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Home My WebLink AboutPermit Electrical 2006-4-28 Date GDe 5--0l- ~ 9PRINOFIEL9f\..) ('^ . ~~~Yj · ~1' ~h~f~ , ' CITY OF "SeRINGFIELD, OREGON '~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (' oMZ-OO 6 -00 5>0 S- , 2 CONJ'RtlCI'OR INSTALLATION ONLY B. Senlc.. ori;~ders - Inslall~tion, Mier"tio~~ ~r.R~loc"tion: . . ,,_. + ~ .. .... ~. _.' - .J". . .'. . . . ElectricalContractor G4-E E \ec..T('-~C .Tille. 200Ampsorless /frO / .,$63.00 " , 201 Amps to 400 Amps ,I . '-. ,~75.00 401 Amps to 600 Anlps , " S125.00 -, .,' I.. ",.1:-' , 601 Amps to 1000 Amp,U'" ,,'.1, ",' ""r$163.00 . ,{\___,.". \ l1,.\ 1'1 I 1 LOver.1 000 AmpSIVol\S )-33" _ ?3~ ,., $375.00 Reconllect Onlf' 1 tlu' "- ' $ 50.00 Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps Over 600 Am.~s or 100.0 Volts see "S". above. Signature of Supervising Electrician D. Branch (;lEcui.ts' . "........':' X ~ :6) \.V' rL~ .\!N~~,A,It~~ation or Extens, ion Per Panel -::> 1) . Tf9netSltc~l.t. . S 43.00 !',aF,~_~li'diii6nllii€ir'cui(<i~IV(!t,h.: IF TW"WO"K oJ8T r .An", "' ._. OIl"L::.J AlServiceoi{F,eeder:!jermitHIS P' , C>(:. .$ >3.00 Owners Name "VII l"':/TH: IJel(ElSr",cn-rCOMi,lEI\CtD-O'~"I~": . ENI\III I~ II!Or /0 I II./JnLO \ I ~ "S j1fJ.Amnr,i/'1'\ "n') Address 7 ~ t..J 14e il;'N M!~ce!I~~",!-Ur'~~SJiceJfe~~er not'iiJc~uded):-ElIch Inst."l1alion City ~ f>Fh .' I. LOCA1'ION OF INSTALLATION 101 "vvf+ b,\-Tt:-: bfL LEGAL DESCRIPTION ^ i7P:?-_~.Y'Jl.{u O//OZ, JOB DESCRlPnoN 'WlOVlU me vir- ~Y'fV{Le .{.UI S IC(}Vl Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Address ?.n, ~O 'f.. I Co E!> b 5!.f1 6. \ bd 1'\ \1 Phone -!1 [07.. CH{o 2.7 City Supervisor License Number .dQB'OS Expiration Date ID - I - 0 (0 . Constr. Contr. Number dL(2..J5 ~ )D- 1'- 0(0 Expiration Date Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: #~ ~ 6D'- ~~ Inspection Request: 726-3769 3. COMPUrrEUESCffEDWEB&OW . ..__. . L... ,- A. New Residentilll- Single or Multi-FlImily pe,' dwelling unit. . /.. 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 S106.00 $ 19.00 $50.00 (03 '. C. Temporary Sen'ices or Feeders $ 50,00 $ 69.00 S100.00 " &'.00 Pump or irrigation S 50.00 Sign/Outline Lighting S 50.00 Limited Energy/Residential S 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUB1'OTAL OF ABOVE' roq .Q() s.r;? A1.e~- 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnslElectrical Permit Application I-06.doc . .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00505 ISSUED: 05/0212006 APPLIED: 04/28/2006 EXPIRES: 1110212006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 101 Mountaingate Dr ASSESSOR'S PARCEL NO.: 1702343401102 Springfield TYPE OF WORK: Sign TYPE OF USE: New PROJECT DESCRIPTION: Service and circuits for monument sign to subdivision Residential Owner: Address: MOUNTAlNGATE DEVELOPMENT LLC 1071 HARLOW RD SPRINGFIELD OR 97477 Contractor Type Electrical 'res yOU to I CONTRACTOR.INFORMATION, L,~n u,':,ly _ ~....~: Cj' ~l \... ~...... ro 1 forth Contractor ~ "~'1 CC~11~f. II~iceii's,e.S a~F;\~iu~,t.ion Date G & E ELECTRIC INC '. . .1... '~ ,,'.; '.Il1'1054468Ln ~A.~ ~.:,,0~/'_5!2007 '" ..", J~~OJ ...... ." BUILDING INFORMATION I;: the telephone r.;',;,"" l\1e GUIHv" ,'- Utility NotlhcatlOn # ?ru~1~fLes:Jr t!l~ Oregon 2-2344). Lot Size: Height of~[ucture 1-800.33 Sq Ftlst Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Phone 541-967-7045 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: . Total: # Street. Trees Rqd: \1' l\-1e \NOP,\\ Handicapped: ~B;{"J!'':W!~lei~M,:,ll Ei,\,\P,~eP,M\1 \S NOl Compact: I i.('.fofEot\coverr,~~p, 1\-1\S NeD rOp' iI\lI\-1~~:~~~f)uOP, \S iI\3i1NDO . , "''''~,...... ~_.." '" I PUBLIC, IMPROvEMENTS I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation DescriDtion , Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amounl Value Date Calculated Pa~e I of2 . .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00505 ISSUED: 05/02/2006 APPLIED: 04/28/2006 EXPIRES: ] 110212006 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 Ff'f'~ PllWJ $6.90 $5.52 $6.00 $63.00 5/2/06 5/2/06 5/2106 5/2106 Receipt Number 1200600000000000580 1200600000000000580 1200600000000000580 1200600000000000580 Fee Description + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Total Amount Paid $81.42 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 ReIlu~ 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 true and correct, and I further certify that any and nil 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 lhe street, thntthe 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 Pa2e 2 of2 225 Fifth Street Springlleld, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2006-00505 COM2006-00505 COM2006-00505 COM2006-00505 Payments: Type of Payment Check cRcceint 1 RECEIPT #: .~~ C.of Springfield Official Receipt "Iopment Services Department Public Works Department 1200600000000000580 Date: 05/02/2006 Description Perm ServfFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By G&E ELECTRIC lNC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 11334 In Person Payment Tolal: Pa~e 1 of I 8:24:40AM Amount Due 63.00 6.00 5.52 6.90 $81.42 Amount Paid $81.42 $81.42 5/212006