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Home My WebLink AboutPermit Electrical 2009-12-7 , . p . CITY OF SPRrNGFIELD, OREGON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRIW PERMIT APPLICATION . 1.' / City Job NumWl/2I5lk - () ~f:; Date );)/07 () (, l40~~~~(;;::i~::~ LEGAL DESCRIPTION 1103 d~ /.10 dO(JD IiOB DESCRIPTION fr/rJ/fflLfW7a 'XvW7 C/vcu0 Permits are noJansferable and expire if work Is Dot started within 180 days ofissuance or iCwork Is Suspended for 180 days. City ~_ {;S6- / r'l1. Phone Expiration Date 4 7 Be; 50 0-.ff/ n 7 l"i 7, R. 'Se{ I..).//)J/~ , ( - Supervisor License Number Constr. Contr. Number Expiration Date Signature of S~R!1"isin ~p-/ ~~~-;;~ ~c-- - Owners NamJl1J/YlMf14 &P/}0/ Address ~ ('viD1f'J ~ 1~ City~~L P~~ - '1 OWN~ ~STALrJ'jf;[7 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. l€e)MeBE'll"'r"'n'S~HEDWnEiBE:llen~ Service Inclnded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 200 Amps or less 201 Amps to 400 Amps lll'TI!,r.:. 401 Amps to 60~Amps $125.00 601 Amps1i6flOOOfA'n\iis SHALL EXPIRE IlSr6:i!OONORK Over 10QQ~;O;-rj1pWm@ UNDER THIS PFf$~'7?;O.Q) NOT Reconnee\51~I,~ENCED OR IS t,8.'.~:82~t~H~R $ 63.00 $ 75.00 Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 680Affi~'U(j1Wo-vO''Ia($waa.'1'~~WJres y~u. ~O D.~nl'li'''1Wi!j11W~~'~ f\jolirrtlfiOo~ . , Ne'TrN.,~fligJSft~J\~,*,ll1tmll!~I\I!.oAR 952-001 ./ / :> Oneffl~.t You may obtain CQoie' of tSel3:003s b\ 7'...5 ~acli ,,'l\\iWl~ ffi~'eh\'fl~i~Note: ll'ifl te~eJ.~,Qne. J v' "erv1cM~8Wff6fWl~ Orego,. \Jiilfl'y ;~otlTicati~ I ,"'- ...........H~li~I.'lS" I<c,~"..itJ"J"",~>3...i 1:' u, ' '" ", " E. . MiscellaDeOUS1(~ie~.~~~~eleaer=~ID.~I~~I~d) -Each Installation Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee Is $45.00 + Snrcharges 4. & I. U\:l 3.0:? 4'06' {o./O l'iP1o State Surcharge 10% Administrative F TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application I-03.doc ~ 1J5 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~iiii!!'!";l,'i',~"," ;.'. 1Iir' , ~', . . , -_.. ... : . , _._.."T.-....._ ".- <& of Springfield Official Receipt .Iopment Services Department Public Works Department RECEIPT #: 2200600000000001663 Date: 12/07/2006 9:23:35AM Paid By RAY DEMAY/AMERICAN EAGLE ELECT. Item Total: L:heck Number Authorization Received By Batch Number Number How Received Amount Due 43.00 18.00 3.05 4.88 6.10 $75.03 Job/Journal Number COM2006-0 I 566 COM2006-0 I 566 COM2006-01566 COM2006-01566 COM2006-0 I 566 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Payments: Type of Payment CreditCard Amount Paid njm 048479 In Person $75.03 Payment Total: $75.03 cReceintl Page I of I 12/7/2006 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-0I566 ISSUED: 12/07/2006 APPLIED: 12/07/2006 EXPIRES: 06/07/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3050 GAME FARM RD ASSESSOR'S PARCEL NO.: 1703221302500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION: Relocate circuits from outside panel to inside panel. Commercial Owner: IMMANUEL BAPTIST CHURCH Address: 3050 GAME FARM RD SPRINGFIELD OR 97477 Phone Numher: 54-726-7814 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor AMERICAN EAGLE License 153834 Expiration Date Phone 12130/2008 I BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Spriukled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard Sethack: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I I\lUTICrsidewalk Type: THIS PEBMJJs~M.1J/hfai.Ps\RE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. N ATfENlIUi\l:ult::yur, ,dW requires you to otes:follow rules adopted by the Oregon Utility .. . _ . _. _ ._ _ ~._ __.o.JI'_-"t I'\llVLI"\#QUVII ",..........,. (,._...._.... '" __.. ._t.. in OAR 952-001-001 0 through OAR Ig~-Mq.\ion Description I 0090. You may obtain copies of tl, ~ . -. -- -... D . r:allingthe.cenestetINote: Ihetelel$~e;fSq Ft Square Footage escrIption f Ty,pe 9.nstrucllR"" Nt'" ,'. . number ordle r yUII UUI Y 0 'olCIDilttIpher or Bid Amount Center is 1-800-332-2344). Value Date Calculated Page I of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01566 ISSUED: 12/07/2006 APPLIED: 12/07/2006 EXPIRES: 06/07/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fl'l's~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $6.10 $3.05 $4.88 $43.00 $18,00 12/7/06 12/7/06 12/7/06 12/7/06 12/7/06 Receipt Number 2200600000000001663 2200600000000001663 2200600000000001663 2200600000000001663 2200600000000001663 Total Amount Paid $75.03 I Plan Reviews I 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 Rl'ouirl'r1lnsnl'l'tiono. I r r'liII "iiIiiII Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify tbat all information bereon 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 witbout 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 furtber agree to ensure that all required inspections are requested at the proper time, that each address is readableJrom the street, that the permit card is located at tbe 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 Pa!!e 2 of2