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Home My WebLink AboutPermit Electrical 2007-5-25 ~.:'~::~p-\ ~~~:~~e:~Z~~;;rPH'(S41)72~37S3 · FAX'~:,I)72~;;J:~~~~t~ Signature of Supervising Electrician r~- Owners k( AnH bu:ohsOYl Address /crcg IV&-. City ~.ff.JJ Phone 7+.7.QS22-. 1. jqsg I ~ L\it~'L.N ro-W JOB DESCRIPTION . dCO ~ ~5utJzU' .) . 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. Electrical Contractor ~ ~ C- Address \o,-Z b ,0 Qj37tf Sr- · City~"e/~~CiDPhone 147-22J3 Supervisor License Number 243>-,$ Expiration Date l b-l- Cf7 Constr, Contr. Number \ 0L'1~ Expiration Date 5-2,;2--67 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 (p(!; ~. S t-z, d\ ~ 3. A. Service Included PTTJ.Q~oor~~~:13lle~gn law requm~c:: you tt; $106.00 . ~dc aClChJ.lgnal ~. ftHO! 0 Util't followdi-H ~tiWegp e oY"l 11:1 regon · I Y 'p Th les ~~'"' ~,..t f'''' $ 19.00 'lotification Center. ose ru (... v "'- aT" In oAtf~~~UOl1ijom~\9(Jgh OAR 952-0C 0090. ~~hb%~y&16Pai~fe'~iWs of the rules: $50.00 call' nter. (Note: the t~lepn?~~ nu~ ' , : ~~Mttf~g{j~li~'~t~i~lci~~1i~~1';'~J , , ~~tt:zf.T'c "/" "'<;,,-JciS.u,L;!.:L:c..:b.:....LLb,,;:,,--,," 200 Amps or less $ 63.00 " 3.(1) 201 Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163,00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less $ 50.00 '<?'pI Amps to 400 Amps $ 69,00 NOT'l4~r A~s to~e~ t~MRE IF THE WUK\\. $100.00 THIS P8fe~JdoSH AUT~P~~~~~f?2~ \\A i='NGEDf5R~'tg COM "New ;NVr~~M eJD~xtension Per Panel ANY 1~ ~rrcuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ~1.(JD o.oLf lA- 3D 3./~ 7% State Surcharge 10% Administrative Fee ~c? ~ ch t='..u..- fOTAL Shared Drive(T:)/Building Forms/Electrical Permit APPlica~L70./fj Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00754 ISSUED: OS/25/2007 APPLIED: OS/25/2007 EXPIRES: 11/25/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1958 I ST ASSESSOR'S PARCEL NO.: 1703361200700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: 200 amp service Owner: Address: JACOBSON ANN D 1958 I ST SPRINGFIELD OR 97477 I reqUireS you to ATTeNTION:~~~~~nh~~e Oregon Utility. follOW I U11;;~_ "'--r ose rules are 5tH fv.' I CONTRACTOR.uUi!~U~JrWN1~~1~hrOugh OAR 952-00 In'"'Om ~::>"A\JV I ,; co ies of the rules \ Contractor 0090. YIfui~obt2f'xP^rnt\~ ~fJhoIU)one ALERT ELECTRIC INC ca\li'n1'J~V center~ ~1~~~/~Mt..Q~otificaS'ltIP.747-2213 -- ....-J"_1'J1 lllCi O. -::> .. 44) BUILDING INFORMNTfON , . ',~ 0"'''_~S?-23 . Contractor Type Electrical # 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 Ist Floqr: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street ~ree~ I~q.!l(' C E' Handicapped: Paved DrIve ~J . CJ'.QlPilJ.it. % of Lot Covlp;t~PERMIT SHALL EXPIRE IF rAt: vvuRK AUTHORIZED UNDER THIS PERMIT IS NOT ~JU_te_~_.t'I:U UK I~ J-\DJ-muuIJi:~ ~on I PUBLIC IMPROVHM'E'N'TS. , J-\I~ t IOU AY PERIOD. Sidewalk Type: DownspoutslDrains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pae:e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00754 ISSUED: OS/25/2007 APPLIED: OS/25/2007 EXPIRES: 11/25/2007 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 1 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 5/25/07 2200700000000000836 $3.15 5/25/07 2200700000000000836 $5.04 5/25/07 2200700000000000836 $63.00 5/25/07 2200700000000000836 Total Amount Paid $77.49 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. 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 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 Pae:e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00754 COM2007-00754 COM2007-00754 COM2007-00754 Payments: Type of Payment Cred itCard cReceintl C;- - of Springfield Official Receipt L .Jopment Services Department Public Works Department RECEIPT #: 2200700000000000836 Date: OS/25/2007 lO:52:14AM Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + ] 0% Administrative Fee Amount Due 63.00 3.]5 5,04 6.30 $77.49 Paid By ALERT ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid ddk 025287 Phone Payment Total: $77.49 $77.49 Page] of] 5/25/2007