HomeMy WebLinkAboutPermit Electrical 2006-3-14
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726-3753 . FAX: (S41)'l2~6ll9
ELECTRIC#- PERMIT APPUCA110N
City Job Numbe'l.(;rY\ 7 rm(Q - nn '-;;)q 'S
i. "i'{ji:JATl'JON"dItiiNs'i)i.T.i'ATI(JNi;"Y'lt~'('. 3. Itl(JOMPJiifI....'.'iHmJj}SeiiEiJtiIfE1iEi!olvA~,;~:'Ji.i!fi?~~.; ..
(oSO~,..~~;)5T~ &k,,-........."'~""""'~.~.,...._~~"
Supervisor License Number ~7 Lf.2 5
I () -I -D 7 Installatio!\,.Alteration or Relocation
" I~UIU:t'
, / 200 AniP!' or.,lffi $ 50.00 .
ConSIl. Conll. Number ~ . 20,\ ~~~Hioo~;'LL EXPIRE IF TI:IESflielPl!<
401\~~)~I6&PAlJlllkJER THIS PERMIT ISIPSl:JlP
/~ /1.3 )09 o.SY.~H~CED I~JJl~fW~f.OR
:;::':r~;ci'"c, D~~~~:~,r~
C-/ _ Each Additional Circuit or with $
fY\ 00 l/l/Y) $h.~(11~erviceorFeed)pennit 3.00;,.
eo- E. ~~~uif(seJ:~~'I;~~r.'ffJi:iilfJ:-d1r') ~E;.~11~~';;;';'.l
rr\(}.:\f1\ 0 I !t2'=~""''''-'''"'-'''''-''-'''''''''';''''''''b''''""",,,~~~ ,"'~"""'.1
Phonc Pump or irrigation $.50.00 ~.It
Sign/Outline Lighting $ 50.00t
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
(,/3 ~
5 .0_ <-!
(g.30
~/4-. $i
LEGAL DESCRIPTION
\(0).,34 43 002-ClV
JOB DESCRIPTION
~ ~~i:1n:tran~r~0workU
not started within 180 days of issuance or if work Is
Suspended for 180 days.
Electrical Contractor
Address a....C{;:J. .
City~
Expiration Date
Expiration Date.
Owners Nam~
Addreslrff)<=)
City ~t:f,tt -'
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
luspectiou Request: 726-3769
A. ~~tR~iti~tG[:8Siri~i~f~fMtnti~E;'1riil".:F)f~t~dw~iiit*-f'.rI1 ~1~~.
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Service Inclnded
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$19.00
Each Manufact'd Home or
. Modular Dwelling Servi.9, p,r . $50 00
F d .. I ">.V. Orer~- ,- . .
ee er ,'. 'rr' . ~"" "...uy Icywres you t
I. ,I 0r,,,.....*___I... 0
~"".,.."'...-;..".." '''-'l:"'.il\..~..,.:h.....,...>>Iit''.h'''. r, ',' ........~..:f~._.-f~rJlRf!l' J.t"~':';;"H:"~"~
B. ,~s~,.= . "-'~""F"'"'''''.''"''''''''TI''''='I'~ti'''''~''''''~''>~=ti'>-<"''' .<,".". ....-... '
p:j ervlce5 or..; ,t;l:Utrs,-! DSuu. a Q '-',' era onStO'~' 0 00:;'5 '"
-,,- :,"!'::':'1-:;~rto'f'001""'O"t'h" -, ar~ffi'ni1,""'5iH
Il'.' " rough rH n "52 0
200Ampsor.less ,au may obta'- _. . $'63,007 _' 01-
( ". - ... .....~t..,lJC~ t""lf th~r I b
201 Amps to 4OO'A!!'PS e center ", _'. $ 75.W u es Y
n- ~ - , . \" ......,'-'. LIfO t""O.....h
40t Amps to 600 AmpSlf the OreM- ,...,. $125.00 one
(' ..,-., ......,,,.l,Y,Nntdll...at
601 Amps to 1000 Amp~ter is 1-Rnn_ "".., ..,$163.00' Ion
Over 1000 AmpsIVolts ,.. -$315:00
Reconnect Only $ 50.00 - -
c ff:' ."~-<t:'~',,,""~i:"";~S- "'t',;I.l'."'~ "",.,...~;~ \F'.... d;,t';h.~~<t~f<t"J~j; ,::'.;;fit\?~5:;):<f ,\11. '.;;:il'Jtt~j
. r5...~ITIP-,~!!~!Y\Lr.x~~~1~t,,, ~~~ ..l!r!t~:_/(~:~~~"t~~ ,'~. - \.~~~'sa
~I:;""f"';i ,;.".;~;.u,.. ,..~....t.'~' l', -"~',T1~';;~~~'i;-'~>~:~~t)~~'~i;:F'.:J~1~
4. ',SUBTOTAL 'OEABOVE~5t-;~:~f," h,~",;:3j2'QF~:.~,t'j
. --;h.~,-'ot~.;.'" ,: :~... 1. ~'PJ-- "f '?'f'4;_~{;~~"i:-:~:...i~5rtY~\L+~
'f9% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding Forrns/Electrical PenniE Application 1..Q3.doc
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. CITY OF :"lrJHr'iGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00295
ISSUED: 03/13/2006
APPLIED: 03/13/2006
EXPIRES: 09/13/2006
VALUE:
Status:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6505 MAIN ST
ASSESSOR'S PARCEL NO,: 1702344300200
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Change Service
ATTENTION: Oreqon law requires you to
'^'1^'" ",lee adopted by the uregon UlIlIlY
GLENN MELVIN SHINDLEDECKER REVUY- t Th se les are set forth
6505 MAIN ST Notification L.;en er. 0 ru
SPRINGFIELD OR 97478 in OAR 952-001-0010 through OAR 952-001-
_~.....'" ,,_., __.. .....h+.....i... ....."'......ioc nfthp ndp.~ hv
Owner:
Address:
Contractor Type
Electrical
Contractor
MAG ELECTRIC INC
....-~ "':.. . - -.. : _ _"-__ I"I.....~...... +h..." tolonhone
I C~,~~~~C~O~'~N~O~MA no~, IJtification
Center is 1-80r~332-2344), E . . D
-License XplratlOn ate
149834 12/13/2009
Phone
541-461-0387
BUILDING INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rcaryard Setback:
Solar Setbacks:
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
~;;;n~Qjl~WtlinR~ nla ~~::p~~~e~~ad:
THIS PH1MfT C:Hdll I=YDICt: It: TUt: wnnv
I DEVELOPMElNmUNRlIlRMlNVLONIWIS PERMIT IS NOT
t.ulvf~Vltl~vtJ Uh" I~ AiJANDONED fOR REQUIRED PARKING
ove..n~'M~e BAY PERIQO, Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
# 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:
Downspouts/Drains:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
PaRe 1 of2
_~..P.RI~~I'IGl-Dji. .'.....-. i'.
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00295
ISSUED: 03/13/2006
APPLIED: 03/1312006
EXPIRES: 09/13/2006
VALUE:
Status:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 100/0 Administrative Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6.30
$5.04
$63.00
3/13/06
3/13/06
3/13/06
2200600000000000302
2200600000000000302
2200600000000000302
Total Amount Paid
$74.34
I Plan Reviews I
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.
, Re"uiretl Insnection. .
11..111
Electric Service: Approval required prior to utility company energizing service.
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
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
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
J~b/Journal Number
C(')M2006-00295
COM2006-00295
COM2006-00295
Payments:
Type of Payment
CreditCard
o
~CJj
:r
!}
:6:
:r
'l.
3/13/2006
.
RECEIPT #:
",,~.~'_N_~'J:I~___. '....
WI: ..1
I '
..,:
~_'_","~__.'M ,
Jiii.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
2200600000000000302
Date: 03/13/2006
Description
Perm ServlFdr 200 amps or less
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
LISA D ORA Y
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 013609 Phone
Payment Total:
Page I of I
11:14:02AM
Amount Due
63.00
5.04
6.30
$74.34
Amount Paid
$74.34
$74.34