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HomeMy WebLinkAboutPermit Electrical 2004-3-23 c 131o 4-\01- 225 FIFTH STREET. SPRINGFIELD, OR 97477 0 PH:(541)726-3753 0 FAX: (541)726-3689 . , 't ubmitted has the followmg ELECTRIC~P..'E~fuf~. 'Ll ON The followmg proJec as s. ' . zoning, and does not require speCific land use City Job Number _.a\\ . _ Date ' approval., l'lD _ ~ 3. CONIPLETE FEE St;;;~ULE BE'LOV/ 3...023- of Date . ~~ Authorized Signature A. NcwResidential- Single or Multi-Family per dwelling unit. 1. LOCAI10N OF INSl'ALLA110N b(()O Tl-\u RS-\6 ~ Kb 4> LEGAL DESCRIPTION \.f)~~~ \ ['[}\(f) Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 JOB DESCRIPTION WIRINCl }::"6R. VFD $ 19,00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $50,00 2. CONTRACTOR INSTALLATION ONLl' B. ~6tit(}i or Feeders - Installation, Alterations or Relocation: On \aW requ\ras UtUtW Electrical Contractor ~E-Nl\ON:Or~~,d-b~~Jha or~~l' ~IlOVt less $ 63.00 ----;\\~W f,U\a6 a:~.lhose ruleS 2Ng's'2PO~ 400 Amps $ 75.00 Address "l~t\cat'oO ~Ol)10 \hrO~~h ~1\h~~\eSd600 Amps $ 125.00 \0 OA.R 95~,/ obta\O cOP'~~e ~~\'1I1q)~ftJ 1000 Amps $163.00 City 0()9Ci\0l~ . lie center. ,\'1o\a. ~iW R'()liilO~~~lPS/Volts $375.00 ce,\\\f\9 \ , the oragoO Uti ?~a,!,nect Only $ 50.00 nut'\bedor . 1_~nn- ~"l?-' f",,.t'"""~!" .r:- Supervisor License Number 402:<) s C. Temporary Services or Feeders ~ ExIt:ation Date \ () - l- ZDD 4 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. ContI'. Number (\1 A ~iration Date Over 600 Amps or 1000 Volts see "B" above, Signature of Supervising Electriciqn D. Branch Circuits // U ~. .. If . ~ ~..ft .e.. . lR~M.\\\fie\MQ~r Extension Per Panel r-./~ D-~~~\l-,~\-\r..-llt~? i~~\k&~~O' I i"-'SP.t\-\ ~t:D UNDER 1\-\\5 \i~ilGBnal Circuit or with (. \ . " ~'.~1~ . n~ \5. ~B~N rvlce or Feeder Pennit Owners Name vvlUAft'oA.LA . ' t.D)~t\\OO. Address ZOO 5... M ;LL. S ':I1800f>.'( pt E. Miscellaneous (Service/feeder not included) -Each Installation City -S f'g)~ p~ Phone 731;,. ~1641 Pump or ilTigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 $ 43.00 43.00 3 . t)CJ $ 3.00 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: 4. SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee cqb<lOD 3..22- Lf,06 -If53~82 Inspection Request: 726-3769 TOTAL ~Wl. Shared Drive(T)/Building FonTIs/Elcctrical Pcnnit Application I-03,doc Status Issued CITY OF SPRING~lELJ) - Building/Combination Permit PERMIT NO: COM2004-00319 ISSUED: 03/2212004 APPLIED: 03/22/2004 EXPIRES: 09/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line '\'" SITE ADDRESS: 6100 THURSTON RD Springfield TYPE OF WORK: Electrical Work Only ASSESSOR'S PARCEL NO.: 1702342100400 - _ __ \NOl\'trYPE OF USE: Addition Public PROJECT DESCRIPTION:. - Wirini,!Or VFD 'tY-?\l\t. \t \~~ \<2> ~O\ ' '. ,~C\1\C ~\'(~ c.\-\~\.\.\\ -n w: pf.l\W\ u fOr, Owner: WILLAMALANt8~ \) \)~\)~c:.~~~~\)OWC. Address: 200 S MILL ST S ~ yq '7 rC\tlflMC" n~~\Q . .- u\JJ eO \)1'\( \ . - - ~~'{ "\ _ I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER License Expiration Date Phone I BUILDING INFORMATION I ~~~ # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS # of Stories: Height of Structure Type of Heat: \0 Water Type: S iO\) '~\\'1 Range !~D.~~e 0(\ U\'\ \O~ ~~~ ~~~ e Se\ ,d)' N.,O~e?~o 'Q'i \~~\}\es ~~g~~\e~ '- ~\,a '''''..lC L- -'lQ - - f - ..A''e \ Or _ ~ ~\ \ ~\}\ 'O\\O~ ~\O(\ ,\.00. \(\ CO e'. \"e ~o\~\C ~o\\\\C~ g~'2."()~'i ~~~~~\\\\\'1 ,\fJ.b.~' ~ O~ '<(o\) <<' c~ee~l1-'!,~a: '\ n,090. '\~~ \"e \~e~a..,Qti~"Rqd: v 0-\\\\' ,o~, ' ~ ~\}~'Oet ("":. ..% of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I '~~. Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00319 ISSUED: 03/22/2004 APPLIED: 03/2212004 EXPIRES: 09/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $4.60 $3.22 $43.00 $3.00 3/22/04 3/22/04 3/22/04 3/22/04 Receipt Number 1200400000000000361 1200400000000000361 1200400000000000361 1200400000000000361 Total Amount Paid $53.82 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. L Reouired Insoections . 1 Rough Electric: Prior to Cover 2 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. Owner or Contractors Signature Date Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00319 COM2004-00319 COM2004-00319 COM2004-00319 Payments: Type of Payment Check Receipt #: 1200400000000000361 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By WILLAMALANE Received By llh Check Number Batch Number Authorization Number 50653 City of Springfidd Official ReceipJ Development Services Department Public Works Departmen! Date: 03/22/2004 2:46:22PM Amount Paid Item Total: 43.00 3.00 3.22 4.60 $53.82 How Received In Person Payment Total: Amount Paid $53,82 $53.82