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HomeMy WebLinkAboutPermit Electrical 2006-12-15 ZON L \:Y7_ INITIALS r-:J. M DATE t~-l r( -ex, , I ' SOURCE~4(1 ~IY'_I LGi '\; r--.,J Date Id J 161 2-Of) ~ SPAtNe? 'l) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job NumberL.om LiJri.g - 0 \ ~ \ ., 3. A. 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 B. 200 Amps or less j 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only C. LEGAL DESCRIPTION: \/03 3<P II 0' 60D JOB DESCRIPTION: ~:::~: no2~~'~~PI" Ifwo,k b not started within 180 days of issuance or if work is Suspended for 180 days. $106.00 $ 19,00 $50.00 2. $ 63.00 ~,-3 $ 75.00 $125,00 $163.00 $375.00 $ 50.00 Electrical Contractor Address c: tr. f. E!~ctriz !r:C. l~.C~. .~_:O.(I 1~.=2 C;;<"'''~ r .'i nn ':)7477 City I.. ~J "~._,-,,_4, .., <J t'hOlle' Supervisor License Number 4~ LfS to/ I JOB , 85t.fCf q/l/OR " - Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Expiration Date $ 50.00 $ 69.00 $100.00 Constr. Contr. Number Expiration Date Over 600 Amps or 1000 Volts see "B" above. D. Signature of Supervising ~a^-'~ ~''''\!lid. ... lid::> _ ..l,\) fli \cl\\,\_n"'--::"'~ o~t ,OregoniJ"I,ly tollow i u\eS 3~C,t~1'Jd '.I ,,~. re set fortI' pwoeJ:s,N&n~~O D ol;~M101 ,'!ot\IIL;C1.' 1~10~OU\:l\l' T 1. .,- \f't..~~v:-. i~nri:.&ltfle rules ~ E. nn90'~~f:~YttAj~3.' -- ~ thetelepnone' " . C1~, _~r, \Nrptf6~hy--N:etifi':'!:Iti~ Pump or lITIgatIOn $ 50,00 ;111mb t()rtheOregon_~~~1_23446/5 -- ()qq 5 S~g~Outline Lighti~g , $ 50,00 OWNER l~iMJ~:h()~ ' Limited Energy/ResidentIal $ 25.00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45 00 + Surcharges . ~ (/73. ...6.0_'1 ::T. i~ ~'60 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 4. Owers ~igpature: [UU i mil" 8% State Surcharge 10% Administrative Fee 5% Technology Fee TI113 FERlvil-i 3ftALL EXFlhE IF TilE WORK AUTHORiZED UNDER THIS PERMIT IS NOT COMMENCEO OR IS ABANDONED FOR InA~~t~g cffJW~sp E 'FHb1f69 TOTAL Ji .I I. Ljf Shared Drive(T:)/Building Fonus/Electrical Permit Application 8-06,doc 'I:j~'"""t,;",." CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01617 ISSUED: 12/15/2006 APPLIED: 12/15/2006 EXPIRES: 06/15/2007 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2535 J ST ASSESSOR'S PARCEL NO.: 1703361101800 - Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Weather Head (Wind Damage) Owner: V ANIS LISA M Address: 2535 J ST SPRINGFIELD OR 97477 Phone Number: 541-515-0995 I CONTRACTOR INFORMATION. Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION I Expiration Date 09/01/2008 Phone 541-741-2236 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION. Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I ' Street Improvements: Sidewalk Type: Downspouts/Drains: An t;:N IIUi~;vlt:yulllav" le41..l11t:~ yvU. ~iJ follow rules adopted by the Oregon Utility .. . ' C ter Those rules are set fortI THIS PFRMIT ~I-I~ I ~ cY.PI~E If TIlt '''01RI( Notification en...., ~ '1' "J"'~c Q!:\?-OD1 AU VVl.' H~oO:::-UUI-VV v...1 \;lo~' THORIZED UNDER THIS PERMIT IS NOfaluation Descri ti ~" . You may obtain copies of the rules ~ COMMENCED OR IS ABANDONED FOR calling the center. (Note: the tel~~ho~e ~~XrMt~oR A Y P EfJQAf Construction $ Per Sq Ft SquBa.rdeJIfWli9~1or the. 01~g~!:l3U3t2i1it2Y3N~~~~~;:~~ated or multiplier or ll'Arriounventens -Stm- - I.:A/. Storm Sewer Available: Special Instruction: ~JtIICE: Pa2e 1 of 2 Status: Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01617 ISSUED: 12/15/2006 APPLIED: 12/15/2006 EXPIRES: 06/15/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $3.15 $5.04 $63.00 12/15/06 12/15/06 12/15/06 12/15/06 2200600000000001712 2200600000000001712 2200600000000001712 2200600000000001712 Total Amount Paid $77.49 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. I Reouired Insoections I 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 ofthe 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 Page 2 of2 225 Fifth Street Sprjngfierd, Oregon 97477 541-726-3759 Phone C., . of Springfield Official Receipt l ,dopment Services Department Public Works Department Job/Journal Number COM2006-016I7 COM2006-0 1617 COM2006-0 1617 COM2006-0 1617 Payments: Type of Paym,ent CreditCard cReceint 1 RECEIPT #: 2200600000000001712 Date: 12/15/2006 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By C & SELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 396144 In Person Payment Total: Page I of I 2:14:48PM Amount Due 63.00 3,15 5.04 6.30 $77.49 Amount Paid $77.49 $77.49 12/15/2006