HomeMy WebLinkAboutPermit Electrical 2007-2-27
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225 FIFfH STREET. SPRINGFIELD. OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRIC/H. J>ER.llfrr ./-U'J>UCATlON
CityJobNumber c.o""'~C)'7- o-~ Z'1
1--2-, -Of
Date
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LEGAL DESCRIPTION
170 Z 11./ '34
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Service Included
JOB DESCRIPTION 1000 sq. ft. orless $106.00
A I Each additional 500 sq. ft. or
'^' ChO,' I//rt..: 5~.l4 t-r portion thereof $ 19.00
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Permits are non-transferable and expire if work is IJiWWMantlIa NJ om'e"tJf U v
not started within 180 days ofi..uance or if work is ~\lI~~lihglslmyll:S(/yby the Oregon tl..'Y
Suspended for 180 days. !~'Offircation Center. Those RM': ...0 s~.P..oi~
>dUN1"kA'CiOiln'lsiAuJAri-di\mNLy]A B ici~. ". "^:Q.".lQ~...g.1i.~.";~. '.s;(). Q1().:t.!"1f~9.~;tr.""#,..,..,.g'~'?<<.~.i!L.,.,q';.:.'.'I.".i'.'.'t'.'!'''''.'''.'Ni./.il
2." . . ,.,' , ....;, " ./, " I". , ,,;, . d09(fY3u!fffay~bbt~n~l~siQt!Yl'llYlltll'C;:r!"~S~'\!!m,;d%
Elec:~~;~ontractor "h1\)t\'f;;l~itJ1 ~\t~~iC s 200~~fil(jl\M c~n;er. (Note:tl~~tr"~I~~~~fur Nm'N
j7 r;.. ,1.'1. - 20nl\fii'psQO~fJ6~ppr(jgon ~'~I,!_;t' $ 75.00 .
Address J luuSOVl ~t. I,.Lhlt C 40IAmPstt.6wA1lip~1-80G-3,).:.-.:..".;4)$125.00
fA If ()." J/l n ..4..J!'l.A 601 Amps to 1000 Amps $163.00
City ~ Phone rOI~~D72 Over 1000 AmpsNolts $375.00
RecolUlect Only $ 50.00
SupelVisor License Number ~~q3~PA
)C
Expiration Date
Constr. Contr. Number
Expiration Date
rrr~OfS~
L Yo. pf-'
Owners Name tJe-/-J~ t;-LL
Address 3E> i> wr t.
City ""~~\
tJ ; rr
G-ATri"'
Phone
OWNER INSTALLATION
The installation is being made on property I o\m which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
~~.~22,~B~orIOOOVo1tssee':~:'above. ....... ... . ....... .'
D. ~~~;~t!~:5bJ!i1E~~~f~1@@mlliMlTIill~t:m%@mmmrir:M~&mtm:~:@MmM\~~1
New AlIeraIiOp,l'Et:xten,ion Pc. Panel I-H= WOR\<.
One cir&l.U1I" . LL F)(PIRE If 413'.00 . 1
EaChAd'\i~~~~&r~~ ER lHIS pr.f\MIl \S-I~O
Service or \\mI'OWel!O UNO ~~ff'fo~
E.\;ll:tti~~fi\~_~~ilil~~,i,~f;~t,~ii~tfllij:;f,mg':li
Pum ."'. $ 0
p or Imgatton 50.0
Sign/Outline Lighting $ 50.00
Limited EnergylResidentiaI / $ 25.00
Limited EnergylCommercial $ 45.00
Min~~.~.~ Electric p.~~~~.~..~~.~~,~.~~.ion ~~.~ :P~urchDrge5
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4. 1:1~~bt~rJl~1;ri:l~ji~l~i~f:l;:;:;;;llijjil!ijii:!ij!Jjjjijm:
3/0 State Surcharge
10'10 Administrative Fee /
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Shared Drive(T:YBuilding FormslElectrical Pcnnit Application I-OJ.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2007-00293
ISSUED:
APPLIED:
EXPIRES:
VALVE:
02/27/2007
08/27/2007
Owner:
Address:
WENDELL WITT
360 MOUNTAINGATE DR
SPRINGFIELD OR 97478
Springfieid TYPE OF WORK: Electrical Wyoh pJ'ly
'~\JI'fure90n laW reqUires U'l)':
ATIEN ):l'tdOft~I'J:/Neworegon tI R'{,sidentiai
follow ru\ ::i a. op se rules are set fOI" .
Notification Center. ThOh "h OAR 952-00 t
_ __,... 1"1('\-4 nn1nf rOUl.A .
In vt'\n ..,J'_ ~- ',-on 'A~ rll In~ IUlCi"" ....
0090. You may obtrnli'o~e~~ffi~ef~\e~1~bne
calling the cen~r'g(~~ uiility Notification
nllmberforthe ro _~" ".,HI
Cent8f1::i ,-ouu ./J_ -.
I CONTRACTOR INFORMATION I
SITE ADDRESS: 360 Mountaingate Dr
ASSESSOR'S PARCEL NO.: 1702343401400
PROJECT DESCRIPTION: Low voltage - audio, vac, security
Contractor Type
Low Voltage Electrical
Contractor
DIVERSIFIED ELECTRONICS
License
144685
Expiration Date
06/23/2008
Phone
541-484-9078
I BUILDING INFORMATION I
VB
# 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:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
n/a
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Soiar Setbacks:
I DEVELOPMENT INW~wt;~ION I LL EXPIRE IF 1HE WORK
11118 Pt~lilll "'~~ER 11118 PE~~I1'~OO I'ARKlNG
Overlay Dist: ,\U1110RlZEO UN '\NOO\lle.~IFOR
# Street Trees \3~i\MENCEO OR 18 ,\8 Handicapped:
Paved Drive R'l..c'y 180 O,\Y PERIOO. Compact:
% of Lot Covera :
I PUBLIC IMPROVEMENTSI
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descrintion I
Description
Type of Construction
$ Per Sq Ft
or muitiplier
Square Footage
or Bid Amount
Value
Date Calculated
\
')
Paee I of2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2007-00293
ISSUED:
APPLIED:
EXPIRES:
VALUE:
02/27/2007
08/27/2007
Total Value of Project
~
Fee Description
+ 100/0 Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Low V oUage - Residentiai
Minimum/Adjustment Electrical
Amount Paid
Date Paid
$4.50
$2.25
$3.60
$25.00
$20.00
2/27/07
2/27/07
2/27/07
2/27/07
2/27/07
Receipt Number
2200700000000000259
2200700000000000259
2200700000000000259
2200700000000000259
2200700000000000259
Total Amount Paid
$55.35
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.Rl'olJirl'd ~
Low V oitage: Prior to cover.
By signature, I state and agree, that 1 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
~\
Paee 2 of2
225 F:iftb Street
Springfield, Oregon 97477
541-726-3759 Pbone
.
~ of Springfield Official Receipt
_elopment Services Department
Public Works Department
Job/Journal Number
COM2007-00293
COM2007-00293
COM2007-00293
COM2007-00293
COM2007-00293
Payments:
Type of Payment
Cred itCard
cReceint I
RECEIPT #:
2200700000000000259
Date: 02/27/2007
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Low Voltage - Residential
Minimum/Adjustment Electrical
Paid By
ALAN WOOSTER
Item Total:
<":heck Number Authorization
Received By Batch Number Number How Received
ddk 00590A In Person
Payment Totai:
Page I of I
11:10:24AM
Amount Due
2.25
3.60
4.50
25.00
20.00
$55.35
Amount Paid
$55.35
$55.35
2n7n007