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Home My WebLink AboutPermit Electrical 2005-6-8 ~ ) , . , CITY OF\:,eRINGFIELD. OREGON ".-I ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-J(j89'0~'" ,0 ELEcrRICAL PERMIT APPliCATION . r>,~<o\ <,0 CityJobNumber CCw\zm:>r- _00680 Dale .,,~01;,A'5-0 ..c.Y:'-e:~Q,'~, '1\(\~- _ ./'!*-. 1. ~ LoCATION OF INSTALlATION--J 3. !COMPLETE FEE sciijjiibiJ}'flE _ ~,,<0" ~_.. _ ~ "'~ S- 3 So J-?1 A 1# 0 <,<(,\<$ LEGAL DESCRIPTION A. I New Residential- Single OP~1!.1tI~1amiIY per dwelling u '. /702 "3"331 065'"0 f Service Included JOB DESCRIPTION 1l::1M'p ?ow'Er'l PerDJ.!ts are non.transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. ICONrRACTORINSTALlATIONONLY! G 1'0(/ V1J 'f' cl rtOCfOJ 5(/1., Electrical Contractor Address (. J4 ~72( b't)f{ City Phone Expiration Date 575'(,5 10 - I -07 Ii?S7ioY L -l L{ - 06, Supervisor License Number Constr. Contr. Number Expiration Date ';-~"~ ' Owners Name . ~ or I#.., "" E, 53 ~o v11 ,4-tIV :sJ ~ \>P~ Phone Address City 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder S106.00 $ 19.00 $50.00 B. ! Services or Feede~ - ~~allation, Alterations or Reloc~~~~~: ]' Installation, Alteration or Relocation 200 Artipf~iTe~N; Oregon law real.res ~@ 20 IIA!I,ps:t61400' A:ii\p$lted by the Oreal)nUlllillp 401;\\'!.\pS'ili~600':Amj;Sr. Those rules are ~QlbMJ ~~r ~to\~~'gPI160rw{!6Jt.~~2.\I€~,~'p'52-001. r lJO&t:r.yo!l'rn;:lV oblain-copies-of the rut . -b- -----~-l D. Branch C'rCUIts es Y ~-(;dJl#lY-II~e-cefller~(Nole:-the.telephone--- -~..j New1Alte:rati6Dlolt~~ ,1"ej(i!l!l,nNotification One Circuit Center is 1-800-332-2344) $ 43,00 Each Additional Circuit or with Service or Feeder Permit 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to I 000 Amps Over 1000 Amps/Volts Reconnect Only C. tTh";~orary S'-rvices or feeders ~ $ 63.00 S 75.00 S125.00 $163.00 S375.00 S 50.00 ___J SO S 3.00 E. I Miscellaneous (Service/feeder not included) -Each Installation I Pump or irrigation S 50,00 Sign/Outline Lighting S 50.00 OWNER INSTALLATION Limited Energy/Residential S 25.00 The installation is being made on p,vp,,,j I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. Minimnm Electric Pennit Inspection Fee is S45.OO + Surcharges Owners Signature:. : ..:'..:'. 'T S\\{\LL EXPIRE IF MiHliE \~~~lmTOTAL OF ABOVE; 'S" 0 \''; \-'Li\,,\i\ ~DiU\S PER '--~-- I [Iv . lJND~n n FOR sc> ,\\\\nlH'..Lt\.l _-' >C' ^\1C\\\IDONED 7% State Surcharge J ClJl,\:\lE.I~Gt~ ~~R\OD. 10% Administrative Fee S 00 !>.f.!'{ 1 Bll I){\, - B.)O Inspection Request: 726-3769 TOTAL ':::. - Shared Drive(T:}'Building FormslElectrical Permit Application J-03.doc . . CITY OF SPRINuJ<U,LU' Building/Combination Permit PERMIT NO: COM2005-00680 ISSUED: 06/07/2005 APPLIED: 06/07/2005 EXPIRES: 12/07/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone , 541-726-3676 Fax 54I-726-37691nspection Line SITE ADDRESS: 5350 MAIN ST ASSESSOR'S PARCEL NO.: 1702333106501 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Temp power only Owner: JOY HAYNES Address: 5350 MAIN ST SPRINGFIELD OR 97478 Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type . Electrical Contractor GROUNDED ELECTRIC License 158804 Expiration Date 02124/2006 Phone 541 726-6858 I BUILDING INFORMATION I .,. # 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: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Typl:TENTION: Oregon law rESqJReBl\S1!lt1lmt: Range Tfpe':Jw rules adopted by the s.lrF:!lGabliiet~arport Energy iIlatli:cation Center. Those ruSllili:tr(;)th(r',orth Sprink1~4 i!!uj)dllu:2.001-00W~rougl9tIlllRI\m:!-W!.'\:' ---- .. . .. ...... so, ..~... "J'J r. \':.v.Y,'" I "'...."",........ .....1 ~II\;;I I "'Iv,", ""1 I DEVELOPMENT,INFORMA1;JQN INote: the telephone number for the Oregon Utility NotifiM21/IRED PARKING Overlay Dist: Center is 1-800-332-2344). Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I r-!O"lICE: Sidewalk Type: ThiS PERMIT SHALL EXPIRE IF THE WORK DownspoutslDrains: AUTHORIZED UNDER THIS PERMIT IS NOT COlvllv1ENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. . 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 . . CITY OF SPRIrllul'lt<.LD- Building/Combination Permit PERMIT NO: COM2005-00680 ISSUED: 06/0712005 APPLIED: 06/0712005 EXPIRES: 12/07/2005 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 F"". PllitJ I -: Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid $5.00 S3.50 S50.00 6/7/05 6/7/05 6/7/05 Receipt Number 2200500000000000722 2200500000000000722 2200500000000000722 Total Amount Paid S58.50 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, inspections requested after 7:00 a.m. will be made the following work day. ~ir"d Tn.n"dioiLI 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 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 permission of the Community Services Division, Building Safety. 1 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 tbe site at all times during construction. Owner or Contractors Signature Date , Paee 2 of2 225 Fifth Street Sj)ringfteld, Oregon 97477 541-726-3759 Phone . ~t ~ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 2200500000000000722 Date: 06/07/2005 9:02:36AM Job/Journal Number COM2005-00680 COM2005-00680 COM2005-00680 Description + 7% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less Payments: .~ Type of Payment Paid By CreditCard ERIC MAHAFFY (tern Total: Check Number Authorization Received By Batch Number Number How Received djb 121785 In Person Payment Total: Amount Due 3.50 5.00 50.00 $58.50 Amouot Paid $58.50 $58.50 1_ :t~ ;, '. 6/7/2005 Pa~e I of I