The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2006-4-5 Date ZON l~ INITIA'LS. jJ ft_ A!.. DATE ~ -ilC.e- ~ SOURCE '01(] f5;,a?' K1j 0<+- OS - ~OD(,o -? , 'n CITY OF SPRIN( ~ELD, OREGON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54t)7Z6-3753 . FAX: (541)7Z6.3689 ELECTRIC1}!- PERMIT APPI,Jf;1pf}N City Job Numbet . rf'(OJZJO(P - ().J'-fO,t' 1. LOCATIONl(!J!,STALLATION 3. I ~~ ~ ~'n:ir V,'tMl S~ J ;7 ~ 0 J /..1 New Alteration or Extension Per Panel /!JV--- ~frVV l One Circuit .11 /"" Each Additional Circuit or with . \~n "" ,n 0..... - - J _ r'I/J^ I ,l-Service or. Feeder Permit OwnersNam ~ IlUlU-J<..,.<a l.QQ(MIn ~vr Address. {)~l.L0 E._MiSC~~i~~~~~s (SerViCe/~eede'r not ~C!_Uded)-EaCh_!'1Stallation Ci~'j},J.J Ou Pho ..2:A-J~- II '1.:3> Pump or irrigation $ 50.00 \ Cf1{].o L -----. Sign/Outline Lighting $ 50.00 OWNER I 4ST ALLA T/ON . Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 r. LEGAL DESCRIPTION \"103 ;;n3~ 00 1~2- JOB DESCRIPTION 1:>,,> C""" ~C/-i +- i2e ~~C:-+- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor C~f~ l/~_.itt.Z- Address f (0 ,.g 4" 2...iJ '( City VvWtJ.el'Wfi4 Phone 7l( '-{ -0 '/ (/S~ Supervisor License Number 3~ G (, -5 Expiration Date { 0 / (O /0 1) , Constr. Contr. Number 7; 't 1: <;"'"' Expiration Date 10 f'd/J 0 , Signature of Supervising Electrician The installation is being made on property I own which is not intended for sale, lease or rent. . Owners Signature: Inspection Re COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-Fami]y per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufacf d Home or Modular Dwelling Service or $50.00 Feeder ATTENTION: Oregon law requires you to B : S . fCF'IOIi(" n,le-y ~rlr.ll~tt~" bAl" ,,-- "'-- - . R"]'" . . I enl'cesflf .ee ers -' fista a .on, teratlOns'orl e ocatlOn: . Otlllcation Center. Those rules are set fo;th 200 Amps JP,flsf-R 952-001-0010 through $':6\fo052-001- 201 Amps t~~68A~~&may obtain copies C$'1s!ooules by 401 Amps to ff6~I~rmp\ne center. \1~OIe: tn'$i25~oOlOne I U1Tll5e. lor the O. CYUII UIIIllY N"tif;6ation 601 Amps to 1000 A~11J'.1ter is 1-C{;: ::;:.2.$A~3.0 Over 1000 AmpsNolts ~37~:00 Reconnect Only 1 $ 50.00 <:;"0 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amp~~QIfK;E: $ 50.00 201 AmP"1P1~*1'ImIT SHALL EXPIRE IF$Tll9rollVORK 401 AmpsA'lJflMmD UNDER THIS PEF$~lm.(j{) NOT Over 600 .ooM~iH()(jO:~dillisb'e 'Ml','l.i:l~NED FOR D. . Bra~ch~,",u"ilSO DAY PERIOD. $ 43.00 $ 3.00 Minimum Electric-Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE sc:> Lf f:} S~ . 8% State Surcharge 100/0 Administrative Fee TOTAL Shared Drivc(T:)lBuilding Fonns/Elcctrical Pennit Application 1-06.doc ~1'" . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00406 ISSUED: 0410512006 APPLIED: 0410512006 EXPIRES: 1010512006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line . SITE ADDRESS: 1583 FAIRVIEW DR ASSESSOR'S PARCEL NO,: 1703273200132 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Reeonneet TYPE OF USE: Repair Residential I "'.' re('uires you 'u t. _,"Tl"'" (',('"on a. . Utility . , _ ,c.: bV the Oregon ~d~...h Contractor Type Electrical Contractor GLEN A CAMPBELL F..: .' . _ "-'"'r'lSO {Ult::;:> \.A,..... -- \" Ie. l,.C,lteT.Phone Number:R 541~343'1I43 " 1.'J" . 10 thrOUldl1 un -.... i~'CI\h S::,?CJ1~OO . copies of the rules by Y m'lI obtain h ne f1f1CiCl. UlI ~, . . '''nIp' the telep Q.. r.?HIf\P \lIt" .........".-.., Uti\it NOtlllCcUlUll I CONTRACTOR INFORMATI0NI'I the oregoo~~332~i344). "enter IS 1 ~8 License Expiration Date Phone 73995 OS/24/2006 541-744-0705 ;: Owner: " Address: FLORENCE E BREEDEN LIVING TRUST 3879 LANGTON AVE EUGENE OR 97402 I BUILDING INFORMATION. :, # of Units: Primary Occupaney Group: Secondary Occupancy Group: Primary Construction Type Seeondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: ~ 0 T \ C. E.: ~qn,,<Ea~ag~,(i:arp'ClrtK Energy Path: TUIS PERMIT SHi'lll Sq'Ft Other:\\TIS NOT Jr1 , NDER 'dl~ rt.-'." Sprinkled Building:TuORIZE'iilal OccupantlLoad:OR t\U n _ _ro. nn Ie b.P.A.\\J.Uu \lLU I ".,."""...".. " " ~. I DEVELOPMENT INFORMATION,. PERIOD. n..' REQUIRED PARKING Frontyard Setback: Side I Setbaek: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' .; Street Improvements: Storm Sewer Available: Special Instruetion: Sidewalk Type: Downspoutsmrains: Notes: . I Valuation Descriotion I Description Type of Construction $ PerSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated PageIof2 " -ri:_ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00406 ISSUED: 0410512006 APPLIED: 0410512006 EXPIRES: 1010512006 VALUE: Status Issued . 225 Fifth Street, Springfield, OR .' 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 8% State Surcharge Service Reconnect Amount Paid Date Paid $5.00 $4.00 $50.00 415106 415106 415106 Receipt Numher 2200600000000000430 2200600000000000430 2200600000000000430 Total Amount Paid $59,00 I Plan Reviews , 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. , Reouiml Tn~?e~t'lW Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have earefully examined the eompleted application and do hereby eertify 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 strueture without permission of the Community Services Division, Building Safety. I further certify that only eontraetors 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 loeated 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 .,1, JoblJournal Number COM2006-00406 COM2006-00406 COM2006-00406 Payments: Type of Payment Check "2' .' , i,. ., '" ~J: - , ) :) tl.,! .' .. A '.;il! ~ ~ " , J 'J ',"1 , t~' " '!:; .... 415/2006 . RECEIPT #: Description Service Reconnect + 8% State Surcharge + 10% Administrative Fee Paid By GLEN A. CAMPBELL .".~II!!'I~..-'~"" - .... lJt..1 ~.i JiJ..ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200600000000000430 Date: 0410512006 Item Total: Check Number Authorization Received By Batch Number Number How Received njm 3854 In Person Payment Total: Page 1 of I 2:18:46PM Amount Due 50.00 4.00 5.00 $59.00 Amouut Paid $59.00 $59,00