HomeMy WebLinkAboutPermit Electrical 2008-12-5
Date
ZON \(YvLv
INITIALS ~ r--'.-
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;225 FIFTII STREET. SPRINGFIELD.OR.97477 . PH:(54t)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION:
LoW\'2-00g-- 0'7 Y I
1., 1:~~]{lii~~~i~~2-i$'JIIIII 3.
I b -S""3> S s.+-
200 Amps or less $ 70.00
201 Amps to 400 Amps $ 83.00
401 Amps to 600 Amps $138.00
~ 601 Amps to 1000 Amps $180.00
City Po:).. Jl.hone T'd.:i.~ I,.:; ;: (,c., <:; Oyer 1000 AmpsIVolts $413.00
(/ I I t:N ,,~,l V'O<!ull raw requirfjtH'6\\h~ 001 $ 55 00
follow rules adopted by the Oregon Utility Y .
, Not~ptio,n Ce,oter. Those rules ar'l!ll!tlmT1h~__.<,EE'~"p-
Supervisor License Numberln @E::>3tt2ni1'1-001 0 through O~fl~li~ryASelYicS\!'i,!~'eeile~~8' ,t~ilil!!
I 0090.. You may obtain copies of the rules by
Expiration Date / Q- / .!:allf.l(! the center, (Note: the tel\J"m!I~ion, Alteration or Relocation
IIUIIlI.Jt:1 lor l~e. uregon Utility NDi~~orless "
I L{ i ~ Ilfnter IS 1-800-332-2344lro I Amps to 400 Amps
401 Amps to 600 Amps
Oyer 600
';-jI-"~
. '5 ~ I f.-v /t-.....
>{,7c.( OYISV...,l vA,
C'ty bB=-C~ Ph NOTICE: .. I' ., . . $ 55 00
I ' 'fAIS PERMIT SHALL EXPIR wmmlr ' .
. ' AUTHORIZED UNDER THIS ffi.tXtf e ~g. $ 55.00
OWNER INSTALLATION COMMENCED OR IS ABAN tfFclffgy eSldentlal $28.00
!he DI:'tallation is being made on'<<PJl"flrd flWl'1l!mOD. Limited Energy/Commercial $ 50.00
IS not mtended for sale, lease or rHIl.' Minimnm Electric Permit Inspection Fee is $50.00 + Surcharges
. ..., 1Il'.'E>>"'-iJ'E~~2i'E'H. '1'_' . '
4.'SlffBTOII!fl!)/OEilfBOVE ;.. ". 811 Boo .
. r:.ti~~'J:Wy./;. '" . .,b,,,,"" ~ ,,:]y~~,-, ":_>' ..~
12% Stilte Surcharge
10% Administratiye Fee
5% Technology Fee .' '?',
,~~ >
, ,
City Job Number
LEGAL DESCRIPTION:
/703Z5"ZL(
JOB DESCRIPTION:
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Permits are non-transferable and expire if work is
not started witbin 180 days of issuance or if work is
Suspended for 180 days.
!(5()NffiIDreTOR'1NsTAEmirj(')N~ONE'E,
2. Ji>'~""'~fi}11BJ~TI~;h'%'tJ;ilfHh:q%F'hP;2'if3~i'f6:~d:0iib~2tU:1;j-'H'""'1 '
. ,~,
Electrical Contractor ..::::. TEOE !:fr-hY~t.
Address
f 0, Boy: "115' (
Constr. Contr. Number
Expiration Date
c/<~: - (N
~,.u........_ ,
Owners Name
Address
Owners Signature:
Inspection Request: 726-3769
A. !~~~~R~siaeritial~,'SjD ~ leYO+r:!MiIliifF:ffiil,t':~:r{aW~IIiIt0;I:ffi~ffi.m1,-
~~~P"g",,'4~fuffi~=>Ji""'''''''i' Y..~...""'ki'~"= -, g1 "'--.....8'"'"
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
$117.00
$ 21.00
$55.00
B.
I $doo
;$'76:00
$110.00
5'7
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
. );;k;;;:0~ffi'a_J%:".ii1~~;;B"'llilliGi~W;n+i$;. ~ .. !i'~4%J!;# . .-.' , '" _'_~!f~
E. 'M,~~!13Deou$f(l)et;xifWfeeiler(ii.!!!;!ff.sl,ulI.!'i1)"'J;1~c!!~In,stallati011'
'~ .
57
bBlI
5-
2 "
72~
TOTAL
Shared Drive(T:)JBuilding FormsJElectrical Permit Application I-OS.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01741
ISSUED: 12/05/2008
APPLIED: 12/05/2008
EXPIRES: 06/0512009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 1633 S ST 1635
ASSESSOR'S PARCEL NO.: 1703252402400
Springfield TYPE OF WORK: Use Initials
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Temp power only
Owner: SULLIVAN KELLY V
Address: 3674 OXBOW WAY
EUGENE OR 97401
I CONTRACTOR INFORMATION .
Contractor Type
Electrical
VB
License
,_' 147618
BUILDING INFORM A nON ~ '
# of Stories: Uiles ,/outo
Height of"StnlctfJieeClOregon Ut\I\Wtk
.~l:-\.U\G.~- \ne tiot."
.,--'-': "'Type of.Heat:b'/ ale se
f W"tC'YTu~'- -;-hoSe (\.lIes ^"95'2.001-
.., "" at ~lr"xpe." u n O"n 5 b'l
",. ,:2,\'Range1I:ype:1 tnlO .~s 01 tne lule e
~~ 01',\\ ~Erie'f~~ ~l!Jlr~n COf~, tne te\ej)no~Ol\
0090, '{SiNi\\''i!&~\BlJiI\h\?eiJi.iIiW Not~iR.a
w:",.n(\ \\1.8 w Q'P(\?;;: 2. ~^A'.
I QI;LVlmm!~~~~AnON .
Expiration Date
04/09/200~
Phone
541-221-2665
Contractor
STEVE HAUCK
# of Units:
Primary Occupancy Gronp:
Secondary Occupancy'Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R.3
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq,Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overl'ay Dist:
II Street Trees Rqd:"'"
Paved ~.rive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Notes:
1 PUBLIC IMPROVEMENTS ~
Sidewalk Type: f i\,\E \fol()?~
~. . D ~?s%E \~\i \S MO
\\O~~E~~\i S~DER i\'\\S ~~En f()? ,
i\'\\\'\ORIIEO UOR \S t>-Bf>.~
f>.U WlcMeED cR\()O. __
Street Improvements:
Storm Sewer Available:
Special Instruction:
Valuation Descri
Description
Type of Constrnction
$ Per Sq Ft
or mnUiplier
Square Footage
or Bid Amonnt
Value
Date Calculated
Paee I of 2
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01741
ISSUED: 12/05/2008
APPLIED: 12/05/2008
EXPIRES: 06/05/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid ~
Fee Description
+ 10% Administrative Fee
+ 120/0 State Surcharge
+ 5% Technology Fee
Temp Power 200 amps or less
AmonntPaid
, Date Paid
Receipt Nnmber
$5.70
$6.84
$2.85
$57.00
1215/08
1215/08
12/5/08
1215108
2200800000000001713
2200800000000001713
2200800000000001713
2200800000000001713
Total Amonnt Paid
$72.39
I ,Plan Reviews ~
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.
ReQuired Insnections ~
Tempor3l}' Electric: Approval required prior to Utility Company energizing pole.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is trne and correCt, and I further certify that any and aU 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 Community Services Division, Building Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project.
I further agree to ensnre that aU reqnired inspections are reqnested 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
times during construction.
Owner or Contractors Signature
Date
Pal!e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-375~ Phone
City of Springfield Official Receipt
Deyelopment Services Department
Public Works Department.
RECEIPT #:
2200800000000001713
Date: 12/05/2008
1O:46:18AM
Paid By
WILLIAM ROBERTSON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
57.00
, 2.S5
6.S4
5,70
$72.39
Job/Journal Number
COM200S-01741
COM200S-0 1741
COM200S-01741
COM200S-01741
Description
Temp Power 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment
CreditCard
Amount Paid
djb ,
055102 In Person
Payment Total:
$72,39
$72.39
cReceintl
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