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Home My WebLink AboutPermit Electrical 2003-9-22 ~, , 3, roject as submitted has the following . FAX: (5iJ<lr)171l6~~oes not require specific land use approval, (2.. Zoning I..l") 7--22-03 ~~ 14-03 Date \ COJl1PLETE FEES@HtJ9MlLJJf1JiNJ@~tr <.:r\l-0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PER1l1IT APPLICATION City Job Number C.O 1.4\ ZOO] -00 91..{ 7 Date , . ~i:h 'IIOU~Qt;, ...,.".., C. ., TempP,llilii,X~~rvic.es(<lIJFeeders ~1,\2X\l\f I" i' '~~O("l'{'\ \..,~, : ",if ' ., . f~\9<;v, ~':\B Of...,,, r""'; lO., ........,n.:::~-\ '\C\'" ~'., "/i.21h~t~mi tioni3Alt~ratton or~elocation ~~ . -- \1" u.\~v~ ".-\"\~S9 \ t..~\ """1-. j\'v' . ,-'-+'/......, t ~ _ .\ ,,\1"''':'''''--'' ,"'~b;,200'Aml?s<ofless, -,'\?is ',. ,0 . ,.::.'.1, ." t'r' ,.." -. "...,,,, 1 ,,, Constr. Contr. Number I '-/~ I ~\"'" "",' .,:<~20:l p}mpsJo;40QAWps'.~'0;9 ' ~ /- jl'lVO'"'' . ':,~,'''' ',,! "'-':4o'fi;R".SctO:'bb'o'.All;;"~n3.t\On ",\, .." '" ,,,' "\,,,..., ., E ' , ' ',',II ',' '" .,..~ ,t'~' '\\."."'.".... x lratIo a ,,' , ,,~ -~.' . rn ' . p ~~~ ~(;~4 tjJJS. V~~~i.'~'~':_'.~'",:~-,,~..e_,~~rf~~;~~~_g,,:.~~tfQ92 Volts see "B" above, Slgnatu e j, $!tlrVlsl' v ._ o.~ '~:"", D. 'PJi'!l1;lcl1elrcUlts 1 i((I0v, :,o.<('S ..' .,. ,,, , \ ~ f,r:-.'r'.',. " New Alteration or Extension Per Panel ex.... \ J One Circuit Each Additional Circuit or with Service or Feeder Pelmit -'>>'~':"',,~~O'r'^,- '". ~';~"~"'v' ", "'":' . < -,.:.',- }---':-::" _ _ '_ ~'l' -<;,:' - - -:v-'" > E.MisceHaneous (Service/feeder not inc1uded)-Each Installation NOlT~CE:' ~.. Y~'RE \F'tHE WORK " lHIS PERMhlpSh\ht'R~a~Ji~l~ DERMIT IS w.n $ 50.00 AUTHOR,~~4jMI1fJt mUfl ~ FD FOR $ 50,00 OWNER INST ALLA nON COMMENGmeijlfll!~~ ~~ ie~~a1 J $ 25.00 The installation is being made on property I own whichANY 180illtAi(eij~~~rCommercial $ 45.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee i@,-OO>+ Surcharges 1. LOCATION OF'INSTALLATION 0A.~+ '''#~d,~J wfht ~g7- LEGAL DESCRIPTION 1703 Z3Lf3 JOB DESCRIPTION 1270-0 LoltJ Vol~~,~ /~-S I / 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 INSTALLATIONONLl' Electrical Contractor 0, ~ Q.X' 3,\ C'., eA 6:1 E>_&I:::>Of c:...s, Address eO. Do)l...... YoSY~ City G.(~-0r-SL 17'-16thone'-{~L-\ -qOl~ Supervisor License Number ?:> %q 3 LGPt- Expiration Date l CJ / / / 05 Owners Name ~~.rt: Address ?C fS e ~ City f::::u-b-tfI E[' IT .J::<... '7Lf zs- Phone Owners Signature: Inspection Request: 726-3769 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 ' Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19.00 $50.00 B. Services or Feeders - Installation, Alterations 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 $ 63.00 $ 75.00 $125.00 $163,00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 lcr- <iT :5 f )-- L( -s-o .5 z (,r 4. SUBTOTAiOFABOVE t0K.t;'v:<: ,,:<'" 7% State Surcharge 10% Administrative Fee TOTAL Shared Dlive(T:)/Building Fonns/Electrical Pellnit Application I-03,doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00947 ISSUED: 09/23/2003 APPLIED: 09/22/2003 EXPIRES: 03/23/2004 VALUE: SITE ADDRESS: 882 Mint Meadow Way ASSESSOR'S PARCEL NO,: 1703234312700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Low voltage Owner: FUTURE B INC Address: PO BOX 7425 EUGENE OR 97408 Contractor Type Electrical I CONTRACTOR INFORMATION I Contractor DIVERSIFIED ELECTRONICS INC Phone 541-484-9078 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description License 144685 Expiration Date 06/23/2004 I BUILDING INFORMATION I # of Stories: \0 Lot Size: R-3 Height of Structu~<\U\{es ~oU, rw Sq Ft 1st Floor: TY.ne of(tl.~at~\J'~ f Ofeno'(\ \J'i.\,\ r\' Sq Ft 2nd Floor: - '." )ttj~ "t'ne "" et o. V1hr .-M'"E.t'rnCWa~~ T~e.e;,N \eS ate s 00' Sq Ft Basement: p\,\ I {U\af!langerlY~~;oSa fU OP\R 952.- \. Sq Ft Garage/Carport '0\\0\1'1 :\'o",E_hergf'Path:\IfoUg'n ~ tha tu\aS Sq Ft Other: .,' 21.\" -\ OO\V' 'SO'" e NOt\ \c 952-00 \ - \'(\ co?\a te\e\)\lon, Impervious Surface Area: r.1'I-p. _"' nota ,L~' the ,., _",~\()n ,\- _#_.l\l.'U",,AoJ _~ I'~'LJ.- ?''In,,,,_- OO'I~II!)EVELOYMENT I~EQEJ\1~TIQ~\ I ca'\I"~ t\la V' -.... 3'3'(.-&'-'-'" moet \ot LDr;5 '\ _BOO- nU, <!l,v,er.lay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING Total: Handicapped: Compact: % of Lot Coverage: I PUBLIC IM~~!I'W1ALL EX~~E J~;;{IS'~~~ AU1HORIZED UNDE~ibe}V.l\,e~~fi FOR CEO OR IS ABANtwt' COMMEN DER\cRYwnspoutslDrains: , ANY 160 DAY r . I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Value Date Calculated Total Value of Project Paee 1 of 2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00947 ISSUED: 09/23/2003 APPLIED: 09/22/2003 EXPIRES: 03/23/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Low V oItage - Residential Minimum/Adjustment Electrical Amount Paid Date Paid $4.50 $3.15 $25.00 $20.00 9/23/03 9/23/03 9/23/03 9/23/03 Receipt Number 1200200000000002187 1200200000000002187 1200200000000002187 1200200000000002187 Total Amount Paid $52.65 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. ReQuired Insoections I 1 Low Voltage: Prior to cover. 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 Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00947 COM2003-00947 COM2003-00947 COM2003-00947 Payments: Type of Payment CreditCard Receipt #: 1200200000000002187 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Residential Minimum! Adjustment Electrical Received By djb Check Number Batch Number Authorization Number Paid By ALLAN WOOSTER 000177 055390 City of Springfield Official"Receipt _ Development Services Department Public Works Department Date: 09/23/2003 8:54:46AM Amount Paid Item Total: 3.15 4.50 25.00 20.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65