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HomeMy WebLinkAboutPermit Electrical 2005-8-24 The followIng project as ~s the 'Ollowlng ........._ not reCWil~ClfiC land use sPe;JINc.l~"-D nlng 'E;/ l...t II 'br.3"' '5 ~.:,..--...." .-.~ 1 I ~r' c-('I ~- ....) I ' \ ' '"". < CITY OF Sf........NGFIELD, OREGON " " . " . . 225 F'WTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)1Jar.,3689 ELECTRICAL PERMIT APPLICATION City Job Number ! () IlIA z,.:>O S- - 0 114 cr l\u(ll'8';<J..Si99~e . Date 6't.-'f ~ 1. LOCATION OF INSTALLATION ") 2 <...~ I Ph f:;A-Sp,JJ:SO- LEGAL DESCRIPTION 1703. Z'2. I '3 3. COMPLETE FEE SCHEDULE BELOW oobOD A. New Residential- Single or Multi-Family per dwelling unit. Service Included JOB DESCRIPTION ZOO AM I 1000 sq. ft, or less Each additional 500 sq, ft, or portion thereof Each Manufacfd Home or Modular Dwelling Service or Feeder Sf:rt.vlc..e (.A.,,~e Permits are non-transferable and expire if work is nol starled within 180 days of issuance or if work is Suspended for 180 days. $]06.00 $ ]9.00 $50,00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: b3 ~ru]:re ofsupervtng E~DL _' . - \{0\\g~ch A~d~j~~~]\q!"~~inqt'y;tJ\\1E ~~V[l" r _ --- __' ,/I ,/ 0A(L<' 7.-r- 'A AI .,-U\S Se7,i,c'e or;Feederpermit PEP-Mil Ie:. NOI $ 3,00 OwnersName 'DrfJ-.l"O'f'Y n-~ =tr-/rt'V 1[1,' ~ 'ItOUliOER \11\;:' EO FOR 7>~~AJ < ~He"'t.;4.vf- P.Ulc~~~liscellaneOu'S'(S€~.i~~}\1~er not included) -Each Installation Address " CONl\.\t"uk~ PE-RIOD, City '5 ~ f>\\ Phone Z 1., 1- 4247- I\N'< p\!"ml], Qfirrigation Sign/Outline Lighting Limited Energy/Residentia] Limited Energy/Commercial 200 Amps or less ..D<. ....~. r~.nuires YOu-'.'" EN~tt.f(!J\'e\Jl<llO"""mp"::: e on Uti''')' Address f.1),g~x '1138'1 fATT,\ w r4.0.L..a'1lllptolllOWAlllPpr g e set'nrlh o 0 UIe1> ,,,,<>se rules ar _ ~ Notificatie\\lGefifiilrlO Utm Am\l('OAR 9~?-001- City t.~c.2IJc DR. Phone {na -27jLjn OAR ~ell()~fIil~~~~~~s olthe rules by ''0'/0'( 0090. Ycfu:mll1j~IYNote: the telephnne calling the center. ( Utility Not,licatlon Supervisor License Number 1-\ BAt", S nun{ber bn\\lBRry~\lA-,1~es _~IJ!\\',')~.rs Center is 1-3()O-::l"" / fj ) f) / / 0 7 Installation, A11eralion or Relocation , Constr, Contr, Number \ 1.\ ~ q3 7 Expiration Date /2- Z 7- oS Electrical Contractor A-( tLet[Qlu Expiration Date 200 Amps or less 20] Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, D. Branch Circuits New Alteralion or Exlension Per Panel One Circuit OWNER INSTALLATION The installation is being made on y,~y_,;, I own which is not intended for sale, lease or rent. $ 63,00 $ 75.00 $125.00 $163,00 $375,00 $ 50.00 $ 50,00 $ 69.00 $100,00 _~.J $ 43,00 $ 50,00 $ 50,00 $ 25,00 $ 45,00 Owners Signarure: 4. SUBTOTAL OF ABOVE Minimum Electric Permillnspeclion Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee Inspeclion Request: 726-3769 TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application I~03.doc 63 l{l{ ( 6J'D 73?L . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01l49 ISSUED: 08/24/2005 APPLIED: 08/24/2005 EXPIRES: 02/24/2006 VALUE: . -Wt.~~~~~I;I~ , ; ; - - _'U_m ._ -0'_ ' ,Status: Issued . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3241 PHEASANT BLVD ASSESSOR'S PARCEL NO.: 1703221300600 Springfield TYPE OF Electrical Work Only PROJECT DESCRIPTION: 200amp service upgrade TYPE OF USE: Repair Residenlial .'I\J~~ y...S '<' ~\\J\ _ ,.;. \" \S \'" IPUBLIC IMPROVEMEN:fi;I'?S'\'o.\~~ "<,\JY-- \\"V \~". \'\\)~ ",~. :0 '0\ \,S'\'o. ,,-\'.~\J Sidewalk Type: '.;\\'V ",\~ '0~\J c. \>.\J \~\} S V\; \:l\:.\l '\)<;>-. \'" ~. Downspouts/Dralns "\ '(\'\ '0\)\'\ ~'<-\'> S'\'o.\\J \,-',j\ \\S;.\:.~ \'>~ '? c,\)\~ \ i0 w~ Owner: DERAN PARSEGIAN Address: 3241 PHEASANT BLVD SPRINGFIELD OR 97477 I CONTRACTu", U'rORMATION I >l~\\ Vd Contractor ee.\li\ef> 1 \.l\\\\\l:l License BRYAN!t~MU,.~x){e9Q~ c.~\ql~ 149937 ~~OW. ~~9\eo b'j ~~ I'/o'BiiitDlNG iNi10RMA nON, P' 0'I'l (U\aS e: {\\al. \'(\~IQ\l9" . ,\'(\6 \ ':"' 0.6 # of Units: \O\~ a'UO{\. e6 ,.()()"\\) ~ CO<;J16S Q #\l!f,S,t~,~~:~ Primary Occu~~'($:Mg2.'()() O~ 0\6', \'(\:l\.~tght-of Secondary Occul\~ '10\1 t{\a'l {\\el. \.~ {\ 'J\I\lt!?:!1!<\of Heat: Primary Construc~Q.lI~~f6 \'(\0 ee e\f!j.e90 Q.'2>'2>'2.-Waler Type: Secondary Construction~ \ el \01 \'(\ is"\ lor:) Range Type: # of Bedrooms: {\\1t{\'O Ce{\\01 Energy Path: Sprinkled . Contractor Type Electrical nla I DEVELOPMENT INFORMATION I . Front yard Selback: . Side 1 Sethack: Side 2 Sethack: Rearyard Sethack: Solar Sethacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: Street Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multip6er Square Footage or Bid Amount Type of Construction 1 of 2 Phone Number: 541-221-4242 Expiration Date 12/26/2005 Phone 541-606-2797 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Fl Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated . . CITYOFSPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01149 ISSUED: 08/24/2005 APPLIED: 08/24/2005 EXPIRES: 02/2412006 VALUE: Status: Issued 225 Fifth Slreel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Tolal Value of Project Fees Paid I Fee Description + 10% Adminislralive Fee + 7% Slate Surcharge Perm ServlFdr 200 amps or less Amount Paid $6.30 $4.41 $63.00 Date Paid 8/24/05 8124105 8124/05 Receipt Number 1200500000000001235 1200500000000001235 1200500000000001235 Total Amount $73.71 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. IRpnlli~ Electric Service: Approval required prior to ulility company energizing service. By signature, I state and agree, thai 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 wiD be made of any structure without permission ofthe Community Services Division, Building Safety. I further certify that only conlraclors and employees who are in compliance with ORS 701.005 will be used on this project. . I further agree to ensure thai all required inspections are requested at lhe proper time, that each address is readable from lhe street, that the permit card ..located at the front of the property, and the approved set of plans wID remain on lhe site al all times during conslructiolL Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone I , , . 9 <lllliity of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200500000000001235 Date: 08/24/2005 9:20:15AM Job/Journal Number COM2005-01149 COM2005-01149 COM2005-01149 Description + 7% State Surcharge + 10% Administralive Fee Perm ServlFdr 200 amps or less Payments: Type of Paymenl CreditCard Paid By ROYALE CONSTR Received By djb Item Tolal: (;beck Number AulblHization Balch Number Number How Received 191757 In Person Paymenl Total: Amoont Due 4.41 6.30 63.00 $73.71 Amount Paid $73.71 $73.71 , :~ " ': 'Y ~ ~ ;' 8/24/2005 1 of 1