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Home My WebLink AboutPermit Electrical 2003-12-11 ,. 'II' ' CrtY:oF,Si:-~JNGFIELb OREGON c..: ';'~( ~:, "<'i~ . .' .._. . '.. . _ .." .. .'. ' ~. -:J' 1..:';';, ject as submitted has the tollowing . FAX: (541~nli$8~es not' require specmc land use approva1 t.:\:){Z... . 1711.-{;J Zoninr ,~- \d--o~ 1''/U Date 3. ,:sgA~flirli~E.l}~~!1~~Jilft.ui"~;;;~~~~~a 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PERMIT APPLICATION City Job Number ClM1 ZOOJ.- 0 I Z. 3 b N~w Alt~r~ti~n ?~_-~~t,er-J~ilol~.ref..~a,~~l.Js \feu to One Circuit .. ., : $ 43,00 ,. .' .' , ~~. .' ~" \. .' J l.". . I. ,,; t" .Each Additional Circuit or with I ' ., -0' "c;', ..". ,..... -'" "$'300 S~'i:"fe, or Feeder~ermlt " ':.' '( 1'1':""';:.<. ,-T.,' '. " -.f . ,;..v{':;.-.!f'(" ,'.,. -: ' ,: +'....... '-""-~l""r.;,,;'~"'~','~ '{,,..;.,.'ry"',:ri. E:' Miscellaneous (ServiceJfeeder not il1chjdeii)'~Eacli: Installation' '..l~._;lJl.I"Ll;.J....._.:l.::..;.CtJ.J:::::"...~;...v..-...... .....;. ~~..:. ~_iI~~..~..t:~~ nUll~ ,," ~ I':~' \ 'C;l '\"', ~,.ij':$::\;S(}:O'O Pump or irrigatiol', "n., :'. ..' .. " Sign/Outline Lighting . ,. $ 50,00 OWNER L"1STALLATION Limited EnergylResidential I $ 25.00 The installation is being made on JJo9.n~= which Limited Energy/Commercial $ 45,00 is not intended for sale, lease or redct1IIfPERMo'T SHALL ~~fnlIET.M&iWPl\ldlit Inspection Fee is~ + Surcharges AUTHORIZED UNDER THI~ .R{;.RMIT IS NOT. ,.: '. ",", . '," " 1.': Owners Signature: COMMENCED OR IS A8AmgRmMltOFAB~VE:., .': :.' :'1,\ )1';; I-f \ ANY 180 DAY PERIOD. ,..hW._if!:!_ . ..-<",..-. ._.., . ., '-' .. 7% State Surcharge 10% Administrative Fee Date I. r.){OCAriOf./OP'JNSTALIA110N5"~~t,Y!.13 J:~"...,l\"'<'~"'''''''''' .., ;..1_ ._ ~ ;-..1~.lil"...,.J'. _.'_ ::,". ,..\:.. ",., ,_" ,.:i<,~:..~:&:,L.i:.oi"/l'l';';"') J/JLf iJ~/ro,,:::>e c. 1- LEGAL DESCRIPTION /703 Z3LfL/ JOB DESCRIPTION" 0.7900 Lo'.J VO{~/t5 t- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~i~-::: .:,"....,."-".?o\.,.~,~j-? :"h'~,~":I;.t. '" I '. ;.,', -',', " "..,; ;.,,,, " .('>....~::'.$; . COJliTRACTOR'INSTALLATIONONl;Y'. 2. YEtll'~~~~~~Ma.M.~..r.,....;r:d"_,;,,,,'.J.:tG':i.l...:;~;:i Electrical Contractor \:1;'<2X'<:"; \: (",(\ ~\ esc \ n:':l<\\ (.S Address ~) \"). P,D)<. L{ C\S LI %" City Cu..o.., '17'10'-! Phone LI6'Lj- g l:) I ~ Supervisor License Number :) ~ <.o:s l b A Expiration Date I c) / I I 0 s Constr. Contr, Number I 'i 4 (" ll' 5 Expiration Date J" /;)-:', / elf. Signature of Supervising Electrician ('V;S:b/lu-~~ Owners Name Sc.o It 'S./~'7mlll..'" .l //s.'-/ }:,E-/ro"SC" c f- C; "P0J Address City Phone , Inspection Request: 726-3769 A. I~Ne,,: Resid~~ti~l::- Sin'gl~'or~JVI~jti,"Fa,;;ji:;; p~/~\~~;li;i~:JJJi}1 .~....~...~.,.... ,_, ....,_ _" ~'.~~.. _ ..... .,"',.....,_~_~-'.,"1'C.U:...~..,_'j.,\:.o; Service Included 1000 sq, ft. or less Eacb additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ;t. . ''1,''T' J'"if.:...:'.;,.;v..".-....;,.'.,.,;.u; ':- -~', .,;-....:'.{ I:..'!:'/,.:::~~~~:M:..~$"l!t.\ B. L~er~i~~s~~r- F e~d:~f!, ~~J~~_~~!la..t!~~~:A.,I,~f,~j~ ti?'~~~~r JtlIo~~ti.o~~-:~ ... W'Oo..."...,'-.~.....=__..__........._........._l;:.:.. .."",__ >0< _........,.__......i;;ii0Jii',tlD:.~~..wJR1!J:Uj 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $ 63,00 $ 75.00 $125.00 $163.00 S375.00 $ 50,00 91~,", '1,',:; .' \ ,7" -Tl'<-e: :::;;"'"""t.;1',-, "'-.. M:,".;';~'...St~;,!",:,.'J';";',.. ,..~t"~v~~~~. ~ <: ~, c. ..~.Te~p..C?:~,ry~~~~'i.~'X or.!~!~~~~t~,~.~ ~ "',: ~.' 1:I:~::~2~,' ~~~~ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, :;-:_"-'~'.;r.."".;-'. . _"'-;~"l~~:'s....:t~,'*,'i~~-"'t~;.,,,,.:-;.;.:,!,:(;.~~~l:.~,' .. '0',,' , D. : :B,r.an,~h:ClrcUlts-,~}i':'S~:.'f~.:tl_.r~~.,':t\..::~::::.:i.;H ::,-~~~~ ~'.. - t~' . ."'......t..~"O':"';<.............v,."'..-J-.,' ...,~~.w .............__k,!J..~... ........"'~...,-~---;.- . ". $ 50.00 $ 69.00 $100.00 -z~ TOTAL 30- 'IS-o SZ6r- Shared Drive(T:)lBuilding FonnslEll:I::trical Pennit Application l-03.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~rKll'\juNJ!.LU Building/Combination Permit PERMIT NO: COM2003-01236 ISSUED: 12/11/2003 APPLIED: 12/11/2003 EXPIRES: 06/11/2004 VALUE: SITE ADDRESS: 1134 Delrose Ct ASSESSOR'S PARCEL NO.: 1703234409900 TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Low voltage Owner: SCOTT SIEGMUND Address: 744 EDGEMONT WAY SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION 1 Contractor DIVERSIFIED ELECTRONICS INC Phone 541-484'9078 Street Improvements: Storm Sewer Available: NOTIC.E: Special Instruction: THIS PtRMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT Notes: COMMENCED OR IS ABANDONED FOR ANY 1RO nAY PFRlon, I Valuation Descriotion I $ Per Sq Ft Square Footage or multiplier or Bid Amount # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Description License 144685 Expiration Date 06/23/2004 BUILDING INFORMATION 1 # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: VN Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft O.th~~:, \\tPS 'IOU to __~ \_,_, f- \\\ 01 r (!mper:~ou~ ~,~~~~:~ ~~~.~:~ I DEVELOPMENT INFORMA iioN 'I a(.".J!jl~U "',',:' 1\1\.::. :,8 3~'. ',~O': . '.' r I I ,..... .- .. ~, ':.. ...-., , . ..'-.. i_II":.:...'. t'" )'REQUIREDPARKING '~o\.ltll..t.~ _ 'l."l,:rj ,il~" ..,~~''\nl\~-~ ~ " ll~tl I,}I . . : ~[.,-., ,;, Overlay Dist: " Of\l""\ ..!~ 'r~"V ..~',",~ "',1" 'To~.al.:. ~,,:,I:-,....~,.,n3 # Street Trees Rq~:J911. '(, 'L\ ,:,. ' 'sr' " -. ',': ''-II~!!~i:c~PPI~~i;:r(iOn Paved Drive Rqd: ca\\1ng \.,1 -.. ':., ,\', f."'~Jn Compac,t:Ii\ \ ''"If i..J\ tl ,.... - .("\ -1'),>_ ..3-\ .},. 0/0 ofLat Coverage: nurn...... ('""\'" ~':' ;.'~ : .... ,...I".~.... - - I PUBLIC IMPROVEMENTS I Sidewalk Type: DownspoutslDrains: Type of Construction Date Calculated Value Total Value of Project Page I of2 . . CITY OF SrKll'i\.J1'1J!.LlJ Building/Combination Permit PERMIT NO: COM2003-01236 ISSUED: 12/1112003 APPLIED: 12/11/2003 EXPIRES: 06111/2004 VALUE: Issued 225 11ifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I. Fees Paid 1 Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $4.50 $3.15 $25.00 $20.00 12/11103 12/11103 12/11103 12/11103 1200200000000002584 1200200000000002584 1200200000000002584 1200200000000002584 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. 1 Reouired Tnsnectinns 1 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 ofthe Community Services Division, Building Safety. I further certify that oniy 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 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2003-01236 COM2003-01236 COM2003-01236 COM2003-01236 Payments: Type of Payment CreditCard Mi!-.!~'-~":"'"."- '] -=~; ...-....~,""",,__ -""",r " Receipt #: 1200200000000002584 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 000246 045274 City of Springfield Official Receip~ Development Services Department Public Works Department Date: 12/11/2003 8:42:42AM 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 . .