HomeMy WebLinkAboutPermit Electrical 2006-9-6
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ELECTRlCAjPERMIT APPliCATION
City Job Numbe~L 'Y(IJ - tl\ \50
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1. 'iLOCATION OF;INSTALI:ATION:;{t'iii:ii.~i~
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lEGAL DESCRIPTION:
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JOB DESCRIPTION:
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3. Ii 9.()MfLETEI;Eg $CHEDL'LE lw!-mYI{~~#\:;i!~(;~~i;t().., .j:~!
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A. "~' Nc.,fResidcntiaI -=::SiIigle or.!Vlulti.Family'''pc'foweIling unit:-:;"~r::
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Service Included
1000 sq. ft or less .. $106.00
~ Each additLqn.a! ~~1;!MoreQu\reti yvv.'.-
GVlJJ.. d~jj;pl'ittla'u,~F~O'f'r t d by the Oregon Ut\~lty"t$ 19.00
l\nw rules adop e les are se' IV"
Permits are non-transferable and expire if work is 10 .pch Manuf2~!igtHOlile'O;;J ru R 952-001
not started within 180 days of issuance or if work is Not\Nfo'd~Pa~~'tf!li8g ~riJ'ieE>~ah O~ rules b~50 00
Suspended for 180 days. in Qi'e\?der" y obtain COpies 01 he h ne .
~~WZidOR~STALL}{TfoN'oNLY,~ og~~'s~f~~~tfJ~~O~e'1~~~~At~ig'i\1Ji;~~~R~f.~ii~ii~~
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Electrical Contractor idl/iilll t!L....Wt;7P I{,! He, 200 Am\ilMtre~~s 1-80 I $ 63.00 ~ c ~
fJ . / 201 Amps to 400 Amps $ 75.00
Address v'O BoX J /700 401 Ampst0600Amps $125.00
.' 0. q 601 Amps to 1000 Amps $163.00
City Iiij;itL~ Phone _?/(f(-f/J 0 Over 1000 AmpslVolts $375.00
Reconnect Only $ 50.00
{\.u,u S-R tU/l, ~ ~ {l rl rt
Supervisor License Number 33 9' .5 ~- 5
Expiration Date /0 ~ I -0 <7
Constr. Contr. Number ,C; b (, '7 7
Expiration Date ,'5-1& -() 7>
Si""","""""~N;71k--
Owners Name ~r ff)~.
Address ~ rYVlmcv ~
City~--, Cf1:;;; -
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owner~ Signature:
. Inspection Request: 726-3769
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c. ::,~;T.~!ll,Pf?r~ry.~Se.!:ylces' or.'f~eq~rs'?lr::'~~1f~~'t~~. tI'~:u1i:;~\"t'~~t,'i'.
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Iniilulf\~'E :"-lteration or Relocation
20?l4'i'g~fAl\'i\'r SHALL EXPIR~I~ THF WIDrnCl
20A~~D~14~Oftl'lffiER THIS D~QMIT I~ OOJP
40cfr~Mf'N~MlffisIS ABANDmIE~ FIJWOO'OO
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New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
y $ 3.00 . ;;Y.p
v ,
>~_"";{9?t.:"~-y':'~>1}!~it~t1'?'='.~:S'fc~\?-'-3'c~.1{:':<~'::'l'f ',~':,i;' Nt~ ":;-~''''>.~~'':-:-f'',i ':, ~"",.~-~
E. ,,:~liscellalle.ous .(ServiCe/(ee~er. Ilothicludedj ",Each' Installation"
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Pump .or irrigation $ 50.00
Sign/Outline lighting $'50.00
limited Energy/Residential $ 25.00
limited Energy/Commercial $ 45.00
lVlinimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. {~~~!P.fl(~f~RtM:t~~~~~1fit~LI nr. aV .
. ro.q~
J?' ...., 0
<i . ~b
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL . . Jr JOt. 0 I
Shared Orive(T:YBuilding Fonns/Electncul Pelmit Applicmion 8-{)6.doc
275 Fiftb Street
Springfield, Oregon 97477
541-726-3759 Phone
.
_~,.C!I!II.W..,......
UA..,
~..,'::
~ of Springfield Official Receipt
~elopment Services Department
Public Works Department
Job/Journal Number
COM2006-0 I 150
COM2006-0I150
COM2006-0I150
COM2006-0I150
COM2006-0I 150
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200600000000001239
Date: 09/06/2006
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
PATRICIA LEVIN/L1VEWIRE
ELECTR
Item Total:
(;heck Number Authorization
Received By Batch Number Number How Received
nJm 037787 In Person
Payment Total:
Page I of I
9:25:3IAM
Amount Due
63.00
24.00
4.35
6.96
8.70
$IU7.UI
Amount Paid
$107.01
$IU7.UI
9/6/2006
.
~ CITY OF ~rKll~t.t< IELD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2006-01150
ISSUED: 09/06/2006
APPLIED: 09/06/2006
EXPIRES: 03/06/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2577 MANOR DR
ASSESSOR'S PARCEL NO.: 1703233301100
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: New Service and eight circuits
Owner:
Address:
BROWN RYAN S & TERESA D
2577 MANOR DR
SPRINGFIELD OR 97477
ATTENTION: Oregon law requires you to
follow rule" adopted by tile Oregon Utility
Notification Center. Those rules are set forth
in nAR 952-001-001U mrougn Ut\r1 ~"c.-uV"
I CONTRACTOR INFORMA'fION'I/ obtain copies of the rules by
. calling the center. (Note: the telephone
Contractor nu~,is~,n.~~ the '!):.~p"irationt'pliteJic;P.h()ne
L1VEWIRE ELECTRIC INC 5669b.,nter is 1-8QS/16/200844). 541-344-4928
I BUILDING INFORMATION I
Contractor Type
Electrical
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Lot Size:
Sq Ft1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
.' (/;.' :: Sq Ft Other:
n/a. P"RIOccupant Load:
"l\.J L \11 I ~r1.411 I='x"PIQC It Tllr I.." '
I DEVELOPMENT INFORMATION'~11t1UHILt:D UND~R THIS PERMIT-IS'I~i;I'
. . MENrro OR REQUlREDIP.ARKING
AN"':';~D'YP . "._~,tulvn
.1 I'l ." Ul'Cln
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved' Drive Rqd: Compact:
% of Lot Coverage:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of2
.
# CITY OF SPRI~'-'NJ'.,LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2006-01I50
ISSUED: 09/06/2006
APPLIED: 09/06/2006
EXPIRES: 03/06/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees P.'Iid I
Fee Description
+ 100/0 Administrative Fce
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
$8.70
$4.35
$6.96
$24.00
$63.00
9/6/06
9/6/06
9/6/06
9/6/06
9/6/06
Receipt Number
2200600000000001239
2200600000000001239
2200600000000001239
2200600000000001239
2200600000000001239
Total Amount Paid
$107.01
I Plan Reviews ,
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
L.Reonired Insnections I
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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.
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 construction.
Owner or Contractors Signature
Date
Paee 2 of 2