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Home My WebLink AboutPermit Electrical 2006-11-3 .I Jj;~i1:1;~,; ,~~~~,~ '1 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECI'RlCAL PERMIT APPLICATION City Job Number (0""" 'Z.CJO b - 0 1 U /0 Date J 1_ fY\1l-v l \ I 0'51 laoc;.o ~. ~p I ~ IE ;" - - M' r / ., . -.J , I r _~-. _/ . l"- -'rj)~ 2_06 1. r LOCA,rioN OF lNSTALIA'11(W" , zooS O(7I#f'~ . r:,.'}- LEGAL DESCRIPTION /70::5 2-5'-( 'Z.. oogco JOB DESCRIPTION b. (jAil.. TIl6r~ /470 -0 ~e.u:t'.. I Co-.s/~ l"'-':. -'r..ll Permits are non.{ransferable 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 2. I CONrRACTOR-iNsTALLA:nON ONLY': B. [se-;:;'i~~ ;;F~~d~~s =-In's~~~~II~ltera~i~';;;' Rel~~~;;;n~~~ Electrical Contractor C, hI'Ll') f PYlSIfYl tde.r.. otLL '200 Amps or less $ 63.00 :'Ii I 201 Amps to 400 Amps $ 75.00 Address !;;{)D ~. D l'1'le-ho ,i"l:ii,.LL.:, , I.V, 401.Amps to 600 Amps $125.00 IVOt.~. .. ".lies '-, -Unt/ . . rlf },ICa/i a,601.Amps to.IOOO,Amps $163.00 City t8 J.i. JJ-- Phone JI) 'Ilr'!tlA J>--IJ5~n Cer.9~~T~oO.IAti)~_'s&7JJites YOU t $375.00 - -- J VUI:IO. Yo -OOl-51',cjmnect,QI\III/ regOt) Un- 0 $ 50.00 ca/fing u. may ob u Ihrnl-lpt,- esar" Ii"' Illy Supervisor License Number 4 Ol q 0>'mb". !ne CEG:<I. .~~~P~r~ry,S~iVice,Lor:t{~lii!i-" I c.:Jrrheo' Ote:tt.VlrnerUI'''V/ /,) 01 enter is 1)~Gallation, A'lt~i'.tion, o/'Reiocation -Rn -''''(VN .'~"ut)e . r 4 ((/ 200If.-mp(0r::!i~s~tlfICation Constr. Contr. Number .) 0 20 I Amps to 4004Amps -, I" ~ 401 Amps to 600 Amps Expiration Date ~ N%t;. Over 600 ArnPs or 1000 Volts see "B" above. Signatumup sin Elec ~i HIS p D.I Branch Circuits 7 ,.. '4 RI1~/r SHI/LL New Alteration or Extension Per Panel / /1 ~ . .' D UM.{)c- EXp,Ci\?~ Cjrcuit $ 43.00 L( - (} ., ~iVY -, to OR ~R rHISG4~h''''-daj!,oP.i\~Circuit or with L /8 0. I DAv 181/8/1 S"'llIV1917p,r.Ml1ef.!r.ermlt 0 $ 3.00 Owners Name ~'eN "'tl'! PF1lJJ.il; NDON/;.;'. / IS ~~J:f' ___ Address 21'77 OfY......',L ~r' E.IMiYcliGileous(S.enicelfeedernot included)-Each Installation 3. [COMPLETE FEE SCHEDULE BEWW A. I New Residential- Single or Multi-Family per dwelling uuit. '----- - Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 $50.00 1 J Expiration Date $ 50.00 $ 69.00 $100.00 City <; :YF~ Phone Pump or inigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges 4. r;r:mTO~AL'OF ABOVE I:, I I{&& 610 -sor 8% State Surcharge 10% Administrative Fee ~ 'Yo T'~ Fi:~ TOtAL OVVNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Shared Drivc{T:)lBuilding Fa Inspection Request: 726-3769 -[~ ~ . .ITY OF ~rKINljl'l1!.LD Building/Combination Permit PERMIT NO: COM2006-01410 ISSUED: 11/02/2006 APPLIED: 11/02/2006 EXPIRES: 05/02/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2005 OL YMPIC ST ASSESSOR'S PARCEL NO.: 1703254200800 ATTEN1IUI\jU(tJgolIl!~Il~'~J'rY~~ill.J .bddition PROJECT DESCRIPTION: 7 circuits for freeier/cQole~i!l!t!!I~!!J;~Jl.!l'!fytr~!1J Oregon Utility Notification Center. Tho<::", ",1,,<:: Am "ot Inri' in OAR 952-001-0010 through OAR 952-001 0090. You may obtain copies of the rules b\ calling the center. (Note: the telephone _.._l..__~__.l_ _ _ . ...... .. Springfield TYPE OF WORK: Electrical Work Only Commercial Owner: Address: POLEN FUTURES L L C 2197 OLYMPIC ST SPRINGFIELD OR 97477 - -- "-. ..,- -....::J...... .....\"'\1 I\lVllIl",QlIUII I CONTRACTOR;INFORMAT-I@N"I)' Contractor Type Electrical Contractor CHRISTENSON ELECTRIC INC License 458 Expiration Date 05/01/2007 Phone 541-688-6121 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I BUILDING INFORMATION I IUUllllt: TH I SIj."'fIStorie~ Lot Size: AUT.' 't~' rSt~.M.\r~XPIRE IF THE WOSq",Ft 1st Floor: I ",., .. c Jj'HeatDER THIS PERMIT IS Nllq Ft 2nd Floor: OM il'tIGl'iiYJi.HlIS ABANDONED FOR 'Sq Ft Basement: ANY lOO1tfA!iYPf:RIOD Sq Ft Garage/Carport Energy Path: . Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVt.Lvr,.1ENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicappcd: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Datc Calculated Paee 1 of2 . ~ITY OF ~rKINGFIELD Building/Combination Permit PERMIT NO: COM2006-0I4I0 ISSUED: 11/02/2006 APPLIED: 11/0212006 EXPIRES: 05/02/2007 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 F~~s P3W $6.10 $3.05 $4.88 $43.00 $18.00 Date Paid 11/2/06 11/2106 11/2106 11/2106 11/2/06 Receipt Number 120060000000000t596 1200600000000001596 1200600000000001596 1200600000000001596 1200600000000001596 Fee Description + 100/0 Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Total Amount Paid $75.03 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. , R~flW~ri Insn~"'~ Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 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 Safcty. I further certify that only contractors and employees who are in compliance with ORS 701.005 will he used on this project. 1 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 2 of 2 225 Fifth .Street Springfield, Oregon 97477 541-7.Z6-3759 Phone . 1j:~~;~ IJtfL .c ' c.r Springfield Official Receipt D.opment Services Department Public Works Department Job/Journal Number COM2006-01410 COM2006-01410 COM2006-01410 COM2006-0 141 0 COM2006-01410 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200600000000001596 Date: 11/02/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By LARRY CHAPMAN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 002725 In Person Payment Total: Page I of 1 3:02:37PM Amount Due 43.00 18.00 3.05 4.88 6.10 $75.03 Amount Paid $75,03 $75.U3 1112/2006