_. Ole9v'\" ".2~"~1' 401 Amps to 600 Amps CallI O.~~.. ExprratlOn Date -f;":"'~ ~~ . \ter Over 600 Pump,oi' inigation $ 50 00 S[gnlOutlme ~ . $ 50 00 ' OWNER INSTALLATION Llm~~~~entlal 825,00 The mstallatlon IS bemg made on p(operty I own WlllCh ~ ~~~~~){;~~elc[al $ 45 00 [S not llltended for sale, lease or rent K\Cfc:. ~ ~;'l\!~ill\t.\~~~permit Inspection Fee is $45..00 + Surcharges .\\fi \''t:.~~ t"\ \)\\~4 ",\~j1h6TAfjbltAnOVE~!J1g".~~1:;:0:(~i5': .. / s- Owners SIgnature , \>rr\'O Q~\1.'t:.v r:::,~\;".. w;., >_",,,, >;,h,*,fiE 4"",.~,m;Jil!f,"3i1';,~,,~>lil,v~ f:7 ~\\\~ ,-..\\'V't:.~ \''t:.~ State SUlcharge 78D 'Vr:::,~~"~\) ~~ 10% Admm[stratlve Fee ~<;o \\\\'l '\ 2'/0 Technology Fee 'Jlr . ss- TOTAL gt ..- , Shared Dlive(T:)/Building Fonhs/Electrical Pennit Application 8-06.doc ;':!~_'~K_~.',':">'-;'._ :::'-"-"::;j ';', "."-"'~ ''; :;,,'.~"~'R;, \.'n~'h~it";'ki'''~:;:';<'\Y~'>' f;'~':':',-~'"-'-:'f;:<;,~.' 10 l'i,L9CATION.oF.1NSTALLATION:,;i':ii:'jc,: <n." .,,'.,.;:;_, .'",\~,. ; ""."f :"~ :,-.' ',.:;..;c . >t.;,',.,,,:_,",,,,-,,,: ,:';;;;"'.~;J\./".,;:..-.,;,.;," ',,-J;tk J..'Y;"':,'"'.t;, ,1;.- -~ ,''';- /9(;, ftIr.,dnv 7S:r- wh I , LEGAL DESCRlPTION:' (lD~ 23]] 04 S-oa JOB DES1RIPION per~i!a~:'~~::able,~ ex~:~~::: ~ not ~tarted within 180 days of issuance 'or if work is Suspended for 180 days. 2. Electrical Contractor :)13 ~LECIR..I( /1.."'\(... , Address 4-~8 5' -r <SA 'BeL.LE srR.E:.€'T: City 6.U6~"If=. "",,~'i'. / J'~J (+L" (/b ~ 5. /M...clew /(r,.; f Phone 7l(<{- /8iD Owners Name l'i b ~ P ,c~ Address Clty Inspection Request: 726-3769 ~ ..;.. Ii:'>' 'C.; -', .."...; ';-.." ,,' ',-C, ,~'.''',~ .~':!_ '..'_'.".. ,':.','.. "_< . -." <. --'''.- ,... ',.J..."_:";:;O; '.,- Ie..,.. : ":-~-;' . " 3 .;CgYPLETE:FEES,9!1fP.T!fl;,B.!":5.9, H': C,. ;.Y..';:_.~~<'~;, ",,:.,;_.'<:.~:>'O, ...',"", . -/ . . .,"". __:.. ,:'-.:._.. ....) "'," .;',-- :.....""'.\ -.. '. ~. .";';. "-,~" ~,.~.~;. ", ,'.t.>;,.. .'.'h",,,~,_,:. ".. A, ,"N'6;,ReSid"ential ":Slngie.~r.~1i1lti:F,ari1il)'per:~we.1l;iig ~Ni..':"'~! ;",.",' ",,;,,"',{, .'h..:.,-:;;~'.,,,,.-/".,',,- :,.....', . -. -~ ;c.- ..,i" "."~'< ','.".' ,-.. -..." ," ,...'..-' ......,-".. - ,..... .,. ~".'" ,:.:'- Service Included' 1000 sq, ft, or less 'Each additional 500 sq, ft, or portion thereof Each Manufact'd,Home or Modular Dwelling Service or 'Feeder' . 8 I 06,00 $ 19,00 $50,00 B. $ 63,00 $ 75,00 $12500 $16300 $375..00 $ 50..00 $ 50,00 $ 69,00 $100.00 ,. .D. ~.-:irP":' New Alteration or Extension Per, Panel One Circuit , / Each Additiona) Circuit or with ? Service or Fceder Permit $~O $100 ~V" Ir E. _~FlI:"'~FCII,I!i"!: r' ,,' 1i. Status Issued' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01469 I,SSuED: 09/26/2008 APPLIED: 09/25/2008 EXPIRES: 03/26/2009 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753, Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 196 HA YDEN,BRIDGE WAY ASSESSOR'S PARCEL NO.: 1703233304500 Sp~inglield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Add / alter 4 circuits Owner: Address: JUDITH CROSS 196 HAYDEN BRIDGE WAY SPRINGFIELD OR 97477 Phone Number: 541-744-1890 'I;, ,," I CONTRACTOR INFORMATION ~ ' , Contractor Type Electrical Contractor JB ELECTRIC License 104929 Expiration Date 03/14/2010 Phone 541-687-5770 ""!r~",' . . .,1' \,V-" '~:'I BUILDING INFORMATION I . ..l"..~ ',,-,, 't "" "I' 0 ' :, .,' '''. -~,tle reg U"" I JO"I.l[:~I.'lii\P C"r~' u' ,on HIlty # of Units:" in (I,!',R";S-2~O~1 :~US'K~f'Stories:s are set forth Primary Occupancy Group: 0090Ri~u ma 0 'f;lei~litloJIS(j\li.~!'!.'3'2_001_ Secondary Occupancy Gro, up: ca'J~'n the / tbt~~e')l>>tHeal~he rules by P . C . T en er, \!"'''''t t I h nmary onstructlOn ype num for th 0 lTe'-I....: e ep one Secondary Construction Type: Center~s ~~~)t eNot/ficalion , # of Bedrooms: ,,' -~H~rity:Pii'iM4). Sprinkled Building: . " n'a Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPM~NT INFORMATION'" Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: :~. '7';.:,:;'~ Overlay Dist:, # StreetTre,es Rqd: Paved Drive, Rqd: % of LofCoverage: REQUIRED PARKING Total: Handicapped: Compact: Street Imlirovements: Storm Sewer Available: Special Instruction: I~U IllIe;_ J.f..UBLJC I Mp,">r'\IFMEN.."," ' THIS PER~::l '" .."...... 11 T~RK: AUTHORIZED UNDER THIS PERMIT IS NOT Sidewalk Type: COMMENCED OR IS ABANDONED FOR , Downspouts/Drains: ANY 180 DAY PERIOD. Notes: I.. V alll~tion Descriotion I Description Type 0" Construction $ Per Sq Ft or multiplier Square Footage or Bid Amoun't Value Date Calculated Pa2e I of 2 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 P~id ~ F.ee Description + 10% Administrative Fee + 12% State Su~charge + 5% Technology Fee Add, Alter, Extend Circ Add,Alter, Extend Circ Ea Add Amount Paid Date Paid ' $6.50 $7.80 $3,25 $50.00 $15.00, Total Amount Paid .$82.55 I Plan Reviews I 9/26/08 9/26/08 9/26/08 9/26/08 9/26/08 ": CITY OF SPRINGFIELD ,Building/Combination Permit PERMIT NO: COM2008-01469 ISSUED: 09/26/2008 APPLIED: 09/25/2008 EXPIRES: 03/26/2009 VALUE: Receipt Number 2200800000000001449 2200800000000001449 2200800000000001449 2200800000000001449 2200800000000001449 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the sa,me working day, inspections requested aft~r 7:00 a.m. will be made the following work day.' . Reouired Insnections 1 Rough Electric: Prior to Cover . Final Electric: "When all electrical wor,k is complete. By signatur'e, I state and agree, that I have carefully examined the completed application and do hereby certify that all ipformation hereon is true 'md~orrect, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springtield 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 theiCommunity Services Division"Building Safety. I further certify that only coutractors 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 proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the appro'ved set of plans will ~emain on the site at all times during con~truction.. Owner or Contractors Signature Pa2e 2 of2 Date 225 Fifth Street Spririgfleid, Oregon 97477 541-726-3759 Phone Job/Journal Number COM200S-0 1469 COM2008-0 1469 COM200S-0 1469 COM200S-0 1469 COM2008-0 1469 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200800000000001449 Description Add, Alter, Extend Circ , Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By DANA ALONSO ~' Received.By t:heck Number Batch _Number djb Page 1 of 1 City of Springfield Official Receipt Development Services Department Public Works Department , Date: 09/2'6/2008 r Item Total: J" iAuthorization Number How Received 027288 In Person Payment Total: " 1:15:39PM Amount Due 50,,00 15,00 3.25 7,SO 6,50 $82.55 Amount Paid $82,55 $82.55 9/26/2008