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Home My WebLink AboutPermit Electrical 2008-12-19 ,';' 1'. Date ZON M O~ INITIALS ~ DATE f'V'\0\.~ SOURCE "'~\""" IZ.}/J,hf "'. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726..J753 _ FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City 10bNumber {:.oM Z-OO f' - () 17 S 7 l. ~OMOEliNST:WT'!(!m@MlF;r~ 3, ~,",",",",",",",",",~\,,-%,."",il';'''''''"'''''=''=,"_ifl.~ 4':;S\y~ H"")ST"'S0"~\)CI. (~~d\ O~ LEGAL DESCRIPTION: i70JJ 5Zl( () '7100 I'le.""" 5e.\Y'~c-e.. O,M \f'\A.--;,e.. JOB DESCRIPTION: :..~ -'",W S~IU' A...l re:wt'r,:- Permits are nOD-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~F9wm~YJffiV]tjrJ[ffiffiffiNjGf+qqIT'0Jv.C';:;"~O;OL~I('Wr~ r,,~Ql!!1EJlA€TORrINSTAEl!:A:TJ(i)Nir(i)NE~1 2, #dJ2L~'=2'~~rltl'~tJ~($~~~~.pll Electrical Contractor 1:.~ l)ot,'oC\5 ..r~r Address :, -y::);;lLf LQ rri::>s S hr-O{ h @ City c:r~......e\\ Phone (q.IIJ 22S-)32? Supervisor License Number 5"50,)5" Expiration Date /0 - c) - ;)())O A. Service Included 1. $121.00$ J:J./ ,~ 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $ 22.00 Each Manufact'd Home or Modular Dwelling Service or . Feeder $57.00 B. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolls Reconnect Only $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 c. Installation, Alteration or Relocation 200 Amps or less "'" "9 $ 57.00 Constr. Contr. Number C Ljqi 201 Amps to 40~.!s& ~ . $ 79.00 401 Ampsto~~~.. ~ $114.00 :::::no;:~pe~:n~:ec~~O II D,(~~;~.i~\_~_fj ~ ~..... A New AJter~~?~~'(~~"9rr;'~el ~ ~ / One Circuit ~ ~ ~~ %.'0 ~ 0, "<>L. $ 50.00 l,../ Each Additiona~i~ifor:;wi~ '(,,6> ~. 0, . Owners Name (<\",\,,\ IIC()~l ... ~ _ Service or Feeder~~;%,."Cl%~7Q 1~6> ;;q~ $ 5.00 ~ ~",,,,~,,",",~",,",~",..,,,...,,,,"6>.:<9<<.::;S.."',..6>.J!' __...-1 ' ~ ~ - E. 10Mj~;~~li~:W~6J~ViSf~".~"'>ti,,-:u~~0JI!i-;-'fi~i0-~~/;;;~E~hll-w:itrn:fg2ir Address 1:'3J02!-J CCllWO"'- . _ ""...~._"",...._.L.~~~~~!L~i,.!!.!t~",~....."."...__..,,.", - "' v '. .. . -~'''-~;:'V-ll\'v.'Y'~~ . \\ ~_~~;o..~~... ~-1::'<9-",,,, '&.~ ;:::".<!:9 CIty ~~~I\ Phon<!'.!!>~.Y..<''P,['c\:;i::'? PumpoTlmgatlOn l? 9:,.'!b". <;> ~ ~ .00 ~ <'-i., ~~ Sign/Outline Lighting !? ~ '1>.'6>,p 't>>>'~ 57.00 A <-"" V" t!}. ~. "" <> . OWNER INSTALLATION ~ 'G> ~-~ Limited Energy/Residential -o,:;l. $ 29.00 The installation is being made on property ~~h~ Y Limited Energy/Commercial $ 52.00 is not intended for sale, lease or rent. , ~ '6> .:;p.A~nimum Eleclric Permit Inspection Fee is $52.00 + Surcharges ~ ~ ~ ~\iF-0""'0'0;:;===C';:;;:;0"&'''i;F,"''''~"J'iiW!'1X&$mw0wlLl1'''iW!riM=_m;:;;;:;''''''!B!ii 0_';_ Ib~~~~:~j~f InspeclionRequest: 726-376~t::::'U'it ~ T~t 15.~.G". ~ . Q Shared Drive(T:)/Building FormslElecttical Penni! Application 7.08 doc .~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line CITY OF I'lrKlNGFH..LlJ Building/Combination Permit PERMIT NO: COM2008-01787 ISSUED: 12/1812008 APPLIED: 12/1812008 EXPIRES: 06/18/2009 VALUE: Springfield TYPE OF WORK: Electrical Work Only SITE ADDRESS: 433 4TH ST APT 1 ASSESSOR'S PARCEL NO.: 1703352409800 TYPE OF USE: Repair Residential PROJECT DESCRIPTION: . N'ew service and rewire Owner: GROVER MATTHEW E & TISHA P Address: PO BOX 154 CRESWELL OR 97426 Contractor 4 ""T'~" License Expiration Date COMPLETE ELECTRICAL INST.~LLATION)!,l!,4ntt,... 10/14/2010 BUILDlNG'INFORMATioN:f the o;~;~,r~~}o ()~;nn.-: "::J~-OOl'001 0 th-Je rules are set 0~r # OfcSni~s:1 may obtain c~ou9h OAR !k'!!-tJlJf? H'ii5H~Jo!,S\lr1lojYr,~er. (Notes of the 1'.!11,t M,t Floor: Type'llPHelitr the Oregon ~'. the tele~!'bll~'i{,d Floor: Water Tylfe::nter is 1-800.33t,lity NotifiS!ltlFJrPasement: Range Type: 2,2344). Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Contractor Type Electrical # of Units: Primary Occupancy Group: 'Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: ,Solar Setbacks: Street Improvemenis: ' Storm Sewer Available: Special Instruction: Notes: DescriPtion Type of Construction / I, CONTRACTOR INFORMATION I Phone 541-225-7827 R-3 VB I DEVELOPMENT INFORMATION I' REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % '*bQ!; Coverage: lICE' 11-1/<, ~ . . I PUBL1(!;lLWlR~~M~J fX ' , A"NUIUMENCi~ OUIViJER TH~~Jfaikl1JYQVORK Y 180 R IS A .'PERMrr.lo..., , DAY PER BAAtI'Ilrn<nsll.6!n,,",uv!ll": IOD. "UUJ~tu FOR Total: Handicapped: Compact: ,I Valuation Des~riDtion ,. $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa!!e I of2 -~'iP!l1S'!l\~;!k, :if- .. :~ Status Issued CITY OF SPRlJ'<\.:i1<lJ:<.LD . Building/Combination Permit PERMIT NO: COM2008-0I787 ISSUED: 1211812008 APPLIED: 12/18/2008 EXPIRES: 06/1812009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fees. Pai~ I Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Residence Wiring 1000 Sq Ft Amount Paid Date Paid Receipt Number $12.10 $14.52 $6.05 $121.00 12/18/08 12/18/08 12/18/08 12/18/08 2200800000000001755 2200800000000001755 2200800000000001755 2200800000000001755 Total Amount Paid $153.67 I 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. R'>"l '"('d J . <.r)(~('tions . II... .1. ... 1I11.~11I11 Rough 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 bave carefully 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 ofthe 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 further 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, 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 constr(Jction. Owner or Contractors Signature Date Page 2 of2 225Fiith Street Spr,il1gfield~ Oregon 97477 .,... ' 54P726-3759 Phone Job/Journal Number COM2008-0 1787 COM2008-0 1787 COM2008-0 1787 COM2008-0 1787 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description Residence Wiring 1000 Sq Ft + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By COMPLETE ELECTRICAL City of Springfield Official Receipt Development Services Department Public Works Department 2200800000000001755 Date: 12/18/2008 Item Total: Check Number Authorization Received By Batch Numver Number How Received djb 122843 In Person Paymeut Total: Page I of 1 11:14:47AM Amount Due 121.00 6.05 14.52 12.10 $153.67 Amount Paid $153.67 $153.67 12118/2008