HomeMy WebLinkAboutPermit Electrical 2006-8-15
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRIC1L PERMIT APPLICATIpN " ,
City Job Numbet(.Q:Y\'2..cJC( q - () I 0 cfl1ate ~I dUck
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LEGAL DESCRIPTION
l'ln3 d., lLm3Lom
Supervisor License Number Lt 7 ~ S-- 3 C.
Expiration Date 10/01 ~S ~ Installatitn;.Alteration or Relocati,onc I\-\E WORK
~ I ~\(\U" "-'.. SU/\ll E.XPI\-1t Ir '''1
, 200f~WPf~fl~~~11 In \S-f'E?~ft.\1 ~~<WD
Constr. Contr. Number { "5""'~ "3 Cf, 20IA1ftp.seH;1~~~rlWmER 1\-\ t-...1{1(\W:n ~.OO
, , / j ~'401'C8l00\J\<t?-.08@nWR IS /\B/\ v -- $100.00
ExpIratIOn Date I ~ 30 / >00 ' 0 00 A -" n 1\ '](OD1=A \ (\ D. "B" b
. I ' t ven . '. . wp-swr\ u(}-Vb1ts see a ove.
Si~,.isi~gEle~c."a _ ~,_ D. ',It,.'
, New Alteration or Extension Per Panel
One Circuit
/ / ~ Each Additional Circuit or with
I ~,_ _ 0 Service or Feeder Permit
Owners Name ~ L\ \6(7'/ b~
Address\.=?\ PU'J.~~ ~ ~
Ci~~ Phon, --1
OWNER INSTALLATION
JOB DESCRIPTION
~Y\U
Q~Lt. '-t-
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 ~ev; C4.., ~ G{B[;
Address l{ 0 &7 G/~ rl / /L;;.
City e~~-e-'e
.j
Phone 6e,6-fft'/'?
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.
A.
. S yOU to '
Service Included N 0 egon law require 'I't
'i\;rTFNTIO : r 0 "00n Uti I y
1000 sq. ft or less- \' adopted bV the r $106.00t ~Mth
Eac~ additio~a. i~~0 ~H ff:o~nter. Those rules are ~:2~OOI-
portion ther~pfL\\Icat\an l, ~ 001 n throuqh <:$1'19.00' _ I'"
:n OAR 952-00 1- , . ' s of the rulb'" ..;/
Each Manufact'a Hometor"ay obtaIn caple te'lephone
n"Q(f,~ YUl, ,,, Nt. the
Modular DweHmg'SefV1tceeocenter. \ 0 e.., $:<:o,IjI'riication
Feeder calling nO' - l't,IIh: r-~\:llJl
_ for the rt:"=!u.1 ~... J
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$ 43.00
$ 3.00
E.
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial -'" Jl' 00
Minimum Electric Permit Inspection Fetls $45.00 + S rcharges
4':).00
3 .(00
:;;1 . ~ "')
\t 5~~35
4.
~ State Surcharge
10% Administrative Fee 4-' 5'10
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application 1-03,doc
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-01049
ISSUED: 08/16/2006
APPLIED: 08/15/2006
EXPIRES: 02/16/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 64 W Q ST
ASSESSOR'S PARCEL NO.: 1703271003600
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: One Circuit
Owner: BRABHAM LARRY R TE
Address: 131 DEADMOND FERRY RD
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
Electrical
Contractor License Expiration Date Phone
AMERICAN EAGLE 1538~~'OD \.0 12/30/2008
BUILDING INFORMf\Tio'~ ~':)0 \j'i.\~~I\n
-\' ".0 - n<e set \ 0"-
, - J \05 0.' '2. 0 \
# of Stories: ':,\,\OS'3 (U v O~~ 95 - 'o-Ti-ot Size:
Height of.StructurcJugn ~ ~\-'e lu\eSSq Ft 1st Floor:
-- ""Utl" 0\\\1 e
Type ,?CHeat:\ 'D co?\es \e\e?no~ Sq Ft 2nd Floor:
Wa,t~f\\l>JP'e'D\(3.\ ~O\e'. ~~e ~o\\\\C(3.\\Osq Ft Basement:
, ,Raiig~ TYlte:\eC ~ D \j\\\\\'J AA). Sq Ft Garage/Carport
-' ci~ne'rgjJ~~~O\eg~0_33'2.-'2.'.) Sq Ft Other:
"SpFinRled,Ru~ld1n~: n/a Occupant Load:
\lV'" r.eDW'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION'
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
_\ \~ \NG~"
I PUBLIC IMPROVEMEN~.I \.. r..'f,.?\~r.. \r~~\, \'2> ~\j \
\'\U \ \ Ot~W\\' ~~~~'~"~~~r..\) rG~
,\-\\'2> \" 1't.\) ~~ t:.~ ~
~\),\-\G~\L- t.~~~~OUlS/Drains:
c,GW\~t.~~~'{ ?t.~\G\)'
f\~'{ '\ 'nO
J
Notes:
I Valuation Des~ription I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-01049
ISSUED: 08/16/2006
APPLIED: 08/15/2006
EXPIRES: 02/16/2007
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.
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid
Date Paid
Receipt Number
$4.50
$2.25
$3.60
$43.00
$2.00
8/16/06
8/16/06
8/16/06
8/16/06
8/16/06
1200600000000001267
1200600000000001267
1200600000000001267
1200600000000001267
1200600000000001267
Total Amount Paid
$55.35
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 Insoections .
Rough Electric: Prior to Cover
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 ofany 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
Pa~e 2 of2
225 Fifth Street
Springfield; Oregon 97477
.
541-726-3759 Phone
Job/Journal Number
COM2006-0 1 049
COM2006-0 1 049
COM2006-0 1 049
COM2006-0 1 049
COM2006-0 1 049
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
(':4v of Springfield Official Receipt
elopment Services Department
Public Works Department
1200600000000001267
Date: 08/16/2006
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
AMERICAN EAGLE ELEC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
095791 In Person
Payment Total:
Page 1 of 1
8:56:37 AM
Amount Due
43.00
2,00
2.25
3.60
4.50
$55.35
Amount Paid
$55.35
$55.35
8/16/2006