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Home My WebLink AboutPermit Electrical 2006-3-27 " . 0 CITY OF SPRINC )ELD, OREGON ~~ ~~~IALS ~.~, DATE "'-.. I;iD' "'" SOURCE UY2- IV'/""\ 3 IXl./)J y:J . tJ"V\- ll5 FIFTH STREET. SPRINGFlELO, OR 97477 . PH:(541)7l6-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION Cily Job Number c.e..,... 'L. 00 '" - c> c> -:J b 0 Date "1 - z.. 7 ~ 0 b 1. LOCATION OF INSTALLATION 3. COMPLETE FEE SCHEDULE BELOW C/l C. '3 AIl..q 14'/ LEGAL DESCRIPTION A. New Residential- Single or Multi-Family per dwelling 1702. "] S']"1 0 7' bC>O Service Included Eacb Manufact'd Home or Modular Dwelling Service or Feeder ATTENTION: Oregon law requires you to CONTRACTOR INSTALLATION ONL~lIow rul~', a~!JfX!!,&sl.l'!f.e_edj~I'Sg-:Instlill:i!ion, Alterations or Relocation: Notification Center. Those rules are set forth :~ nl\R 952-c2.9!l"~P1P...s9rrl~.Jh OAR 952-001- 0090. You m~91(MlJisltoGl.00)Amps'1e rules by ""lIing thE.40:LrAmps(!Or600 AmpSllephone number for6\i<j3NnpSlio'lJ oooil\'~Wification Cer~e~1 OOOORm1;1?%M4). Reconnect Only JOB DESCRIPTION ~ ~k 3 /VlA-uJ-r?....rwt1 po'-'RL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address Cily Phone ,.,,",,"' U=" N.m"', J~t- Expiration Date 0 Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Po~ ~J . Address ?,)(7t7! IA--h:R. I'~ Ge- 17 , Cily~-V . Phone 7V7-0'XJ[J OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. ~e/~ \b.I~ J:\ Inspection Request: 726-3769 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $t06.00 $ 19.00 $50.00 $ 63.00 $ 75.00 $ 125.00 $163.00 $375.00 $ 50.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less ~ $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits ~-o New Alteration or Extension Per Panel One Circuit $..13.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 " ~WE \NO?''' ~O~l,IalleouM~t~~t~~\~I'r~\IIfil) -Each Installation PE?\-lIli S i\-\IS PE? OR ~~i~'ijJi\J&lOE~ "'B",~OO~EO r $ 50.00 . ~U~iljl','L'i8~~d' QI) $ 50.00 &~'f'~\541<w-'/R.~B~~ntiai $ 25.00 Jmlted Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE ~ '1 S- ,.... ~ at:) ":>r- 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Permit Application 1-06.doc . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6963 Main Street ASSESSOR'S PARCEL NO.: 1702353309600 . \...11 f OF ~n\,.ll.JGFIELD Building/Combination Permit PERMIT NO: COM2006-00360 ISSUED: 03/27/2006 APPLIED: 03/27/2006 EXPIRES: 09/27/2006 VALUE: Springfield TYPE OF WORK: Use Initials TYPE OF USE: New Residential PROJECT DESCRIPTION: Temporary power Owner: ROBERT GREEN Address: 38704 CAMP CREEK RD SPRINGFIELD OR 97478 Contractor Type Electrical Contractor OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: , Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction Phone Number: 541-747-0300 , CONTRACTOR INFORMATION I . ec' ,\v-\'i.~~'l cc-,\)\\ License<'''-' Expiration Date Phone _ \2'\" \ ~ O\e\)':;e s~"~J:FJ\'" , ". ,......-, .... -,- s.... BUILDING INFORMATI0N. \\)W e , 0" - '. ,\\\~ \)'!i ~". ,,'0 . " '(\\0 sO e\ey ?J.\\o # of Stories: \) \: o,:,\e "e \: ,\\\0 Lot Size: . ",\\' r I, \), .....\0'" Height'ofStructure;o..e'. ,,__, \~ ,,\ Sq Ft 1st Floor: 'Tipe~'rHiiit~ ~~ \)\\\\';,?r'" Sq Ft 2nd Floor: . V" \",\. 00 ,.,,7--" . .' 'W. ate.r Type: O\e'0 ~_?i~ Sq Ft Basement: ~ .....v ......'~...... ?:>\)\J ,.' ,,\.)J Range TYI~e:'. \' Sq Ft Garage/Carport \)'"' ,,\\'.... ,...., ~ ,,=> c;En~~gy:!,,\',t,IJ:' Sq Ft Other: ,l'prinkIed'Building: nla Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compa~'\)",,~ ~ \"~ S ~\J\ 'IO\""~ ;'<]\<1\\\ \0- I PUBLIC IMPROVEMENTS I~. S,,'r-\..\..~\"\S ~\J~~\) \- \\~\ \;'X:.""\s%lt~)li~ye~'r-~ \~~"\J""'i51't~s~;~~ains: 'r-'-' ~~'X:.~ \)~ c,'0 " \ rof0 'r-~ I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . . CITY OF SrKll'itd'u'LU Building/Combination Permit PERMIT NO: COM2006-00360 ISSUED: 03/27/2006 APPLIED: 03/27/2006 EXPIRES: 09/27/2006 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 L.F"".. Paid I Fee Description + 10% Administrative Fee + 8% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid $5.00 $4.00 $50.00 3/27/06 3/27/06 3/27/06 Receipt Number 1200600000000000349 1200600000000000349 1200600000000000349 Total Amount Paid $59.00 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. Temporary Electric: Approval requIred prior to Utility Company energizing pole. 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 tbe 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 reqnlred 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 of2 2"25 .fifth Street Snringfield, Oregon 97477 5":1-726-3759 Phone Job/Journal Number COM2006-00360 COM2006-00360 COM2006-00360 P Jyments: Type of Payment Check ." ;~ :4 " " :'1. .~ " " 3/27/2006 . RECEIPT #: Description + 8% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less Paid By GREEN AND SONS INVESSTMENTS "r~~. ~.. . , . ' <. .. .'- ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200600000000000349 Date: 03/27/2006 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1080 In Person Payment Total: Page I of I 2:00:29PM Amount Due 4.00 5.00 50.00 $59.00 Amount Paid $59.00 $59.00