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Home My WebLink AboutPermit Electrical 2003-9-22 . wmg prolec~'lSo~ubmitted h th f" . 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(54I)726-3753 ~1i'~:a6lAad~~t1ro't"i'equire speCi~i~ la~do u~:lng ELECTRICAL PERllIIT APPLICATION approval. \ -r-..(2. . c; Zonlnn 1-\,) CIty Job Number (.t)VIt\zoo'J-:-oo9JO Date /-Z2-03. - r1I ".i~'2. . uate ~\ ~ t.J1'v .) \ 1. LOCAI10N OF INSTALLAI10N 3. C01l1PLE~tJftilltJ$~PLE B.EL01J\! ';<v..J <8-1 b JII/l, A + jt1!1&"~a,,", Electrical Contractor U 1 Jer~\C((?rl r;~O(\\~ 200 Amps or less 201 Amps to 400 A!'lps 40 I Amps to 600 Amps 60 I Ari1ps to 1000 Amps Over 1000 Amps/Volts Reconnect Only ~\J\\~ \t ,\\1(. ~\J\ c. Temporar\.'l.~V-.&.~~l\$~e~~~ ~. ~~\..\.. :\\\\'0 ~ ~I(.\) t ~~"\\~t:.~~i'hI?~'W8r..~I~~~~r Relocation ,\\\'0 \\\J~Q1l~~\}r~~.\~. $ 50,00 ~\J\ ~\A~~~~'d Amps $ 69.00 ~\J~ ~fb~ps to 600 Amps $100,00 ~~i Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits LEGAL DESCRIPTION 170:SZ3Lf'3 I Z. ~tOu JOB DESCRIPTION Lo vi V DIke, c / (2t::S Permits are non-transferabl{ and e~ire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Address P t) l Rt)0( L{o54 r '171./0<{ C, I 9 City r;;.~e.Y\.SJ._ Phone '-to 7 - 07~ Supervisor License Number 3 ~9 3 Lei A- JoftloS Expiration Date Constr. Contr. Number 1 L{ L-f l.a.XS Expiration Date IolM'iotf ::f1;p;:t];' '"" Owners Name ~ Lr r:= Address PO a 6 x City e:u&-(;:::/II'e' Phone 'iJ. 1- 'OV/ft.c5""'i "742-::;- OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. New Residential- Single or Multi-Family per dwelling unit. Service Included ] 000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ ]9.00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: $ 63.00 $ 75.00 $]25.00 $163,00 $375,00 $ 50.00 New Alteration or Extension Per Pan~ O C. . r: "ot~ \ $ 4300 ne Ircu.lt. '.' ,..,e" :}S9':>: " ":.?~'! ' Each AddItIonal ClrgUltor rw~th;;:' '. ".. .),\,t . r(:1Ul.l.' t ~- 'to ,.~~...} .,...-<....".:' $" 00 Servlp;: .o(fee(ler. P.~l;ri}it.: - r-';" r -, u, ~', . ~ I .), 1'\-""\ \.\- . ,,"'otJj ,\~.-J' ..,...t,.\",V .. 'E"" \.# ~ J \. -I __ ':'\ \,\ \.., '<.' t. ~\ ~~ .'lYliSc'~ila~,~.o'U~~(s.~I:,"ice'lfe~~~;' n~t iIi~i.~~,~d) -Each Installation ~C\,C .' ,'\ I .-~ ." .....~. t. ,.....,~__..- ,~,..."....f", J .':,__:r~~." _f. :;I~':''$ .-~."....,;~ r/: ~,,,,"-=,,' ~, "of'. ~~'::;:}n NC"\' 1'P;uIRP or 11!~ga.t'lon .' ~ ,.\"':. . . 4 ..,,,~......'.,..,~. $ 50.00 '\ C:'~igtV0utiin~,1:iglftrn~ ~ ~_:';'Y:" ~ r. r:).. $ 50.00 O~\.'. ~..'" .0,:,,0.. 2. 'l.r- , a ~J..,irnited J:nergy/~siaentiaB'j ~ ( $ 25,00 I''''t.-. , r>rf ':~~ .," ~r' ,\...0\)V nIJ+nited r.It~~gy'7Commercia] $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 2-) 4. SUBTOTAL OF ABOVE lj~ :5 1)-- L(SO ')2 b) 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Eleclrical Pen~lit Application I-03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00950 ISSUED: 09/23/2003 APPLIED: 09/22/2003 EXPIRES: 03/2312004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 846 Mint Meadow Way ASSESSOR'S PARCEL NO.: 1703234312400 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 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DIVERSIFIED ELECTRONICS INC License 144685 Expiration Date 06/23/2004 Phone 541-484-9078 I BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: ~ Size: Height of Structure ,\\t. \NG Ft 1st Floor: Type of Heat: t:i-'r.WS:- \t ~\, \S q Ft 2nd Floor: . ~~r TYJ>~X\~\..\.. ~S 'r't.\\ \) tG~q Ft Basement: . ~O g1\~P~~~\)t.~ ,~ ~~\)G~'t. Sq Ft Garage/Carport \\\~~ ~ttatb. ,S ~'O. Sq Ft Other: ~\)\.\\CJ t..\Ct.\) G~Q~G\)' Impervious Surface Area: 'r~~~\''l "\ 0,_" I DEV~~~Nt~FORMATION I REQUIRED PARKING R-3 SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Overlay Dist: Total: # Street Trees Rqd: OU \0 Handicapped: Paved Drive Rqd: \J'.J '(eo.\.\\'(es ~ \J'\\\\\'/ <;:ompact: M,,~On \a: 0'(690 't \0(( % of Lot Cef\~~l!gel' d '0'1 \ne aTe sa 00'\ ~€.~\\ a.do~\e oss '(u\eS ~ 9;'f{l-' ~ ....\~s ._.-,n .",nOp.:. .,,\~S.t I PUBLI~:~.~i'~ROVE~~~TS\~~n~~;\~s ~ ~~;~~O{\~n \'1 ~? 9~'" :'1 opw N(SideWalk;:n ~.~pat {\ 0 ....'ou ((\a. ~ec ~ I '\\\\\'i t'. YP 090. '\ he cen nO'" U ~I')/!A\. o \\\(\9 \\' "'6 0'(6~ DQw.~poufs!Drains: Ca: '(\0'(\\'. ,\*BOO*,).J . nu'f{\p6 cen't8'C \S Notes: I Valuation Description' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value . Date Calculated Total Value of Project Paee 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00950 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 L Fees paidJ Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Amount Paid Date Paid $4.50 $3.15 $25.00 $20.00 9123/03 9/23/03 9/23/03 9/23/03 Receipt Number 1200200000000002190 1200200000000002190 1200200000000002190 1200200000000002190 Total Amount Paid $52.65 I Plan Reviews I To Request all 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. Reouired InSDections 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 Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00950 COM2003-00950 COM2003-00950 COM2003-00950 Payments: Type of Payment CreditCard Receipt #: 1200200000000002190 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 055368 City of Springfield Official Receipt Development Services Department. Public Works Department Date: 09/23/2003 9:01 :47 AM 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