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Home My WebLink AboutPermit Electrical 2003-9-18 ?"';. :'I"Y.i~~~';;: '\. . G:rtY;~&F g' llliidEffiED' bREBON i " ,~;;" " ~ ,i. ,,'<<,;. ./~>~~~, "I n' '4' ".-Z1~...'.,~.J" '," ,_*'fi1 '"" "'''"''' A', ~t\ {.:",.lt~ ::(.~ f ,<,~ c 225 FIFTH STREET. SPRINGFIELD OR 97477 . PH:(541)726-3753 . FAX: (94'f)'Piit/;:jG8/jlroject as submitted has Ihe loll owing , zonmg, and aoes not reqUire specific land use ELECTRICAL PERMIT APPLICATION . approval. T"I (2 CityJobNumberCOWlz,oo.J_OO?O"f Date '7-/b-03 Z~ning I k' (/ 1. LOCA110NOFINSTALLATION 3. COMPLETE FEE SncJfEDULE BELOW OJ-I Cl ~~ / ., n AuUion2ao --sTgnature L)~ C)~ -41 r !/c~nm /?d.. 200 Amps or less /" 201 Amps to 400 Amps \0 401 Amps to 600 Amps iO'o) .~\\i ,0'" \:)\' ~\ 601 Amps to 10.00~inP~0r- \\0_ ,) "//., D? /, 4.. ,<" .t>,~ ?e n.v -", _'-, v '-' J Over 1000 AmpsNCj(l<' ~~0 ,_"-" \ ~v 0 - v C\'ClV Reconnecl'Only~ .;,\0'" ...<?'-" v\'l;~ J ' .0\'0'1) 0'0" e \ or :(\:l \ O<:-~ !\''" v\0 \,cP "<,,X' ,,\ 'I _~ ~O~ _\ 9~ Tinlp~r~'ry S!rvic!'S.or F~eders\c.'): ,\<(..\- ~e-< -;....~ ,<:l' c,o~' . '\S'0 _\0\\' ...'\ ~" ,p c-<:t '.-;. \(). .__\ \~ ~,. r ~\O-.tl . \liistallatio"",AIteration o'r~Rclocation '\Oo:i.{\\c.~ 20;r~niii1 ~;,'I~\'0~O~ vn..~'2I/..~ _\' .r -.> ,. C'" ,,~,.., ".rJ \-f0 O'r 20 I Amps io ~OO Alfi~ " ,,()~()401\<A;"ps~~:~66'Amps $100.00 v r'()-' e' ",~ v,.(\,'O "'(>j\' r-Qver 600JAmps or 1000 Volts see "B" above. D. Branch Circuits LEGAL DESCRIPTION I [02. Q'f fli JOB DESCRIPTION o/i/oo ACJu~ S-'e-~v/cl?'" Permits are non-transferable and expire if work is not started within I 80 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor ~J./ a ,k/ec..( Address rO, / t: ,j 7 City -*al"';~ Phone Supervisor License Number :2" 7/ S Expiration Date /0 fie,) 'i'" Constr. Contr. Number '2 0 / 7 c... Expiration Date /" ;'/,J Signature of Supervising Electrician .p~ Owners Name '.\,~Rr"''''e J-b/h)-k:n.... Address gb073 f)r",~~o-.1 br City e CA. c;.- Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature:" Inspection Request: 726-3769 ~~ 'b~ tj~ ~(,j A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: 1?--"'$63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 5"0 $ 50.00 $ 69.00 New Alteration or Exteusion Per Panel ,*,Iii'~~ One Circuit . ,\~\S0(l.\)'\ Each Additional Circuit or with ,~~ \'( "~'\~mQ. Service or Feeder Permit ~'-I.9 ~(.~\~\)"'<"'" . ~~\.: ,~,~' ~\)~\. E. l\fiSCell~\~~~1j~e~J~b~?uded) -Eaeh Installation ~ f:l '?~ ~1.\.\) \)~ f:l ~. Pump or i~~~~ ~c,\.\) '?\.~\<:::) $ 50.00 Sign/Outlin~~(iP~ ~ \)~ $ 50.00 Limited Ener~~<\<i'H'lintial $ 25.00 Limited Energy~~ommercial $ 45.00 Minimum Electric Permit Inspeetion Fee is $45.00 + Sureharges 4. SUBTOTAL OF ABOVE 50 35"=> 50" S-8~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:)/Building FonnsfElcclrical Pcnnit Application 1-o3.doc . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00904 ISSUED: 09/16/2003 APPLIED: 09/16/2003 EXPIRES: 03/16/2004 VALUE: SITE ADDRESS: 5655 MT VERNON RD ASSESSOR'S PARCEL NO.: 1802041401100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Service reconnect Owner: HOLLISTER JOANNE Address: 86073 DRUMMOND DR EUGENE OR 97405 Contractor Type Electrical Contractor DAVID R KIDD # of Buildings: PrImary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction 1 CONTRACTOR INFORMATION I License 35651 Expiration Date 05/05/2006 Phone 541-726-9303 BUILDING INFORMATION I ~\o ~'lO .,'.\-1 # of Stories: ~e~ ~ \\;CotSizc: . lj"u.\ :(\ V '!('\ HeIght of Structure "j \c~,c ",:Sq,1:~ 1st Floor: Type of Heat: ..'v ,,,eO cc,e _,SqFppdFloor: .;~ 1\\:-.,....' r' '\.. , Water Type: ,j~\ '()' ~ ,0" ,,:'/' Sq Ft Basement: Range('f.ype:~ (,~(j~~",nY'~'0r." \ \';\::'~q'FfGarage/Carport .... \ \ \ r'\') ., ,'" _' l . r.:: ,..~, Energy PJlth: ..:'" O\\" 0'~ ' ~pSq,-Ft'.other: r(\ ,.....- '....\\ -,~ ,\\' \,\ r".'- .,....~ "\~\-. r I\I~ \ , _,,\ '-..' ,\..,'" ,', '\ '. ~~...\ ....,~.I"!pervlous Surface Area: . ~\\O I;. ~ " '-., .~ 0 ..',\\'.. _\ ,\;,. I, DEVELOPMENT "INFORMAT10N'i;ro'it.-' .(\ v """\ 'oJ .....- ~ ...... J ~\J"'" , ,,:A\)' .....-' .\\\. ._\' ("\\.iJ "..,,-:) . -\ ,..... Overlay,Dist:,\ '," ~,p'\" ",\J~ -...., # Stree~,;Jrees Rqd: Paved Drive Rqd: REQUIRED PARKING Total: Handicapped: Compact: % of Lot Coverage: ~'iJ?-~ . \Co '\~~ '0 ~'iJ\ I PUBLIC IMPROVEMENTS ~ \.~i-'?\\'\~~?-\lI\ \ "'<~?- . \'.\; :\.I,\\~ ~~'V r;;)i\~~~\lI\\ S~~\)~~~~~~lOlVype: ~~\~ '?~ ~Sl.'t.\) \j?- \l>o~nspoutslDrains: \'.~\\\~'t.~c.'t.~'{ ,?~?-\\j . c.\j~ \'O~ \)1>' \'.~'{ I Valuation Descriotion I $ Per Sq Ft or multipUe~ Square Footage or Bid Amount Value Date Calculated Total Value of Project Palle 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00904 ISSUED: 09/16/2003 APPLIED: 09/16/2003 EXPIRES: 03/16/2004 VALUE: " Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Ff'f'~ P3\!U Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 9/16/03 9/16/03 9/16/03 1200200000000002137 1200200000000002137 1200200000000002137 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 Relluirerllnsnf'ction'U 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 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 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00904 COM2003-00904 COM2003-00904 Payments: Type of Payment Check ~~...'C~'.. ~". i "~ ' ... J .. "~'.""' . ....'- ' Receipt #: 1200200000000002137 Description + 7% State Surcharge + 10% Administrative Fee Service Reconnect Paid By KIDD AND COMPANY Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department. Public Works Department Date: 09/16/2003 1:04:39PM Amount Paid Item Total: 3.50 5.00 50.00 S58.50 How Received In Person Payment Total: Amount Paid $58.50 S58.5U . .