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Home My WebLink AboutPermit Electrical 2006-7-7 zo~a INITIALS ~ rv- DATE1-' ~ ,-u~.~ SOURCE"M~ r-.... \ V225 FIFTH STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION / City Job Number LoI4/I Z.OO {;,-c.:::sD 3C{ c 1. LOCATION OF INSTALLATION, Date 7/7/06 , ,_ ( I 3. ' COlVIPLETE FEE SCHEDULE BELOTV ).355 YoLA;SDA I - LEGAL DESCRIPTION 17D.3 Z l{ c..{l.( A. New Residential- Single or Multi-Family per dwelling unit. ~f\lqC\, M {j)l) \lC S.~DL 02200 Service Included JOB DESCRIPTION 1000 sq. ft. or less $106,00 . Each additional 500 sq, ft. or S I[R. V ( Cf Ii u:e:fLA11o.0 portion thereof $ 19.00 E'achManu(act'd Home or Modula;,Q~~~~&!glfgq~1! to $5000 . Feeder _:- [, co l-.:800n Utility - ' ,I. j 1'",:::8 (L'/"'S .. " -'J"" n J J ,M~ 8etforth CONTRACTOR INSTALLATION ONLY,,,, _,.~: ',SetVkes:'oigF:e@l~Rcrt:}Jl~<;t3.I a'tion, Alteratio s or Relocation: .".,1 c.' ',ill CC ' VI.)/- uu1- - - - ,c;, "1'0\8' J c., ,:12r,,"',=, (iI' ,J" Oltleru/esby S~j'J.'1 lor j~'~26flAtitps'@rllill~ ta/apho $ 63.00 Lll" O{"':Jn'l.I.IJ'" ne Celltsr i~O ~-rr!psI{{)140j)~ffi'cation $ 75,00 40 ~~tf5~~~4>4j1.ps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts I $375.00 3?S'~ Reconnect Only $ 50,00 200 Amps or less $ 50.00 ~~l(rnf;t> 201 Amps to 400 Amps $69.00 THIS PER'- '401 Amps to 600 Amps . $100,00 ';Ulfi0RI~~g C~~ &iff'~~IFoJHJ,6.d^\@,.. i~~see "B" above. COlvJME/\JccD l)R'.!,'Sh~ ~ljJ.ftf)i;6M1T. IS N!H . , ANY 'j 80 'D,~\" ~ER~:~~~i~~1~9IRJlsion Per Pa~el One Circuit Each Additional Circuit or with Service or Feeder Permit 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. Electrical Contractor s P~)w~\.t) /. c./?_/J Address / r-i () City So- l 7 yt{- (..)1> Phone Supervisor License Number l (J ? 3 I) S \ Expiration Date (f) 107 f Constr. Contr. Number Expiration Date Signature of Supervising E1ectIician _~ )'fDAAJ< - "-1' ~ rp Nt~~ ~ c.lPbL<;' /'8"'9 ti /\J. '12./;> City S(J- Phone I c/"I- c:, '3>9 ~ . - OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. owne7:r~~_ I~'t' 726-3769 .--' C. 1 Temporary Ser~ices or Feeders Installation, Alteration or Relocation $ 43.00 $ 3.00 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 Electric Permit Inspection Fee is $45.00 + Surcharges 4. SlJBTOTAL OF ABOVE 37.J ;>0 "7 75'0 Lfl{ Z ~ 8% State Surcharge 10% Administrative Fee TOTAL Shared DJive(T:)lBuilding Fonns/ElectIical Pennit Application I-06.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ;t'CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-00846 ISSUED: 07/07/2006 APPLIED: 07/07/2006 EXPIRES: 01/0712007 VALUE: SITE ADDRESS: 2355 YOLANDA AVE ASSESSOR'S PARCEL NO.: 1703244402200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Public PROJECT DESCRIPTION: Service alteration - Briggs Middle . Owner: SCHOOL DISTRICT #19 Address: 525 MILL ST SPRINGFIELD OR 97477 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 -.,. I . . _ ,;. '-"'V req(Jir .'11', " '"_''' Jy the 0 es You t ......., II t ('--,~ _ J '''~I reg 0 0090 \,~.,-.: :;,J1-nO'10' ;ose rUles On Utility , rou rn~ "th 8rA Ori!l;.". qV()hf~: rOUOhn._~Setf()rth nl1J:)ll~'CJ Ille Oent~:'''~, l.:OPies ' 'f 1::102-00 I CONTRACTOR'I'NFo.,Rl\1.A TlOl~lll th~f the rUles b 1- vl:1nter is 1_~~~f/ Utility .A~~/~PhO[?e y Lrcen9e'2-23f4j~lI:t\t,l8t9, Date Phone BUILDING INFORMATION I # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Spri~kled Building: 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 DEVELOPMENT INFORMATION I ' f\HO TU::e , REQUIRED PARKING Overlay I1;~lS ~U~. Total: # Street Ji.lfjes Hd~~IT SHALL EXPIRE IF THr!fa"!dicapped: Paved DFiV.f~F {lil D UNDER THIS PERMIT~~~~t: % of LotCbv~flJGED OR IS ABANDONE IS NOT NY 180 DAY PERIOD. 0 FOR i ." ';' I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pafe 1 of 2 Status Issued ~"CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00846 ISSUED: 07/0712006 APPLIED: 07/07/2006 EXPIRES: 01/07/2007 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 1000 amps/volts Amount Paid Date Paid $37.50 $30.00 $375.00 7/7/06 7/7/06 7/7/06 Receipt Number 1200600000000001031 1200600000000001031 1200600000000001031 Total Amount Paid $442.50 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 Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . C' f)f Springfield Official Receipt L_ , dopment Services Department Public Works Department RECEIPT #: 1200600000000001031 Date: 07/07/2006 10:07:03AM Job/Journal Number COM2006-00846 COM2006-00846 COM2006-00846 Description Perm Serv/Fdr 1000 amps/volts + 8% State Surcharge + 10% Administrative Fee Paid By SPFO SCHOOLS DIST 19 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 48208 In Person Payment Total: Amount Due 375,00 30,00 37.50 $442.50 Payments: Type of Payment Check Amount Paid $442.50 $442.50 cReceint I Page 1 of 1 717/2006