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Home My WebLink AboutPermit Electrical 2006-4-6 ZON I ...:[)?' INITIALS N \IV\. DATE 4- --&-9 I1O\.p SOURCE t-J~ 22~ FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number eO m d- 00 to .- () 04-01 1. LOCATION OF INSTALLATION 183 S. 50 W LEGAL DESCRIPTION ~ ~ if: c1()oA JOB DESCRIPTION \,o~3:>3 32- OStL)D Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Supervisor License 7um r Expiration Date Constr. Contr. Lber EXPiratioLe . sf of Sup..-,,;,mg Eleotrioioo Owners Name ~ R ~-t~ '5 () 1J Phone 7 C//-otj 19 I X' 3 5. " City ~J Address OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. . 7;/;;:;;!M-U 'f ,/(. 1~? -/M9 () -v ~OnS.~~.v Inspection Request: 726-3769 ~I b LQh { . Date 3. COJUPLETE FEE SCHEDULE BELOll1 A. New Residential - Single or Multi-Family per dwelling unit. Service Included 1000 sq, ft. or less Each additional 500 sq, ft, or portion thereof $106,00 $ 19,00 Each Manufact'd Home or ittjtfeE~elling Service or $50.00 THIS PERMIT SHALL EXPIRE IF THE WORK B. A~iji\l@~liEl3eW~fliij;iI&3tIiJi\M'trtJ&lilihl or Relocation: COMMENCED OR IS ABANDONED FOR "'0' .? ,00 2A~J*"l~otJIt~~S PERIOD. A $ 63,00 II 'J 201 Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts $375,00 Reconnect Only $ 50.00 C. Temporary Services or Feeders Installation, Alteration or Relocation . 200 Amps or less $ 50.00 ATT~m~ t9ti~~J requires VOL~ ~o $ 69.00 follo~~Ut>-J:1.,PM~~~tlcN!Jwme Oregon Utility $100.00 Notifil0M~r(S(i)oeA"fu15s Jr~{foo ~b~~ W~'1f't 19Sre, in CD~RID;M~~cOO11~~hrough O~R 952-0u - 0090, You may obtain copies of the rules by IN ew,A Iteration. ol1lExtensio,!l merrRa1l1l13 ca II[I\:J (lT~ t-t::IIlt::I, ,,,,,"",.., ,t" nun?B&rqgp~He Oregon Utility Notification $ 43,00 Each-Additional (r'ir~\t:s>p~i:thJ.4). \Jt:lllc;l 1..;,) I ~v -- $ 300 Service or Feeder Permit ' E.Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50,00 $ 25.00 $ 45.00 Minimum Elec'tric'Permit Inspection Fee is $45.00 + Surcharges 4. SlJBTOTAL OFABOVE (IJ.~' 00 50~ &;.37J 74-- 3Y 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T: )/Building Fonns/Electrical Pennit Application 1-06.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 183 S 50TH PL 1 ASSESSOR'S PARCEL NO.: 1702333205100 PROJECT DESCRIPTION: Service Change. Owner: BATES DEBORAH L Address: 183 S 50TH PL SPRINGFIELD OR 97478 Contractor Type Electrical Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-00409 ISSUED: 04/06/2006 APPLIED: 04/06/2006 EXPIRES: 10/06/2006 VALUE: Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential ~~QTI~~: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR JlNV 1!in nAY PfRIOD. I CONTRACTOR INFORMATION I License Expiration Date Phone BUILDING INFORMATION I # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled_BuJIding: n/a Occupant Load: A I I tN liON: OrAnnn IRIM rpm Iiro~ """ +" DEVELOPMENT I'N.FORMA'I'r(i)~ 1 "e Orego~ Utility . -~""uULlVI' VCIIlCI, IIIU~ rules are set foR'EQUIRED PARKING in OAR f3~2-001-001 0 through OAR 952-0(\.-:1 _ . OV15r-Ia~ qlst. mav. obt ' 'f Yl'otal. # St~e~t ~Tr~~s Rq6: am copies 0 the rules lnl:.ndicapped: Pave~'Blfi~'i R~d~enter, (Note: the telephoneCompact: % oPLmBcJJ~~a~~~ Oregon Utility Notification Center is 1-800-332-2344), I PUBLIC IMPROVEMENTS. Sidewalk Type: Downspouts/Drains: I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 2 Status Issued CITY OF SPRINGFIELD I Building/Combination Permit PERMIT NO: cOM2006-00409 ISSUED: 04/06/2006 APPLIED: 04/06/2006 EXPIRES: 10/06/2006 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 + 8% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $5.04 $63.00 4/6/06 4/6/06 4/6/06 Receipt Number 2200600000000000433 2200600000000000433 2200600000000000433 Total Amount Paid $74.34 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. 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 Pal!e 2 of 2 225 Fifth Street Springfiel~, Uregon 97477 541-726-3759 Phone C;4-, of Springfield Official Receipt 1 .:lopment Services Department Public Works Department Job/Journal Number COM2006-00409 COM2006-00409 COM2006-00409 Payments: Type of Payment CreditCard 4/6/2006 RECEIPT #: Date: 04106/2006 2200600000000000433 Description Perm Serv/Fdr 200 amps or less + 8% State Surcharge + 10% Administrative Fee Paid By FRED C, JOHNSON Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 006968 In Person Payment Total: Page I of I 11 :54:54AM Amount Due 63,00 5,04 6,30 $74.34 Amount Paid $74,34 $74.34