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Home My WebLink AboutPermit Electrical 2007-7-30 ZON L-'[)2.. INITIALS IJ tv'\ DATE -, --'3.0 - ~-, SOURCE rrvn~,f J. . . - r ,. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City"~:~~~~. be~.flCO:"' LO. ~).~~6:\ 2- 'C- 1. : LOCATIO $TA,LM'ribN:' 3. COMPLETE Fim SCHEDULE BELOw' I ~~.~ ( . 5-~/LALAV-V\- LEGAL DESCRIPTION: (. V\..l'\r ~ t'\ "6 '1 A. New Resid~ntial:':-Si~~le~~M~Iti-Family ~~~dwelling unit:'" ~ '2-()O ~ Y K J ~ S:;~;~~I~:lude~'--'-'-'"'-" '." ". .,. , -"- JOB DESCRIPTION: t""{ o~ '7 'l 6c ~ D~(J..~r:o 1000 sq. ft. or less $117.00 Q-L ..... ~I A.D Each additional 500 sq. ft. or () ~ ..) \ ~_,-,~r__ portion thereof $ 21.00 Date l.-30 -0\ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Each Manufact'd Home or Modular Dwelling Service or Feeder $55.00 L ~ ... ".-. . ,<'..." .' ' 'Y._ ,,_ , .' 2. r CONXR4CTOR rNSTALfATIOiyONLY, B. ! Services or Feeders.....; Ins!a~latio.n, Alte,ratio~s or Relocation: EI,ctricol Contracto, ..~ ~~~o Amp' "';", .- '$ 7000 ~ ,(!>O P .J? U ~\S ~1 Amps to 400 Amps $ 83.00 Address I 0 I r? O~ z (Q L\. oA"X-<V ~ ~ 401 Amps to 600 Amps $138.00 (fl A ~~ '# <,(\~01 Amps to 1000 Amps $180.00 City wv<\- L~ M.1t ~\...{ Phone tlf @>" Over 1000 AmpsNolts $413.00 ~ '\~"O ~'V Reconnect Only ,0 $ 55.00 Sup"""o, Lioon" Num~~"1~~~~~ C, iT~~P~<ary s"';'~~..,(4. l~ <;)~ ~<::; ,tI' ~o .... gf ~ Expiration Date ~ .~~ 'Q.~ Installation, ~~i4.tbn~~o~o@, f\ ~ ~~ . 200 Amps ~%5~0..~0~O~ t?S'0 ~ ~o~~o~ $ 55.00 ~ ^(t~~ _0 ~ ~ ~'?j"r.vy Constr. Contr. Number ,.. 201 ~'5>~~~~~ r-"O ,0 ~ $ 76.00 y ~ 40~~& ~~~0 t?S'0 ~c~. $11000 Expiration Date I 0(( cJ~1 (/ q &,0 'b1 it~~ b~~;~~. " . l I ~~~~;,t,W.S#l~"r~~fl,:"e B abov~. Signatu.re of Supervising Electrician ~ 'Ilt\ <<~v~~~'.0<f,,~l?) r ~~o~/F ~'t$!~~-,O'" .~"'-' -- - - ' H /J ~ frW ~~,.~~~t&o~ ~'b;nsion Per Panel / Jf:::/- \ ~ {II ~~~~\d-::..~ $48.00 ...~~~~tfiJ'~ircuit or with "- r.2.,nr '1:"1' ~ r"',.~ Serv~rFeederPermit -..? $ 4.00 Owners Name lr'1.../ '? v........ ~ 'V' ;:>..... ~ Address 2>, em fub COcl0 Ln Cityfj l~ hJJ Crl:::! Phone - \~ OWNER IN.hAftJ.lcfJ ( ~'"2....,OO < E. Miscellaneo~~ (~ervice/feeder notinclude4) -Each Installation The installation is being made on property I own which is not intended for sale, lease or rent. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited EnergylResidential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges ~ . -. ~ -. Owners Signature: 4. SUBTOTAL OF ABOVE erz.. c:o 0,5"0 A ,,7..D 4--, ~o lOO..~ 8% State Surcharge 10% Administrative Fee 5% Technology Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01122 ISSUED: 07/30/2007 APPLIED: 07/3012007 EXPIRES: 01130/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1566 LAURA ST B ASSESSOR'S PARCEL NO.: 1703274104400 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Add service. Owner: JOHNSON LOVING TRUST Address: 3700 BABCOCK LN #67 EUGENE OR 97401 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor CAMPBELL ELECTRIC License 73995 Expiration Date OS/2412008 Phone 541-744-0705 I BUILDING INFORMATION I # of Units: &:. ~~~~tories: Lot Size: Primary Occupancy Group: ~"\~ ~ \~Ight of Structure: Sq Ft 1st Floor: Secondary Occupancy Group: -1Q~f(, ~~ ~~e of Heat: Sq Ft 2nd Floor: Primary Construction Type \. "()'":~\<b ~~ ~~<v Water Type: Sq Ft Basement: Secondary ConstruJ;ijon TY~~~ ~ "\'" ~<v~ Range Type: Sq Ft Garage/Carport # of BedrOOmS(\$,~. ~~ ~~<() ~~~ Energy Path: ~ ~Jt Other: ~~ f!6_ ~~~ ..,<(.~ ~ ~~ \<b t'\<V. Sprinkled Building: n/a 10 ~o $~":..~ant Load: \ ?\'::J #\v,1" O\'v i'c,6 ~(\ J '0 J' ~\)'\~\~~~\)~~ ~ I DEVELOPMENT INFORMATl@,*_ ~c,e~e ~~~~CQ ~~ ~\)~' \ro~ .....o~~eCQo~e\~ o(\~EQUIRED PARKING ~~ O~e'!J o'Q lOe t\' ~ ~ ~~. &~~ Frontyard Setback~ Overlay Dist: ~. O~",,6 "\~o ~o~~ 10 0 \.~6 .&,a' 1 otal: Side 1 Setback: # Strtlet '1Jo~~....e\. ~~~ c:P~\6..~e ~o~,. Handicapped: Side 2 Setback: Pave 1t~~()6 ~S:J:j ~(\ ~o""'~~~~ Compact: Rearyard Setback: % of . ~~~~ fb.~ ~e\' ~o(\~'" . Solar Setbacks: o..\..O~ .....~ 9j ~ ~ ~ 0\6 ~~ " ",r ....0 'r-e .yllJ . '" I PUBLIC IMPa~K\.e\ ,- Street Improvements: f.~ Sidewalk Type: Storm Sewer Available: Special Instruction: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01122 . ISSUED: 07/3012007 APPLIED: 07/30/2007 EXPIRES: 01130/2008 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. Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $8.20 $4.10 $6.56 $12.00 $70.00 7/30/07 7/30/07 7/30/07 7/30/07 7/30/07 1200700000000000974 1200700000000000974 1200700000000000974 1200700000000000974 1200700000000000974 Total Amount Paid $100.86 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Reouired Insoections . 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 thafall 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. ,~Q. ~(GP( Owner or Contractors Signature l/~o/c/~ Datel I ' Pae:e 2 of2 2.25 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-0] ]22 COM2007-0] ]22 COM2007-0] ]22 COM2007-0] ]22 COM2007-01122 Payments: Type of Payment Check cReceint I RECEIPT #: 1200700000000000974 Date: 07/30/2007 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By GLEN A. CAMPBELL Item Total: Check Number Authorization Received By Batch Number Number How Received 4077 In Person Payment Total: Jmp Page ] of ] 10:11:55AM Amount Due 70.00 ]2.00 4.]0 6.56 8.20 $100.86 Amount Paid $]00.86 $100.86 7/30/2007