HomeMy WebLinkAboutPermit Electrical 2005-11-21 (2)
zunmg, and"doos not';~-u"'J~"'~'.~lltt IOlIowmg
approval. q U,Ji~~nd use
,,~,,~,", . LU---' 10S
!aD!' - ~. I I. 0 .~~\i' iJi~ ., inQ ~,,-'..':'~.I.--.W==>,
1"1' "'!jAt.",,:",.' "- ....:,.~~, "H ,~,'" __~.:~, . .
225 FIFrH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726,~6~!/;igna~;Q;,rn~~ct
ELECTRICAL PERMIT APPliCATION . .' .' . '~o...'~~ J
City Job Number (I~M...1..6-0'<'; - 0 110 ~Y1 Date 1\ - ;) 1- oS- '
1-
Over 600 Amps or 1000 Volts see "B" above,
D. Il<:'"Bmffi'Citc'~itsi\\l"~~~~~~~~J:~"~.i.!Ii.':!,!,*'..;~;.;~~'.!\'il(j
'~'_"""'f!-_b''''~'~'~~,"",~~~'3l.:>'~-'''''''''' i .,~""~~:E" 'lJn~""~
New Alteration or Extension Per Panel l '3
One Circuit I $ 43,00 7.--
A rEachTKdditional$ircuit or with '7 . J
1(lIl(Service-o~.F~d~r 'Penllil' requires vn..b.- $ 3,00 (tJ --
J' 'o;,:~-~ "'U~fJ'''U uy me Oreaan l!'ili\l
~~2u~:);j:::'~aj'.lf~"P..;n ,!,;\~;",>!~.,.J:"'f'..t-4~"'~'" .........>:r.-,..."-'V';;A,,..'..,ji.,
r E,' RM!S~!!an.it'~,(~~~1~!i.~,~~~~9Jj~S!~~W"'~.a.fl(I.lfst'!!t~I,~!!)I
" .'1 Yc J may I)bf . . -~"''' " :> -001- .
. PumPlor irrigatiiili copies al.the rules h\l $ 50,00
.. .. . c Co",,,.;' rNnte' th t I
. . ,SignlOutline,LightingU' e e ephane' $ 50,00
_ . ......, "Ie UI "-'401 I Wit N '. .
OWNEa~lIlJl..,..TATION Limited.EnergylResidentialY allllcatlon $ 25,00
'''"'1'....;l:7'. '.. -- uvv'''''.<-~344J
The ~~ltl!foR~~erog ~L'f ~ >m [ own which . Limited Energy/Commercial' $ 45,00
IS not mCl:\-ldcld(f!>fI!~EJ \mEJg'Rr~~ IF THE WORK Minimum Electric Permit Inspection Fee is 545.00 + Surcharges
UMMENCEO OR IS A ERMIT IS NOT ~_"",","""-M''''''''''''=~"''""'!i-'''~'' ~.;;,V~-'~ If
Owners'~ialll\tnn"OAY p BANDONED FOR 4. MS.lJBTp;rA.LLOFAB()~~~;~<"~&'ki'%~."' "t1 -
'OU ERIOO It"""..,."..,,,,'~.,.__.>r',"",]."''''=~ !/!'1'~ 'if'iw I'm" ,"'"'., ':1
. . .~ ~ 7% State Surcharge 3, '13
~ ~ 10% Administrative Fee if,90
Inspection Request: 726-3769 ~ ~~ TOTAL C}Z:3 '3
C-."
- "" Shared Drive(T:)IBuilding FonnslElectrical Permit Application I-oJ.doc
1. r,1:6CAfY6NOF.XiNSfXt';"'AtidN~~
. ~~~~;.'J-c:.SN:t<.__U1~~':i~.
/22./ !N-r)/b,if ~r:
LEGAL DESCRIPTION
17'03'(j,f'13' OOIO;'A
JOB DESC~ON fitt1;}1 r1 j'}fldh CI/C't/l(
).1M j)t5tfu1tt5W y- f1?U- c/~ 15
. Permits are non-transferable and expire if work is
j, not started within 180 days of issuance or if work is
Suspended for 180 days.
!#:eONT..iRrWTo&J:iNST.APf!'4.TION~~."..'
,2. l~~."'t;...~.~c,"J,~,~'~",n.v1i~~"'-"
Electrical Contrac~RE ELECTRIC. INC.
P.O. BOX 23154
Address EUGENE, OR 97402
City
Phone 3rlf-f7Z?!
Expiration Date
3.393-5
10-( -07
C;'(P091
VV\1rY ZlZOh'
Supervisor License Number
Constr, Contr, Number
Expiration Date
Signature ofSUperviSin~~
7I~
Owners Name
Address
:J ;r ;;. J
_<~f-t--IJ
IJ/t1W14
5"1
City
Phone
3. rteoMPI.:J:.l1!FEE'fSCiiEjjtftEljjELO~$.iI!;I"1;'iI!lli;,t!~i1'i'i
~~"""""".l..h>":~~~,_~_",,,,:*~~~~
A. ~1'W1it~id~ti~f~~gICJori~='F~p'~~lli1.~g',ti'~ii:'l,~
~~......,.."., -<tv' ~ 1"~'''''''.r'''''''~':I..o:A~~''''''-'-- ,~~~
Service Included
1000 sq, It. 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. ~s'~~~TJ.{~rF~1m-~~ris:f~1:;l::it1;~1n;r'atfo1i~rJR~.~ru~rin~~
~~"1~j,,~"~lI.I!'P'l..-<<,;;;'l""'~i'~'_;I\1"U'(.,'r~A.f,,"'~::1C':3li''''''~~~iJW;l.l'I:'r'''-''~''' .f;
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 63,00
$ 75,00
$125,00
$163,00
$375,00
$ 50.00
~"~!t_~"':tN~'i(;.~~~r.:":l4l'o.~"""~J:i'~'~~."'"~.l'~
C. [jl''I"~.'!'PJlr.~r.y..S_''J;Y1~.~JQr.lF:..eileq, ":;PPf'?/I.' 7"1.'
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
$ 50,00
$ 69,00
$100,00
~
,-
.
.
CITY OF SPRINGFIELD
Status
Issued
Building/Combination ~ermit
PERMIT NO: COM2005-01627
ISSUED: 11/21/2005
APPLIED: 11121/2005
EXPIRES: OS/21/2006
VALUE:
225 Fifth'Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2221 DAPHNE ST
ASSESSOR'S PARCEL NO.: 1703244300102
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: New Circuits
Owner:
. Address:
BECKNER MICHAEL R & WANDA M
2221 DAPHNE ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
LIVEWIRE ELECTRIC INC
License
56697
Expiration Date
05/16/2006
Phone
541-344-4928
BUILDING INFORMATION I
# 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:
nla
I DEV"'LvndENT INFORMATION I
Frontyard Setback:
Side I 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:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDralns:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of2
.
.
Ll1 r OF SPRI1'\jljN~LD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2005-01627
ISSUED: 11/21/2005
APPLIED: 11/21/2005
EXPIRES: OS/21/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fp.p.~, Pllirll
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$4.90
$3.43
$43.00
$6.00
11/21/05
lII21/05
11121/05
lII2lI05
Receipt Number
2200500000000001603
2200500000000001603
2200500000000001603
2200500000000001603
Total Amount Paid
$57.33
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.
L.~p.o/Ji~
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 herehy certify that all
information hereon is true and correct, and I further certify that any and all work performed shall he 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 ofthe 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 ofthe property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa!!e 2 of2
l~l
225 Fifth Street
....Springfield, Oregon 97477
541-726-3759 Phone
.
~!
~~.
"ty of Springfield Official Receipt
Whelopment Services Department
Public Works Department
RECEIPT #:
2200500000000001603
Date: 11/21/2005
I :48:46PM
Job/Journal Number
COM2005-0 1627
, ,
COM2005-01627
COM2005-0 1627
COM2005-0 1627
Description
Add. Alter. Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
,
Type of Payment Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
43,00
6,00
3.43
4,90
$57.33
"
"
Amonn' Paid
cpeck
t:.
~.
LIVE WIRE ELECTRIC
lkw
10389
In Person
Payment Total:
$57,33
$57.33
, ~I
" .(
:'
>
. . ~ i~,
'j
~i
,
u'
~~ .
"
,t ::
"
"
:', '~l
"
:\
I,;'
li'
~
"
11/21/2005
Page I of I