HomeMy WebLinkAboutPermit Electrical 2006-5-22
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215 FIFTH STREET. SPRlNGFlELD,OR 97477 . PH:(54I)716-3753 . FAX: (541)716-3689 .,;':":i<;<.''''. -'~,:.,. "
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1. LOCATIONOFINSTALIATION 3. COMP~FEESCHEDULEBELOW'
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A. .New ReSiileutial- Single or Multi-Family per dwelling unit.
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,,\~ Semeelucluded
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JOB DESCRIPTION ' . ,i":J',e', 1000 sq..lkoJ',less
/t-P . I \~t: \ ,8C 0(1 U\Eachl'llliditional 500 sq. ft. or
2c:>o JEltvl c.f7 ~ ~~c,'~~OO_3,P9rtio81it\~Of
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Permits are non-transferable and'explre If.woi'k'ls Each Manufact'd Home or
not started within 180 days of Issuance or If work iJ Modular Dwelling Service or
Suspended for 180 day.. Feeder
LEGAL DESCRIPTION
) 702 3,L(1.( Z
OLtLfO(
$106,00
$19.00
$50.00
2. CONTRAcro~TALIA710N O~Y:, B. Services o,r Feed_i,;,:; IDStallario~. Alterations or Relocation:
Electrical Contractor ~~_ (' f).rl\tl("cut.t~ t") 200 Amps or less r:::F.'J I $ 63.00 6 J
~, "..~. \'L 20JAmpsIo400~\f\t.'-N ''j't $75.00
Address n~ '1\11 \ _ ~ o.....v-..Lt.. 401 ~t>~\~i\WI\\ \'0 \'~ $125.00
~ - f '" ~\)\\IJ \601 =~ \llOO~~t.\) rail- $163.00,
City 0 '(t 0 IA. I Phone \.~l\\ )lt~O,cfP:.~\\'i5M~~ijIi.U $375.00
~ \.\\f\'G~\~Rffi\. $50.00
~()WlWI~6Qh'1 ?'cW\.l' ," ,
Supervisor License Number ~ lA..8 S hl'-l'l \C. Temporary Services or Feeders
Expiration Date 1.0.1 \ , !\.Do'" )nstallatlon, Alteration or Relocation
200 Amps or less
Constr. Contr. Number .!to. Q.5 'Oc.., 201 Amps to 400 Amps
"'\\,-\\ 1\ "~A 401 Amps to 600 Amps
Expiration Date fJNf'JV'" Over 600 Amps or 1000 Volts see "B" above.
D. Brauch Circuits
$ 50.00
$ 69.00
$100.00
Signature of Supervising Electrician
(Li.;;t1,~ ,
Owners Name Lo /2.A S fl.A tz..p
Address bC{ tv Yl44,# So r-
City ~ t::>F ~ Phone
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E. Miscellaneous (Service/feeder not iucludcd) -Each Installation
OWNER INSTALLATION
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50,00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
The insudlation is being made on property I own which
is not intended for sale, lease or rent.
8% State Surcharge
10% Adminislralive Fee
63
5O'f
6:n
7L( 3'(
Owners Signature:
4. SUBTOTAL OF ABOVE
Inspection Request: 726-3769
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TOTAL
Shared Drive(T:)lBuilding FonmlElectrical Permit Application 1..Q6.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
.LlI t OF SPRINGFu,Lu
Building/Combination Permit
PERMIT NO: COM2006-00603
ISSUED: OS/22/2006
APPLIED: OS/22/2006
EXPIRES: 11/22/2006
VALUE:
SITE ADDRESS: 6484 MAIN ST
ASSESSOR'S PARCEL NO.: 1702344204401
Springfield TYPE OF WORK: Electrical Work Only
nTd~ <;>RUSE: Repair
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",I Ohl'\ 9. \ S \)fhone Number:
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I CONTRACTu." lluORMNflON<'
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PROJECT DESCRIPTION: 200 amp service change
Residential
Owner:
Address:
541-
LORA SHARP
6484 MAIN ST
SPRINGFIELD OR 97478
Contractor Type
Electrical
Contractor
ROSE CORPORATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Speciallnstruclion:
Notes:
Description
License
54431
Expiration Date
09/30/2006
Phone
541-686-0905
BUILDING INFORMATION I
# of Stories: Lot Size:
R-3 Height of Structure Sq Ftlst Floor:
Type of Heat: Sq Ft 2nd Floor:
VN Water Type: Sq Ft Basement:
Range Type: Sq Ft G~m~~Carport
Ener~ Pa~h:C'j:' I'IRE ~\ilW.iQ~her:\\
Sprinkl~@BAl1diitg;\i st\I\L\nll co o{>cciipa\lt Ill,ad:
..., lIe Dt-r\w\ .~...n "T\-\\;"J r (\"'_ ~f'\n
I DEVELOPME'N~IINFORMA \fio~~ I\BI\NDll\~l:U ' -'
CON\\'J\l:\W~- PERIOD. REQUIRED PARKING
.1'./ 'BO DI\'{
Overlay QlSt: 1 Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS'
Sidewalk Type:
DownspoutslDrains:
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Pa~e 1 of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00603
ISSUED: OS/22/2006
APPLIED: OS/22/2006
EXPIRES: 11122/2006
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 ~
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
$6.30
$5.04
$63.00
5/22/06
5/22/06
5/22/06
Receipt Number
1200600000000000685
1200600000000000685
1200600000000000685
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.
I Renllirerll.~
Electric Service: Approval required prior to utility company energizing service.
By signature, 1 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.
1 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
Pace 2 of2
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone
~
."~..
WiL. -
C... of Springfield Official Receipt
.Iopment Services Department
Public Works Department
Job/Journal Number
COM2006.00603
COM2006-00603
COM2006-00603
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
1200600000000000685
Date: OS/22/2006
Description
+ 10% Administrative Fee
Penn Serv/Fdr 200 amps or less
+ 8% State Surcharge
Paid By
PHIL ROSE
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 023021 In Person
Payment Total:
Page I of 1
9:39:21AM
Amount Due
6.30
63,00
5.04
$74.34
Amount Paid
$74.34
$74.34
5/22/2006