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Home My WebLink AboutPermit Electrical 2006-5-17 L.DZ- S-I7-0<.,o 1\J 1"" , ~S-Pt2U7~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ',. . ~ EtECTRlCj\t p"ERMITAI'PUCAHON ~JP City Job Num~'2~ - fry) 6 K'"' ..s Date '3-/7- 2 crv~ ~ ,,,,J.:..;,,,';,,,, ,.<11" , fA :~_-.H,:!'_~~::1JtU~ \:J 1000 sq. ft. or less $106.00 Each additional 500 sq: ft. or I. ,~'n 12"! rocH'ires YOll to portion thereof ^~~:-:"Tn~. Or . .".., ~12:Q9,1 U,ililV ! "'~'<i\~:.:'.,,,:,.,....JUj ~..- t ;,...,C'....tforth Each Manufact:d Home.?:. C':r,\',r. -j,l;]c3 ru.('s ~'[~I- 1- Modular Dwelhn~Serv~~e.?rCJ10G 10 throuD\sfo:JiI ~:'.~~?~", Feeder ,'; '.' .. . t . CaDI'S 01 t,lO r -. -. . ., '\ \' 1111"\1 OL'.am ,.... PI' ,- I" "~ _ - _ l' e te1unllone 2 CONTRACTOR INSTAI.LATION ONLY B. Services or Feeders -lnstallatiolir.A\1~ra'i'totil or,Relocalioni . ,-"." .,.' '~Ol~(10n Utility I\!Otl"""",Q' :<"?J n , numul;r for Ul~ ~. ~n ')~(\4) /.? u- Electrical Contractor ~ '{a,\('(\O.r ZJ. O{::\-r; G 200 Amps or less Celller is ~~.3$63:oo .V?~- ~ -.-J 201 Amps to 400 Amps $75.00 Address l~\ 7::.. '2...~(c\ l\\I-e.. 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 2..1L\LS \D I \ 10 l Installation, Alteration or Relocadon 200 Amps or less $ 50.00 Constr. Conlr. Number ct Dr Je.. 201 Amps tq~20{tr~~ $ 69.00 /l 401 Amps t0600,Amp.sMIT SHAL $100.00 d..\ \NSoO ~ ""0 f"tt1 L tM~IHE IF THE WOR Expiration Date ~ ). I.&'" 0 0"-- Over 600 AmnsTorllOooNolts seeE"B".abovepERMI K ~ '"':.:I""<>,:"~l..U UIVU t1 IHI:) T IS NOT Signature/ofS pervi ,;g EI D. Branch <:;1r.~y!,I~tNCED OR IS ABANDONED F ~~IV""."..~~. . OR New Alteration or.Eltension :~~(f1!~el One Circuit $ 43.00 L./CtLiI ' Each Additional Circuit or with (l L d /I, Service or Feeder Permit $ 3.00 Owners Nam I l Xlf r () lA-/ . Address SDs \"(lmr/ k 0,w........ E. Miscellaneous (Scrvice/feedcr not included) -Each Instollalloll ciruSnl 0 ('~ Phone U 'J_~O OWNER INSTALLATION ~ .. qo50N~;-lTION ~ 3. LEGAL DESCRIPTION t \ I o:S ?:r-1 Q \ a Lj CJOl.) JOB DESCRIPTION aan~ -Szewt- ~ Permits are non-transferable and expire if work is nol started within 180 days of issuance or if work is Suspended for 180 days. City I ~.J'\O Phone t.\;~L\-Sld5D Supervisor License Number Expiration Date The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 -~1~J', COMPLETE FEE SCHEDULE BEWW A. New Residcntial- Single or Multi-Family per dwelling unit. Service Included C. Temporary Sen'ices or Fcedt..'rs Pump or irrigalion $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Eiectrlc Permit Inspeedon Fee is $45.00 + Surcharges 4. SUBWTAL OF ABOVE G, 3 (:JJ '5 . c;Lf en - ..so ~L::I . 34: 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding Fonn..;/E1ectrical Pennit Application 1-06.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 905 NANCY AVE ASSESSOR'S PARCEL NO.: 1703272104000 PROJECT DESCRIPTION: 200 Amp Service Owner: Address: CHEPODA CARl LEA 905 NANCY AVE SPRINGFIELD OR 97477 Contractor Type Electrical . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00583 ISSUED: 05/17/2006 APPLIED: 05/17/2006 EXPIRES: lI/17/2006 VALUE: Springfield TYPE OF WORK: Electrical Work Only ATTaf.YPE:O~F'USE: laMlteration you to Residential ,'Ol.~ow rules adopted by the Oregon Utility Not ,:catlon Center. Those rules are SAt forth '" ~n" ~""'uu '-UUIU tnrougll OAR 952.'0'01- 'oC8~.. You may obtain copios of the rules by ce.l,ng the center. (1'\ote: the telephone number for thA ()ro.f"'IAn Ilfila.. ~. _..'r' ._ I CONTRACTOR INFOR:;iltO~oI1-80'o-332-2344).H--"-" Contractor DOUG PALMER CORP Phone 541-434-5600 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction License 90725 Expiration Date 05/03/2008 BUILIJII"-, INFORMATION I # of Stories: Lot Size: Height ofStructii~e:;:: Sq Ft 1st Floor: Type ofHeat:HIS PERMIT SHALL EX S,q ~t ~n~, ~~oor: Water Type;\UT HORIZ 1~41F!IBasemMt;)RK Range Typet;OMMENCED UNDER THS'qfF.t:G#ij'ge~qWlort Energy Path:^,v I ED OR IS ABAS.iill::ltR\!J'i"iJR Sprinkled B~i1din~l!D DAY PlD'lriOD. Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC lI"r"vvEMENTS I Sidewalk Type: DownspoutslDrains: I Valuation Descriotion I $ Per Sq Ft or multiplier Sqnare Footage or Bid Amount Value Date Calculated Paee I of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00583 ISSUED: 05/17/2006 APPLIED: 05/17/2006 EXPIRES: ll/17/2006 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 JI....s P3id I Fee Description + 10% Administrative Fee + 8% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $6.30 $5.04 $63.00 5/17/06 5/17/06 5/17/06 Receipt Number 2200600000000000615 2200600000000000615 2200600000000000615 Total Amount Paid $74.34 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. L.R..oui~ 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 trne 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 strncture 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 Pa~e 2 of 2 225 Fifth Street Springfield.,Oregon 97477 S41-726-3759 Phone Job/Journal Number COM2006-00583 COM2006-00583 COM2006-00583 Payments: Type of Payment CreditCard cReceintl . RECEIPT #: ~~ .-r of Springfield Official Receipt Wvelopment Services Department Public Works Department 2200600000000000615 Date: 05/17/2006 Description Perm Serv/Fdr 200 amps or less + 8% State Surcharge + 10% Administrative Fee Paid By DOUG PALMER ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received njm 062800 062800 In Person Payment Total: Page I of I 1:56:49PM Amount Due 63.00 5.04 6.30 $74.34 Amount Paid $74.34 $74.34 5/17/2006