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Home My WebLink AboutPermit Electrical 2004-1-9 (2) r . 0, I Ii. · . ..-: s submitted has ihe tollowing - ^ . ' zoning, a requ\re specific land use 225 FlFIH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~<i5/1il)726-3689 . ELECTRICAL PERMIT APPLICATION '. . Zoning ) _ ! ~~ '-I / City Job Number LOIM ZOO'-{ - 0000'iS Date / - 7 ~ (;) L/ Date.. "i. lA I 1. ~'T'i'O'~."''''I-'TO''N''''','O''~IN.'''S.'T.'';i'iiriKl:1-0''''~~.~:', , ",,,,,,,,,,,~,,,,,,,,,,,,,..,,,,Aulllorlled;,S'IJO,,tUlf\..,, .._....~<:i. ,<w><; ..~.". ~ I ."'.. S?\ . r. l\1lI\i~~~ 3. f".'9..Q}'I.... B.,~.'ld<.,. ~,~:l.g.g. .:.$,.~.'H'-" J<:.Q,Y1#....lJE. L.,.,.9.~......\" " ait).~t, i,X',;:~",Y',:;;,.;.. .'.~f:," '. . p~,~r~~u;ltlf;r1.(:~"r::::.J;;;~ _.._~-~" -'"._- -~_. '.~ ,~- ~. LEGAL DESCRlPTION /703. / '54 0 ., JOB DESCRIPTION' 03/0'0 h (LE' J\A\ill\k~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days.' ~'~'>fJ'K."""~.t1f>""""'i'::.~~-i'~t'''';'':'>~~~~~ 2. -'~q,~CTOliWSTAJ?~~g~~~ Electrical COlfctor 8f'fA. ('" M~ t Fk Address I/O &ox 9 n City t({.t...J~ (( Phone (){3.-(7{/7 Supervisor License Number Iff t1t:>') Expiration Date /0-0 l-oL / Constr. Contr. Number /'?,/79~ ~k-c> <) Expiration Date Address _/' 'J 86""''f'-~e... n,hLJ'^-.I . "I. . U.../I -tJ:H . .....--1 Phone . I .' -.~. The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~~~~~I~~,~:.~'~!'~:?<1t",g;,,!i(,~iii.iitv~ca~ii~,r.R.'i'r.;":iI~' 'r~ A ""Ni:"-""Rc~"d' ""t'''''I''''''S...-c'I''''''''''llt'.'F ""'I'^"''''''d'''''~'I''liri'''''''~'' ~." .,,;, . i];,' e~' eSI en 13 ..:.~ fin e,or:n. U I": alllJ )', per., we (T'UIllt. '~~J1 .~$"""'~""~"'*'l.~~~o '~'"'-''>~'~''''':;.f-''=~.:..J;:.a,..~1$if.'.~~1lo..ti''' ~ 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 ~~~~~.~~~~~wY~:"~;.'~:i.W~ft~'~~ B. ~~~~~~~!:~~~~,~~ll~~i~~lJq~~rJt~~gt~~ 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolrs Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 -<;0 1 c. ~!rre~~s~~~;\i~a~~,~ ENilON:ore-gom t\1e Oregon 0\1 \Y'~''''''''''''.";- In~~~ip&eYt.!ldal/)Wb\-Wel&"l'UiW!; afe set tort 2pg\ka"Q)fi6SS3nter. :~~oU'Jh OA~ 9ill~~ 2~~~Z~~t in copi(lS of the ~lo 496~~~~f;, ~Not~,\~i~ :'o~f c~~8Pt ove~!A.w~~ ~o 8'e~ !:I'll v '. D. m~l cu' New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with ., Service or Feeder Permit $ 3.00 E.l~~~~~lS''';~~~i1i~llidwtJ:tLU~' ~. I ~~uNoffi1 . 1'EfffvWf\S'Ne' Pump Jl..~Ri~W;rEO OR IS AiJ.A1\InnN~~ f{j]OO SignlO&fili'e~i!i~St~g:y PERIOD, $ 50.00 LimitedfEil~r~esl~ential $ 25.00 Limited Energy/Commercial $ 45.00 '3 ~tril'iti6J'i Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~-SWi.t'$,.o:.~;,~~,~;f...\:.:iE~:, 4.' ',SrJBTOTAL:OE'ABOVE ~~~ti,~ 53 --S?L 7% State Surcharge 10% Administrative Fee 5~C> bZ,O( TOTAL Shared Orive(T:YBuilding FOrnlsJElectrical Penrul Applic.Hion l-Q3.doc . . CITY OF ~rKlNGFIELD Building/Combination Permit PERMIT NO: COM2004-00008 ISSUED: 01/07/2004 APPLIED: 01/02/2004 EXPIRES: 07/07/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3530 GAME FARM RD SPACE 1 Springfield TYPE OF WORK: Fire Damage, ASSESSOR'S PARCEL NO.: 1703154003100 TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Fire Damage Owner: PATRICIAN MOBILE HOME PARK Address: ATTN: SCOTI WRIGHT ]]70 PEARL ST EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BEAR MOUNTAIN ELECTRIC LLC License 136298 Expiration Date 08/06/2005 Phone 541-895-8833 SETBACKS I BUlLDINC1MNFORMA TION I ., liS "C-' ~t1, , i:J,... . #.or,Sfones.:. Lot Sue: C(j . 'Tn ''''OJ ... Heigh~f;"l.tnlctYre Sq Ft 1st Floor: "A, "Iur- 0, '-^ u't 'v)T)'pe'.'l~~eatUIjr, '4t.t. Sq Ft 2nd Floor: Wftfb!rJleb Vf"..s> f",rp;, Sq Ft Basement: Range'T.yIll':.~ IS 'tSrS ~f" ~ Sq Ft Garage/Carport Energy pai1\.irIOO 1811jr, Pf"..9, '1ft Sq Ft Other: . VOIjr, Ittlll. tv-O)\lpervious Surface Area: 'f:'^. ,<'I. 'tfio I DEVELOPMENT INFORMATION: ,01}' 'VI REQUIRED PARKING # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 Setback: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Total: Handicapped: Compact: Rearyard Setbac~TTEN % of Lot Coverage: Solar Setbacks: f " rlON:Oregon law reQUI o OW r. ,I.oco ......._ --1 ',,' res VO'I tl"l lotitication Cent;r:Th~~li!H~Lie'IMPRo.VEMENTS I I OAR 952,001 0010 h . - _0' ('/r1' Street Improv.llGlS\Y.syo ' .' -. . t rough OAR 952-00' u may 05taln co ' Storm Sewer AvlilBil/lcg the center N p~es of the rules I Special Instructllllll1ber tor the 0 . ( ote. the telephone . regon Utility N t'f' f"'~~.~.;~ 1 Ilnn 0 , 'cation Notes: . - -332-2844). Sidewalk Type: DownspoutslDrains: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa~e 1 of2 . . CITY OF SPRINGl'lJ'.LU Building/Combination Permit PERMIT NO: COM2004-00008 ISSUED: 01107/2004 APPLIED: 01102/2004 EXPIRES: 07/07/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fee. tlWU Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Service Reconnect Amount Paid Date Paid $5.30 $3.71 $3.00 $50.00 1/7/04 1/7/04 1/7/04 1/7/04 Receipt Number 1200400000000000016 1200400000000000016 1200400000000000016 1200400000000000016 Total Amount Paid $62.01 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. ~ Reouired InsnectionsJ, 1 Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 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 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 tbe approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00008 COM2004-00008 COM2004-00008 COM2004-00008 Payments: Type of Payment Check , ~,.~~,.,'.",', ~. ............_'".~;..,._ .."..r . ..i f Receipt #: 1200400000000000016 Description Service Reconnect Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BEAR MOUNTAIN ELECTRIC Received By djb Lheck Number Batch Number Authorization Number ~ City of Springfield Officiai Receipt Development Services Department "- Public Works Department Date: 01/07/2004 1:10:12PM " Amount Paid Item Total: 50.00 3.00 3.71 5.30 $62.01 How Received Amount Paid In Person Payment Total: $62.01 $62.01 . .