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Home My WebLink AboutPermit Electrical 2007-6-5 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COoN' 'ZOo, - no ~ ( ( .Date b - C; - 07 B. ~/..... ~ f:? 200 Amps or less . . % !::? 5e201 Amps to 400 Amps ~ 72/L~.,.j;;- ~ 401 Amps to 600 Amps i ~ ~jJj 601 Amps to 1000 Amps 0 Phone 7 [1.. 9 (-,flt/!l!j; Over 1000 AmpsN olts j :~f' t- ~ . Cf .$! ~ Reconnect Only ~ .:::::; .:::- CJ .0' . '-./ J-..::. c';f OJ ~ ~ 'v i/ Q; L{ 7 q$.$ J ~ ~j :." 9::- ~ / '........:::;;C::;$ /() - I -r.to.:Sf '-~~) Q. tf~: 'v J../ ->.. ,~' '-.' ~ Constr. Contr. Number (AI ;:.~. ..z",:~~~ Expiration Date 9 - -,."- ' ~' 1:. ~ fo rsName U ~ adress ~/ 5> City S:r~ _:_' _'-:"',~'_':" ,:-;'" <:",. . ". _'::/ ~ _:":'\:'_ ,:.>>;: _", -__":':~.::: _:':_: :::.::::. -':',_;"::}:-:':' :. :__::,-"':'-::',:-: :"0._,"'; :.'>';<0;(:':-;;::':':,:', }(':::':' __ __ ~: <:.<:;..:::::.::.:,:,~:::.:.: ',' 1. LOCLlTI()N OFINS'!#tLJ!!TIO 92' ,. S "'sf'd LEGAL DESCRIPTION 17D32b2~ D (OC> ( JOB DESCRIPTION . J ~p ~v/6lL 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 J[LM Address tfJ. 9 ~o-~A ) City Supervisor License Number Expiration Date ~~c!l.t: sr Phone OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 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 $106.00 $ 19.00 $50.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ~ C. <.:: n, 0 'S' i:l Qj~ -...;;g~ Installation, Alter$o~ot1i~Jii@ ;p ~ c:;- <J....... f-) ~ Qj .;S ~/rt 200 Amps or lessd; (:} )] P 9: r.' .~rr!v $ 50.00 201 Amps to 4~Wpt >-?~8 # -;:--:?\t $ 69.00 401 Amps to~~~& /? :-R,.<? $100.00 o co- ..... , ---0 Q' Qj cO Over600 up ~rqjj ~j1t~~~above. D. o ...." ..... New Al<<r;@oi!Sbf:.i~n~~~Panel ~ '1-....., '\ ....... 0 U One Circuit .ii' ? J/ ~f ;2 Each Additional-t:i:iiuif-br3Vith Service or Feeder Permit ~ S-0 $ 43.00 $ 3.00 E. Pump or irrigation Sign/Outline Lighting Limited EnergyiResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. c;;D L/ ~ &/0 State Surcharge ~^/}!f- 10% Administrative Fee i -;;; .. ) &' \v5..J S1"~~~~'/ "-/-:;;- 2-0 726-3769 ~ D\o TOT:.\L // 0 ~ ~~ 0..: "\: Sh,red on.<(T, ~i,g F""",""""';';;;;''' Appli~t'" I ~3."'" Inspection Request: Status Issued CITY OF SPRIN(j~lELO Building/Combination Permit PERMIT NO: COM2007-00811 ISSUED: 06/05/2007 APPLIED: 06/05/2007 EXPIRES: 12/05/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 92 S ST ASSESSOR'S PARCEL NO.: 1703262301001 Springfield TYPE OF WORK: Use Initials TYPE OF USE: New Residential PROJECT DESCRIPTION: Temporary power Owner: SHERMAN SNOOK Address: 92 S ST SPRINGFIELD OR 97477 Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor License Expiration Date Phone JEM ELECTRIC INC 161235 ..... 09/07/2008 541-729-1074 ~ BUILDING INFORMA nON I s ~o~,~::::.~ ~ .~e "V ~o"\ ~ 0010 K.' ~'" # of Stories: ~ ~e~~eq; ~e <O~<:>~~o~ze: Height of Structu~~\~ ~e ~e<O ~ ~<<- C!j ~~F~ 1st Floor: Type of Heat: _121'00 0- 'O~ e ~o\). ~ 0 ~e ~(j)~\dl'd Floor: Water Ty~P\ R,e ,\~oCj ~o\).~ s 0' ,e--e~~~ Basement:.., Range~e:'O-O-O ~e" '\j.;s' o,l. ~e ~~q Ft Garage/Carport E9Ri~ ~\fJ~ ~'\j'\ \010 C; 0,121' ~,~ ~S~\l<t Other: SP)-~~~~{JUil~g: 0'\;J'~ ,. ~ gi~ f})~ ~ Occupant Load: <,("\ ,~Q). <,_0" ,,~ .",10 .r-.: _ ~ I DEVELOf~Nq.1~<~~QID~v' \; ''\j'\j~\)' ~\"q: ,\0 ~,e\ ,- Overlay Dfs~: ~'\;Je (;10 # Street Tr~~Rqd: Paved Drive Rqd: % of Lot Coverage: R-3 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: Descriotion Type of Construction ~~ _ ,~\:S....~ ,\'0v S ~V X, ~ ~'\ '\ ~ Sidewal~~~<<-~ ~ ~\:S D*'~tt~~~~~ ~'\\'~' ~'\ s '0~'V~ S ~~~ ~~ \ '<.<<-~ 1,,<-'V \j'<:- '\ ~'V' '\0~~\\ \j ~ ~\> ,<-'V" I 'V. '<-~ ,~' ~v 'V~' I Valuation DescriPtio~.J.. \~'0 ~~ $ Per Sq Ft Square Footage or multiplier or Bid Amount I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: Value Date Calculated Pa2e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00811 ISSUED: 06/05/2007 APPLIED: 06/0512007 EXPIRES: 12/05/2007 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 Temp Power 200 amps or less Amount Paid Date Paid $5.00 $2.50 $4.00 $50.00 6/5/07 6/5/07 6/5/07 6/5/07 Receipt Number 1200700000000000686 1200700000000000686 1200700000000000686 1200700000000000686 Total Amount Paid $61.50 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 Temporary Electric: Approval required prior to Utility Company energizing pole. 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 Pa2e 2 of2 225 Fifth.Street . , Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-008II COM2007-008II COM2007-008II COM2007-008II Payments: Type of Payment Cred itCard cReceintl RECEIPT #: Description + 8% State Surcharge + 5% Technology Fee + 10% Administrative Fee Temp Power 200 amps or less Paid By JEM ELECTRIC C;4-., of Springfield Official Receipt 1. :lopment Services Department Public Works Department 1200700000000000686 Date: 06/05/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 840030 In Person Payment Total: Page I of I 8:12:20AM Amount Due 4.00 2.50 5.00 50.00 $61.50 Amount Paid $61.50 $61.50 6/5/2007