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Home My WebLink AboutPermit Electrical 2008-9-30 ;:,~',:,t~ CITY OF "SPRINGFIELD fOREdo~t,< j _ ..,".~',~~ ", ""- ~ "- -'; "-. _~-- ~. ....1. - _ '1 .~. '..1'h " ."''-t.:~. ZON \c9--V INITIALS ~yv--.. , DA~ 7,0 00 SOURC~ (\)A/7) , \ 225 FIFI1I STREET. SPRINGFIELO, OR 97477 . PH:(541)726-3753 . FAX: (54t)726-3689 1:LECTRICAL PERMIT APPLICATION f nH!l(X)R - Olll R;) 1. lIfio@'i'ib..N...',.;'OP:iNsTJiiii1i.4:ltioN1IIr1l ~',4__.._.":"~..~~'".~m._._.-_..._.,.~,..._. - J.-llJ5 N '-5 ,~t-V'\l:l~ City Job Number LEGAL DESCRIPTION: \103 8.'P d l 0] ,<=:no JOB DESCRIPTION: 3utnlce...- c..-~n: " Permits are non-transferable and expire if work is not started witbio 180 days of issuance or if work is Suspended for 180 days, "coNTRi5:oiFJiNstAii1!ATiONQN1Jy;~ ' 2. !tf!,i~''''WAilAtM:;flli'':P''~'\!!Miw.i!"'%10''''1Wh;'-'i:D'JlW\lJi,"''''';,'i'''~1!i!IW0ii/1j!ffimm&""s;;;j}lrl""~M'~1 ElectricalContractor if1!. 17\01"+ dt IAU )~c.. Address'3;2'3 I. b.J2_\'\e.\ I ( (~~ City()tk&p_'~ Phon~ 7rl-C\-J~SiI Supervisor License Number ~ 4':;, ~, ') Expiration Date 'A / I J 10 IV. I Constr. Contr. Number ~. 7 6'"() b Expiration Date I!! 6A (') 1 ()q, Signature of Supervising Electrician 2)) ~ row' V Owners Nan';~\Yo ('\ ; \) '6-c...l. \L'a -\l 'C5--'\h -=::,-r ) AddressY\ ~ S Ci~~(Q ,OWNER INSTALLATION Phone The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Dale CJ \ 2D1 [)9( 3, ~CQ1@fiJE.f~1tElf~eiQtQ@!fJ~p.o:WA'"!krlllt'llJl!,_ ~'~~'1~i''!.-~:E'~J!Ii'l'''i'!i&~~.!lE~''''l:1'",:,,,,7''''"':''t'V;''Eif?':'''ilif'~:!~-':;d:lF'9]1fiii':"IU~ A. ~,~~~iR!'!!!!~!1!"'~c~1.!!gt~.;gJ:JiMu!!!iE~IJl,tJYJpe_!i!!~~!1.t!1gi!1n!!!~ 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 $]21.00 $ 22,00 $57.00 [:7"~'i%@~~~~"~~.d'~litll''?'''''~:''~ B. n~!~.~E~~~MZfi~~.~;!:!~~J!!tt~~h1r1l~~~!l<!.2~~!jon:'.:. 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts ReconnectOnJy .:2. $ 73.00 $ 86.00 $143.00 $]86,00 $426,00 $ 57,00 f"'_i'~Aifi&~"L'"''~';;{'~'~\~''~l'~1'::'~4',;;;~,,.";jg,~_o.iJ;~'''",":". ~~4. C.~lTempora!1'$er::vlces:orFeederslik;;[;q;'UiIiifi<:i~r~2 -" ' - ..;~, };-,_",,",,,' ",_"~",,,, "', ""''''''_'"'",''"~'~~~~m''. -,"_'-~"~~~".,'<'ffitG'"~_ ____., __ ~ __ $ 57.00 $ 79,00 $114.00 New Alteration or Extension Per Panel One Circuit ~ Each Additional Circuit or with Service or Feeder Permit :J $ 50.00 $ 5.00 ,"""~;;}:i*@~i!ti~@;,Tl0'~~~'i',t':iW')'t)%r~',:;!i?id,,'7lf'~;;'%i1&~~J6""Sf:"\,-r.'Fii;jgfii~'*hd:='ii5'''';' E., i~M',~~~I!!!1lC"o.!!~(~,~!\l~~~in()tlJl.!:!!t~,~!!)J~,-!!acbiIn,~!!,,!1~~!o!! Pump or iirigation $ 57.00 Sign/Outline Lighting $ 57.00 Limited EnergylResidential $ 29,00 ' Limited Energy/Commercial $ 52,00 Minimum Electric Permit Inspection Fee is $52.00 + Surcharges 4 ~.:SUB7:0T;M!rOE&omOVE1fd.~~lii 'l ~'I _ 6""" . f?~~",_~"lte"~""'_",bc''''''''f'''''~i~",,,,ib~'g%~J.JiiI!.~ '"'C:>"-..(). 12% State Surcharge (. W 10% Administrative Fee ') ?(. 72 5% Technology Fee \ ,c:..,. i ~C). \qK. i"d- TOTAL Shared Drive(T:)IBuilding FunnsIElectrical Permit Application 7-ll8,doe _~'F!.RIN.G...~._." .,__-. :'.....'.. ~L.,.,. : ,..' I " ,! , ". " "',.." " . _, .... _,_,,_,..u_,_. ... \~0:l~/N q f- er CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01482 ISSUED: 09/3012008 APPLIED: 09/3012008 EXPIRES: 03/30/2009 VALUE: ~'"".., Status Iss u ed 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS:, 2145 5TH ST ASSESSOR'S PARCEL NO.: 1703262102500 Springfield TYPE OF WORK: Electrical Work Only , TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: service change for residence Owner: HAXBY PAUL DAVID & BEVERLY L Address: 2145 N 5TH ST SPRINGFIELD OR 97477 !CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MY ELECTRICIAN INC License 87506 Expiration Date 11/20/2009 Phone 541-729-1454 BmLDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooins: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla' I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbllcks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: H;,Qli\\hiilde!VO 09 L ANV l:lO:l 03NOON\ffiltnph~O 03:JN3V11WO:J ION SIIIWl:l3d SIHll:l30Nn 03ZIl:lOHlnl:f >ll:lOM 3Hl :ll 3l:lldX3 11l:fHS llWl:l3d SIHJ. .j;JWJN I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type:, __, , DownspoutslDrains: ,.-.. . " ~ Description Type of Construction ATTENTION' Oregon law requlresyoU:t,O >_"..., ...l..~ ~r:IoDted by the Oregon ~t~ I 1 Notification Center, I nose IU'"'' "R 952-001- Valuation Descriotion In OAR 952_001-0010thro~gh oth , s by , 0090 You may obtain copies 0 t e ru e $ Per Sq Ft Square F~otage caliing t9~hH~nter, (Note: t~~~:;:en or multiplier or Bid Amonnt number for ffie Oregon'Uilll'T 4) 10 , Center Is ,1-800-332-234, " Notes: Pa2e I 01'2 _ ...; -,. -'." '.,.., -SI::;.i(O.'.~....'. ,...... .,.Ii.'. ~. it ,....,.. I . "'." ,., , , .I" r . ..' .~' " ,J' ,_ ._."._, __.. _., "~~__'_ c " ._ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid' Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid $15,60 $18.72 $7.80 $10.00 $146,00 9/30/08 9/30108 9/30108 9/30/08 9/30/08 Total Amount Paid $198.12 Plan Reviews I' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01482 ISSUED: 09/30/2008 APPLIED: 09/30/2008 EXPIRES: 03/30/2009 VALUE: Receipt Number 2200800000000001459 2200800000000001459 2200800000000001459 2200800000000001459 2200800000000001459 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 Recl,uired Insnections I Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. 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] further certify that any and all work performed shall be done in ac~ordance with tbe 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 witbout permission of the Community Services Division, Building Safety. I furtber 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 proper time, tbat 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 tbe site at all timeS;::;OiJ U Cf /So! ~ S- V Owner or Contractors Signature Page 2 of2 Dale o 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-0 1482 COM2008-0 1482 COM2008-0 1482 COM2008-0 1482 COM2008-0 1482 Payments: Type of Payment Check cReccintl RECEIPT #: Date: 09/30/2008 2200800000000001459 Description Penn ServlFdr 200 amps or less Add, Alter, Extend Citc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By MY ELECTRICIAN INC Item Total: Check Number Authorization Received By Batch Number Number How Received kr 3219 my In Person electrician inc Payment Total: Page 1 of 1 9:23:14AM Amount Due 146,00 10,00 7,80 18,72 15,60 $198,12 Amount Paid $198,12 $198.12 (' 9/30/2008