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Home My WebLink AboutPermit Electrical 2006-8-18 ~,'ELD 1::=_'7~:::'; ZON L_i'''YL ,.' /?";t INITIALS .J,vl ~"~"":'"""~i')} DATE )b~ 0(01...- &;1 ",," SOURCE ~\~'l_~ Date 1)'. $5' Z(1)~ - I j 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COIMz..OO~- 0/0 bZ. , P\lm:p'.;~~\rrigation , _ ';, (I "S\tn/PflAiA~~ Lighting r ),... \' \ ~ . , 'C...,'. ;,) c: 'I.;imifei!;'fnergyIResidential '.' . - ,\".J I'. I) \ ., ' : c '." ~\' \- , . The installation is being made on prop,ertyI own\whi6h ':. .f') \ Limited Energy/Commercial $ 45.00 ., I" ',' "_ < \.~. ... ,- ~:) U\' ,(' $,\) , IS not mtended for sale, lease orrem:<,.:.c\:,I.~' .'..~.J,( ~0 ". Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ,J \JI" \\,:".." ,(:\\'.~ ., -' . Owners Signature: ;::J';'~\'~~, ~,.' ~ S rJBTO TAL OF ABOVE . '" , 1 "Q. \ .ck 8% State Surcharge .f\~ ~~\J' 10% Administrative Fee \..) ~.... 'Zo, '"TCcH ~e'F TOTAL 1. LOCATION OFINSTAL,LATr'oiv. ., J7Ib"E- .~f LEGAL DESCRIPTION }?0"33bZ\ 1 gz,oo JOB DESCRIPTION ~OC=> ~ S P"L c..tfA-,~~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ,CONTRACTOR INSTALLATiON OmI" :'leCtriCal Contractor 6'~ r ('1 } 1/" 6 ~ 0 :5 Address p 0 bo )l (p OJ 7 City 'JJ rd1 {fv) If Phone 7 Y 1- ;; 7 ~ + Supervisor License Number L , '7 ,) J j Expiration Date / 0 / 0 7-- ,-,' .'." ",. ~.' ' Constr. Contr. Number 1,~'(./4 ~ ~ I () /07 ",.,.,:,; \ ~ .. " Expiration Date ,-"', \......' \ ,~ ~.J \ .' . ignature of Supervisin ~I . ~ ~6-LC ~.,... Owners Name ~"ll\ . Address 17/b ~?F~ Phone E City OWNER INSTALLATION Inspection Request: 726-3769 c;14 8" 3. C01UPLETEFEE SCHEDULE BELOlV'; , ,:.- ''<~'.;''-'' . . ..' --- .'-- .-' . . . A. ,New R~~idential':':Single' or Multi-Family per d~elIing unit. ~ .. . ,,_. '. _ _ .', .; . , ".", ". ' " . .. '7 Service Included 1000 sq. ft, or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50,00 B. . Services or Feeders'- InstalI~tion, Alteradons or Relocation: , -"." ..~ ,. ' . .'\.,.. . . . - - . . 200 Amps or less ' 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only .-'olGI}\0 .. . .... ... ,.. .,. , C:~7~mpgr,arySeriices or Feeders .-,.<. d ~:,,'.'0 ,- . - .,. InsiaIlatio.~lA1teration or Relocation . , \ .-' ~ \-,\1 200 4.mps or less . ~ . ~ - '201 Am'ps'to"400 Amps , 40 11\mps toJgoO Amps , 6~ $ 63.00 $ 75.00 $125,00 $163.00 $375,00 $ 50.00 $ 50.00 $69,00 $100.00 " ../. Q~sr;600 Amps or 1000 Volts see "B" above, .' f. . if Branch Circuits' ' \ . --' ~I .-' New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. ,Miscellaneous (Service/feeder not included) -Each Installation $ 50.00 $ 50.00 $ 25.00 b> ~"1JC1 6~ 3/.r ~.., 'l..l..- , .. Shared Drive{T:)/Building FonTIs/E1ecu;cal Permit Application I-06,doc CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-01062 ISSUED: 08/18/2006 APPLIED: 08/17/2006 EXPIRES: 02/18/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1716 E ST ASSESSOR'S PARCEL NO.: 1703362118200 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: 200amp service change TYPE OF USE: Repair Residential I PUBLIC IMPROVEMENTS I '-NC)~~ Sidewalk ~~'e\t. S ~C)\ 'P'Q.~~\~~S)b\\}\ ~ ~u"\\C~~\'J\\\ S\\~t.~ \\\\~~\)G~t.\) ~~ \\\\S '?~~\1t.\) '06\\ \s ~li)l\ \\'0~~?I\~~c,t.~, Qt.~\C)\)' \.,,~!\~!. -'"' jr' v :\tl\J Valuation Des ~i\ tion Owner: DA VID ENGLE Address: 1716 E ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BURRELL BROS ENTERPRISES INC License 136446 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: \0 Height of St.ru.. ctureOU.\,." .' ,>\'-- - \j\\ \\J Type of Heat:, ~~O\l , <O~\\\ W t T' -,' e81. I. a er ,ype: 3S8 ~ aC)'\- Range Ty,pe'~esO:' 'A gS'2.- \--." ..J~' \ r'" \oS \J' Energ~_,pjl.tlj}:\ ~ \\\e ~u v " SprinJ{l~d :~il'ilding\8?\\0~e n/a . '<I',;' ljV, . .\""\8 \(:) ",~",'\O\l VN Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: , ~o .IDEVE,LOJ~MENJ.J'NFORMtTION I oJ'J.' " l; ,,'~ UI--':;::I- ':)'l-~v Ci,\"\:;).' (i.XI.8 aaa-':) , '-'I \0 ic; ,\-u 0011'0v C8\\0verlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft qr multiplier ; Square Footage or Bid Amount Type of Construction Paee 1 of2 Expiration Date 08/20/2009 Phone 541-747-2724 Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01062 ISSUED: 08/18/2006 APPLIED: 08/17/2006 EXPIRES: 02/18/2007 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 + 5% Technology Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $3.15 $5.04 $63.00 8/18/06 8/18/06 8/18/06 8/18/06 Receipt Number 1200600000000001294 1200600000000001294 1200600000000001294 1200600000000001294 Total Amount Paid $77.49 I Plan Reviews, 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 InsDections 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 Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726~3759 Phone Cj+... of Springfield Official Receipt 1 Jopment Services Department Public Works Department Job/Journal Number COM2006-0 I 062 COM2006-0 I 062 COM2006-0 I 062 COM2006-0 I 062 Payments: Type of Payment CreditCard cReceinll RECEIPT #: 1200600000000001294 Date: 08/18/2006 Description Perm ServlFdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JASON BURRELL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 00689B In Person Payment Total: Page I of I 3:37:06PM Amount Due 63.00 3. I 5 5.04 6.30 $77.49 Amount Paid $77.49 $77.49 811 8/2006