HomeMy WebLinkAboutPermit Electrical 2007-6-18
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125 FIFTH STREET, SPRINGFIELD, OR 'n477 , PH:(S41)7U-3753 'FAX: (S41)7U-36l19 ~ IllID' SOURCE t~ (A"\
ELECTRICAL PERMIT APPliCATION l -' '-1"'
City Job Nwnber .f..aM ?J:)O? - 0 <:) g- ro Date 0./ I ~ ,.. 01
1. Wrf)~~O::A~TION: 3. I cOMP~TEj~E.S~IiEI)fJLllBELOW__ _~.==
. CITY OF SPRll jFIELD. OREGON
InltaUatlon, Alteration or Relocation
200 Amps or less "'~. $50.00
201 Amps to 400 Amps ,~'~\)\'~~$69.00
401 Amps to 600 Amps \'i' ,\X\" ,Co. ~v $100.00
Expinttion Date ~er.6()Q ~JlS or I~fS~T~~~~~,-.
j2Signature~O~S& D..~~~nc~-{~~", \Y-~~~~_
\~~w~AiIl'ratlonit'r EIteli,!lOii'l>;r Panel
\~ <?J1~ C~1!.!I~ \) ~ \~ l' $ 43.00
. 1 \~~If,gddi~ ~'f~With
. L- ~ .1 I ~~ce~F~W&i(' } @ $ 3.00 :3
OwnersName _t+( ",,\ ~t'~'1J,&-'{c! ~",~~'\).\)~~ ______n~ _,
Address Z oz., -S- ~L... s f E. l~_ella~cou'J~rviCC/feeder _no! Included) -Each In'lal~t1o"--'
City S? r () Phone 7Zl- "5,7 ) 3 Pwnp or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidcntial $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inlpettlon Fee I. $4S,OO + Surcharges
4. i SUBWTALOFABOVE--- I fc,b
\----.~~------- --_..----
8% State Surcharge c;- 1:-1!>
10"10 AdminiStrative Fee to ~v
5%T~mmo~Fee } 3~v
TOTAL ~ '61 ~
Shared /lrivc(T:)IIluiIding FormslElcctri<a1 Permit Application 8-06.doc
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LEGI7g~2b~ (
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JOB DESCRIPTION:
~~Qrl)lc..e h'n \ (Y'lS.J.,crlI\ ,
Permit. are non-tranlferable and osplre If work Is
nol.tarted within 180 day. ofl"uance or if work is
Su.pended for 180 days.
2. [CONTRACTOR INSTALuTION ONLyl
El~lrical Conlnletor - CTr' oi<::::rro<.e r:: /)
v r /
Address 201 s: /9-1"'---
City 5'pj'oI Of' Phone 7U-3rtl
,
SUJlCIVisor License Nwnber ~<:,
ExpinttionDate in/Or /D7
r ,
Constr. Contr. Nwnber
OWNER lNST ALLA TlON
The installation is being made on ..-....f I own \\hieh
is not intended for sale, lease or renl
Owners Signature:
In.pettlon Reqaest: 726-3769
-~--- ---~~----,
A. ll!e~ Re.identhll = Single or Multi-F,,-mil)'-,,~r d..elllng unlt~:
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$19.00
Each Manufaet'd Home or 'lo\l \0 :i
Modular Dwelling .ServiceSr,e'" '0\/:.I~.x. $5000
F dcr ,eo:. 00 ,~(, .
ee \~~' oleg.~ ",e" ~(\\.
r------~ -~ l" .r..- _ - ---- ---~
B. : Serv!c~l O~F~dc'ri-;-;lnst~I!~~on;'~Jterulion. or Relocation: .
~\\ffr-;ooV- "<'0U""- \l<;)" - \'<;Ie' c. i,0.. .- ... - -~-7-'
i'-\\~~O(t~f~,,~~,I~sg,\() \\"\~(l W'" 0' .::,,/9\~J'C$'63.oo ~ ..:>
,0\\02}!j\~P~lS'\400 lli\lps'O~\e" \'<;Ie .,eI\I"V $ 75.00
"0\,\401 P$Ps t'1>600")AmP'~O \)\/:.1\'1 : ^~" $125.00
I~ Ct>-\'- ~' ~W' '00 ,,'{..-
10 601 ADips t'l,JOOO AJ11p'S, ().?>?>", $163.00
()r~ei;\!900~~pWV:;tts:'O() $375.00
Re&nnecfc%i . e\ 1'0 $ 50,00
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c. 1T~;po';-rY Senoices o~ F~~~_
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13-782 SOOSHEETS.FlLlER 5SOU.o.RE
.2-381 &l5l-"EETSEYE.f'...-..sc-SSQUAAE
~2-3B2 ICXlStfiTS EYE.{ASf!' 5 SQUARE
42.3119 2CJOSI1EErSEYE~5SOUN1E
42-392 l00AfCYCtEO ~"'iITE 5SOUARE
42.399 200 RECVC;U:O WHITE 5 SOUARE
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I CU"'1V\GT",,,.,,,..ORMATI.oN I
001CO- O(u\.j.... \\0\\."
.0,139 \\,\13 13 513 "\.
Contracto.I)~. \8<\ 'o~ 10\135 al 9";)?-'00 LIcense
O\VNE~: l\eS \;\O~~, \\,0513. .n\'\ Ol'S". ",\135 '0'1
\O~~\~<)\\O\\ ~~~.II\I;BUiLDING INF0RMATi.oN I
\'l.Q' ",,?-S";)?-' "OU'V. "0\13'. ".- "O\,\\IP'
Ot \fI'31 t\'l "','.hl\'l
# of Units: II' ,.\).'100 Ce\\\el. #~f\~t_orte~'\AA),
Primary .occupancy Group: OOJ '\\\\9 \\,\13 ,\'>13 O\'Heigh!)of.Structure:
c\;\. \o{ \.\\ J 9.\,('.) .
Secondary .occupancy Group: (\\'0131 \13\ \5 (J'ype of Heat:
Primary Construction Type \\1) Ce\\ Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building:
.
Status
Issued
225 Fifth Street, Springfield, .oR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769In.pection Line
SITE ADDRESS: 1500 Pioneer Parkway East
ASSESS.oR'S PARCEL N.o,: 1703263102301
Springfield
PR.oJECT DESCRIPTION: Add service and circuit for irrigation
.owner:
Address:
CITY .oF SPRINGFIELD
201 S.oUTH 18TH STREET
SPRINGFIELD .oR
Contractor Type
Electrical
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00850
ISSUED: 06/18/2007
APPLIED: 06/11/2007
EXPIRES: 12/18/2007
VALUE:
TYPE .oF W.oRK: Electrical Work .only
TYPE .oF USE: Additiou
Public
Phone Number: 541-726-3761
Expiration Date Phone
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft .other:
.occupant Load:
I DEVEL.oPMENT INF.oRMATI.oN I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
.overlay Dist: ~'/..
# Street Trees'Rgd~IQ '\'
,.. ''''' 1, \ \' l \
Paved\O.rive Rqd:\S ~Q
...c.. , t~" .nllK, \
\'\01\\1.... \\ S\\~V/. ~\MN\over~g~t\\
-<\.lIe; \'t.~~~n \ \~\)t.\\ . n ~~\)Q~t::
.~~\\\\)~~;'II~uBiic...MPR.oVEMENTS I
CQ~~.j'S.: \)~~ Y'-"
~~'{ "\ ~\)
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Paee 1 of 2
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Value
Date Calculated
.
. CITY OF SPRINld<lJ!..LD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00850
ISSUED: 06/1812007
APPLIED: 06/11/2007
EXPIRES: 12/18/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
56.60
$3,30
$5,28
$3,00
$63.00
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
Receipt Number
2200700000000000982
2200700000000000982
2200700000000000982
2200700000000000982
2200700000000000982
Total Amount Paid
$81.18
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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
Electric Service: Approval required prior to utility company energizing .ervice,
Final Electric: Wben all electrical work is complete,
By siguature, I state and agree, that 1 have carefully examined the completed application and do bereby certify that all
information hereon is true and correct, aud 1 further certify tbat any and all work performed shall be done in accordance with
the Ordinauces of the City of Springfield and the Laws of the State of Oregon pertaiuing to the work described herein, and
tbat NO OCCUPANCY will be made of any structure without permission of tbe Community Services Division, Building Safety.
I further certify that only coutraetors and employees wbo 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 eacb address is readable from the
street, tbat the permit card is located at the front of the property, and the approved .et of plans will remain on the site at all
times during con.truction, .
Owner or Coutractors Signature
Date
Paee 2 of2
225 Fifth Street
Springfietd;Oregon 97477
541-726-3759 Phone
.
~
Wic ..
1iiIl' of Springfield Official Receipt
_elopment Services Department
Public Works Department
Job/Journal Number
COM2007-00850
COM2007-00850
COM2007-00850
COM2007-00850
COM2007-00850
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200700000000000982
Date: 06/18/2007
Description
Perm ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
RICK CURRIER
Item Total:
{;heck Number Authorization
Received By Batch Number Number How Received
djb 027944 In Person
Payment Total:
Page I of I
2:54:33PM
Amount Due
63.00
3.00
3.30
5.28
6.60
$81.18
Amount Paid
$81.18
$81.18
6118/2007