HomeMy WebLinkAboutPermit Electrical 2007-6-22
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INI'llALS . 1\ I M
DATE (f) Ill{) /61
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COMPLETE ll'itSl!, SC.l1l~JUltrLE BEIXJW
225 HFTll STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
.ELEel KIeAL PERlVlIT APPLICATION
LOlItA. zOO 7 - QO 9 30
C TemporarySer'Vices oriieeoc!'s
~~
."'.......H~..__, '" .._.._""~.. ~_ .,,~,__~...~. V:':;;'
'.,,'.~<."''''..''n., "H<~.' "'."-'U '.n n.",~.,,~,,~ 'l~
200 Amps orless ~ ~. ^>"" ~50,OO
201 Ampsto400 Amps ~~~/~ '11j69,oo
401 Amps to 600 Amps /..()-/~'~~~JOO.{jO
lTO (. 'U ~
Over 600 Amps orlOOO Volts ~B~~~ ~
D. f:km?f'lJ! nr~r~5 1j1'70 ~ . ~ <~
New Alteration mr Extension Per Fa~~-1: 1J ~ ~
One Circuit <? ~,O~~.
Eacl~ Additionai Circui~ or with , <? ~ ~ . .~
Semce lJr FeooerPenmt $ 3.~ ~/ ~___
. '. ..... ..... .' '.' .<?~./1) ~
E.MiscenallCOla...(Servicelf(~e{iei' !lIot i.UH:hUded),,",E.-i(~b~~
Pmnp or iITigancm _'.H,,_ $ :Jv.o-O "'p' ..._.._.____
SieuJOutliw: Lighting _...__ $ 50.00
tY~'Y;:l~'l.? INf;TA1LL-'(.Tl{JP.J ATTENTION: Oregon law reqni~CEt~ylResidential $ 25.00
fhi.,) ftlSil.lHHlHill i;" l>elnn m;J~ic tft1l\g'li\bHtlef(5t~PJVtf,&. by the Om~na1lJl~~)iYlCommCiclai -.. ;l) "b.OO --
is rttlt inft::tld"[f fm' s"Ii?'.,I'::MK'ff.lQtj;~&ation Center. Thos~.w)p~.ar.JUmt fqrttJ-""." Ie' ~~"....>...n ';'~::::':'~=-tVL' <""1"":::.::;:-'"
. . in OAR 952-001-00'j 0 thrOJ~~gh.Q%lr~i.2~q~1 ~:... ~""r-,,-~,,.m b,. ,~, ,." ._..I~ , ..,.... """f< "'6 >
"wners ~if!.Ilaiuw: 0090. You may obtain copies .oftheio'19S"by--" H......~ S?,t..f
~_.~.___...__...~__.. _..._.calli!lgJb~ .Cen.ter. (Note: the>f(i)I(jf!Jt\0f,HtdH\'::::~ ,_b7!_~
number for the Oregon Utility 1j\fOtiMat~~trafi-vt: l'~e '?.l.J:.
I"""""'",,, ~"""<, 1y><>,,-g. Center is 1. 800-332 -2:~ :::"oi""" ,~,' 4:L --;7'0- -- - - - .
,a,:m';! nriv"iT')lRl1illfitil> !Qlril""ttir1l1 ~T!nil Aflt.lknl;r'l) g.Of, do~
City Job Number
1. LOCATION OJ/1NS1fAlLLATION:
7'?3 A^cl~r~
LEGAL DESCRIPTION:
\)()513/(
OO~OD
JOB DESCRIPTION:
'2-0 c::> A S'2-v'L ChA~~ t!'
",--", ...... _.- - ... . _6. .._,--. ..,. ~,--.......-'--"~~.- - ...._-~... ,......- -'-------~ .-.-..- -.---.., -~.-7~...---
Pef'm!t.1{ ere ~tl'U' t!'":!'~~f~~~Jif) <l~d c~;t1+rr':: '::.'IY::f~ ;~
not started. within. ltm dnys offtssu:u~ce tH' if ",::J..r-:.: E
Smi~"".-J"dfllW tf{~ 4!Eys.
.~
-(-rOl+Ti "]fJ.A (~?JOJ{ JNl3~{:I}[J:.~/!r._~rl();r~'()T:ff.J,-i<
,,'-'$.
,"...........'1.'.,.1 r.(>r.......~tn':-.\ "",. ~"'" ~).",.'\ ......... -"',,. ~ i IJ i'~"";' '"
1.._ ~;.Ii..o:.j, .......J.. "-~..~_(;"""~'-}'" . .~~::... 'l_'~ ~ i-';:; .,......f;":...., " ~,.;; f'<~01:J ~z~
4"'-.-.:i<~~~,j-- - -- . - --~ - ,',.. ,. ~ ~...~
, '.l ,., , 1"> --;-; .f _' ....,.. .f'~.., "I
})(ll,1.re"s ~-j'''''''''' t""':-f'lh.lf;f I ~r'J,f'M'~-t!,'f') { Hi";;;".
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('!y 7-'! ~ ." 0 A ~ Phon':) . ~.,~. .'.~.~,!._ c:::"'.... ., l....";..~... ..!:.'\
.:: ::'g~'~-<:\i:.F';"__.__.. .. .~~ _ ~.__
~..d.l
Supcrvi'Jor License Number _..6i'"'1 q d ~~,
Expiration Date ,__...____...19l. \ f~?:.1,.
Consn-o Cantr. Number
'-v.~~""."
Ii ,\ '....:JD
Expiration Drrte ,11..0 I D %
---'~'~------_..- .
Address
c:"J.
7Z-~
S?-Ff\
L<::-w l ~ ~
;\_:":'_.~ . .... --. ..
~'"tLS 0.-
Phone /'17 - L; 7/{
Owners Name
City
Date
'".' '.. . "'"
. ", - - -, .
A. New ResidentfuI'-Singie orMulti-Fami'iy peniweUhrg unit.
Semce 'neluded .
lOOO sq. ft. or !e~'5
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
.,.- ... ~ ~ ..... - - -...
~. ::-~~':;': ,. :~;.;n~ I r:.,V:l~: :. >_:!rF~. t)t
A:iodu!,H~ K~\'.:'cltmg, Sei'\:'icc 01
Pc""....:-!""
SSG-.n;!
a. St'....,.d...t's or l\;'tci}dets - liJ"<;tfla~$8t~"u, j<\UN'l~tj(r\1;; or R~iQc;c"~;,;' .
2t}(}:\mps::;r 1::::::;
201 Arons to 40D Amps
/
bJ
47' ,", f),h
.~J ~;." .; ~;
$ 71.00
.101 /\~YlpD ~_~j -S~10 .\::11.P~~
:::!~::_!){~
601 /unps to WOO An1ps
n.u.",.. t 11tu) A *~""" l\l ",H!.'>
+ . .. .~. p - -j- .
~"i,r.;~I'~~~
~.:..v......uv
~~..,c: fH'\
Reconnect Only
$ slum
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00930
ISSUED: 06/25/2007
APPLIED: 06/22/2007
EXPIRES: 12/25/2007
VALVE:
225 Fifth Street, Springfield, OR
54.-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 723 ANDERSON LN
ASSESSOR'S PARCEL NO.: 1703331100500
Springfield
TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: 200amp service change
Owner:
Address:
ED LEWIS
723 ANDERSON LN
SPRINGFIELD OR 97477
Phone Number: 541-747-4711
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
DOUG PALMER CORP
License
90725
Expiration Date
05/03/2008
Phone
541-434-5600
VB
BUILDING INFORMATION I
- "'" H u~fI;;'
# of Stories: THIS PER' Lot Size:
Height of Stru~ttir~10R MIT SHALL fS%Ft Ist Floor:
Type of Heat:-"OM . IZED UNO ~ Fffgnd' ~lqor:
Water Type~VN MEN CEO OR ER TS:q.rp~"KJr~~tWORK
Range Type: Y 180 DA Y IS AB~Rt~~.,G/arage/~r\PJf
Energy Path: PERIOD. Sq 'FiJljlh';rfO/1
Sprinkled Building: nla Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
ATTENTION%)oti~~n<Qo~e~ta~el:ires you to
follow rules adopted by the Oregon Utility
'I .',' "" ~ 71 .
t"lVllllVUUUl1 .........GIILC,I. IIILJ,-'l~ ILliG":' r..tl G 0'l"Jl IVI LII
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
in o.AR hg~.J;JIt-l~crl]~'flf~QX,I).;~I\l'~~1i~ "52-00 1-
0090. You may obtain copies of the rules S'ilJewalk Type:
calling the center. (Note: the telephone .
b f h 0 U '1' N 'f" . Downspouts/Drams:
nllm er or t e regon tllty otl Icatlon
Center is 1.800-3322344).
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00930
ISSUED: 06/25/2007
APPLIED: 06/22/2007
EXPIRES: 12/2512007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6.30
$3.15
$5.04
$63.00
6/25/07
6/25/07
6/25/07
6/25/07
1200700000000000815
1200700000000000815
1200700000000000815
1200700000000000815
Total Amount Paid
$77.49
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.
I Reouired Insoections I
Electric Service: Approval required prior to utility company energizing service.
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 OCCUPANCY will be made of any structure without permission of the 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 will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Page 2 of 2
225 Fifth Street
SpringfieliJ, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-00930
COM2007-00930
COM2007-00930
COM2007-00930
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Date: 06/25/2007
1200700000000000815
Description
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
+ 10% Administrative Fee
Paid By
JULIE FORD
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 04035A In Person
Payment Total:
Page I of I
lO:47:57AM
Amount Due
3. I 5
5.04
63.00
6.30
$77.49
Amount Paid
$77 .49
$77.49
6/2512007