HomeMy WebLinkAboutPermit Electrical 2006-1-9
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2%5 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 0~~'\~~ -~: -oj -... -, .'
ELECTRICAL PERMIT APPLICATION . '<'(l~O\ <"~ "
City Job Number {Jj W\ 2-006 - 000 I "3 Date J - So\\'l~
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LEGAL DESCRIPTION 10\10'# (~ Ce(\te(A:TNe,,:~esideniia'd,Sitigle or..Multi-Family per dwelling unit.
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170'3 26 C{ I D C?l~~g2.aa\.a,,\~.ervIC~'Ii;;c1ud~51e9\"10(\e (\
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JOB DESCRIPTION "/~^J II "-~:'J1'''' 1000. .it.orl~stl' $106.00
/V~ v/~/hIt't!'n~(,1e cente n~' ",1..1 .,
.d /J _ $1'3.\1\1'9 t\"le CEacJi-ad~~g2n~1i5oo sq. ft. or
1M I {' /C'OWJt.t r- r,,'jfpJ6{... CIKCtl.6Zf>'( icPQrli8h'tIiereof $ 19.00
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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 Modular Dwelling Service or
Suspended for 180 days. Feeder $50.00
2. ! CONTRACTOR INsi'~ t T :4.Ti~N OM.-~ B. I S.~rvices or Feeders_ Jn~tall;;;i';:, ~t;;;;tions ~'Relo~a;ion~=
,.~;~?~~'J~~:~~;.";~ciIY OF Sl.-...JNGFIELD; OREGON '.: . { ',' .~
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Electrical ContractOlt.NEWI~E ELECTRIC. INC.
P.O. BOX 23154
Address EUGENE. OR 97402
City
Phone 11'1- 'I'll ~
Supervisor License Number "53 '13 - S
Expiration Date / tJ -I - t!) 7
Constr_ Contr. Number 5~~ r 7
Expiration Date 5 - / ~ - 2LJo0
Owners Name
Address -1{2h4
City S t:>,..::'b
~d~
oC,Icmf-,sL
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
200 Amps or \i,Ql'C~: IT SHA' I ['IP1P,e ft3:0IllE WORK
201 Amp.to~11 ~~D UNCER nUt; IS~MlT IS NOT
401 Amps to 6W rNCED OR IS ,~eANOO~FOR
601 Amps to I~ DAY PERIOO $163.00
Over 1000 Am~O $375.00
Reconnect Only S 50.00
c. I Temporary S~rVices or Feeders
_., ...i-_~ ___
'.._. ~.u__J
Installation, Alteration or Relocation
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.
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D. \ Bra~c'-' Circuits . ,
New Alteration or Extension Per Panel
One Circuit I $ 43.00
Each Additional Circuit or with /]
Service or Feeder Permit !' - S 3.00
$ 50.00
$ 69.00
$100.00
----,
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E. I Miscellaneous (Service/feeder not incl~ded) -Each Installation,
. .' -..;.. ------ ~
Pump or inigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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4.! SUBTOTALOFABOVE
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- -.,.- - -
If'
3'Z
4,D
57~
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding Fonns/Electrical Permit Application l.o3.doc
" . ,."" rrnuires yOU to
. _.' I..... the> nrcQon UtllllY
I CONTRACTOR INFORMATION ~lre set forth
.~. u' ..~. OAR 952-001-
C " r 'C' ,0010 thL't;'uqh E" t' D
ontractor " . ,. \ '.: ( .. . . . lcense the XPll'a Ion ate
LlVEWIRE ELECTRIC INC \' "Lll11i'V 0l;tal(\,~5~~~7;h:' leleohor05/16/2006
I BUII;DING'iNioRMA..'FIONIHity NotlfiCa.tlon
. '0' . 1 80U-;j,j2-2344).
Center IS -
# of Stories: Lot Size:
Height of Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Patb: Sq Ft Other:
Sprinkled n/a Occupant Load:
.
Status: Issued
225 Flftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
: 541-726-3769 Inspection Line
_.
'II SITE ADDRESS: 1064 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703264109200
PROJECT DESCRIPTION: Add 3 circuits
Owner:
Address:
CHESTER CLARKE
1064 OLYMPIC ST
SPRINGFIELD OR 97477
Contractor Type
Electrical
~ # of Units:
'. PrImary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
R-3
; Front yard Setback:
, Side 1 Setback:
SIde 2 Setback:
Rearyard Setback:
Solar Setbacks:
'0. Street
.
Storm Sewer Available:
Special Instruction:
Notes:
, Description
,
Tvpe of Construction
VN
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-00013
ISSUED: 01105/2006
APPLIED: 01103/2006
EXPIRES: 07/05/2006
VALUE:
Springfield TYPE OF
Electrical Work Only
TYPE OF USE: Addition
Residential
Phone Number: 541-
Phone
541-344-4928
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Overl~Qlt:ClE: . HE ~I
# StreeT~ERMIT SHALL EXPIRE IF T J apped:'
Paved R\:Jnltllid!ED UNDER THIS PERMIT I I act:
% of LeXWlMtIOOfD OR IS ABANDONED FO
ANV 180 DAV PERIOD.
IPUBLlC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDrains
I Valuation DescriDtion I
$PerSqFt
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00013
ISSUED: 01/05/2006
APPLIED: 01/03/2006
EXPIRES: 07/0512006
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
l.Fp.p.~ PIl)r11
$4.90
$3.92
$43.00
$6.00
Date Paid
1/5/06
1/5/06
1/5/06
1/5/06
Receipt Number
1200600000000000015
1200600000000000015
1200600000000000015
1200600000000000015
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Total Amount
$57.82
:
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.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 otcup ANCY wiD be made of any structure without permission ofthe Community Services Division,
Building Safety. 1 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 ofthe property, and the approved set of plans wiD remain on the site
at all times during constructiolL
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
5'11-726-3759 Phone
. .
.
Job/Joomal Number
COM2006-000 13
COM2006-00013
COM2006-000 13
COM2006-000 I 3
Payments:
TWe of Payment
CreditCard
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1/5/2006
RECEIPT #:
~
~ of Springfield Official Receipt
.elopment Services Department
Public Works Department
1200600000000000015
Date: 01105/2006
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
JEFF LOZAR
Reeei"",, By
djb
I of I
Item Total:
Lbeck Number Autnonzauon
Batcb Number Number How Received
034819 In Person
Payment Total:
12:25:17PM
Amoont Due
43.00
6.00
3.92
4.90
$57.82
Amount Paid
$57.82
$57.82