HomeMy WebLinkAboutPermit Electrical 2008-12-29
Status
Issued
CITY OF SPRINGJ:<lJ!.LD
Building/Combination Permit
PERMIT NO: COM2008-01811
ISSUED: 12/29/2008
APPLIED: 12/29/2008
EXPIRES: 06/29/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1110 C ST
ASSESSOR'S PARCEL NO,: 1703351411600
Springtield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT ~ESCRIPTION: Service Replacement
Owner: KEELER JOHN WILLIAM
Address: 1110 C ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
CHRIS MILLERS ELECTRIC INC
License
62377
Expiration Date
12/21/2010
Phone
541-895-3660
. BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:'
# of Sturies: Lot Size:
. Height of Structnre Sq Ft 1st Floor:
Type of Heat: ' Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:'
Range Type: NOTICE:' Sq Ft Garage/Carport
Ene,rgy Path:, , THIS PERMIT SHA~'t ~~:IF THE WORK
Sprmkled Bu"dmg:AUTHORI~ UNO~f{'~ P~I'fMIT IS NOT
. I DEVELOPMENT INFORM;l;l<tUjj~lliiED OR I~ AtlANUUI~l:LJ run
. ~I~', I W JAY PERIOD. REQUIRED PARKING
Total:
Handicapped:
Compact:
,
/
Frontyard Setback:
Side I Setback:
, Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: '
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
OOg- ~ 51 J9lUeo
'(vv8?-Z8~-, ,~"~'r\ '''Ill JOi JeqwnU
~Oql:::';...JiPt'''I'l ,l";l;"~' III DUll1~;J
I PUBLIC IMPROVEMENTS eUOlld6\a\ all\ :a\ON) 'Ja\ua,O a... 1"0600
Idoo U\13\qo 1\1lW no^
"q sa19Id%WJ/kJ&R6ill\ CHOO-\00-ZS6 \:I'VO U!
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lI\101 j\!9\;!!OSp6ljWOramo: dOPll salDA MOllol
"~!t~X~~~!~~:J~~~10aciajo :NOI1N31l'V
Notes:
I Val~ation Descdotion I
Descriution
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 01'2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01811
ISSUED: 12/29/2008
APPLIED: 12/29/2008
EXPIRES: 06/29/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753' Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Valne of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 12% State Snrcharge
4- 5% Technology Fee
Perm S~rv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$7.30
$8.76
$3.65
$73.00
12/29/08
12/29/08
12/29/08
12129/08
2200800000000001776
2200800000000001776
2200800000000001776
2200800000000001776
Total Amonnt Paid
$92.71
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.
I Refluire.d Inspect!"nsJ
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have 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
tbe Ordinances of tbe City of Springfield and the Laws of tbe State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any strneture withont permission of the Community Services Division, Bu'i1ding Safely.
I further certify that only contractors aud employees who are in compliance with ORS 701.005 will he used on this project,
I further agree to ensure that all required inspections are requested at'the proper time, that eacti address is readable from the
street, that the permit card is located at the front of the properly, and the approved set of plans will remain on the site at all
times during construe.tion.
.-----:::.c:..L ~~~
z- t ' /).e-_
20"''?-
Owner or Contractors Signatlire
Date
Paee 2 of 2
"
'.
ZON
INITIALS
DATE
SOURCE
l~
~
\7J?_C1jCJb
tJ\/~
225 FIFTH STREET. SPRINGFIELD, OR 97477 '. PH,(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CDrYldC05 - D l8 ( I
1.
sr
/ / / CJ C 5,p7~;F;Lb
L~~() ~~\~ \\\0('[)
JOB DESCRIPTION:
5~ ~/4=C~,e.u;r-
Permits a~e non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
2.
Electrical Contractore""'.....,; h-t
Date
3.
A.
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
$121.00
$ 22,00
$57,00
B.
".".;- ~":: /~~ :;r',...noo Amps or less
20] Amps to 400 Amps
40] Amps to 600 Amps
60] Amps io 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
k' $73.00 '7:<",0=:>
$ 86,00
$]43,00
$186,00
$426,00
$ 57,00
Address
'5 '3 ':$ 51? /C> Y,t.LlAJ;'L..L) ~
Ci~~.4~~kLL. , Phone :In- cYS..5"C?
Supervisor License Number :? 2 2.. S'''?
Expiration"Date
/0
(J/ 2C/O
62 3 ? 7
Constr, Contr. Number
Expiration Date /2.
2.(
2...(0
Signature of Supervising Electrician
~
Y:~'
Owners Name
Address \ \ ..)
City ~ (\"d. /' Phone
OWN: ~~~T10N
The installation is being made on property] own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726..3769
c.
Installation, Alteration or Relocation
~~~~~ s ~t~MAll EXPIRE It 'rlJ~ ~~
401 J\! 5W~~DER THIS PERMI !bf~~,~
D.i~ ~ifoi&liF!~=::t~~~~~~_.
New Alteration or Extension Per Panel
One Circuit $ 50,00
Each Additional Circuit or with
Service or Feeder Permit $ 5,00
":-"'_'Y"~'~.iY.1i.I~ri\'nQ~"n'~ ':"~~!J.t~~t~....t!l+~;"~{~'''''0'''iE7i'ful!iill"w!
E. f0Miii"i'tfft'~Wi"i!T\ rceY11 .. ", .' "," ''''Nn~tiiJ:'H~~m:h1InsfamitiO'nlTJ
f~r~~~lfs?adoPtf3T~os~~le;~Etset'\ortn-Z-
PUD1RBnjj'qjg\itlli\tCen~~~1 0 thro' ,,]h OAR 9l'i~'I\l501.
Signffil(jj~ ~liI?i ";btain co~i"S of the $~1l,'fJiY
LimiOO~W~\\W~ti'JI. (Note: the tel~~a~;\\9n
LimiteH~fOlnlt1lJr€I~~gon UtllIIY Iw;l~ 52,00
, Minimum Er.~tric p~n\;J>Jcfl&Rfe~~s2{5i~oo + Surcharges
4. !I:lV:B~TmOE~5VB~11k~ih~'i#~ '13 c0
=M",~4,;'" '''''''m'_'''''';H",'&",.!1j~JF'",,,,,J0??2'''''''Gi'iN8W'''ktMj00~~ -
12% State Surcharge '6.' 'lLP
]0% Administrative Fee 'l.. '~}
5% Technology Fee .3, Lc>5'
TOTAL
~,';).ll
Shared Drive(T:)lBuilding FormslElectrical Permit Application 7-0.8.doc
225 Fifth Street
Spdngfield, Oregon 97477
54~-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200800000000001776
Date: 12/29/2008
1I:31:32AM
Paid By
CHRISTOPHER MILLER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
73,00
3,65
S,76
7,30
$92,71
Job/Journal Number
COM200S-0 IS1 I
COM200S-01S1 I
COM200S-01S11
COM200S-01S11
Description
Penn Serv/Fdr 200 amps or less
+ 5% Techn910gy Fee'
+ 12% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment
CreditCard
Amount Paid
KR
03154C In Person
Payment Total:
$92,71
$92,71
,
cReceintl
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