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Home My WebLink AboutPermit Electrical 2006-4-6 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54I)726-S6Sij>9 ELECTRICAL PERMIT APPLICATION Date City Job Number{oWl.'Z.OO,"oOC:> '1 0 t:> Date L/ -b -0 b A"thOrlzed Signaturp _;.ct hs~as the following s not ~uireoPjll:~ use NM ~~ . I \} CITY OF S... JrNGFIELD. OREGON :~. ' I. ~~~(i)__WSfl~~\l~_ 3. 1~(i)MiP~~~Ji)~h;~.~iE-h@lM '?., 33 f.{ 'be-f.?alA ~'L LEGAL DESCRIPTION 170~ zbt ( JOB DESCRIPTION ~L.)rc..t:: XtiAJ Srl-vL.) 'bX'IJT"I""7 Permits are non-transferabh(.nd expire :if work is Each Manufact'd Home or not started within 180 days of issuance or' if work is Modular Dwelling Service or Suspended for 180 days. Feeder 2. 1~.'';",J~J~&.l,l~.,.l~i'W~~ B." Electrical Contractor t ~ a 5 ~f..:,drl' C;--::I;?c. 200 Amps or less ;i ' 20 I Amps to 400 Amps \ ' Address V(J Bo)( ) 1.j rt d- 401 AmpSlo 600 Amps'), ',,', ~. }lJ.) \' C~, r. /1 7 I .601 Amps tb IOOOIA~p~, 'L\1~ rll\e5 u~ Ci~ (I n~f7eIO Phone ~y - ;;r;)'36 \. Oxer:.lOOO~p~Ni't,'ile \elep',o''''. , .,i'":.l"': . JReconnecf0nly~Ol i \\1 Not\'\CallV1. - " nCl 1.\''''' ,- 0' 9011 \J,\.\'\ J Cd." '--' r.'f the 10 _ ......-.<) i) 44). LJg~ ~rs "ll"lt~r e ~~ /O-o/-'doCi7 ~Ryq 1 - ) - d(JO ~ or~OO A. ~", siB ti..1 rt",~~11n.t:::\"IUL"tll;ll:nl Service Included 1000 sq. ft. or Jess Each additional 500 sq. ft. or portion thereof $106,00 $ 19.00 $50.00 er-ations 01" elocation: I I $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 b1 Supervisor License Number Expiration Date Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100,00 Constr. Contr. Number Expiration Date Owners Name ~ r+ ~ oS " C; \--.c Add Z?.... '-( ~ 'r'" '- r E. I feel! " 'ncluileili).. 'acli ress ~ ~ ~..., r- ~ f t'l II I_ s: ~ t=~ Phone '1 "flp -lI.i1JS ,Pump or i~ga~<j;ll\\\t. \r ~\ \S ~O\ $ 50.00 "\01\C~Si!W!Olitlit}e\Li~htiJi'gl't.1l\ t.\) 1'0\\ $ 50,00 OWNER INSTALLATION \~\.l\S ?t.'tTI;:i~;;\ErThf~;R~~ia~<;l~) $ 25.00 , \ \ ,\ O~\L-,:v_ . ~\l, \';:) t'V' . The installation is being made on property J: OWll which 1\\1\\1 L(!RJ@ Ener~J\?qmmerclal $ 45.00 , . d d Ii I I ("~,~W>\:. - ,>4 91''1'\ IS not mten e or sa e, ease or rent. vMinimum Electric Permit Inspection Fee is $45.00 + Surcharges I\~" lUY , 4. New'Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 I.( $ 3.00 IZ City Owners Signature: ~5Jlb@1jY,. I o' - -: . , .' Inspection Request: 726-3769 TOTAL 7::::- b 750 13b 50 ~Io State Surcharge 10% Administrative Fee Shared Drive(T:)/Building FormslElectrical Permit Application I-D3.doc . .CITY OF SPRIl'il>1<u,LD Building/Combination Permit PERMIT NO: COM2006-00408 ISSUED: 04/07/2006 APPLIED: 04/06/2006 EXPIRES: 10/07/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2334 DEBRA DR ASSESSOR'S PARCEL NO.: 1703261101800 ... r, ",~" '''\'' rQquires youTYPE OF USE: PROJECT DESCRIPTION: Replace-servlceand add 4 c.rcUltsregon Ut,:lty " .\1 \ll~ u::.u:)te~,bY.~'~,~~ ilre set forth Owner: CURT BOSISTO r'(J:I:,.at~on \"e~'~~~iO'~;;;OU9h OAR 952-uU 1- Address: 2334 DEBRA DR in OAR S52-00 'n copies 01 the rules by SPRINGFIELD OR)(9,74.:i~u.~a;A~~:~' (Note: the ~~I~~~~~:n vv.".."'oJ lor thp Oreqon Ullll~Y I .~: number I.CONTRAG"!:OR<INF0RMATlON I Gel Springfield TYPE OF WORK: Electrical Work Only Repair Residential Phone Number: 541- Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION' Expiration Date 09/01/2008 Phone 541-741-2236 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq FlI sI Floor: Sq FI 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Fl Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: NOTICE: I DEVELOPMENT INFORMATION I THIS PERMIT SHALL EXPIRE IF THE WUKI\ AUTHORIZED UNDER 9.,!~lfy:l)iS1\T IS. ~OT COMMENCED OR IS J{I~rfll0f~~1{SiiI. ..Paved Drive Rqd: ANY 180 DAY PERIOL1,./o ofLoI Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC Il\o"rtuvEMENTS, Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . .CITY OF ~rK1r~hl'1""LD' Building/Combination Permit Status Issued PERMIT NO: COM2006-00408 ISSUED: 04/07/2006 APPLIED: 04/06/2006 EXPIRES: 10/07/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ToIal Value of Project F~~. ~ $7.50 $6.00 $12.00 $63.00 4/7/06 4/7/06 4/7/06 4/7/06 Receipt Number 1200600000000000437 1200600000000000437 1200600000000000437 1200600000000000437 Fee Description + 100/0 Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Total Amount Paid $88.50 , 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. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. By signature, I state and agree, that 1 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 10 the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. 1 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 Page 2 of 2 225 Fifth Street Springfield~\oregon 97477 541-726-3759 Phone .iii~ Cwf Springfield Official Receipt ~opment Services Department Public Works Department Job/Journal Number COM2006-00408 COM2006-00408 COM2006-00408 COM2006-00408 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: 1200600000000000437 Date: 04/07/2006 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By C&S ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 040279 In Person Payment Total: Page I of I 2:24:03PM Amount Due 63.00 12.00 6.00 7.50 $88.50 Amount Paid $88.50 $88.50 4/7/2006