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Home My WebLink AboutPermit Electrical 2005-4-25 ~~INCFIEILD .....:.._. ~!' &,A: . 1 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-36Y] ~!r~~~ ELECTRICAL PERMIT APPLICATION JI " _ \ "\r'''';~ ~JII CityJobNumber ~V\;tZc>O)-004~\S"" Date ,.-2-1-01 ~~, ".. ",> .- (.00- ~ .?o~ " .. 3. ,.'COMI>r;;.:;i!J:i~$Cli!fP~E_' ::~;~..:;)",-:] .'G;. #6)'~ ~ \J'l: <.00- -~- -.e;' - - ~,,;,.1 A. ~iYR~id~~Eg~$i~gl~L~~:Multi~Fa. ~'''Y,'... '~-IJj9g~;S] , ..~"- '0 o o-~ ~ o~ o "'., '\i ,') '\ ....~,., ----,,-., .--~- - ,........,.............~.....". -. ...... -, -', .":. -'~;..I' '. 1. 'LP-Ql.TI()NQFJN,STA Tf~T!01'C!ij;;2J -~crbb NAt'lC';- ttve LEGAL DESCRIPTION 17l>~ 2,'2.-( 03,)~D JOB DESCRIPTION 20- 6 '/tW\P $(L"C 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. :.'CONiIDiciOR'INsTAT'i4TIONONLZ'] 2. --....=.,,- P . .' \.--. . . . '..r;;1,'~" . ,f;' ,- .1 Electrical Contractor [,>" ,-,(.\n=, Flrr+v,(' I Address :;2 \ -)=) \;0 :_~ 'V\ t\\/( City j-' l \,~::o), k: Phone -,:)+:'),l~C: ') Supervisor License Number ._ __..- ...,.c' .,J'J.,l,C .j Expiration Date \ D / ,...., \ / :2001 . I Constr. Contr, Number \ 'l ~ S '::) Expiration Date [', ~/ 0 '3/ ~:;:.. C'.:t! '\ Signature of Supervising Electrician ~~R~h of:. Name ~~ l.ffrL Address 9 b b AlPhtlc..., A-v City S~f.h 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 Service Included 1000 sq. ft. or less Each additional 500 sq. fl. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. ;1~eryi'~~r~~~~~~)~t~ll~ti~~,'.Alte~ti~~~,-Ot..~~I~~~'~~.(}.~~.':.,] ,l'200fNJtill.s-u:,~e I $ 63.00 10'1- .'v/v: r(;ln N 70]NA'm~S'a A~ law re' $ 75.00 in ~~013A'mp'lJgfi~A1Iil>by the cil'les You fd125.00 009~6i. f},,1np$Jg>J !88~ l/tflse rule;:yon Utilit}S 163,00 qj'BlI000if<IYJJ~mrou9h 0 -. 17_ :ser fOIl!b'l75.00 n ca1fiQa,&;ceftll/e In COPies Of ~,1 <7O<!'OOl$ 50,00 :m~~~;'~~~~O~?~/j~e:J.~>, ':,"'0,.',," ),1 . '""!II . ';~U~~~2 e . .~~~~. " . '_" ",' .~ Installation, Alteration or ~ktion 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. ':Br~I)(;~Ci~~ts~:_.~';}~~:~,;~E.:."":';.::~I.~' ~~ :~!;.~, ~., :.~. ,.' ,~.:,::~:,:-~~~~:'.::~~~;'..3 63 $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Permit $ 3,00 M"TI"c, , ID'; ,::.0;:....._"'" - " .1.r.-"'h"'nc>'I'~-{rHf=1'I~'" ," . -, ~ E'1'L~.!.s~elIaiieo';s,(~iceiieeder.~otinclUd;d) -E~ci.;lh.taii.ti.;;, ~~~~A.~~tD'uNO~R l'HIS-?tR1t1Ir-1'6;~l- ..... ' - Pump Or Img?oonOR IS ABANDONED FO::; 50.00 siBJ6MIiI~ihSkhOngn\OD $ 50.00 lJM\\~J~o.r~l%.rslaential' $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges -...,..........,.-. ~". .....;=-~ ......... '~N~ ... '.~) .. 1 4. 'SUBTOTJrLOF';;tBOYE;:,:'\": \.',;?: ~:J:...~........a-~..'", 63 Y'il b"'>o 7~71 7% State Surcharge 10% Administrative Fee TOTAL Shared Driye(T:YBuilding FormslEIt!ctrical Permit Application I.OJ.doc -Wlr&?A'N~I!I~' .. J \ ~ . _.u.,~. _, , . '_.' 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: COM2005-00455 ISSUED: 04/2112005 APPLIED: 04/21/2005 EXPIRES: 10/21/2005 VALUE: SITE ADDRESS: 966 NANCY AVE ASSESSOR'S PARCEL NO.: 1703272103500 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: 200amp service change TYPE OF USE: Repair Residential Owner: MARCELA LEAL Address: 963 NANCY AVE SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION I Contractor License REYNOLDS ELECTRIC 17252 ATTENTIIIlIBUlLDlNG.INRORMATION t follow rules adopted by the Orego; Utilit Notification Cent~l~q~~trJ~rules are If Yh in ~,3: 952'001-(JHel'Ph~f Struct'url!, 9se art v l3'l'{ outnOAH 52-001- 0090. You may O~J1lfJ ~~s: of Ihe rules by ~!i~rng the cen '4r.t1~ ' '.eihe telephone number for Ihe ~~~tie IW!y Notificalion Cenler IfgC- i!a3B~; nla # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Sethack: Rearyard Sethack: Solar Sethacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description I DEVELOPMENT INFORMATION I Overlay nist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Phone Number: 541- Expiration Date 02108/2007 Phone 54 I -343-7297 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupnnt Load: REQUIRED PARKING Total: Handicapped: Compact: NOTlCE~UBLIC IMPROVEMENTS I THIS PERMIT SHALL EXPIRE IF THE WOh~~dewalk Type: AUTHORIZED UNDER THIS PERMIT IS NOtiownspoutslDrains: COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I Valuation DescriDtion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Paee I of2 Value / Date Calculated . . CITY OF ~nul~t.FIELD Building/Combination Permit Status Issued PERMIT NO: COM2005-00455 ISSUED: 04/21/2005 APPLIED: 04/21/2005 EXPIRES: 10/21/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 4/21/05 4/21/05 4/21/05 Receipt Numher 1200500000000000486 1200500000000000486 1200500000000000486 Total Amount Paid $73.71 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. 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 herehy certify that all information hereon is true and correct, and I further certify that any and all work performed shall he 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 readahle 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 Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 54r-726-3759 Phone . . .!II'~'_C!liIlp.O . ~'..'''.'..''.'.'.'',........ . '. " ;;. '; I..~ ; ~ ~ity of Springfield Official Receipt Wevelopment Services Department Public Works Department RECEIPT #: 1200500000000000486 Date: 04/21/2005 10:23:00AM Job/Journal Number COM2005,00455 COM2005,00455 COM2005-00455 Description + 7% State Surcharge + 10% Administrative Fee Perm ServlFdr 200 amps or less Payments: Type of Payment CreditCard Paid By REYNOLDS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 035568 In Person Payment Total: Amount Due 4.41 6.30 63.00 $73.71 Amount Paid $73.71 $73.71 " 4/2112005 Page 1 of 1