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HomeMy WebLinkAboutPermit Electrical 2008-12-9 'ZON \0~ INfTIALS llc-\ A!" DATE' t~~'i.. O't'> ~ SOURCE ~fl.--o. Date /d-/oyj{;~ ~ .. . .:' " . ~ .' . . ~_. . -"" ..' 1 ., . , :r,~~,"~~}fllY.Q~:S.~NNGf;rpLR, q~~qN; '1: : ." 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726-3753 ~ FAX: (541)726-3689 ELECTRICALlERMIT APPLICATION City Job Nnmber (/Om 2-L(() 7"- 0/73 (/ Installation, Alteration or Relocation 200 Amps or less $ 57.00, 201 Amps to 400 Amps $ 7~.00 M"i,oo ",," to 401 Amps to 600 Amps ATTENTIUN: YI "nI,I~:oJ: nrPOOn Utility \Ipw rllh:~ "u~~.eu OJ J '" selforth ~er 600 Amps or 100 olt .see "~'~b6Ve. Those ru\e~ ~~e 0" /)ill- ~1Ji"i-~,,=. "" 0J'~"ll""" . , ''''1'l;/,?!t~'lIlii!l_i~ Signature of Supervising Electrician D. Jl!!!!!n.~Iik.(j!ir<;,qi,tS+~'l;!i!!lP ..... I ~..'"&,,~ E'" ' am;r,ll by ~ " New Alteration or Exte~2rJk,p~~~~ma hnter. (Note: the tel~f,hone /) , , ca"m\j l'Ii L1nt'Et!9t't~tlon . , :H ~ One Circuit number for he Or!ll~ei.b(j' II 3''') , Each Additional Circuit or with Oe~r IS 1-800-332-t;, ~', C'O V" ' NOnCServ;ceorFeederPermit J ~ $5.00 ii>=' Owners Nameleu/1 a'.c...- 'Jr1 C-/( / ('j:m'rNJs PE ,/lIT <;~AII ,FXPIRE IF THEVvut\" Addres>o-'")q/q / 7~ /:)i . .\UTi!8 . ,\~ ? COMMFNCED QR.IS. C,ty;Jv.:?LI'?e-.- Phone . ANY 1 &pmfl'h"1:I'1fttSI! $ 57.00 , {I , ~~OutIine Lighting $ 57,00 OWNER INSTALLATION .' Limited Energy/Residential $ 29,00 The instaIIatinn is being made on property I own which Limited Energy/Commercial $ 52.00 is not intended for sale, lease or rent. Minimnm Electric Permit Inspection Fee is $52.00 + Surcharges ~ 4. 1;(rp;-7 S c.,-,) 1. ill!~'l'~liioN';!QB'iNsf;if"r~T:lONi'_ jM.i","';dry>Af'\"""'1<9'W."",,:,"~_'rXJ'f~'J'l'!i~'""""'~""""~"""_~'"if1''',~;",w,~"iI." fuU- , ::JY/J' /7 y'L . , LEGAL DESCRIPTION: 170.3-;:)~2,-/-'O()3<(1 JOB DESCRIPTION: \(11-c/1(/v ((flr!ODr;,C Permits are non"transferable and expire if work is not started within 180 days of issuance or if work is Snspended for 180 days. r~:::Oli!$'~:dmltf{0,'Vl!""~~'r:\i0'J;Vf~ilFJjIii@Gl~'iribItftJPtiW)'MV\;;:;j'7'iJ",;,i\!l '€O...TrT'J>'....'~' OR.mST,)fIiI!A'ITONONbE"' 2 '.Qim,,^,= ~~~~.,,,,,,,",, '=''''''''"''''''''''''l"._-~''''''',d,,,,,",",,;,-'d\~,,_,,,,,MiL''''_,c..J'1'! .: ,_, "",*",._",,,,,,,,,,",-,",,,, """,,,,-~e\,,'~"'c<'" ,__ " .. ,~_"",.,",,,,,,,,,,,,i,,,,..,.,,,.,",",,_,,,'%I Electrical Contractor f AS r :5 ) D (, (; a C r/?/ C Address 3')j) 'i3 50S Cf.(r( Uv I City SP'><:LO Phone 7V /, / V99 Expiration Date LJ7 ) 7 s )(Jp/- IC9 1/7770 lo-V-ocr Supervisor License Nnmber Constr, Contr. Nnmber Expiration Date Owners Signature: Inspection Request: 726-3769 ~~~-""'._-'""'''''..~ ..__~L'"""~'='~"'''"'"''''~'~'_"'''~''''''''''''''"'"''''"''#,=''''0=<ry,,,,,..,,,,,,,,'"mmr,&" W"""'''''''''"M!'l"N''m 3. eo~",' :J3,EEEfS6HEDlJIjJ!)qJEEOT#~..f.,W'$:t;' ""'1lb1"'i!l .. " " . "'_'u~"'"A~'"%0",_W'~"'N"',-"""",,,^'!C-"C"_'''''_____ ,to e., k -! _ _ ,i!' ,__ "', ,,,. R'~ ,_ I' , lif.:P.:r"'%!i;Jl@W'~'Ii1W,,",~mW;m1"""4!@;",i~"fW~~mzr'~t*'"0/*""/ij:W.,,,"""ttlhi%","""";["'_-_- 'r~1:>Yell A. ''fNew,Resiilential@!l'Siii'' ie'O"MliltllFamil~e"i(jweDin uli'itJ~.~' ~~,----'","_-...""",,,,,!,,,,,,"""'__n._,.~~.g""""'"'''''h,,,,,,~.V''0''_-!''''"_:)4iH,,'!.li;.._-"'.----'0_~""__'_gc;,,,_._,_.._.,,;c_:;f'W'i Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or , portion thereof Each Manufact'd Home or ModnIar Dwelling Service or Feeder $121.00 $ 22.00 $57.00 li"W1W1(;."ilti0!1!t!"'!%S!'%i!K""Miliiiirif'''\'-O<''N'''''ifili' :g,!tTw!'C"r;W,j:$!iWili!\P}:;;@w,JM\1n~\";I;;W'.YL'f!"';~~"il!Wl, _ ,- B 'S,,'_m'"''&~'E'''''ad/''JlRf,l''' l'I"V.ti~~","",j/jt""-"fi'C. ''''''-V.-''''R''''I'''~-tC.'"' " . " ~Pi!~~cl!9,!i~,,*j,~~ m"~g~~~,~~/Jl,g~l~,\$~ Pfls-qrtu:y;~?~,",IO!!_~ > 1 200 Amps or.Iess 20 I Amps to 400 Amps 40 t Amps to 600 Amps 60 I Amps to 1000 Amps , Over 1000 AmpsNolts Reconnect Only $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 C. ,12% State Surcharge 10% Administrative Fee 5% Technology Fee a ,----- TOTAL 15 ,~) Shared Drive(T:)lBuilding Fonns/Electrical Pennit Application 7-08.doc Status Issued CITY OF SPRIl'iuc1'1.l',LD Building/Combination Permit PERMIT NO: COM2008-01736 ISSUED: 12/04/2008 APPLIED: 12/04/2008 EXPIRES: 06/04/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 241917TH PL ASSESSOR'S PARCEL NO.:' 1703243400347 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Remo:del Residential PROJECT DESCRIPTION: Circnits for kitcb remodel Owner: MCKICHAN RONDA F Address: 2419 17TH PL SPRINGFIELD OR 97477 / I CONTRACTOR INFORMATION. Contractor Type Electrical Contractor EASTSIDE ELECTRIC INC License 11 7770 Expiration Date 10/04/2009 Phone 541-915-9828 , BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height ol.Structn're Type of Heat: Water Type: Range Type: Energy Path: ' I Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd:, Paved Drive Rqd: % of Lot 'Coverage: Total: Handicapped: Compact: I PUBL~C fMPROVEMENTS I ATTE' Sidewalk Type: , f NT/ON: Orr. '0- '" . , ollow'rUles ad Downspouts/Drams: , opt" ...'"' ',,, "0" to Notificalion Cent eQ by the O'2.~,-,; I ::.." . er Th ' '~.....l; 0W' Y ,~~~t~952'001-00; 0 th~~~gl~leOs are set fo';th Notes: NOT " ou may obtain ,I fiR 952-001_ ICE~ callmq thp /"on'__ ..copies ofthe nd,," h,: I HIS PERMIT SHALL L ....m:-::, ;v'lhe Ore ,"v,e" !fIe telephone' AUTHORIZED UNDE EXPIRE IF THl:~ion Descripti6nnFr is 1-f0~~3~tlllty Notification COMM _ R THIS PERMIT~~NnI ' , 2-2344), .'.. ENGED OR 1<:: AlH~IJ:\o"JED er'Sq Ft Square Footage DesCrIptlOnl80 0 /f,ype.of,Constrncnon , F, It' I' B'd A Value " til r'th UD. 0 u.p .er or I mount Street Improvem~llts: Storm Sewer Available: Special Instrnction: Date Calculated Page I of 2 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description - + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Cil'c Ea Add Amount Paid $7.50 $9.00 $3.75 $50.00 $25.00 Total Amount Paid $95.25 Total Value of Project I{ees Paid 1 Date Paid . 12/4/08 12/4/08 12/4/08 1214/08 12/4/08 Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01736 ISSUED: 12/04/2008 APPLIED: 12/04/2008 EXPIRES: 06/04/2009 VALUE: Receipt Nnmbel' 1200800000000001201 120080000000000i201 1200800000000001201 1200800000000001201 1200800000000001201 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, ' , RpOl: "-ed To .nc'dions . III" 1111 I. 1111.'.. II Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefnlly 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 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 with'out permission of the Commnnity Services Division, Building Safety. I fnrther certify that only contractors and employees who'are in compliance with ORS 701.005 will be used on this project. I further agree to ensnre that all 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 Signatnre Page 2 of2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone "f,...,()~'nD~,' .....". I..,. tair'" , ....'. ' , , , ~ . ,. --. ..' "-' ""'",-:,"_._,-"','-~ ..- City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-0 1736 COM2008-0 1736 COM2008-0 1736 COM2008-0 1736 COM2008-0 1736 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Date: 12/04/2008 1200800000000001201 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By ROGER D KING Item Total: Che-ck Number Authorization Received By Batch Number Number How Received njm 04595c In Person Payment Total: <, Page I of I 1:51:06PM Amount Due 50,00 25.00 3,75 9,00 7,50 $95.25 Amount Paid $95,25 $95.25 12/4/2008