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Home My WebLink AboutPermit Electrical 2004-3-23 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLIC~ON ~ ~ f\J.'m -. The tOllowing project a b City Job Number CO/A1 zeOli - ate.) Z Z- c)L(loning. and does not ssu mllted has the tollowlng / ajJ~roval. require specific land use 3. COMPLETE FEE StlirIifigHlLE BELOW t=rn D~ ~~3-o~ A. New l{csid~l~a~r~~~jW'i\\IJ""ult;-""nlilv De~Wi1g unit. I. LOCA110N OF INSTALLA110N t.:{'S's:Q"ltt.l71 ./fii'.^ ""..-c- _ (L I -''''-:...J'..',,~~V_-,H'''(.j'''- c_ . , LEGAL DESCRIPTION I8'OZ05"2.1 08l.fOO Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 JOB DESCRIPTION ~r-;tA) ~.~ulr.A Fol'<. I ~J~..r-ATIO\...) $ 19.00 Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modu~rrQ~'i'li\Xl,~Service or $5000 Suspended for 180 days. ION' Oregon \a'fJe1f:~~rQgon Utility . AiiEN1 ~ led 'Oy \h9 \ tort' 2. CONTRACTOR INSTAL/fd.WJn~'rJ)NC1! ol~r 1h&e ti~O"'~~9!r2~s -Installation, Alterations or Relocation: 'lo\ilICa\ion e 010 \hTOUgh"" ulQS \ Electrical Contractor NA _ OAR 952-001-0 t ',n catl\95~st9ftl% e 1 $ 63.00 "3.;)Q on may ub a ..nA.."'IAlon 0090. '(ou \8T tN@J:",,"l'S'ttJ"'. ~IW $ 75.00 Address "Ailing \ne cen or~gorlilltl\~~t 8 Amps $125.00 number\or ~'~~;e 1_lInro6'0Ai;?~~~\-000 Amps $163.00 -- ,...-,~. City Phone Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 Supervisor License Number .q 02..<' s C. Temporary Sl"fvicrs or Feeders Expiration Date I ()- , - 7_0()4 Installation, Alteration or Relocation 200 Amps or less $ 50.00 Constr. Contr. Number tv A I;\IOVIC~: 20 I Amps to 400 Amps $ 69.00 -THIS PERMIT SHAll4~Mlr to 600 Amps $100.00 AUTHORIZED UNDEFPrRlS'~t~,M1~l$olts ~ee "B" above. Signature of Supervising Electrician COMMENCED OR 19'AW{t~UB3l6fb~ IIlOT ; 1/ ~ j J ~NY, 180 DAY PER/OBlC\v Alteration or Extension Per Pime) J.',J/MU~ 'D '....&/7~/V OneCltcull g Each Additional Circuit or with 3 Service or Feeder Pennit Expiration Date $ 43.00 $ 3.00 'f, 00 Owners Name Wi<1..Ar...AlAl--)& "PAR/C. t-../$r' Address Zoo '5. 1'1 :LL <,,_ E. Miscellaneous (Service/feeder not inclnded) -Each Installation City 'S PRI~\:(,cjA'\ Phone 731, -4tYf4 Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee . /7-,1)0 S,o~ '7_2.0 S"4..Z"f Owners Signature: 4. SUBTOTAL OF ABOVE Inspection Request: 726-3769 TOTAL Shared Dri\'e(T:)/Building FonnsfElectrical Pcnnit Application 1"'()3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00082 ISSUED: 03/22/2004 APPLIED: 01/21/2004 EXPIRES: 09/22/2004 VALUE: ,j' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4350 Mt Vernon Rd ASSESSOR'S PARCEL NO.: 1802052108400 Springfield TYPE OF WORK: Site Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Electrical Permit for service for irrigation and SIDEWALK PERMIT FOR A PA THW A Y CUTDOWN WITH ADA RAMPS. Owner: WILLAMALANE PARK & REC DIST Address: 200 S MILL ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type General Electrical Contractor BROWN CONTRACTING INC OWNER License 114260 Expiration Date 05/30/2005 Phone 541-338-9345 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT I""uKwIATION , Frontyard Setback: Side I Setback: Side 2 Setback: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS' Street Improvements: Sidewalk Type: Downspouts/Drains: Notes: Storm Sewer Available: SpeciallnstructiQR,;EN-r' }\I I IUIII:urellOft law reljUlftJs you to follow rulGS adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 0090. You may obtain copies of the rules b, calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). NOTICE: THIS PERMIT SHALL EXPIRE IF THE WOR~ AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page I of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00082 ISSUED: 03/22/2004 APPLIED: 01/21/2004 EXPIRES: 09/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Oescrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project If"... P~W Fee Description Sidewalk Permit + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $75.00 $7.20 $5.04 $9.00 $63.00 1/23/04 3/22/04 3122/04 3/22/04 3/22/04 1200400000000000095 1200400000000000362 1200400000000000362 1200400000000000362 1200400000000000362 Total Amount Paid $159.24 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. UeotliredJn~ne{'tion~ I 1 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 2 Rough Electric: Prior to Cover 3 Electric Service: Approval required prior to utility company energizing service. 4 Final Electric: When aU electrical work is complete. Pa~e 2 of3 . . CITY OF ~rK11'lu..IELD . Building/Combination Permit Status Issued PERMIT NO: COM2004-00082 ISSUED: 03/22/2004 APPLIED: 01/21/2004 EXPIRES: 09/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 he made ofany structure without permission ofthe 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 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00082 COM2004-00082 COM2004-00082 COM2004-00082 Payments: Type of Payment Check ~.:~ ~ . ~'~,..'l'" -,...~. Receipt #: 1200400000000000362 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By llh Check Number Batcb Number Authorization Number Paid By WILLAMALANE 50653 City ofSpr:ngfield Official Receipt Development Services Department Public Works Department '. Date: 03/22/2004 2:48:19PM Amount Paid Item Total: 63.00 9.00 5.04 7.20 $84.24 How Received Amount Paid In Person Payment Total: $84.24 $84.24 . .