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Home My WebLink AboutPermit Electrical 2004-11-24 225 1'1Ho. STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (561'Jil6>.90689 ELECTRlCALPERMTI' APPUCATION .... . J :O'O~9~;"u.o City Job Number .f(J/NIc.aUi.l~ 01'1'-1. I ... DatC I(I"Z:J g"""- 0'<%"1.' 'I1t "',,/. -'0/ '.r.s"... '~''''~~H'',,,,.,~~,J.~ ~. '-~'~" '-.......... '-''''''e' "',~"-' 3. COMJ>llel~i.dili, ' . \B.c.l.;' . -' ~~ - . ~" " - ~ p,.~. ~~ . Q-~.s' ~_ ~. m_ _'?~~... _ "'~. 0... A. ~. - ;..,. .ti-17''''''Sjiig!~' ,... .".L . , e " eslw:D ill"...:.. (J e.:.OIt ,wti~ . ,... ~~'-"'i<<ii ,. . . Service Included ., ~ JOB DESCRIPTION. 1000 sq. ft. or less. . Z 1.,. ./ A Each additional 500 sq. ft..or . I (..( 1Z-<...~,-,I'S ~ 2-200 $(2.v'c.Sportionthcrcof.. ! . Permits are non-transferable and expire Ifwork is ,. not started within ISO days of issuance or If work.is Suspended for 180 days. 2. [~~@:~ti:~~q.~ B. ~~~~A~~~~1~~j~~~.t~ ElcctricalContractor_jl'lse}>~ "f)arltk dfL(.!nC 200Ampsorless .2- $63.00'. / Zb I 201 Amps to 400 Amps $ 75.00 Address 1-525 [,oJII DYlt;.. Dr 401 Amps to 600 Ai!'1>> , W' --"..I__~ SH;i\Q9 ,^ () .., ilL' ~711,r 601 ~1~~~.wB~t~~nb;tr~~(;;;~!>rl~t09 City f:\MQ HA, Phone ill't. p. '12 Ov"f~tI&~c~~~.er. Those ",I"" areW.1.0lth \ RccOnncctROiilJ2 001 0.010throl'nhnAR~~o.OO1- In VA ~",' . . - . b~~~~~~f.;~~jf!J.?'~~r.-.e.ffHt ~~~L..<<",,_~ C.~." ..-e!\~~~~ nu~ber for the Oregon Utility Notification . Installation, ~~,*~lli,o'1!"Jecs!l2D2344). . . 200 Amps or less $ 50.00 20 I Amps to 400 Amps . $ 69.00 40 I Amps to 600 Amps $ I 00.00 Over 600 Amps or 1000 VOIlS see "B" above. D...~E@f,g~~~~~..~~ New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit .' I. ~;:tociTiON;OB1N~TIO~":~~."1Ellilr. . ~v'-'''''-=~'' >!!""......~.......; .~~~~.-~~1 ~')3~ i/W!+IN 'S') LEGAL DESCRIPTION 17D2 3Z4 Z 00600 Supervisor License Number 4-73+ --S Expil1ltionDate iD 101/07 " I I Constr. ConD'o Number 2-0 - % ~ 4/5iP7G I Expil1ltionDate 10 / o~ ) 'if /07 / Sisnf1. of SupervisinS Elec~ian l/,.-/-. ~;v()L oJ.rs Name J5.dZA ~Av~- PO iJ 0;<, -z..-z..- \ City s.? (::0 ~ L--L-L. Address Phone OWNER INSTALI.ATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: Inspection Request: 726-3769 > . SPRI.NO~~ ~... . ~ ..~ - . ., Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 $ 43.00 17 . ::> b $ 3.00 f'Ji?~~~~1~(~~~illWfficlir.f@x~~7iffu.~ 1 Hls~~~n;:;-.t~~'f'ffl't:i II ~77~"';A; un1\.~'''l~---:':,l~ii'. AU~WdliiRgl.ti6\1ER THIS PERMiT IS NCS50.00 COSfWoilli;ft~illShtilisABANDONED FOR $ 50.00 AN!(i4J'l~ ~~&-1R1\fi'J.1ntial $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~-",~."~~~..""",,... '. ~ b"7 4. ~~,W~~9lf~Q~ ..;~~1~~ I' t- 7% State Surcharge i I "3 'I 10% Administrative Fee I b 20 I '3" '7 )=::L TOTAL _,......,,~;__I:'__~n=1_...:....1 D_:t .......1:....'''''' 1.Jl1 rlnr. . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01441 ISSUED: 1112312004 APPLIED: 11/23/2004 EXPIRES: 05/23/2005 VALUE: . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4535 MAIN ST ASSESSOR'S PARCEL NO.: 1702324200600 Springfield TYPE OF WORK: Electrical Work Only Overlay Dlst: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: ATTENTION: Oregon law requIres you to fnll,\lu ~t'.a.. ..........:-.~~ "',.~: ~:-:7:-: ~::~ll- I PUBLIC IMPROVEMENrESlfon Cenler. Those Nles are set forth . fl. lmrl ~52-0S\&i!WaW 'l'V/?M9h OAR 952.()()1. 0090. .You may obtaln?O.eie~ of the rules by calling the \!eJfWl('''(mlllf.~:lelephone number for the Oregon Utility Notification Center is 1-80Q-332-2344). TYPE OF USE: PROJECT DESCRIPTION: 12 circuits and 2 services Owner: BERAKAH LLC Address: PO BOX 221 SPRINGFIELD OR 97477 , CONTRACTOR INFORMATION I Contractor Type Electrical Contractor JOSEPH BUNCH ELECTRIC INC License 156761 BUILDING INFORMATION I # of Units: # ofSlorles: Primary Occupancy Group: Height of Structure Secondary Occupancy Groul1:0TI CE: Type of Heat: Primary Construction Type T'HIS PERMiT SHALL w.a'feF\'i:y~eTHE WORK Secondary Construction TypeUTHORiZED UNOER~iiIjil~ lFyp.;:1IT IS NOT # of Bedrooms: ~OMMENCEO OR IS ~e~.~lO:'Jt~\1!:9 FOR HIV 1 RO nAY PERIO~rlDkled Building: nla I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard' Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Pa!!elof2 Addition Commercial Expiration Date 0812112007 Phone 541-344-8745 Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Value Date Calculated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01441 ISSUED: 11/23/2004 APPLIED: 11/23/2004 EXPIRES: 05/23/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L.Fl'l's P9JsU Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid $16.20 $11.34 $36.00 $126.00 11/23/04 11/23/04 11/23/04 11/23/04 Receipt Number 1200400000000001649 1200400000000001649 1200400000000001649 1200400000000001649 Total Amount Paid . $189.54 I Plan Reviews , 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. . , Reauirl'd Insnl'ctionsJ Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Electric Service: Approval required prior to utility company energizing service. 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 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. 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- Pa!!e 2 of2 225 Fifth Street Sprihgfield, Oregon 97477 541-726-3759 Phone I . a~ Wii:. ! Jiii..ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000001649 Date: 11/23/2004 1:12:57PM Job/Journal Number COM2004-0l441. COM2004-01441 COM2004.01441 COM2004-01441 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee' Payments: Type of Payment CreditCard Paid By JOSEPH BUNCH ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 607315 In Person Payment Total: Amount Due 126.00 36.00 11.34 16.20 $189.54 Amount Paid $189.54 $189.54 11/23/2004 Page 1 of1