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Home My WebLink AboutPermit Electrical 2006-11-15 3. '/~~"'~~~ . 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number CIDYt !J.lYJ..t?-OI4-t, I Date JOB DESCRIPTION 1000 sq. ft. or less ~ThlLYX ,(!;y. f p~ ~:0~::~~~1500 sq. ft..or . Permits are non-transferable ~nd expire ifwork~ Each Manufact'd Home or ., not started within 180 days of issuance or if work is' l.D . Modular Dwelling Service or S50.00 Suspended for 180 days. . Feeder ,"" I L ' . -.,' ., 'is you lu .J.....ll........ ~"t_ ,.. fIi~~.c~~~~~~""~"i!/;~..,,. B. ~~g~=\~:~nst3:I~~j\tyf~."srorIRel?9t!on:... in OAf-1 Ci'i2-l'JI.:JO"I 0 1hrou0l1 OA~-l '1-)2-001 200 Amp~QI::J.e~s.JU In:11' cOli::in M;":: :l~Me,o?ul~~:" 201 Amps to~400'Amns c!"n~"r (""'''' "," S.75.0010, _ ~ "..i ..1"'- - .\:.;. I' J \bh:<tJl 401 Ampslto:600'AinpstilC Orcgnn /1;';1"" S125:00a;;::. ,,,""'......... l 601 Amps to looolA'in-Ps'r is 1-f'nn."1:>-~3Slq3.00 '" Over 1000 Amps/Vo!ts S375.00 Reconnect Only S 50.00 1. t(iOCATIO;roEfNST'AiJi!AriON~f1..~ ~.~~~:L~~~,~~,_.......~._",....~JJiI5'~ 535 0 Mtl,iYl LEGAL DESCRIPTION \l 0'2- O~ ol 0","50l ~......._~'~.......I-<;;:I5.~~~""'Q-;->\;1"': ,:;,...c",<c_~ 2. ~<;;[g~lli$L~1I2~.Q~r!~ Electrical Contractor fh~-t,.:Jr( 'fa: :J Nt Address 2fi D ~}.;'w>~~F City 6.)c,&r?- 0>1.'-: 'Phone . ~/-<;\,'"/o Supervisor License Number .q 77 J. S Expiration Date 10 - c I' 07 Constr. Contr. Number f L.J (, 74~- Expiration Date D I - I ~ - 0 "7 . Signature of Supervisina Electrician . d~o~f:t/P~- /~' r', 6~ersName,=J~ ~( Address S?:J?O TVl1!l...Uv City~. Phone~-~ OWNER INSTALLATION The installation is being made on' property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: .726-3769 ~~..~:~,~""'-"-~~"',...~~~ry A. ~~~.J~_~lden,!}~!~~!!;;l~~!,g;Jt~~! Service Included S106.00 S 19.00 c..~~!i1,,'O'ri~;s~IWife'm'~;F€e1l'~fs'?!~,,~\(~l.ii..,,~.-. "', .~,jj ",~_r_~~,,.,.:.:..;..._.>-....,"''',_.....,,..'''__......~,r~;;~~~~ -. .. .. .. ~ Installation, Alteration or Relocation 200 Amps or less I S 50.00 .c:;o. op. , 20 I Amps to 400 Amps S 69.00 401 Amps to 600 Amps S100.00 Over 600 Amps or I 000. Volts see "B" above. ~~r''',~''- ',...", D. iBrari~!!~Gifc1iilS .... <r. New Alle Extension Per Panel One circJil-ilS PERMIT SHALL EXPIRE lf$lla~Q<wnRK EachAddld.bliillm@l!9rLlfi~ER THIS PERMITdS NOT ServIce OI'F..,."m",.Remnb' S 3.0. vVlifiYft""hvc OR IS I\OI\NUUNED FOR E. ~"'MJs~Il'a~6iiaA<.E~~Wil"")~:m'lli~G"llift~ ~....~'''....._.;.tr9-~,,-r,,_..~_.:::.Ii~''','_,~,~~ Pump or inigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial S 50.00 S 50.00 S 25.00 S 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~~~,"""".7l.,~~,I!.~_ '. '~, 4. MVBTOTAL'OFABOVE ;f;~~~~~~lh;:;'c:" t% State Surcharge ;o~:f~~e TOTAL r:;().oo +ob C:;.oO Z~ fD{, Sh.ared Orive{T:)lBuilding Fonns/Electrical Permit Application I-OJ.doc 225 Fifth Street SP9ngfield, Oregon 97477 541-726-3759 Phone .~ ..;~ tM... _ '. ~. C&of Springfield Official Receipt .Iopment Services Department Public Works Department Job/Journal Number COM2006-01461 COM2006-01461 COM2006-01461 COM2006-01461 Payments: Type of Payment CreditCard cReceinl' RECEIPT #: 2200600000000001582 'Date: 11115/2006 Description Temp Power 200 amps or less + 10% Administralive Fee + 8% State Surcharge + 5% Technology Fee Paid By HOLLY MAHAFFY Item Total: Check Number Authorization Received By Batch Number Number How Received ddk T37355 In Person Payment Total: Page I of I 8:27:I3AM Amount Due 50.00 5.00 4.00 2.50 $61.50 Amount Paid $61.50 $61.50 I 111512006 . .Lll Y OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01461 ISSUED: III 1 5/2006 APPLIED: III 1 4/2006 EXPIRES: 05/15/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5350 MAIN ST ASSESSOR'S PARCEL NO.: 1702333106501 Springfield TYPE OF WORK: Electrical Work Only Owner: Address: TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Temporary power pole for Christmas Tree Lot - Crossfire World Outreac~ lJ"~ Ic..lY'J rl~4 ~\lIltj:::' yo .' .~,., .,. _ __IH,\I~\1 t'~\l~'.'! ru~e-~ a~;o~tEd oy '''r''u' ;-'e'"'~;e set lor\~ C 'e' ThoS,3 . ~ 1 Noti\IC:1'Jon ..In... (In OAR 9:>2-00 in OAR 952-001-03,:?nt~~~~S of the rules b; 008U. YUU ,,,_., -' ote' thotelep"U,"" I CONTRACTOR INFORMATION"I"ter. (N U;ililY Notification numos"u' ,,,J.o~eg~~_"1;2_2344). License,r IS Expiration Date Phone 146745 01118/2007 541-521-5690 HA YNES JOY LEE 5350 MAIN ST SPRINGFIELD OR 97478 Contractor Type Electrical ContractDr MITCHS ELECTRIC INC BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secoudary Coustroction Type: # of Bedrooms: . # of Stories: Height of Structure Type of Heat: Water Type: Rauge Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION' REQUIRED PARKING NOTICE: Total: THIS PERMIT SHALL Efirtla.'CiMlif- WORK AUTHORIZED UNDERflqmp:amMIT IS NOT COMMENCED OR IS ABANDONED FOR lI.ff ~ X ~w DCOlnn I PUBLIC IMPROVEMENTS I Sidewalk Type: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Speciallostruction: DownspootslDrains: Notes: I ValuatiDn Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 _G!'~I'.CI.!ll~~ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01461 ISSUED: 11115/2006 APPLIED: 11114/2006 EXPIRES: 05/15/2007 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..... P3W Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid $5.00 $2.50 $4.00 $50.00 11/15/06 11/15/06 11/15/06 11/15/06 Receipt Numher 2200600000000001582 2200600000000001582 2200600000000001582 2200600000000001582 Total Amount Paid $61.50 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, inspectiDns 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 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 permissioo 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