HomeMy WebLinkAboutPermit Electrical 2006-5-24
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CO~MPLETE FEE SCHEDULE BELOW
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225 FIFTH STREET. SPRINGFIELD, OR 97477 0 PH:(54I)726-3753 · FAX: (541)726-3689
JOB DESCRIPTION
Rtda CtntJJ Par~{
Pe~mits ar~on-transferable and expire if work is Each Manufact~di Home or
not started within 180 days of issuance or if work is Modular D,weHmg [f{e.'fY.\./ice Qr · ,,' ,. $<:.0 ~(),
S d df 180 F d /' -, ,II uIL'IL~ ,- '- 1!=-r..J1.. M
2~,pe;O:;:U:;;~STALLATI~N ONLY B.e:e:k~~~~!,~}~g;;~f~~~)~t%~;~~~~i.iO",
Electrical Contracta/t/j' P'U /~~ E~r~OO Amps or less ' / $ 63,00 &3.aD
201 Amps to 400 Amps $ 75,00
401 Amps to 600 Amps $125,00
601 Amps to 1000 Amps $163,00
Over 1000 Amps/Volts $375,00
Reconnect Only $ 50.00
ELECTRICAL PERMIT APPLICATION
City Job Number (DYY'lQDO~ - On(Od.l
1. LOCATION OFINSTALLATION
p~y ~i>~~ S/'
LEGAL DESCRIPTION
l ~ OL rHo I L -
o [ (00
Address 3.Jj>JI?" /~~L-W/~~ ~
CitY~,.......?~.-(L _ Phone ~7f:-.J' / I(C)
Supervisor License Number _~ ~~ ~,::::> I? S
Expiration Date / /J
tf)/
2-C0 "7
/
ConstI'. Contr. Number
If 2-:1?;?
r
Expiration Date
/2-
Z--e>t:Jk
2../
Signature of Supervising Electl;cian
c~~
Owners Nam~/ /.; d !"/ ~ /fA / i!! /. ~
.,
Address 9,r y '--:-.h ~ n:-~,,;- s,r-
City <' ~ ?..L' L.-J;
L- /"
Phone
OVVNERINSTALLATION
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.Nc'w Residential-Single or IVIulti-Family per dwelling unit.
Service Included
1000 sq, ft, or less
Each additional 500 sq, ft. or
portion thereof
$106.00
$ 19,00
c.
Installa~~n!AIter.a~j~~r.,Relocatipn- "
200 A111J?S'{}f JeSS' 'n :- - ':
20 I Afllps to 400 Amps~ .' i,
401 Amp:-sto6QOAmp~ '
I'.'"
$ 50,00
$ 69,00
$100,00
D.
New Alteration ~r' Exte~si9n ~erranel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43,00
$ 3,00
E.Miscellane()us (Service/feeder not included) __Each Installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50,00
$ 50,00
$ 25,00
$ 45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SlJBTOTAL OF ABOVE
&,/;.6D
6.04-
&,~6
7 if, 3L{
8% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Fonus/Electrical Penui! Application I,06,doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00621
ISSUED: OS/24/2006
APPLIED: OS/24/2006
EXPIRES: 11/24/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 984 FILBERT LN
ASSESSOR'S PARCEL NO.: 1802061407600
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replacing panel.
Owner:
Address:
CUMMINS CHRIS & MICHELLE
984 FILBERT LN
SPRINGFIELD OR 97478
Contractor Type
Electrical
Contractor
CHRIS MILLERS ELECTRIC INC
Y,:Tutir;:: L LL EXPIRE IF THE W~RK
~~'\:II~E~~I~ ~\~~FR THIS PERMIT_~~NOT
i....U " "" '.'-' IS ABANUUI~t.U 1 UI'
" ,. ._""rl\ rlR
I CONTRACTOR INIF-(j)RM~TION;::IRIOD,
>\ 1'\ " \ " ,; -' , ' -
License Expiration Date Phone
62377 12/21/2006 541-895-3660
BUILDING INFORMATION.
# 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:
n/a
I DEVELOPMENT INFORMA nON I
~WUlRED PARKING
law requires yo . l,
Overlay~i~t.:.NTION: Or,e.gon tIle Oregon uT?t~~,:.,
# StreetfT,rejes Rgd:, adOpled by \-c ere c;r-Handlcapped:
UiIL" ,-- - Th C'8 ru '::::'" ,.'~ ~ .
Paved,DriverRqd:l Center, 8..., \.-, 0." J 9r:)Q;ompact:
1'101111,-,'--"''-'' th Ol'gl: ~,n '"
% of Lot.~overag~:G01-001 0 r " ' "tl~0 rLoI8S by
III ,-",. ...~.. bt"'il co:;:JS 01 I '
, m?\I Q c.'\, , , ,~,,,,._,,,
"r.r,I"-"" v:)U I .:.l.] , ,.,1.0 -":-,\,,.. .J .~"..J
l.J.i _,'Jo ' . _.'~ {";-. \ ...,.(P '.\ \(. .
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
., '...> c_ ,r; \ . ~ - .., " .' '"\ I ", ~f .' '
I PUBLIC IMPR~..VEMEl'JJ"SI~, (')>,:' (;'-'-,~;,(~~.;"
, ;,:",r.:: 'Sidewa'ikType:
Downspouts/Drains:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00621
ISSUED: OS/24/2006
APPLIED: OS/24/2006
EXPIRES: 11/24/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone '
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
L Fees Paid J
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
$6.30
$5.04
$63.00
5/24/06
5/24/06
5/24/06
Receipt Number
1200600000000000702
1200600000000000702
1200600000000000702
Total Amount Paid
$74,34
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.
I ReQuired Insoections 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
Pae:e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541..726-3759 Phone
Job/Journal Number
COM2006-00621
COM2006-00621
COM2006-00621
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
(':~' of Springfield Official Receipt
1. dopment Services Department
Public Works Department
1200600000000000702
Date: OS/24/2006
Description
Perm ServIFdr 200 amps or less
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
CHRISTOPHER MILLER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
ddk 215684 In Person
Payment Total:
Page 1 of 1
9:41:12AM
Amount Due
63,00
5,04
6,30
$74.34
Amount Paid
$74.34
$74.34
5/24/2006