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Home My WebLink AboutPermit Electrical 2004-9-22 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 . FAX: (541 ELECTRICAL PERMIT APPLICATION City .lob Numbe~ 7--00 <1- 0 t-l7 J2.ate 1. '?'f:y 'v' .~~li~;,~n: 3 'Z:>C(p l/' ,''''15VY'\ l Co\... ~ _ I " LEGAL DESCRIPTION \ -, 0'')... ~ \ L+ '2, (-)"2, \h~ . - ): 26-3689 ~o ~& "- ~ ~.;.o~ I I :-0"'0 ~ o~. ~'" ~N::::"~ utX(- "1. 6~,.& . t-~( ~"O' ;~"'9:' 3. f~,~QMP. "T$TE.'T(jjjjEifs,:'~,~m"P' <:-. ~~::'~~'~~"C;'_-2~,~:~~n~~~ ~-'''.~~~.~''\'''' ,,;,;.:':'..:_,*-.... .,g,~,~.",,~~ A. ~,~N' 'esiacntla~' 'U1 -.l.:'A~ . ~;'..i~"~'~'J!1J~'.t~;"':4..\:.,~ 1.:::..tf. JOB DESCRIPTION ~~ l~- #_1 ~_ro'v~,O.'P.L (_ Permits are non-t'a sferable and eXPir~'o~ ~ not started within 0 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor G Cr S 'C'('.Jnrc..,., Me.... pfJ &x ) 'f~d City ~/~ Phono 7tJj-dd30 Address Supervisor License Number 4~9lj.S )0 -CJ I-o'l 3<6 'Ie; q-j-OB Expiration Date Constr, Contr. Number Expiration Date Signature of Supervising Electrician ~~~ \ Owners Nal~~ ~f'C'(Jl- _ Address 6"f>Ov ,,^, Y2MJv\ l ~~ Ci~ ~ I'L-- PhonQ /31.0 - U, 2, ~ OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 B. Service Included "- ' " I 000 sqMT&~TJON: Oregon law requims yfill . Each aJ~~10iVamli>:Q)s&dfbf-ded by the Orego Uti" porti~ttltifre<e1.tlon Center, Those rules ::irp s.... Each mIJ&fJc~g1tQ~kgp10 through OAR 952-0 Modu~9~llilYg'lS~bV(e~~n copies of the r~~& '@j Feeder calling the center. (Note:--th-e-ldvtJlione ~ ,'f"? '''i<'ii..;;;:. ' :to 1:,_n,,~',\!1' ,~:;,;<,..(. ,;0 er.Vl 0 $ 63,00 $ 75.00 $125.00 $163,00 $375.00 $ 50.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts [Reconnegt Only , ,. ... , , 1.":< t.s 0 T ,{o N_ . c.. A 'tJfffl~."f~"'" ,- '<':'" I ~ ',Leu UNDER THIS JER . CBM~lfi~b.~G\OO~BoABA~(5~v~bT IS NOT A~do k~f)&YIJSs:RIOD. 0 FOR $ 50.00 201 Amps to 400 Amps $ 69,60 401 Amps to 600 Amps $100.00 q:,;r ~9,2 Amps or 1000 Volts see "B" above. "lij!~-':W:4'~"-'fl4~G''''' D ~"'B";""~" 'I'" ,,'. . :,'. tanc L I i:d;~:.::~;.:..tllin::3.~~J.;:; New Alteration or Extension Per Panel One Circuit J Each Additional Circuit or with Service or Feeder Permit / $ 43.00 $ 3.00 <13 () U C;;/, ()D ~.r:::r~~..- ~:~l."":;'--:N/-~.~t.~r~, ."',:....,' ' E ,. lMi" . -''>'>11' ",,,, '" "'')'8 . r;, ' see aIie6:l1s'i~ ',' 0 . ~13~l~;:a~1~a~~~ttr;:;7;~i~&j~;J}~; Pump or inigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee ~..tL& L-f. t, c)V ~ 4 . 4~ ~ L10 ~., I Lf, ~~ TOTAL Shared Drive(T:)/Building FormsfElectrical Permit Application 1-03.doc , _$PFUN,GIli""1I!iU.D , . ! Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01172 ISSUED: 09/22/2004 APPLIED: 09/22/2004 EXPIRES: 03/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line "'..' ,. .~~, SITE ADDRESS: 3506 VIRGINIA AVE ASSESSOR'S PARCEL NO.: 1702314303103 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Repair fire damaged wiring ATTE'f.y..P:~:O~~J.~E~r. ,..".R~p>>.ir-3S w follow T'ii,-,': ' . 1.1, .oj'.:) . Residential ') J 'r. - " ...I,....+:.f:,.........,t;-_ -f~ Owner: PETZ MATTHEW & REBEKAH Address: 24029 DODDS RD BEND OR 97701 jnOAR2,~:-2. .-/t-O~~:' .~l: .c...J~,..~()!'-~t.. 0090. You may Obbl/1 copies ofthe mlb .J)' calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Owner: ENGEL DAREN C Address: 24029 DODDS RD BEND OR 97701 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor C & SELECTRIC License 3849 Expiration Date 09/0112008 Phone 541-741-2236 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION. ,_ I... ~t< 0 tl1t:;: # o~Stories: THIS PERMIT SHA~~t~~$rp'c //= THE Height ofStructur~UTHOR/ZED UND~~Et 1s~ Flgori:n WORK Type of Heat: COMMENCED OR ~,q F,*Iri~IFIi~dr:lT IS NOT Water Type: ANY 180 DAY P SjiiM~alli61i!{;) FOR Range Type: ER~t Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Paee 1 of2 ;"~~~Rii~GF.Ia.Q ,..,.",."....,. '-.'"",- ...... _:- .- CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01172 ISSUED: 09/22/2004 APPLIED: 0912212004 EXPIRES: 03/22/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation DescriPtion' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project L Fees Paid. Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $6.40 9/22/04 2200400000000001188 $4.48 9/22/04 2200400000000001188 $43.00 9/22/04 2200400000000001188 $21.00 9/22/04 2200400000000001188 Total Amount Paid $74.88 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 Reouired Insnections I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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. ~~QJ.ko.JC~_~.e9- ,~~GC<-{2<&t~~\ 4)':d?1-1 ~t5V4- Owner or Contractors Signature Date f.:J ,_____ Pa2'e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone SPR;G.F.IE LOiij... .. ... WtL... .......'9'1... ~ . .6 ('lty of Springfield Official Receipt t'elopment Services Department Public Works Department RECEIPT #: 2200400000000001188 Date: 09/22/2004 12:50:39PM Job/Journal Number COM2004-0 1172 COM2004-0 1172 COM2004-0 1172 COM2004-0 1172 Description Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard MELISSA GEHRKE Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 022705 Fax Payment Total: Amount Due 43.00 21.00 4.48 6.40 $74.88 Amount Paid $74.88 $74.88 9/22/2004 Page I of I FILE No.994 09/22 '04 09:40 FAX:541 741 2473 PAGE 1 I D: C&S ELECTR I C , I NC . . . 225 FIFTH STREET · SPIUNGlrlELP, OR 97477- PH:(541)726-3753 -FAX: (~41)716.36.~9 JI r' ELECTR.lCALPERMITAPPLlCATION.iJ . 0. f~f1.~ ~II 1tJr City JobNumber. Date 7 - ;r;; -0 7 'd.~~~ ;;f!jt 1.. 3, .. 35tJ{, JLi. \ . LEGAL DESCRIPTl~ JOB DESCRIPTION refa-rF /1/,,-.. ~Jr;l1~ Permits Ill'l! llon-tnmllfuJ'llble and cxplrlllfwJk Is not litlll'ted within 180 dnys of lsmnnce or Ifworl{ Is Suspended fo'r 180 dnys. 2, Electrical Contl'actor Cd- S . f}~~. AddJ"e~a .&/3() X 1 'I ~~ City SfP/d. PhOlle 7Y/-~d3' Supervisor Licell~e N~lmber tJ(J {;)e- Expiration DElte Constr. Centr, NLlmbor Expin\titJn Dal:e SigtWllrc of Supervising Electdciml Owne.. Nm", :;J.eff- ~ _ Acldl'ess ?/7:J. 3-{) .5.r. City Sf.ftrJ. 'Phon~ 736 - ~3~ OWNER INST ALl-A'nON 'TIle inst~lIation is boinfJ made on prepel.ty I own which is Mt intended for sale, lea!\l'l LW j'ent. Owners Sigm\ture: InspClctioll Request': 726-3769 Jjfr/.~. A. Sel'\'lce Included lOaD sq. ft. or less Each additiolllll 5.00 s'], fl. or portion tll/lreof Each M!lnLLfacl'(J Home or Modlllar DwellinH Service or Feede[' $106,00 $ 19.00 $50.00 B. 200 Amps 01' le~~ . 201 Amps to 400 Ampll 401 Amps to 600 Amp~ 601 Ampll to 1060 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 ' $ 75.00 $125.00 $163,00 $375.00 $ 50,00 c. $ 50,00 $69,00 $100,00 New Altel'ROon 01' Extenlllon .Pcr Panel OnQ Cll'cuit I Each Additional Cjr(,\~tit or with -1 Service or Feedet. Permit f~ $ 43.00 $ 3,00 :13.00 '~),OO E. P'Imj) or ilTigiltion $ 50.00 Sign/Outlino LightinlI $ 50.00 Limited Encrgy/Residei1l'ial $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Illspectlon Fee III $4!.OO + Surchnrues 4. U. J'. If' II; I.:~ ,toil:l ,\, 1'1' ., t , Y,,' :',\I,I"I,~lll fj : ,!t'. '1'1 I 1'1 " ,h,:. 'I" Ii'. ,\""./, f""r "/', .1/"." 'Itl"">:.'" "111,,/,,1'., "Ali!' "'j !" ',"t ',',' "I" f.I,~ "\).. ~ I !,I,';lI (I,~ Il' II' 'f 'V" II!'" I ,;'1" \' \'," ~ ,'!"j~ *1 i )' ';' i , \'''\''~I.'':'!'I!JIII:I'\I,-L ',,:,.:,I~ ~(1.J1'1<",~\N:~rl,1~':~~".k", ',: -..11..~,'I\~.'I.I"'.'I,';l'" ';':":'1: ;'r,,~ ,,\ ~ ""~ ~ I ' \ I', ,..1.'" I' ~ .' ,f:, -f1"~. I ,I I " ,ll 7% State Surcharge 10% Adminisl1'lltive Fee ~'1. 00 4.4'6 ~~'iP _1_l-J.s '?~_ TOTAL Shol'rldDl'lvo(T:)ll3ufldlnll F(lrmilBl~lTicftl PermIt Apl'liclItioo I.O),doc