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Home My WebLink AboutPermit Electrical 2004-11-17 l' . " I I' . SP~ 225 FIFTH STREET. .SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 b~8~ ' . . jectasSU ,,9 '.... . ELECTRICAL PERMIT APPUCATION. TMtO\lOWI~g:~~s not requir . I , ... City Job NumbcLa'rv'\2...c1)L\ - aa I 3(pDate U \ $ -2' <"::::)(~~a~n . (I.: Q~~. - ' .... . l. . t1t]>~t!Qq@jM&-~@;'~ 3. ~~~EbEJ;l~~Z~~JIibrlP~~jt}tW';~~ ... J I L.J I ma (J(\ <5 \ .. ~ "I"lJized Signature- LEGAL DESCRIPTION A. ~i!~~~\c!BM~i!i~~~t;!~[I~,!!I- \ I f1 '3 35 41 Old" UO Service Included . . ATJENTION: Oregon law requires Yell to JOB DESCRIPTION 1000 ig11,!; oi}~~so adooted by 'h: ':",:,:n'1SJR~.l~O 6, {:~-em C) r0...A-; ~ Ea~m~~~~'}jl€r?rThOSe rules are Sf\~ddh po In OAR 95NJ01-0010 thruu91. OAn 902-u$1- Eac~~ii1M!w'l;Rl'tain copies of the rules by ~~:"CaI.Jlr~~lffiJ>&lffu'f. (Note: the telep~~ fllr the Qre,pon Utill~ NOll1lcation B.Se!iY';es .0. ~~"'~'{~~~jtii~iiJ1I 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 . _ 601 Amps 10 IPPM~s ~16!.~? s C(- ).5;.-0. /~ Over 1000 ~~SJyol~M\T SrW' FxPIRS3'75.001l': WUt'll\ Reconnect OillylS Pt, 0 UNOrn ,.Ule: ~20:OPlT I~ NU' AUTHORIZE __:-':' .n:'J.':'!:'~'I'D.f.nB_._..~.. C. i;~~~'~TI~l~rn~~~ Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D.IDi~i!1G~~~ New Alteration or Extension Per Panel One Circuit I .- Each Additional Circuit or with I < rz:/1 _. \ \ / /l A.JV' = /l Service or Feeder Permit J $ 3.00 Owners NameD \ OV b\1::::~ ~I J VV" L- Address II U ( {Y\tlm '6 \' J:t I E.l!rc~;:(~\~~~~~~i![tm~., .ci~~Mahone OWNER INST ALLA nON Permits are non-transferable and expire If work is not started within 180 days of issuance or if work Is Suspended for 180 days. . ~~'~""5l:~'.U'~~.-::r~l_"''''''~-~ 2. eO~€TORJIN~~.'FI<j>l'(~!i!iY< Electrical Contractor Th,"I k ElPcf,.~ Address , ~ City ~"jg".~ Phone Supervisor License Number "3 "r9. (, 5 10 ) C) 7 / Constr.Contr.Number .J~'. WO('.:;, Ifi'l'3J(; Expiration Date Expiration Date '"'"1-10 'S" , Si~:QU-I~ ""\ The installation is being made on property I own which is not intended for sale, lease or rent. Owners Si~ature: . . ~\~~ ~nspectlOt Request: 726-376~ : ~ ~J"'~ ~\0 f-!-cJ MAres J ~ ~..:\J..I ~ 0 ~j,1'{. <D ~ A '0 ~~C\e(\f. O\L C\l<\'\D $ 50.00 $ 69.00 $100.00 $ 43.00 43 L.f5 Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permlt Inspection Fee Is $45.00 + Surcharges 4. ~o/.Jfc.J9.P~ )(8"- rsU (,./ ~ go. ro 1 {)2. . 7r'p 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Pennit Application l-03.doc -. . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00136 ISSUED: 02/02/2004 APPLIED: 02/02/2004 EXPIRES: 05/15/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1141 MAIN ST I ASSESSOR'S PARCEL NO.: 1703354107200 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: New PROJECT DESCRIPTION: Install approx 250lfwater line', Elect. Service change. NOnCE: I n1,) n:11 IVIII "MALL tM'ltit I~P'IiH~ \!l'.1 IHKIl Owner: STEPHEN KRAMER one'Num er Address: 42113 DEERHORN RD SPRINGFIELD Oall~7~98qIZED UNDER THIS PERMII IS NOT : GOMMtNCED OR IS ABANDONED FOR ANY IHO nAY PFRlnn I CONTRACTOR INFORMATION I Residential 541-896-3205 Contractor Type Electrical Plumbing Contractor THINK ELECTRIC TUCKER PLUMBING CO License 154326 109801 Expiration Date 02111/2005 11/07/2004 Phone 541-232-1212 541-343-8008 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secnndary Constructinn Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a ,DEVELOPMEN. mruJ<J>1ATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I requIres you to ..--....t.ITlf"'\f\.I. nrAOon aw . '(I_:.y I.PUBLIC IMP~o\iiMEN!fSloPted bYs~~~~"~r~' ~~tforth NotilicatlOn v,,, Iter'l~~~~alkITWe~ 952-001- in OAR 952-001-00 ':" '~~;;:" f the rules by 0090 You may obt'Downspout~lDraiJ!s:one . (Note. the le181-"1 calling the center. Utility Notification number for the 0:eagooon_332.2344). . Center IS ,- Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction I Valuation Descriotion I $ Per Sq Ft Square Footage or multiplier nr Bid Amount Value Date Calculated Paee I of3 " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspectinn Line Fee Description + 10% Administrative Fee + 7% State Surcharge Water Line - 1st 50 Feet Water Line - Each Addtll00' + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid . . CITY OF .srKll'l\JN~LJJ Building/Combination Permit PERMIT NO: COM2004-00136 ISSUED: 02/02/2004 APPLIED: 02/02/2004 EXPIRES: 05/15/2005 VALUE: Total Value of Project Fpp~ Amount Paid Date Paid Receipt Number 1200400000000000149 1200400000000000149 1200400000000000149 1200400000000000149 1200400000000000181 1200400000000000181 1200400000000000181 2200400000000001411 2200400000000001411 2200400000000001411 2200400000000001411 $7.30 $5.11 $45.00 $28.00 $6.30 $4.41 $63.00 $8.80 $6.16 $43.00 $45.00 2/2/04 2/2/04 2/2/04 2/2/04 2/9/04 2/9/04 2/9/04 11/16/04 11/16/04 11/16/04 11/16/04 $262.08 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. L.ReouirerU"nsnections I Water Line: Prinr tn filling trench and including required testing. Electric Service: Apprnval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. PalZe 2 00 . . CITY OF SPRINGFl~LJJ . Building/Combination Permit PERMIT NO: COM2004-00136 ISSUED: 02/02/2004 APPLIED: 02/02/2004 EXPIRES: 05/15/2005 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 nf 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 without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees whn are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspectinns 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 constructinn. Owner or Contractors Signature Date Paee30f3 fl 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . a~.'..'i ~! --.: -.~ -. itliiJj.ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 2200400000000001411 Date: 11/16/2004 8:46:45AM Job/Journal Number COM2004-00 136 COM2004-00 136 COM2004-00 136 COM2004-00 136 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Cash STEPHEN KRAMER Item Total: Check Number Authorization Received By Batch Number Number How Received njm In Person Payment Total: Amount Due 43.00 45.00 6.16 8.80 S102.96 Amount Paid $102.96 S102.96 11/16/2004 Page 1 of 1