HomeMy WebLinkAboutPermit Electrical 2005-8-26 (2)
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 '.6~.' J
ELECTRICAL PERMIT APPliCATION "
City Job Number COWl l."'O~-- OlJ6S"Date <?- 26 -OJ
I.
~ bou.,.u
LEGAL DESCRIPTION
I <6D'!. 0 Z:z. ~
3. '!iitJM1i1lliliil;l:KErSeHEDdi1E1BEi?(:)W"--'~
E-~~- ~"'~~___~~~"_~""_."""l!"~~
01000
A.Ii~~~~~.Ittrti~~~~.
Service Included -., ,allOWing projec!js submitted has the fOllOW. ing
1000 sq. It or less ' ---- 7 ..n$'ro{ort1b~
Each additional 500 sq. ft. or
portion thereof
$19.00
JOB DESCRIPTION
'j2t....""1Ntl1.~. ~e- tJli::LIJ Se-a.v1cE
Permits are non-transferable and expire if work Is Each Manufact'd Home or
not started wltbin 180 days of issuance or If work Is Modular Dwelling Service or
Suspended for 180 days. 'Feeder
2. ~~~~1j~~iia B. ~~~!~~~!1!ll1~~~~}~~~~
Electrical Contractor 379 C C~ci? lie 200 Amps or less 'jOU\O '~. $63.00 -fr,.,'--
I t? c:. r 201 ~~Il6\lI~'*~wP;\i\i\'j $ 75.00
Address 3'fC( (!~~r,~ r' ---->T"""- ~.Ole'i\iji'~nJ6oo~klPJ!S'\\OIl~- $125.00
QJ ~N\IO . do\>'60Q,Ammtb'\r,,"ho~-OO $163.00
S' Cl' _~AleS ll' '"\\\vn'::. ,,,~"()p', \ s 'o'j
City (,) Phone (IS- ~r' cen\e~~ill\JlNUnp~11s11.l e $375.00
/I ~o~~~~~~.o~~-~~~~~e \~~~~~~~l\ $ 50.00
Ie c(5/"/ \P. 'loll !"II ~!k~\~, ~-'..,'"
Supervisor License Number J "-( ~<:I90. \ne ~,m !1II'f:~e~'l!'iq...!l!l"i!e
- Ca.\I\lIJ \ I \ne QO-?):''/:-
Expiration Date I,r') _ (') ( - () 7 <\u!"ll'oel ;en\lJnria1iiillon, Alteration or Relocation
200 Amps or less $ 50.00
J.'\& 1.(.2'6 201 Amps to 400 Amps $69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D. iB.~~~(,f~~
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$50.00
-~""'... '7-*.i ',~.~:'" "" "".. j!,J
_. ...,
Constr. Contr. Number
Expiration Date
7-27-07
Signature of Supervising Electrician
(7u~, G~Or>
Owners Name Tt\wte:::. ~ M
S7( ~PEIIf
~ ~,c~ Phone
$ 43.00
$ 3.00
Address
-:::r
E m-~~ll. L'~,l;'(~~~t~''''-I~)IE'~'ilIflfi"''\ii!II'''''~
. . 18<< ap.eous~,_ _e~c'=tl~,~~ ,no In~ u ~_ ,- 'a~u nsta . anon
Pump or irrigation
Sign/Outline Lighting
OWNER INST ALLA nON Limited Energy/Residential
The installation is being made on property 1 own which Limited Energy/Commercial
. . d d Ii 1 I ,- \~In?'"
IS not mten e or sa e, ease or rent. Minimum Electf.lc,PermiUnspec:tlon Fee Is $45.00 + Surcbarges
....t ("I.;:' \... ,..;"un"\~\'_ ,(' Ml\ \
\'~~ \\~~~NI\\ S\-II\\..4,,'liS~ !/b>VY:li
\\"i\S r CoD \l\'-\\)t:D~~~\'~""
1"I0\'l\I'C.\), S ~1'.1\\'lUv .-
p.\)\ - "Ct.\) 0\'1 \ d% State Surcharge
CO\W\\'\~C; \)i'o'1 1't.\'I\0 10% Administrative Fee
p.~'1 u
TOTAL
$ 50.00
$ 50.00
$ 25.00
$ 45.00
City
Owners Signature:
lOb
7'fl.
1000
12t{ oz
Inspection Request: '726-3769
Shared Drive(T:)lBuilding FormslElectrical Permit Application l.o3.doc
.
. CITY VI' ~l'Kll"l'-sl'l~LD
Building/Combination Permit
....... I~II,.....,.... .
PERMIT NO: COM20'lJS;(JTtWlflhasthef 1/ '
ISSUED: 08126/2005 ""- ,__"o..~~ Ing
APPLIED: 08/26/2005
EXPIRES: 02/26/2006
VALUE:
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 210 DORRIS ST Springfield TYPE OF
ASSESSOR'S PARCEL NO.: 1803022401000 ires yoU to
, _,_ N: Oregon \alNhreq~eQon utility TYPE OF USE:
; PROJECT DESCRI"l'IOI'HN"i.9w[a8!J~!llrI\ttrep~ce;sl,;r':,is~lorth
. follOll-l ru\es,..~nl"'. Those rule;. ~ a Q"2-00~-
Owner: JAMES ti~\1I(;c.".v" _OO~-OO~? tnru~~~ ~\ the rules 0,/
Address: 571 ASP u may obtaIn cO . the telephone
SPRING. ~R~%7&Jf!ter. {Notuet. 'I.t" Notilication
,..~ \0'6: .....__,..n.n \ I .J .
numbeflOI '''~.'' Rnn-"I.12-'t.;:;..",.
center IS ~-Tc'ONTRACIUK m~uKMATlON I
Electrical Work Only
Repair
Residential
,
Contractor Type
Electrical
Contractor,
BIG C ELECTRIC LLC
License
156428
Expiration Date
07/25/2007
Phone
541-744-8946
I BUlLDIN", m~uRMATIONI
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
_ Secondary Construction
. # of Bedrooms:
VN
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Patb:
Sprinkled
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
n/a
, DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
IPUBLIC IMPROVEMENTS I
~ct c~~~
\ ,,' n>. t)(I'IRt \r NOI
Storm Sewer AvailablJi' uS' \-,\..k\:,\I S\-ll'.\..~ 1 \-lIS I'tRN\\I IS R
Special Instruction: \\1\ O\-\\1tO \JHOt Qi\NOONtO \'0
1\1.1 \ \1 '~CtO OR IS I'.u
- Notes: C0\~\,,\tl :'/I'\:RIOO.
....N'{W\J\.J/\
Sidewalk Type:
DownspoutsiDrains
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
.'
1 of 2
_."l:I!!'IAIIIIILq; .
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2005-01165
ISSUED: 08/26/2005
APPLIED: 0812612005
EXPIRES: 02/26/2006
VALUE:
Total Value of Projecl
F....s tiW!.I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Residence Wiring 1000 Sq Ft
Amount Paid
Date Paid
$10.60
$7.42
$106.00
8/26/05
8/26/05
8/26/05
Receipt Number
1200500000000001254
1200500000000001254
1200500000000001254
Total Amount
$124.G2
I Plan Reviews I
To Request an inspection caD 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. wiD be made the following
work day.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 pertaming to the work described herem,
and that NO OCCUPANCY wiD 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 wiD remain on the site
at all times during constructiolL
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
8fJringfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-01165
COM2005-01165
COM2005-01165
Payments:
Type of Payment
Check
:'
-
';
"
-
"
8/26/2005
.
RECEIPT #:
""~RIN"'''II!,I?H' __ \
WIi:=- . ~ .
. ,
._~. - -
.ili..ty of Springfield Official Receipt
'.velopment Services Department
Public Works Department
1200500000000001254
Description
Residence Wiring 1000 Sq Ft
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
BIG C ELECTRIC LLC
Received By
djb
1 of I
Date: 08/26/2005
Item Total:
l.:heck Number Authorization
Batch Number Number How Received
1634 In Person
Payment Total:
1l:14:31AM
Amount Due
106.00
7.42
10.60
$124,02
Amount Paid
$124.02
$124,02