HomeMy WebLinkAboutPermit Electrical 2007-3-12
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rlr.~'bl . A!. DATE :3 - IJ- - 07
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(540726-3753 . FAX: (541)726-3689 ""'". SOURCE fYl "-
ELECTRICAL PERMIT APPliCATION . . 0 .
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L( cr BO wtA/,.,r sT
200 Amps or less $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps $125.00
60IAmPstoI000AmI"~OU\0 $163.00
Over 1000' Amps.WOI~~n \)\i~~'J , $375.00
Reco!ll1ect'QclY3 O(eg e set \0' '. $ 50.00
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.....\ ,,\e,c::e- ...:remporah' Se!\V;lces or Feeinrs "'>-"'1': "':..t " ~~ ~? :-:.~' ...- ,'.: ' ." ;-1
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"otl\IC ,,"-'1 .OlnstaUatiOn,CAIt""atlon'or ReI~~'fi'on
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:j090''''I_,g \r2'o (\AmPSt6'400:.~i~.:r
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'" .-<\\)el"40I,Ajrips to 600 Amps . $100.00
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Over 600 Amps or 1000 Volts see "B" above.
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LEGAL DESCRlPTION:
17023331.
. JOBDESCRlPTION:
~VI <Lt' tf.>"A-5.~
0L(20 (
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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: 'CONTRACTOR'INSTALLATJON.ONLYo';
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Electrical Contractor
III ,'j,.~H~ ':CP -nl0
Address
') SrlD
rn~,' O~~ ~j--
Ave
. Cily 5;~6-<<.';.
Phone L;/j f ,zt- >"1-0
Supervisor License Number
L, lil. :>
Expiration Date
IO~ol-.::>"'7
Constr. Contr. Number A:I!i"
Expiration Date
1- Ils"~~...
Signature of Supervising Electrician
4;~.
Owners Name "J:::>ftv" ~ r\.A~ c... Ie...
Address 'Zb(; 3. /JOII A ~,
$:t> pb
Cily
Phone
. OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
!i:".I'''q;~~ ".'''';~I ;\>~",.;" >tF~fi:'rp~'ir"m"";rr::9&;'?~;:1l~~\:T.;t;~~~if'i'~~l'i'~'-'~;P::'
A. ,!Ne," Residential'" Single or:J\1iilti-Familv;'per;dwelling iini!:.'.':"
~~'.;;:..~ "...:...-.:.-.~..a""""~:;"",,,,"~;...:!u.....,...:o:<.....:~~.l:---- -''.,'~ .~.'~';",'f
Service Included
1000 sq. ft. or less
Eacb additional 500 sq. ft. or
portion thereof
Each Manufacf d Home or
Modular Dwelling Service or
Feeder
I
$106.00
lOb
$ 19.00
$50.00
B. ~rse~~i~'~;tt~;:F~~~~s~_;'Inst~ii'~.ti&~,~~lt~Y~t~ri~, cit;'R~f6~~ti6ri:A1J
t:.~'~l.io.i4.1&".r..;;.:::;t;.i:;c;.Y";::~~.::I.;..;!.,,::.li~....~:'A>>'~'1..:';;w.'J.i~...&.-'ii.li;;-;.~~~;.. ~;':".~;{k.~;
t 50,00
$ 69.00
New Alteration or Extension Per Panel \I.
One Circuit .. .' 1'1l" \NO\!"B.OO
E'!.CQp\9~ltlonaICIfCU{~riih't. \r lI.\1 \5 "01
.. "t);/tJiH:'or .F.<<d...\:1e.k.r 1.1\'" ?'t.P. - $ 3.00
. o't.\\~\\V ~Qly\" "D'ru"
'W'iJ,t'-'7.f\'!t\'l'\\l-t~.~ \i:M'K~t\~~!".<'1(1';)":-,,,.=r-;'!O''',,,~, ,,",',' n'
E.~~~~~.~~~.'I.e~,~ot !iisl!!!I~i1).',;.EichIhst:illl~J~~
~~I'-!I~ im~!Ilin?'t.\\\ . $ 50.00
Si~~';\lke Lighting $50.00
Limited EnergylResidential $ 25.00
Limiled Energy/Commercial $ 45.00
. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. r.~tQr~Qfi~9Yft1~~S.~\7:i:~~~~r~f lOb
892>
1..0fo
.<:70
/30 ~
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Drive(T:)lBuilding Fonns/Electrical Permit Application 8-06.doc
.
. CITY OF ~n~ll'\iuNJ<,LD
Building/Combination Permit
PERMIT NO: COM2007-00333
ISSUED: 03/09/2007
APPLIED: 03/07/2007
EXPIRES: 09/09/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4980 MAIN ST
ASSESSOR'S PARCEL NO.: 1702333204201
Springfield
TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Rewire house
Owner: DA VID HANCOCK
Address: 2663 NOVA ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMA nON I
Contractor Type
Electrical
Contractor License Expiration Date Phone
MITcHS ELECTRIC INc 146745 01118/2009 541-521-5690
I BUILDING INFORMA nON I \6S ,!OU,\~"
..,.-.N (2o.ul on U\\'" :\
# of Stories:.;. "''''....., \ k\,!<si2~f-g (6 Sa\ \0\ ~
Height of Structure:., '''''~'AOn\ed 'o':'S.q, "tl'J'siiF~IOO~:"-2-()O\
\ ..... 2>" I" ......."""~ ~ ,..,!"\ ,,';
Type of Heat:"' \ ..1 r,,~eS '''1' \\':sg.l?t.Zlid' 100nuleS
\10" 'v cefl'''' 'b.'(,,<4}-...:. Ht1I:l'
Water Type: \0.. '3\10\"1 _()()'\()t-:S,,!.~\~.!'s'e~~iUb'('lofle
Range Type: \o\\\I~B 9r::/2.-00'" D\'3iflSqlf~q~!lllgeka';ealjO~
Energy Path: C\ O~ OU liI'3'/ 0 ~01 .1$/fFt {?\\~,~\o\\'
Spriukled Buil~i},f:i' ~ "\,,wn/A'lflO\.~CCUP!l~t.,~.td~.
...\\\;,\"", :..hP _,.. -'J.'.~?'
~~ . ...... . \,0-'
I DEVELOPMEl" mruI<.MA:rION"I.&(\S
R-3
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact: \\"
W' -,,-It. 'NO :\
~01\Ct:, "i c:.1-\1>.\..\.. t."'I'.I~;t:R,,^I\ 15~O
I PUBLIC IMPROVEMENTS I \\'\15 I'tl\I'I'~() \l~()t.~ \~'~~QO~t.() \"Ul\
1\11-\0\\ \\ IS t>:ul'
t>:'!Siderta'l\(JlYile<;) 0"
rl'\,,^t<It. ' 'I'r\\1 u.
1~'\W!l.nli6ralils:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
.
. \...11 i' OF SPRURd'Il!,LD
Building/Combination Permit
PERMIT NO: COM2007-00333
ISSUED: 03/09/2007
APPLIED: 03/07/2007
EXPIRES: 09/09/2007
VALUE:
'.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541.726-3676 Fax
541-726-3769Inspection Line
Total Value of Project
Fees ~
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Residence Wiring 1000 Sq Ft
Amount Paid
Date Paid
Receipt Number
$10.60
$5.30
$8.48
$106.00
3/9/07
3/9/07
3/9/07
3/9/07
1200700000000000256
1200700000000000256
1200700000000000256
1200700000000000256
Total Amount Paid
$130.38
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
L.ReolJirerl J~
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is trne 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 ofany structure withont 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
Paee 2 of2
225 Fifth StJ;eet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00333
COM2007-00333
COM2007-00333
COM2007-00333
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Residence Wiring 1000 Sq FI
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ERIC MAHAFFEY
.
Mir~.~~Pl.~.'.,i ........ ".'
I \. ;
- ,.'- '. '
.., '" .
! '. .
....-.. ,-""--.,"f- .,....
<A of Springfield Official Receipt
_Iopment Services Department
Public Works Department
1200700000000000256
Date: 03/09/2007
Item Total:
L'heck Number Authorization
Received ,By Batch Number Number How Received
djb R94323 In Person
Payment Total:
Page I of I
11 :39:39AM
Amount Due
106.00
5.30
8.48
10.60
$130.38
Amount Paid
$130.38
$130.38
3/9/2007