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Home My WebLink AboutPermit Electrical 2005-5-27 ,. · 10 .'0 I ~'t,~D) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 0~"" :'-) ELECTRICA1d'ERMIT APPLICATION .J / \ '-.J. , City Job Number CtYY\J)rro5-tnt;,;::) / Date "<--1);;;(0 () , , Over 600 Amps or 1000 Volts see "B" above. Signature of Supervising Electrician D. Branch Circuits C. j 1 ~A' ~ New Alteration or Extension Per Panel ZI"{ ~ ~v- -- One Circuit V Each Additional Circuit or with ~ /l .. A "\ '} /> I~ _ 1_ _. Service or Feeder Permit $ 3.00 Owners Na IA/V./ !LIJGVL. --rtVYl ~ Address 7 ILt /:hdk/ s j~ _ E. Miscellaneous (Service/feeder not included) -Each Installation City SpY' ./ Phone Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 I. LOCATION OFTNS7'AU.ATION .:')"07 !Zt('h(Jw~ HLEGAL DESCRIPTION o~ti.::1J:J.. nlq/S (I J.~O~~;S,CRIPTION [ \._{/~/'<:1(/Y/q ~~ 7V t.JJt1.tr~ ~.. j;,L..,t ~v Av (...~ ~~ ;;:; ~~nsferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALI.ATION ONLY Electrical Contractor SfEtJE ~ Address r. o. BM 113' { City Ef- Phone 2J,J-J.w Supervisor License Number 3.51'f S Expiration Date IU-=( -n Constr. Contr. Number 1471./9 Expiration Date 4 - 30 - () :y 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 3. COMPLETE PEE SCHEDULE BELOW A. New Residential- Single or I\tulti-Family per dwelling unit. Service Included 1000 sq. ft. or less $106.00 Each ad11':~\.W\bl\l:tb?egon law requires you to portIOn tfol1~~ rules adopted by tho nrp'.:'.oo I..9tOlly Each ~l'.'JHf~5!ifld1p@enter. Those rules are set forth Modulrii 1()'A'l'1i!Je~!1'lti1e(\\!)1 0 through OARf?-20RO~. Feeder 0090. You may obtain WfJ'"'' J. ;he rliles b,/ 1I..h 'pr 1I\lote' !he telephone B. Servic......1 FeeoeFsC.EJ?lItalhllilJl1~- A li~atlOnrll~!atfin1fcatio n: number for the Oregon UtlllY NO I dO 200 Amps or less Center is 1-800~2-234fhoo (/;3.' 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 c. r 'Tcntpo~ry Services or Feeders , ~. ~ '-'...... THI~ PfCR;,;IT <:IJ^, I r-.". Installation, Alteration or:Relocatio"nTHE "VQRK '111Ut-' r.n --",' 200'Amp;~~ lespi'JOER THIS PERMIT 1<:$,50,00 '-'U".'"cl\11 :Hl Qa ,<' AS ..U t 2QIyAmps to 40u Ampsl ANDnNm Cf'lli$ 69.00 1o~ Al,,1jJ~ t~-6008frit~SJD.' . - $100.00 $ 43.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 03. UU 4.<11 (4- :50 7.5. 71 7% State Surcharge 10% Administrative Fee lit TOTAL Shared Drive(T:)/Building f'onn'\lElcctrical Pcnnit Applicntion 1-01dnc . CITY OF ~nuNGFIELD Building/Combination Permit PERMIT NO: COM2005-00621 ISSUED: OS/26/2005 APPLIED: OS/26/2005 EXPIRES: 11127/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 507 Nicholas Dr ASSESSOR'S PARCEL NO.: 1703221201915 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair PROJECT DESCRIPTION: Changing overhead to underground service. Owner: WARTENBEE SHANE & TASHARRA Address: 3368 GAME FARM RD SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION I License 147618 BUILDING INFORMATlONI Contractor STEVE HAUCK # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secoudary Occupancy Group: Type of Heat: Primary Con\Y'IIc,tiqui'Spe Water Type: Secondary co\'iHrbHlmt' TYfe: ALL EXPIRE IF Tf-fta\li@~e: # ofBedroom~HIS PERM I SH 1,'~!flD'rftath: AUTHORIZED UNDER THIS PERMIgprw'1<Jecl Building: n/a . -- 'r: fn'~lnnMl:n FOK [;UMMt'~IJC:u ur, ,:.l :-', ...- . ANY 160 DAY PERIOD. I DEVELOPMENTlNFORMATlON I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Residential Expiration Date 04/3012007 Phone 541-221-2665 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: ATTENT10f'iii1iill(!> Il'fIl'R6VEMiNr~ follow rulGll "Ju.,r,,~ eJ I. :! !",. y. . . . . C t r Tho' s"" rules are set forth SIdewalk Type. NotificatIOn en e . '" in OAR 952'()01-001 0 through OAR 952-001 DownspoutslDrains: 0090. You may obtain copies of the rules b. calling thlll center. (Note: the tel~~ho~e number for the Oregon Utility Notification ~__._.:_ < Qnn_<l<l".?~t Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descrintion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Pal!e 1 of2 Value Date Calculated . . CI1 i' VI' SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-0062I ISSUED: OS/26/2005 APPLIED: OS/26/2005 EXPIRES: 11/26/2005 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 Fp.p.~ P.'\ilU Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid 56.30 54.41 563.00 5/26/05 5/26/05 5/26/05 Receipt Number 1200500000000000674 1200500000000000674 1200500000000000674 Total Amount Paid 573.71 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. I RP.nuirp.rll~ 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 's\:);t3:,1 s/2~~~ Owner or Contractors Signature Dale Pa2e 2 00 22.5 Fif-th Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2005-0062 I COM2005-00621 . COM2005-0062 I Payments: Type of Payment Check 5/26/2005 RECEIPT #: ~....~ . Wii!'. '.-,-"~" '. - -"'--. ........ '. ", . .- ,.... 1 City of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000674 Date: 05/26/2005 Description Perm ServlFdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By THOMAS K. DEAN Item Total: Check Number Authorization Received By Batch Number Number How Received njm 1015 In Person Payment Total: Page 1 of1 11:00:41AM Amount Due 63.00 4.41 6.30 $73.71 Amount Paid $73.71 $73.71