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Home My WebLink AboutPermit Electrical 2007-7-9 ZON Y\I'I NL INITIALS . N f'V\ DATE; -0 -0"" SOURCE f'<I'\~~~ . " 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ('))YY\'U:JO'l.- D \ tJn-L- 1. r ~OCA!I~i#f!e~'1 3. ~~ G6A^ r'V1. AN S ~I (:2(). LEGAL DESCRIPTION: Y;:;,/)<..t&f';; ,::)/)1) II- (Jp..tv;::;/ -+ f') (1 rLbt-5 JOB DESCRIPTION: 01 Date - ,. . ',.~ . ..~..,~ ".,^~....";;--.~,.'F"'-'- '~_ """""~'r'-.;,v;""_" ,':x.. --:'-. . A. iNewResidel!tial-: SingleorMulti~Family per dwelling unit: ".........;...,_;.._..,.._... _ _.,._ ._ _n ~ ......_lon.-_ .. _. ..~__., __."'_e.'"_'_'_~ __ '. .._~_". ..' -" _._.. .". -- .' n_.. .. - . .. . . Service Included $117.00 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $ 21.00 lJaMA{~b1 ,6y /.:2l)OO V <tP/J<~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Each Manufact'd Home or Modular Dwelling Service or Feeder $55,00 f."'. .,. B. i Servic,es orFe~ders '- Installation, Alterations .or Relocation: . ).. ._,.' ....<<4.; .-',,, _do ,_ '. '_'::A .~,."__",;,;.:,~,,,,<,;, ",'-_;,_u.x'H_ :,. '.~ .' . .. >. . . """,")' '. .>,,," , . '" ';-}J~:';""~'-;;:"^; 2. ,CqNTR,AC!?R I~STA!:/:A!I9NON~: . Electrical Contractor CtJIV~I~./I F~l.. U~ I 7!J-00 $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only Address -ElJ3~ ~rG 'ST. Phone 68'i.3.aC. L City E:lJ6GN~ :--.';r~'-~r~, '~;"-',,- --l!7 :;:; .-_.".-"" c. ...~I~T.P~r~r~.Ser~~,~~;2~,"!eeders. Supervisor License Number ' '1979 S Expiration Date / D /0//0 7 . , ., 1t.l9SDq. Constr. Contr. Number ;:20 -L/J'.;l (!.. Expiration Date --1L/ l.....I~, , .;~n1;~ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 55.00 $ 76.00 $110.00 Over 600 AlTIps or 1 000 Volts see "B" above. D. Branch Circuits < New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48.00 t/fdU. //!. $ 4.00 Owners Name ~ UI~rLL-/ A ,-- Address o::Qt)3 OtSaIJ tfYIJ4.N'5. f-~ I Phone .~~{) - 05D~ E. ~\(Miscenllneous (Servicejfe~dernofinclud~d) -Each Installation ...."':v.,"~,,, Pump or irrigation $ 55.00 Sign/Outline ~~~ON: Ore~~ y9U-tG OW~ftG!'ALLA TION Limited Ene.iMnI adopted by the~~n .U1il.it}' The 'PHtSaPfRMWTlfIMt!.t ~P1~fI If'ME'-WOOK Limited En~_~er. ~ose ru~~f) set forth is nOA~'Fffi1tfrmtJ~f1EffmIS PERMIT IS NOT Minimum ~1~ctrt.9_FVdaWaifa_~'\,~~~~~; own~Mij\UiNC.ED OR IS ABANDONED FOR 4. SUBTOT~~nter.(Note: theteJephQB.{J1). ANY 180 DAY PERIOD. 8%'"S~ate su~~=erc tor:helsOregon UtilitY NotlfiCa:ti~Jt/ , 10% Administrative re~ sr 1-800-332-2344). I'~ qQ. 5% Technology Fee 5:'0,0. ~fJ~LC> City TOT AL J '-lfY ( t./ Shared Drive(T:)/Building Forms/Electrical Pennit Applicatiol'l'7-07,doc Inspection Request: 726-3769 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01002 ISSUED: 07/09/2007 APPLIED: 07/09/2007 EXPIRES: 01109/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 203 DEADMOND FERRY RD ASSESSOR'S PARCEL NO.: 1703140001700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace 200 amp panel and outlets. Owner: JOURDAIN TERRY L Address: 5580 302ND ST TOLEDO OH 43611 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor CONRICH ELECTRIC LLC License 149509 Expiration Date 11/02/2007 Phone 541-607-3447 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: Storm Sewer Available: AI I cl.JTtlm~m%W8rP(dWP~ulres you to Special IMOr4r~: foll.ow rule. adopted by the Oregon Utility THIS PERMIT SHAll EXPIRE IF THE WORK Notification Center. Those rules are set forth Notes: AUTHORIZED UNDER THIS PERMIT /S NOT In OAR 952-001-0010 through OAR 952-001- t'f'\~n~1fHO[B 81\ 1- T - OOQQ; Vou mltynhtaln "^pio.. ...f+...':" -\.'I:s k/ A e. . v MDMllJUuNt .Ult - -,lIIng the center. (Note' the telephone NY 180 DAY PER/DO. Valuation Descri tiolO er for the Oregon Utility Notification Center Is 1-aoo-332-2344). Square Footage B'd A t Value Date Calculated or I moun Description Type of Construction $ Per Sq Ft or multiplier Paee 1 of 2 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01002 ISSUED: 07/09/2007 APPLIED: 07/09/2007 EXPIRES: 01/09/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I 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 Receipt Number $11.80' 7/9/07 2200700000000001096 $5.90 7/9/07 2200700000000001096 $9.44 7/9/07 2200700000000001096 $48.00 7/9/07 2200700000000001096 $70.00 7/9/07 2200700000000001096 Total Amount Paid $145.14 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Paee 2 of 2 225 Fifti! Street Springfield, Oregon 97477 541"-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-0 1 002 COM2007-0 1 002 COM2007-01002 COM2007-01002 COM2007-01002 Payments: Type of Payment Check cReceintl RECEIPT #: 2200700000000001096 Date: 07/09/2007 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By CONRICH ELECTRIC, LLC. Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 2821 In Person Payment Total: Page I of 1 10:00:19AM Amount Due 70.00 48,00 5,90 9.44 11.80 $145.14 Amount Paid $145.14 $145.14 7/9/2007