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HomeMy WebLinkAboutPermit Electrical 2005-6-27 " N0 Ing ,!PRI~";;'~ '1/:Q) - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541~1\03li89 Signt;Uf.G~;,~. - . ELECTRICAL PERMIT APPLICATION ! / L--l.{~...-,--LI?q City Job Number CD~ zooS; - ~ e \ 0 Date h 'Z. 7/6 r .-0 ( ( I. ...--. ----..' -...- ...-- __J 3. "C01l!!?L1f.~'b_~ESC_HED~LEB!!.LOW..._ ._, approvel. , - , . CITY OF ~ ."...UNGFlELD, OREGON (.->' . 1. ~iOCATIO!iOFINSTAPAriON-' L__~ ____._ _ ________._._ __ ___ '70 1.5 IU A- / ~ c,T, ( :1"" :/-.-."...,.....p'",.-..."..-'" ..-,... ,"""'."'-'-"'":'.. -'-'-:"'~._-":'-'-"-'. ...... .. ""-'_-~'_"'" 0-,' A. [;N$W ReSiden~a.!.~i'!lPe,~.IVI~ti:~a~i.2' P:r:.~~v.!.mn!.u~i~, . Service Included 1000 sq, ft. or less Each additional 500 sq, ft, or portion thereof $106,00 ~ $19,00 ~ LEGAL DESCRIPTION nO'Z..."2,.S3~06~l\ JOB DESCRIPTION IbO A. OWI-<;r!1Jwcx- rep, J . Permits are non.transferable and expire if work is Each Manufact'd Home or " not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder r;:.-c----...---... '-----"....,--, 1';"-", -----...-.--'---;..'-.--- 2. ; CONTRACTOR INSTALLAtiON ONLY i &- ,~:-;h~<<;rvices or Feeders-Installation, Alterations or Relocation: - -- ',~\'0, \S\~. . / 73---"~ Electrical Contractor L.i -re ~'!!t'6, ,,,;." \ \t.00 Amps or less $ 63,OQ." t7 (,-' ~ -< v ,:.:0 201 Amps to 400 Amps $75,00 ....,., Address p'[) .&x: 1/1 :S'1",,~~"-.,'\\\\",,~\J'" 401 Amps to 600 Amps $125,OO'~'4. ,:;":~,)~\,,,\),,~;>:.,),. 601 Amps to 1000 Amps $163,00 ''>4'0/, City (?I/(-,. q''1t.fi:iPh~~~' \'>\Y:l",;{;;~I;::r.f71'6 OverlOOOAmpsIVolts $375,00 ''''i".9 , ,\\,\~ \\\J\' IJ'-v, '('V" Reconnect Only ..0 $ 50.00 \\ \'" ~ " "_ ).. \)r 0'" ,'~'\ . I _\j'~', .... \ _ ~~\' '(" "---- -- --~ Supervisor License Number ,~ . "6'<) S '35 c. r Temporary S~~;Q~~~'\!...._ __ ___ .__, ___ I . \ei ~0"" ~0<; b'l: 'Q'\ Expiration Date /1) 6 I: Installati~~\1,tio'il'~,'Rewc'ihi9n ,,<:-' ~'\\o' -S-'" 0" 0\ o~ ~ 200 1@ps~re~l;) \ ~ ~'S' 0~~ :~,o $ 50.00 C; q 7 'ff?' ~(tl~to:'40~~~0 0'~ o~'v- $ 69.00 J ~'<4QI~\~~ ~t~l\.'\~ ,y.' $100.00 Expiration Date t:; 'D b ~<<) ~0' ~~ r:J_iR<:- ,t: ,~ ~~ '" ~o~ \~o~~,If~~~~&Q,1gJ~ ee::'~" ab?v.".:___ --- p -- - Signature of Supervising Electrician ,0 ".0. ,~~al\'<.lVCII""n~ "',.. tf f dv ;j;~~<f,'~~:~0~~~:~iO~ Per Panel '- --, 7/ '/ A ~. ~~"~ \0' 0' I . '-(/ , ~Un~&'lfllPitcl~ $ 43,00 v () 1O~~lIditionaI Circuit or with ,~/ /l. /1, ,"V'9-1~~l'eOrFeederpermit $ 3.00 Owners Name __! J/-I-":? I LlJf/o'I Jtt(jA {(.All I UJ~ _ ____ ____ _____ Address ~G'>D fJ. b~ . E. 'l\1iscellaneous(Sei-vke/feeder,notinclud,~dJ-Ea,~~I.",~allation, City J!i t/;" t--:::J/r;;., Phone J1J!...lC-l/b /I) J Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergyfResidential $ 25,00 , Limiled Energy/Commercial $ 45,00 $50,00 Constr, Contr, Number OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Inspection Request: 726-3769 .~: $~~OTAL OF~O~~ __ 7% State Surcharge ..~~ 10% Administrative Fee ~~. TOTAL ~ -- ~l I -" -_..- ~~.DO a,4~ &. , ';Q ~l~.?t Owners Signature: Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1.o3.doc , -Wi" . Status: Issued 225 F1ftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 7095 MAIN ST ASSESSOR'S PARCEL NO.: 1702353406311 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00810 ISSUED: 06/27/2005 APPLIED: 06/27/2005 EXPIRES: 12/27/2005 VALUE: Springfield TYPE OF Electrical Work Only TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Install 100 amp. Qwest power pedestal. ,-- ,,'\..... .,\ '\ , \CONTRACTOR INFORMATION I (. ,~ ~, . , " ' . '..."'{:-....... \V. Contractor'~", '<'" ~'V License TONY KOTH,\~v0' 59748 ",. S'" ~" '<J" I .... ,<\ . ,,,v S r BUILDING INFORMA TIONI ,.,.~ ~,' \ ,\. '\)' }." '. \. , , " .~, .,,0 '0" ~,JV #ofUnits: ~','s "... x-,\..vx.\) "",'I:' Prl 0 "\G"'~\,):-l.' mary ccupancy" ,roup:, C'\'<' S d 0 .\\ ,~..,v"v econ ary ccupancy(\\" ,'t," P'rimary Constructlo'n'Type Secondary Constructio~' # of Bedrooms: Owner: Address: HAMMER JOHN PO BOX 2266 EUGENE OR 97402 Contractor Type Electrical Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction ':-...".... Expiration Date 05/0412006 Phone 541-688-8996 # of Stories: Lot Size: Height of ~ ,0 Sq Ft 1st Floor: Type of Heat: "0 ~O \)~1IiA ~,<,Sq Ft 2nd Floor: Water Type: r:".:il; 0'" e"O ~Sq Ft Basement: Range Type: ;olI \'li O\eC$~e '" r.,'l:\l .. ~ Ft Garage/Carport Energy Patb: O""~ ;-soe ~e"o ~~ OJ \Joe'~S Ft Other: Sprinkled ~e<:$ 0. 'O~ e \V ~ 0;lja,\e ~COC41llpant Load: C1 ,,9. . -''Ie;; . ,0;: .....\ ,"' ,0'9 n."\::-v -:';;::- . ~~ ),. ~,. --- ".... .~,,- I DEVELOPMEN'f-INFORMATJON~" ~O~ r' " " __' ...... <'-V \~'- Ci" ,,<;)v 1;:-" _,0'- ~'" ~"" ~ "..fo '0(0 ~\) ~" ~ co\:) ~'f,; ,.9v~~ray",~iS~'(}~ 0 (o,ro\' e(:!? fY~~ #:Sfreet Trees c,'li 0\ !(,\l ~ Cl.'" .Ju. ,~0 e -V p~Ye\l,g~~~Rqg:~ ~\"o % of.~::t'Coverage:o.e ~/" Q~ REQUIRED PARKING Total: Handicapped: Compact: IPUBLIC IMPROVEMENTS' Sidewalk Type: DownspoutsIDrains I Valuation Descriotion I $PerSqFt or multiplier Square Footage or Bid Amount Value Date Calculated 1 of 2 . . CITYOFSPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00810 ISSUED: 06/27/2005 APPLIED: 06/27/2005 EXPIRES: 12/27/2005 VALUE: Status: Issued 225 F1fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769)nspection Line Total Value of Project FP.es Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 6/27/05 6/27/05 6/27/05 Receipt Number 1200500000000000907 1200500000000000907 1200500000000000907 Total Amount $73.71 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. 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,) state and agree, that) have carefully examined the completed application and do hereby certify that all Information hereon Is true and correct, and) further certii)' 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 wID be made of any structure without permission of the Community Services Division, BuIlding Safety. ) further certii)' that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project. ) 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 wiD remain on the site at all times dr,t: 7;;+2-- h /7- 1!rJ ~ Owner or C"tracto~s Signature Date ( ( 2 of 2 . 225 Fifth Street Springfield, Oregon 97477 . 541-726-3759 Phone Job/Journal Number COM2005-00810 COM2005-00810 COM2005-0081O P.yments: Twe of Payment Check (; ., '. '; 6/27/2005 . RECEIPT #: ~~ City of Springfield Official Receipt evelopment Services Department Public Works Department 1200500000000000907 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By LITE ELECTRIC SERVICE Reeel ved By jmp 1 of I Date: 06/27/2005 Item Tolal: LneCK Numoer Autnonzation Batch Number Number How Received 6788 In Person Payment Total: 2:44:16PM Amou nl Due 63,00 4.41 6.30 $73.71 Amount Paid $73.71 $73.71