The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-12-2 .J 225 FIFTH STREET. . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . ~~llM1)j7~il/illl!l; sub~ittod has tho following , 'fic land use ELECTRICAL PERMIT APPLICATION zoning. and does not reqUlrespocl ') fI\ ' 1(Ppraval. I "T-...r[L City Job Number COM zoo 3 - 0 II C] 7 Date d-- 'U ~ 0./ Zoning l.-V 1. ~iQf:4.f.i"qFO.',f.)ijjS,".'j:,,:4u:A.'.:,~'l_'.I,bN. :~,;'l'f1Il. j::.;~,' 3. ~?COMpIili',J'E1:~~:;Ch:';ui.7U:'BE~~C~);::JI,~~~\?':l'j ~-...-_ ___ _ . ~ _ .....;._ . ~ Ilo" ~ . ~"~t....,~,~.,,,,-,..,,",~,,~...~k~~o,;.,:;..<l~-~(d;.~~ ~-::Mo)':..~~-' """ ~- 1:..ti..."rr."~~' "1"~ h<.ltnOnZea SlgnaflJre /:2h3 f17/4./AJ <:.7' Ii b LEGAL DESCRIPTION 1703'3SY ( JOB DESCRIPTION 08"700 i'r1 DJ e- .f'I ,StLiUV (" L ~AN-.JJ-, Permits are non-transferable and expire i~ work is not started within 180 days of issuance or if work is . Suspended for 180 days, ~,NTIfAcrdii'iNSYA {;PX:,i-lON:-ONf:i7~. 2. ,~. <~~.... ''i..~:~\A~~''"""",'~~,v''':t\~'''.'j<,}''~'~.it..4...../.J EI ,7' O,~ Bci0CLG...LC!..a. ectncat-Co &tOr ~ ":J-A 9 2. ke.Ul'k.tNL . Wctd'ress ~j~ 6~B..FfD -=17 Phone Supervisor License Number 3 ~ I <..( S Expiration Date / 0/0 c,L /0:> 6 -:;-7- // /:>V Constr. Contr. Number Expiration Date ---; Owners Name ~) ~ W fI1 (S "t.<:YV Address I J A.3 frJ At,..j <;7'; ~ -(:, City S fj) . Phone 7 '11- 7/ D 0 I ~ 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 Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder A. - ~i~?Rr;fd?Jfi~~f~rrg'~1~~i~giiiIlffi;'d~ ~)~~,,:.....-...,..- ,..-.......:~;t"".........:<...,......,.~_...'._,.;!',,,..~....:,-,.. ".,.,..-:.;:c $106.00 $ 19.00 $50,00 ~~~""'!>~'r:lli"~'~'i\~t-,' .f;"_'l'-'~;~'''''''' ;J';','t: '~Y,.16'::--"~f'~~:"I' .;~;,:\; ,;~':\~".""''':h ..~" B. f$. Ser'vices!or.:Fi;~<!er.s ''fJlitstall~,tiol};'~I!eriitiQnsgr::Reloca ti6ii:';}.: af"~;.;;.. ....s..... ~....' .~~, .'Y.;...,__,";.~t.-"t. ~.,..'1,;,,,,,,,,,,-""".'-'~-,~!.';,;'!\'2f,~!!\~~.\~,.,,' t....- 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50,00 <;"C) , C. ~ifiiii'(l'oi-a;y.:Servfc'es,~r.if~e'df~1~'jl\;;~~$~~;~~~'i~'1il'!;tf<l" ~,<r"- _._--~- "....~:O''OT'""-:teJ.f.:U,\~\\Jrv--;,;"....~~l...;.~'''.'.'~.. --\\t':~-,;v", , \a-N ( l\nOfl (\ I t II 't' _nQ~ . - Ot R"I '(j..IO ns a a 10n~<utefJa(jon or e oca on"O :nU\~'- \eO u, . \as G" - '2--v 1\"E.~200.Am'Pslbrlessosatll"'O..p-95 ._~ \ $50,00 . r I\\'l:::l::" - (\1' n.\' '"' - \Ollo-N (201 AmP~I(OO'400'AfnP~" 0\ \ne \\''',-'':0 $ 69.00 . a.\,n\\ -- ... (') \'" - n\eS \ n\'v. '-\O\\\lC 4012.Aft!psto 60~;Anlps . .~e \B a.. _..n('l $100.00 ' f>.P- 9"', , .;~ 0\)\<' , In\6, '" . NO~\\lV-' ,,0 \0ver,600 AlllP'sror~OOQ ~oltl; see ':)3" above. ' 0090. if'~7,>i't""'+~"C;;~'<" ;:.;,~~" :' ~'" "7~ ">'iii""'l'''-~ D;'\~"'B"anch~qr,CUiIS~!iif",."q:,\~';:'",""",,: ""'i1kf'.,.v,., ."1'" "":,;,_:',1i"",,;; ca\I . .,.c~\-~i~~~~'_"',~,'J'iM""d'.'i;."""~~~- t;ur.. .... ," ~;'\p.{ . _ .\e. ,~. . (lIlI'New f,!teratlOn or ExtenSIOn Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 41Yf";"~:"-.""':""-4;'~::::"'''''';~;'\)' ,,-., -'-']'.'-"-t".': '~'. ~~. ,'. :z....';-t<~'---,'"~,;;...>;: :-W' E. ~il~J}~s~tl,a~!l~~~s' (Si~):l~~!!~i9~r[l}t?.t!#C~~~(X~~,~~~l!ri,S~~~~4 NOii~~~~~IY~L EXPIRE If lr.~ ~~l~~ 50.00 1\1\$~11E~ O~IYe~l\1\S PERN Ii ... ~' $ 50.00 (>.\liIMfitW~~~Mlill~DONEO fO. $ 25.00 cruiMA~~~F'~Cial $ 45.00 'Mi.dn1~&ctric Permit Inspection Fee is $45.00 + Surcharges 4;'~'s;uBTOfA:U;OlBiBdVE~:~;it~~~1;}~.;..', ' .:' /'$'~~~~ :'--~.-- "!f'.",-~:. -!-j.,~: 'iW:"j-~~,~~, ~9,r..r-'-_I'~~ ' :,....-..._.....".'-..~' .,'~".. --<';~' '.--"''-<.~.,.-~~'Z.~~ 50 SF<=> 500 :;8r::- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnslElectrical Pennit Application 1-03.doc -Wi:~~~I:~P.I~. . I '. " ~---.-. : . '. - . . . CITY OF ~rKll~t.1<l~L1J Building/Combination Permit PERMIT NO: COM2003-01l97 ISSUED: 12/02/2003 APPLIED: 12/02/2003 EXPIRES: 06/02/2004 . VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1263 MAIN ST SPACE 6 ASSESSOR'S PARCEL NO.: 1703354108700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTlON: Move service panel Owner: ROBERT EDMISTON Address: 1263 MAIN ST 6 SPRINGFIELD OR 97477 Phone Number: 541-744-7100 I CONTRACTOR INFORMA TlON , Contractor Type Electrical Contractor GLOBE BUILDING & ELECTRIC License 103677 Expiration Date 01/04/2004 Phone 541-683-7077 BUILDING INFORMA TlON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: S!l.\':ld Floor: t-'tlif~et1lpe: P-.LL EXPIRE IF 1HE~'Ft asement: - ~l\~\!'rYPAI1 SH R 1HIS PERM\1liq II arage/Carport ttlwroA~!l!lJ UNOE OONED ~t Other: \ M"ENCEO OR IS P-.BP-.N Impervious Surface Area: rn '" -f:ll')n 'DEVEWl'MEWr~N~bRMAhoN , REQUIRED PARKING R-3 SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: .__.. .__._.. ..A___......... \....u' ronlllra,<::; \lnll tn Street Improvements: Storm Sewer A vanable: Special Instruction: I PUBLIC IMPRo.V.EMENT~I~pt~d by the Oregon Utility lotification Center. Sid~~~lli~~~e,!J.re set fort I OAR 952-001-0010 througn OAR 952-00 0090. You may obtc..I?,~~!!'~p',!!!,lsLD~ai!ls:ules I calling the center. (Note: the telephone number for the Oregon Utility Notification r."n'(.'r is 1-800-332-2344). Notes: I Valuation DescriDtion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Page 1 of2 . . CITY OF ~nur~uFIELD . Building/Combination Permit PERMIT NO: COM2003-0II97 ISSUED: 12/02/2003 APPLIED: 12/02/2003 EXPIRES: 06/02/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone' 541-726-3676 Fax 541-726-3769 Inspection Line I Fpps P"id I Fee Description + 1 0% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 12/2/03 1212/03 12/2/03 2200200000000001824 2200200000000001824 2200200000000001824 Total Amount Paid $58.50 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. I Reouired Insneetions I 1 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 aDY 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, tbat 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 Dale Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01197 COM2003-01197 COM2003-01197 Payments: Type of Payment Check '" WiE-.~~. .,!1I~1,I!,!! "".'''''.','.. ' . '''''.Ala: I ~; ~J J "',- . " .. . -~'"..''' .. Receipt #: 2200200000000001824 Description + 7% State Surcharge + 10% Administrative Fee Service Reconnect Paid By BARJ SWARTZ Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Departm~nt Public Works Department: Date: 12/02/2003 9:39:12AM Amount Paid Item Total: 3.50 5.00 50.00 $5M.sO How Received In Person Payment Total: Amount Paid $58.50 $5M.sO . .