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Home My WebLink AboutPermit Electrical 2003-10-23 &/k'>::li1~.;;WO Amps or less I $ 63.00 201 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 19" \0 $ 50.00 nUI{a" '''\'' R':: "..,-{.e:"'-"'~\T\;}\I""--_-, J- c. ':!~iO~'L~~~~~~frP-ee<t\~e\ ~~~ :~J.:.'_ ___ ~E.~ aOop\e Se {uleS 95'2.-00 f>.11 InS!ailil'ilon, AI~er1inb'n or.ReJ6C~~n ("Ies I 10 cr.. '" ce II'" \,,{ou.... \"e v "o\il~\l\.~ps()or~leSs')~~ copies 01 ,_"nOf\!$ 50.00 " a<;L" v - .",,{'I \"e ,d.-. X "n O~CH Amp~tg)4QO)A'mp.\~0\e', _ ~_.\I\Ca. '>1>9.00 ~QgtOJ~~~~~eoo'~8~0f\ \.l\ili\i~!'-',) $100.00 D~f~~r~~~~~~'~'\fe~ '~:~b~~~~~_ ,-~ ~.,~_._: New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ... 03300 JOB DESCRIPTION ~~#- ~. -t L. t'Jf4'=S" Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. r-', --.,----;--. -.----~-- -;-- ':l 2. L.:'i.F!!:!:fI!!-C'fl?-J.$'ili.$!1J.-LAT!9l>f ONLY _I Electrical Contractor CH'R.f:r ;z" N<;~< Address _3.!.}<-f' J~ "'" uui..lJ R./ City~~,.~, " Phone R~r-=:> /:" d Supervisor License Number 3 ZZ-h ~ Expiration Date t()~ 6/ - ?~tf [z, '.),7' h~ 2-J - 2/)1)1> Constr. Contr. Number Expiration Date Signature of Supervising Electrician r~ I/k...-/~ __ Owners Name ~+OW~. 2():30~/(.. fi.,.rc f Address City &::v r -t'71/'~ Phone .. .' OWNER INSTALLATION The installation is being made on propeny I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 G' .... ~ './<' . <" ~~,,, , ~..,~ ~~ .-/:,'" ,;~.. '(, f, ~ ' - " \ ... ,'. 1wl,>>" . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 r- .-,-~--'--~--~'--"--~'-"~'-- --,-- B. }~~r:vi,c~s'or.:F~ed~rs ~-..Install~i!on, AIt~e!a~~~n~ or Relocatio.~l: 1 L.,,~___-,,-,~, _._ ..............__._.__-"<l.-___ ~______~~^' 63 $ 43.00 /' '" $ 3.00 r--- --;-.~_c---.--.-- -.- . - _n__ .....-- -. E. : Miscellaneous (ServiceJfeeder not included) -Each Instalfation "-'-- c_'" _'_'__.'__'__'~""'" _ _ ~...;.;... ...."-_ _.--.:.___ _ ___~ _,-,._.1 NCff'W>'iP'r irrigation\..\. EXPIRE IF '\'HE WOR~ 50.00 1~~qiQ!lllMl ~:rn 1HIS PERM\11~ NU! 50.00 /I,\!-i'A@\iI\E:~t\~~~'JW~NDONED FOK $ 25.00 C!:l\Wjt\fdl'&~~: ~~_~cial $ 45.00 MiniBI~'fn \~\QcPrfc Permit Inspection Fee is $45.00 + Surcharges r,",:": ...- --..-::-;----- -- -.-' - .- --. . ----- -- _.. -.....,.-- 4. "'fiuBTCJ'rAL:OF AiJOVE <, I ._w 'I' ." ./:,'7 L{ r~ b~O w72 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)JBuilding FonnsJElectrical Pennit Application 1-o3.doc . e CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01074 ISSUED: 10/2212003 APPLIED: 10/22/2003 EXPIRES: 04/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3125 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1702303403300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Upgrade service and add 2 circuits Owner: OLSEN ROBERT D Address: 2030 HOLLY AVE EUGENE OR 97408 I CONTRALJUJul'iFORMATION , Contractor Type Electrical Contractor CHRIS MILLERS ELECTRIC INC License 62377 Expiration Date 12/2112006 Phone 541-895-3660 VN I BUILDING INFORMATION' # of Stories: s -j0\} :~" Lot Size: Height of Structure ao.\}$a 0(\ U\\\\ ~(\,q Ft 1st Floor: Type of Heat: (\ \~-tl (O(eg sa\' f~q Ft 2nd Floor: Waterlfp.e10 '0'1 \,\\e \}\0S ~(e 9,=>'2-,O'Sq Ft Basement: ~WI~ typ.e:aO ,\\0<:,0 ( 1(\ OJ>i.~ e (\}\0'S,9 Ft Garage/Carport ...-{~~'ne!'l!y.Parh:.-<i .",.o\}g ~ O~ \'\\ "'o~Mt Other: lo.\ \ $,.... :\..... ,,\,\. ,;;I 1\'. \\ I>- ~\o-tl (. (\ Ge(\ ,OO'\~ c09\e r-e \e\e~~\C~ ervious Surface Area: \0 _\\0 _",\ . _In ._' " ~I"\\ I'DEYEI30PMEISIIi iNfo~A(meN~,A~~' . I ,II I - 0.'" ,,0v- 0("'''' 0':)'>- 009 $\9 "::.... \,\\0 . Co '\ ,\')O c.0~~~i~"ie( I. (#JSWeet<rffes Rqd: Paved Drive Rqd: REQUIRED PARKING # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: % of Lot Coverage: - ....\/ Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I :ill?t. \t ,tit. ~~61 ~01 \~~~WlI\ StI~~t.;tll~~'tlr6~ \~~tlO\\llt.O \}~\\ IS f>.,'OI~b~~spoutslDrains: ~OWlWlt.~Ct.~ 1lt.\\\O$. r>,WI '\~\) \) Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . . CITY V.. ~r'K11~\.Jl'lI!,LD Building/Combination Permit PERMIT NO: cOM2003-01074 ISSUED: 10/22/2003 APPLIED: 10/2212003 EXPIRES: 0412212004 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~ Fpp~ Pair! I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Aller, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.90 $4.83 $6.00 $63.00 10/22103 10/22/03 10/22/03 10/22/03 1200200000000002355 1200200000000002355 1200200000000002355 1200200000000002355 Total Amount Paid $80.73 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. L.Reollirer!lns~ I Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined tbe 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 wllb tbe Ordinances of tbe City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany structure without permission oftbe 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 wllI remain on the site at all times during construction. Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01074 COM2003-O 1074 COM2003-0 1 074 COM2003-01074 Payments: Type of Payment CreditCard .i ~.,~-.-.-.-----<'..'... lJa.... ~"~ .._,...,,-'.-.-.,.... ... Receipt #: 1200200000000002355 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number Paid By CHRISTOPHER MILLER 000200 436242 City of Springfield Official Receipt Development Services Department~ Public Works Department Date: 10/22/2003 10:23:20AM Amount Paid ~ Item Total: 63.00 6.00 4.83 6.90 $8U.73 How Received In Person Payment Total: Amount Paid $80.73 $8U.73 . .