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Home My WebLink AboutPermit Electrical 2008-10-16 ZON 4J.r'U INITIALS n rr---/ DATE 10- /b-Or SOURCE fYJ a"t?L/ . , ~ " 225 FIFTH STREET. SPRIN?FIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION I City Job Number CO",,;::O 0 IS' - C:>(..J~ 3 II 1. ~~,"WI~QEm,S'TJi'rirf4~7fiON:l!IIIII!I!!'iill!lEl, 3. ~wEh.'t:i"31mE!SGiiEDimE'1BEilOw!::tRh~~!I!i!:~,\1I!~T, ~_,EI ~~&:W4'j'ii"."'JiQ!t'V""'iIDo'S"",,,,~,,,,,,,,,,,",,,,",,,,~,,,,,,,,,,tr""""!tr...,,~~,,,r^,,u""'t. ~~f"''''''''''''';;ili!ill_;"'"'"'''k.0>"",;,.''M''''''''',""'''",,,,,'"-."",,,.H',,, ,,~.,,'" ....""... .. " .. 7. iI1l..... ti~ uJ eM.. I' ~d2l n" 9N77 LEGAL DESCRIPTION: :l" . I . A. i~I~~~'a'lr~_~IIlgi~iij~r~~!ill~ul~B~~.l. 170~Z 7lttif 10 :SOC> Dale ~ .i{) - /6 -Otf Service Included JOB DESCRIPTION: So f( !Iff' ?t 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $121.00 $ 22.00 - Ii," Permits are non-transferable and expire if work is not started within 180 daYs of issuance or if work is Suspended for 180 days. ii iOO~~oRrmsplEmr.noMifNnE"* 2. ",'c"ij~_'(*JNIlli&~l1dli;,;&M~;;Y;;:CiJ4IiiM\Il . , 00,,<i0i ,"~." " . 'ji$ .'!i" E.J€:rJ...!-y $57.00 B. Electrical Contractor J 1 r Uv\. Ii ~\;:,-~)Q...s i2J. , !i Ph~ne ');jH-I07! 'I !I supervisorLicenseNumb~~ t/7LJ(~nN: Oreg_J1~~~,t~~'" i 0 /IfJIRlw rules adopte Y les,l\~ set lorth Expiration Date I,! - ( - ;~...Ation center.IIMiiftflB\l01<lf9!l'.!l>00A-ReIncation I In OAR 952~~~l~t=s>oIdbe rules by $ 57.00 CODStr.Contr,Number l~!1~S-~. YoUU:~\~S~~!!':" $79.00 i, caJllng tor\tl8ot~l\~--- $114.00 Expiration Date ,I ~renter IId~~ps or 1000 Volts see "B" above. . Address, \. ~ZO g t.J nTt'"Q.fo/ .))tl E. City ~&~Nf:!' Phone ~b~' pr;rI'" _~ $57.00 I tHIS PERM1T,"~t\; RMW~'T $ 57.00 OWNER INSTALLATION AUTHORIZED UNOE\l t~ iN~ential $ 29.00 ;me m.stallation is being m~de on property t~EO OR I~~ ~~ nergy/Commercial. $ 52.00 IS not mtended for sale, lea;;e or rent. Atf{ 180 DAY RiIMOP.t. Electric Permit Inspection Fee is $52.00 + Surcharges ~ ?~ F7l:> "230 -:s W'" 9Z'1 200 Amps or less 20) Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only I $ 73,00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 /J Address :~ '8'~y City ~~, . .. $ 50.00 ~ ~ $ 5.00 Owners Signature: 12% Stale Surcharge 10% Administrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 7-08.doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01538 ISSUED: 10/16/2008 APPLIED: 10/16/2008 EXPIRES: 04/16/2009 VALUE: Status Issued I' 225 Fifth Street, Springfield, OR 541-726-3753 Phone II 541-726-3676 Fax 1, 541-726-3769 Inspection Lihe II " SITE ADDRESS: 430 W M ST " ASSESSOR'S PARCEL N0.: 1703274410300 if , , PROJECT DESCRIPTION: Additional 200 amp service I II SpringIield TYPE OF WORK: Electrical Work Only TYPE OF USE: New " Owner: NICHOLAS ROEHL Address: 3205 WESTERN DR " EUGENE ORI!97401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor J~M ELECTRIC INC il " License 161235 I BUILDING INFORMATION I # of Units: ,i Primary Occupancy Group: Secondary Occupancy Group: P' C " T " nmary onstructlOD ype Secondary Construction T~pe: # of Bedrooms: # of Stories: U Height of Struct~ \0 ;Ml/'S'Pftm\l\l:as III.l\ili\'l i'-\TE':-Jl'\ON'~~~~~~_~L:i~ .a~~ sat togr. to\\O'~ lules rltel. "I'l10$l'l i'lr>.R g52.() "" liticaliOrl Ce Ofo'Wi , ~t.\na f';llea"" ~O OP.P..~~7~~~-~b~!,~~~~~'&/lillllo~e n/a OU~~ili~9 ~D!m~'m~;\~.i.R19:~~ON IlItlalIJ., . 1~~i.)illiii"".' I 1111 Celltel IS Overlay Dist: # Street Tree-S.~q_~.:,..<,v i, Paved Drive Rqd: % of Lot Coverage: Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ',., I 1 Residential Phone Number: 541-579-3364 Expiration Date 09/07/2010 Phone 541-729-1074 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I - , Sidevvalk~ N01\CE~ s~"tt t'lt\'\~1>1t~~ins: . 11-115 PERMI1' R ml$ PE~~'Ytll AUTI-IORIZEO UN~~S A6"NOOt-lEO 'O~ ~?~~i~~~e gERIOO. I Valuation Descriotion I Street Improvements: Storm Sewer Available: Special Instruction: Notes: DescriPtion " Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Page I of 2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01538 ISSUED: 10/16/2008 APPLIED: 10/16/2008 EXPIRES: 04/16/2009 VALUE: il 225 Fifth Street, Springfiel~, OR 541-726-3753 Ptione II 541-726-3676 Fax, 541-726-3769 Inspection Lirie I!; Total Value of Project .F.~.~s P~irl J Fee Description + 10% Administrative Fee'l + 12% State Surcharge I' + 5% Technology Fee I: Perm Serv/Fdr 200 amps or less II Total Amount Paid i~ , Amount Paid Date Paid Receipt Number $7.30 $8.76 $3.65 $73.00 10/16/08 10/16/08 10116108 10/16/08 1200800000000001062 1200800000000001062 1200800000000001062 1200800000000001062 $92.71 I' Plan Reviews I " " " ' To Request an inspectipn call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the ~ame working day, inspections requested after 7:00 a.m. will be made the following . f work day. II " I. I .Rellllirerllnsnections I II .1 Electric Service: Approval required prior to utility company energizing service. II By signature, I state and a~ree, that I have carefully examined the completed application and do hereby certify that all information hereon is true J~md correct, and] further certify that an)' and all work performed shall be done in accordance with the Ordinances of the City II of Springfield and the Laws of the State of Oregon pertainirig to the work described herein, and that NO OCCUPANCY will be made of auy structnre without permission of the Community Services Division, Bnilding Safety, I further certify that only c'ontractors and employees who are in compliance with ORS 701.005 will be used on tbis project. I fur-ther agree to ensure tI~:at all required inspections :Ire 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 all t' d' t t' !I ' Imes urlIlg cons rue IOn. ;' Owner or Contractors Signature " Date Page 2 of 2 225 Fifth Street " Springfield, Oregon 97477 541-726-3759 Phone 1 City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM200S-01538 COM2008-0 1538 COM2008-0 1538 COM200S-0 1538 Payments: ' Type of Payment CreditCard cReceintl RECEIPT #: " 1200800000000001062 Date: 10/16/2008 Description Penn S,' erv/Fdr 200 amps or less , , + 5% Technology Fee + 12% State Surcharge + 10% Administrative .Pee Paid By JEM ELEqTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 130928 In Person Payment Total: '" j II'. Page] of] 12:11:14PM Amount Due 73,00 3,65 8,76 7,30 $92.71 Amount Paid $92,7] $92.71 10116/2008