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Home My WebLink AboutPermit Electrical 2003-8-22 " ( \ (r " CITY OF ~._~UNGFIELD, OREGON \...) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . Ff~t0(54t~~~ilti811s submitted has the tollowing ELECTRICAL PERMIT APPUCATION ~~~'r~~a~nd does not require specific land use City Job Number (0"'-1'2.001_007 B" \ Date Z/Ilf/01 Zonin" CDvZ- " , 4/ " 3. ICOMPLETEj,J!:E SCHEDt.JLn >>JOL.AI. ::'.2-0'3' ""UU'VIILU\,.I 61l:llldlUrEl ~~ 2. I CONJ:RACTOR. INSTA,fLA,!IOJy ONLY I Electrical Contractor flj'",C E/'" r;/-r/ -'". Address 1 C; 7 [(3 )Jtd'-/:7 9 r.S. / 601 Amps to 1000 ~J\~ City FLlJ-'h-.P Phone ?y/-at/f'Y OverIOOOAmp~4Y9~'i.~\\'l , Reconnec{eQ!ilf o~ e\ \O~. \,,~ n~0QJ ,p.~() J k -? 0 J.:Pr( Ioy\-d Si '"' ,..~~.l<', ".' 7'"~ / 7 5 .o~il"'0sw."u~'!rY.lt~~e~i>fJ'Kee~ers . \o~. ~oQ" -<,'r\o<:i ~o,~ ~ \'<" "$;',0(". ~ /0 - J - 0 $.I "..&;:\'\ e'" 0' ~staUatioli', l1Je~tit'Jlro? ~,,-Io~ation 1'-' ~ ~\}~ Ge~200')~ s'09~ess\~0 ~o\\'~ $ 50.00 Constr. Contr. Number dO ~?-'tJ:3 &\\~,c'a.'i.~~7:()()20Ir~:.s:ffi<1t'O'QJW~s-,o.o.'\' $ 69.00 ~O\' ~-:J ~","' ,.,W' ('~\ .,,?... J 01" ,\o\} ~Q.I?~.s;to 6BOZ~nips $100.00 /v - - 0.3 ""C). n\'<" .'"'~. . .~Cj " " I)";,r ~\\~~ ,pyer ~OO,AIiips or 1000 Volts see B above. c'l> A\'O'D-ieBl~;'ch Circuits ; ~\}". , New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with I . "? Service or Feeder Permit _11 $ 3.00 ~ '''\l'''' . ". .. . ....., """ \\';.~' -:\ q. " ... " " '. E. r(\1iS~ellalleous~se't~'\<<lSilD~~~~lfde~)"'Ea~hlu~falIali~n~ \,.\. v' S '('{t"'" ~()f' \)~P'o~~~'ti~\.'i\ \~~ ~\)<;J\'.'i;.\) $ 50.00 ~ IS~btl~1J~l% I>-~\>-l $ 50.00 \\~\f~~l~~\~~al $ 25.00 ~~!!ea'l,i)~e:ommercial $ 45.00 Minim\l.'i\'t:ft,~tric Permit Inspection Fee is $45.00 + Surcharges 4.ISUBTOt1EOfAlJ()~"'ic"' t. h i.( b'Z.. bbo f(?1 1. I LOCATION OF INSTALLATION Z b '7 f G-M..-So,v UI LEGAL DESCRIPTION 170:3.3 bll JOB DESCRJPTlON Sf-lit. .I .::::L C,~+- Permits are no'-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1010 If Supervisor License Number Expiration Date Expiration Date City HA1U>wJ('~'5.~-W 269 ( G"A.Q!:;'Od U.! S 1'1; ;:) Address Phone OWNER INST ALLA nON The instalIation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. I New Residential- Single or Multi-Family per dwelling unit. 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 B.I Servieesor Fe.ede~s - Inst~ll~tion;Alt~ratioi1s or Relllcation:l 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps ( {,,3 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 1 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)!Building FormslElectrical Permit Application, 1-03.doc . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00781 ISSUED: 08/21/2003 APPLIED: 08/18/2003 EXPIRES: 02/21/2004 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 2691 GARSON LN ASSESSOR'S PARCEL NO.: 1703361110104 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: PROJECT DESCRIPTION: Service and 1 circuit Owner: HAROLD PETERSON Address: 2691 GARSON LN SPRINGFIELD OR 97477 I CONTRACTO.lUNFORMATION I e",'l~0'i.~\I.'! Contractor eo..'I>\~ o~ ~ '00. License ARC ELECTRI<;;. \'?>~ ~ ^ O~0~(e <:,~".OO . 115113 ~0~0\6;~ Xlii 'Bmr.DING iiiFGRMATION I (\\0 . ~oQ" -1i~v' ~o'l>~' _ 0' '-' 'vaQ~v' \O~ # of Buildings: -:.(\<;;.~ \}\0'" 0' o~\e~' \ 0 ~ of!"fjf;~erles~\.\~\v'?>" . Primary Occupaocy G~up':~ ~ . o~ C.~,3.00 ..;\~ v H~lgh.t ofiStructure ..".\,~ ~~ (l'" ",,<> _\'" .,,'" . "'. Secondary Occupaocy "r~~,I!:> S7: ^:-l ov e~' ~~~p"e'~llsat: Primary Coustructiou ",yp(el~~ g 0'1> WN ve~" ~eQj\':"~.ts"h:rype: Secoudary' Construction.<rype,b.-{ ~ "S'-e \~e 0 ,,'CRange Type: # of Bedrooms: OO'!J cv.'i.\'0 ~,o~ ~e~\'" Energy Path: fC'Xle c.e~ (\\J Contractor Type Electrical New Residential Expiration Date 07/11/2004 Phone 541-741-0494 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: I DEVELOPMENT INFORMATION I . ~wro:D PARKING Overlay Dist: \?'C. \r \~i\~Q\ # Street Tree~~t. ~t>.\.\. 'C.'j..'il ~ 'il'C.?~\ wcapped: Paved D"vE.Y\~it: a~\"i S "'C.? "i't\\ ~\"Q~t.\C mpact: "\ c.. 'ilt.'" " U~v ~t>.\"V % of Lot Cil~~i'~llj\l,\lt:v Q? \~ ~ t>.U"i 'i~Ct.'i) t.?\Q'i). ,f-~~~. ..7/" 'il I PUBLIC IMPROV~~~TS I SETBACKS Frontyard Setback: . Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsmrains: Notes: I VaIlllation Descriotion I II II , Description $ Per Sq Ft or multipUer Square Footage or Bid Amount Type of Construction Total Value of Project Pa2e 1 of2 Value Date Calcolated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00781 ISSUED: 08/21/2003 APPLIED: 08/18/2003 EXPIRES: 02/21/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fpps P3id 9 Fee Description + 10% Administrative Fee + 7% State Sorcharge Add, Alter, Extend Circ Eo Add Perm ServlFdr 200 amps or less Amoont Paid Date Paid Receipt Number $6.60 $4.62 $3.00 $63.00 8/21103 8/21103 8/21103 8/21/03 2200200000000001420 2200200000000001420 2200200000000001420 2200200000000001420 Total Amouot Paid $77.22 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 Reoul:m~ Insop~tinn11 1 Electric Service: Approval required prior to utility company energizing service. 2 Rough Electric: Prior to Cover 3 Final Electric: When aU electrical work is complete. By signa tore, I state and agree, that I have carefolly 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 he 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 he used on this project. I further agree to ensure that aU reqoired inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at all times during constroction. Owner or Contractors Signature Date Pal1e 2 of2 . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00781 COM2003-0078I COM2003-00781 COM2003-0078I Payments: Type of Payment Check ..~....,.- . WIt., c.'~~.'.'.'.....'".''' ".. . :.:: ,'.'-C',. ., ~:" '.. 1 ,. I ~- i '''''''''__,,''_'U 'r-v"- -, Receipt #: 2200200000000001420 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By ESTATE OF ARC ELECTRJC Received By djb Check Number Batch Number Authorization Number City of Springfielil Official Receipt Development Services Department Public Works Department ., Date: 08/21/2003 9:10:10AM Amount Paid Item Total: 63.00 3.00 4.62 6.60 $77 .ZZ How Received In Person Payment Total: Amount Paid $77.22 $77.n . .