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Home My WebLink AboutPermit Electrical 2008-12-9 225 FIYfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54t)726-3689 ZON ~Q'{L.. ~ INITIALS ~ .-&..... . . A..!.. DATE \'J-q uy , ~ SOURCE ,~~ 12/'1/0" .,. ,~. '"". 'ci[y OP:SPRINGFIELD ORE-CioN; :." , ..if ~ ~,_;j"",., J' $~~~ "" .i:. ~'II'>'~ ,"" - ~-..r"'4.;" . "'l\Y~., '.~" ~',"","; . SPRINGPJELD ELECTRICAL PERMIT APPUCATION City Job Number rovIA 7.ooK - 0/73l.( Date f f I. 1llir,...L....O'-"........".,:.O..,',;:'..,.'"O',',.".,.,.,IN......S.."';fi:,T,{",;.{Tr...,..O., ....i...'.'..-.'..:,<.',...,_.;_,..'.'."':,....'.~_-J.,..'_~ I$-:....~..._......_". . .--... . "..."'" "7""".1'h~' ... .~., ---'J lfu' -=H n r. .. .U n . "'.... 3. iLC01l!J>.&g~.~c;j:jE.c>.'c.J!Aifl!ELQ11';~~~iftJlrif!r1'.:'.-1 (U;,"'~\;b7:.C'k~/;.~ ' L;= "- LEGAL DESCRIPTION: 1703"221\, o ~ '70 c A. m\B'~~iB!l!~~,H!!~J~~~~~'~~~~M1fi!i~'F~~r~m~~~~lWg~~i!t~}i~~ Service Inclnded JOB DESCRIPTION: $'?-ItL. 'CI1t..A:t- r...-. I... k.(- 1000 sq, ft. or less I Each additional 500 sq. ft, or ,A>leportion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $Il7,OO $21.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Snspended for 180 days. I",., ....A.....*..'. ',',-," . .. -., ........--...... -'''1 ,'CONrRAC'TOR.INSTALLATIO-N.ONliYe 2. ;@ie;"F;~."k[;;;;,;"'''''Ld''''''''''Tl4<::r',:'r';j,<:,:;;;':;"'';t-,;,,"t:;''C''''' .,..,''''i~w;,.'",''''y'",:o~~",,';J''F.,+..:,j.f',. Electrical Contractor l?l'JhiS A.-Ie.e.fY'1 L me. $55,00 Address f' (,) . fj.", :x. B. ~~:~J~~t~~~~[~r;:~I~i~!Th!i2~~3&i~~~,t~~~1~7i!1~.g~~;~ 7J . 200 Amps or less I $ 76,00 7J 201 Amps to 400 Amps $ 83,00 , 401 Amps to 600 Amps $138.00 , '601Amg~~0\9Y8Amps $180.00 Phone ~~~,#~t>i:e5~.l1on 'aV(Mb~~e'O~lI~Olts $413,00 folloW rules adopted by W~~e~blorth $ 55,00 Notification Center. Tho~e l~ QA~52.gp~~ ~ , ' '/7U;.......952.001-0010 thJ:o~, ,l;~iW'~~c~~F~~F?IJl1I:I~I,-!l~l:lili'rlll:',," .;;r;'-J~ 7 ~.!) lUU ."..y-obtal(~:. ~e tele~flbn" ' , .~.?i"I!!,~~!4~____"..rr._ ~ - r.('>:~ /0 - CJ I - 2 @V\irfg ~~ ~;~~~gon1kliWlU.Ale~~\imcmtion or Relocation ....".l:.alc~nt!lIIB 1-800~~~r less , $ 55.00 i,,6 t. 78 201 Amps to 400 Amps $ 76,00 401 Amps to 600 Amps $ tt 0,00 .. +......:.~. '(I.. . "'Over '600 Amps or 1000 Volts see "B"above, D. 2 "i 2-1 City t:"1.71!J1.r.- Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date (j -/'-(- 2-01/ Signature of Supervising Electrician New Alteration or Extension Per Panel One Circuit $ 48.00 , f _~ /1 ~. :~~~~tion~~;:~:tor with I $1.00 S- Owners Name C IAA-L1t:Y -- Ie f Address ~I~'I z.'~1" . _ ~~~~~ ".~~\~j~~t~~Lr~!,i!il;ii2ir~~j~d!}!~it~h~tr:"!l;t6~1I City ~,w\P~~?f'7'" ~~ORI7.~~~ u:~~c, ~B~NDO~pf~~gation $ 55,00 / COMMt1llv AY PERIOD. Sign/Outline Lighting $ 55,00 OWNER INST p'LLA nON AWl 180 D " Limited Energy/Residential $ 28.00 The installation is being made on property I own which Limited Energy/Commercial $ 50.00 is not intended for sale, lease or rent. Minimnm Electric Permit Inspection Fee is $50.00 + Surcharges ~%SUBTOTAL"OEIABQVE'lii!l!!ffili!!l;i"'~IlllIW!'.'lil!l 7Ji?- Owners Signature: 4. ~""'?'''..;j<'''''b,1i~,~t<,#';~IA''''"'''~~'''';'''~:c~;,..,.,~I?~~7,;:ffli~'H!#i!M~~~~frffi~ '"---' ,1,{% State Surcharge ? 7b 10% Administrative Fee l'l!5o 5% Technology Fee ]: ,,, 9'1 ~,l, ~~' ~ Inspection Request: 726-3769 TOTAL Shared Drive(T:YBuilding FormslElectrica1 Permit Application 7'{)7.doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01734 ISSUED: 12/04/2008 APPLIED: 12/04/2008 EXPIRES: 06/04/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54 I -726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: ASSESSOR'S PARCEL NO.: 1703223108900 TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition PROJECT DESCRIPTION: BEHIND - 767 Cloverleaf Lp - service and circuit for light pole Owner: ,OGLE CHARLES L & DONNA V Address: 21411 2I2TH AVE SE MAPLE VALLEY WA 98038 Contractor Type Electrical ..to I CONTRACT~~~~ .1 Olegon '<"\ne Ole,:! .., ~ Contrac~E.l'Ii\Or..: dop\ed '0'1 e luleS ale ~5~\1tftse ROBS EJ,lij\#iRre:~\el. ~n~;nllqn Of>.~~ '1"@ti6Wl ~0\\\\C;~52l-~~~~.m~(!;LJNi;i,\~~-iON" \1' Of>' '{ u \..J!- .' I NL{,I! OO~~i\\n~ \ne C~~!~~Jli~%~44)' " . (lI'oel \ol \ ~lructnre ' 1\11 cent ype of Heat: Water Type: .. ' ," Range Type::;. ........ Energy P.'ih: Sprinkled Building: # of Units: Primary Occupancy Gronp: Secondary Occnpancy Gronp: Primary Constrnction Type Secondary Constrnction Type: # of Bedrooms: Frontyard Setback: Side I Setback: , Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMA nON I. 't\\t 'tl(\"~ e Overlay D~,?t \~ ,... \S ~O't 01\C~: .It ~\..~~~I~fIIIt?l1I\' ~r\\S 'i't.?11I'PatM~1R D()~t.\) fO? ~.r'ir$)?\'Z.PQ ~b'<<'~b' e: ~(\W\Wlt.~C~~ Pt?'\()$' ,~~~PUtL1tIMPROVEMENTSI Street Improvements: Storm Sewer Available: Special Instruction: Residential Expiration Date 08/14/2011 Phone 541-686-5444 n/a Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspoutsffirains: Notes: I Valuation Descriotion I Description $ Per Sq Ft or mnltiplier Sqnare Footage or Bid Amount Type of Constrnction Page I of2 Value Date Calcnlated CITY OF SPRIl'ItJJ11~LD Building/Combination Permit PERMIT NO: COM2008-01734 ISSUED: 12/0412008 APPLIED: 12/04/2008 EXPIRES: 06/0412009 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769. Inspection Line Total Value of Project Fees Paic\J Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amonnt Paid Date Paid Receipt Nnmber $7.80 $9.36 $3.90 $5.00 $73.00 12/4/08 12/4/08 12/4/08 .12/4/08 12/4/08 2200800000000001706 2200800000000001706 2200800000000001706 2200800000000001706 2200800000000001706 Total Amonnt Paid $99.06 1 Plan Reviews I 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 Re?uirec\ Iosoectirns I Rongh Electric: Prior to Cover 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 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 without permission of the Community Services Division, Building Safety. 1 further certify tbat only contractors and employees who are in compliance with ORS 701.005 will be used un this project. 1 fnl'ther 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 approved set of plans will remain on the site at all times during construction. Owner 01' Contractors Signature Date Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 1734 COM2008-0 1734 COM2008-01734 COM2008-0 1734 COM2008-0 1734 Payments: Type of Payment CreditCard cReceint I City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200800000000001706 9:44:08AM Date: 12/04/2008 Description Perm Serv/Fdr 200 amps or less , Add, Alte( Extend Circ Ea Add + 5% Technology' Fee + 12% State Surcharge + 10% Administrative Fee Amount Due 73.00 5,00 3.90 9,36 7,80 $99.06 Paid By DAVID LAWLER Item Total: Lheck Number Authorization Received By Batch Number Number How Received Amount Paid djb 097705 In Person Payment Total: $99.06 $99.06 Page I of r 12/4/2008