HomeMy WebLinkAboutPermit Electrical 2007-8-6
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CITY OF SPRINGFIELD, OREGON
ZON LC[)2.
INITIALS N~'
DATE Y / h /0"7
,
SOURCE r't\..1(J~t7.J
I
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:~541)726-3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION
City Job Number CO.AA '2..eo -, -0 II ~ b
1. i-LOCATION OF INSTALLATION:
"3 (p '" So LI3 ~ f \cue..
LEGAL DESCRIPTION: ? . 7
'}702-3Z3C{ o4~O~
JOB DESCRIPTION:
Re.o ~C- 'Y"'\CU ~ ~~b.v au'\~
I . \
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. i .CONTRACTOR INSTALLATION-ONLY;
_ _---,~.--.--_ ____ ___J
Electrical Contractor ~W'\\-\
e\e~~ &J
Address
l.P-o .s,
57 "p-I st.
City 5lDYlVl1ftefJ
I .
Phone 5'11:305'1
Supervisor License Number
A 55t.f $
107
~
10 "
I
Constr. Contr. Number \' ~O '2- 1
Expiration Date
Expiration Date ..., / '"Z.S / 'Z.-t!J(J'1
I t
Signature of Supervising Electrician
~ ~, -4--'~
"--'
Owners Name G'~
Address .~ li ~ S,
City. 5pvw-fc-(J
K~~c.. kt-
43 ':0\ 'D ~t.<..
I
Phone"-.E '1 ~ - 3735
Date
A. ~ -N;;Residential ~ Single o~ Multi-Family pe~ dwelling ~;it~J
~.. _, ~_,___.._ ____.. __. ___ __~ _ _ _0___ _ __ __._ __._~ _~_ _~.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$117.00
$ 21.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$55.00
B. I Services or F-~;ders - Ins~lIatio~-,A~t~~~t~~s 0;Rel-~~~~~~-'-1
I _ __ ___ ___ _ ____ ._. .__ ________ _ _ _ _.J
200 Amps or lesst $ 70.00 "1D,OO
201 Amps to 400 Amps $ 83.00
401 Amps to 600 Amps' $138.00
60] Amps to 1000 Amps $180.00
Over 1000 AmpsNoIts' .oRlt- $4]3.00
Reconnect Only ~~ $ 55.00
C. ~~;'-~:_:_' . --j
~!.I~I:"~"'~55'OO
':OPJ' ~ ~ ~~l- $ 76.00
~~ ~'~ $]]0.00
. :~~ ~~~o V~!~ se~'~~:~ab~v..e:____ ~ -- --- ---.1
. D. rlf;;nchG!;:its .
1,............._______. ..___"._....____<_, __~_ __~__,_ ___._
New Alteration or Extension Per Panel
,One Circuit
Each Additional Circuit or with
SerVice or Feeder Permit
$.48.00
$ 4.00
'. E. r Mis~~~I~~~~~(Service/feed;;not included)--=-Each I~~~-a~~;i~;j
L___. ___' ____._____. ____.. ~~
. ,.;'
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
. OWNER INSTALLATION Limited Enerl/ReSidential' $ 28.00
!he in.stallation is being made on property I own which Li'~ ~~ ommercial . $ 50.00
tS not mtended for sale, lease or rent. e. ,",,~'iJ e\fr~ iI-mit Inspection Fee is $50.00 + Surcharges
Q"t\C~. S\-\~\.\. ~" pt1 -- - -~- - - - -- -- . - ,
Owners Signature: " ~$ \>t.~~\\ U~Ut.\\ \\'\~ O'e) _~~_OF ~OVE _h_ __ __ _ _ _ -' 70
\~ ~1f)~Sl.t.U O~ \$ ~~~ 8% State Surcharge 5~o
I\~ ,,^t.~CtU ~~\Ot). 10% Administrative Fee 7
CO~ Q\) U~'l \'~ 5% Techno]ogy Fee ::rT-
~~'l"\u b (0
Inspection Request: 726-3769 TOTAL '8'
. Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 366 S 43RD PL
ASSESSOR'S PARCEL NO.: 1702323404303
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01156
ISSUED: 08/06/2007
APPLIED: 08/06/2007
EXPIRES: 02/06/2008
VALUE:
Springfield
TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace main breaker panel
Owner: GENE KNIGHT
Address: 44221 MCKENZIE HWY SPACE 034
LEABURG OR 97489
Contractor Type
Electrical
Phone Number: 541-896-3735
I.,fONTRACTOR INFORMATION I
Contractor
DONALD MARVIN HORTON
Phone
541-726-9021
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
~erg Path:
, Building:
. ..; \\t6 \ \~\~
\e1'" -I' ~.
. O~e~ot\ 1~1l lAM JNFORMATION,
~~~~\O~.edO~\e~~~$e ~ Op..~ ~':) \)\9$ 0'1
Frontyard Setback~\\o\f-l t~\~ cen\e~' '\ 0 \"to\)~$ ~~~:
Side 1 Setback: ~O\\\\ca.\\~'2..00'\.0~\e\(\ cO~ .. ~til ~\ft'~ ~ Rqd:
Side 2 Setback: \n Op.~ 9 U f(\e'l 0 ~et. ~o\~\\\",,~ .Drive Rqd:
Rearyard Setback: 0090. .~O \"e ce~ Ote~O~'l; ot Coverage:
Solar Setbacks: Ca.\\\n~ t \ot \"e \, \.&0
. ,..nOe _ ...",,~9t
..~ . V"'
I PUBLIC IMPROVEMENTS I
N OT ~~talk Type: .
THIS ~tRMrr~J.[r~PIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
License
116021
Expiration Date
07/2512009
I...,!!UILDING INFORMATION'
VB
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
REQUIRED PARKING
Total:
Handicapped:
Compact:
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!:e 1 of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01156
ISSUED: 08/06/2007
APPLIED: 08/06/2007
EXPIRES: 02/06/2008
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
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$7.00
$3.50
$5.60
$70.00
8/6/07
8/6/07
8/6/07
8/6/07
2200700000000001240
2200700000000001240
2200700000000001240
2200700000000001240
Total Amount Paid
$86.10
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
Electric Service: Approval required prior to utility company energizing service.
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
Pal!:e 2 of2
2~5 'Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-01156
COM2007-01156
COM2007-01156
COM2007-01156
Payments:
Type of Payment
Check
cReceiot I
RECEIPT #:
2200700000000001240
Date: 08/06/2007
Description
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By.
DMH ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 1256 In Person
Payment Total:
Page 1 of 1
10:16:23AM
Amount Due
70.00
3.50
5.60
7.00
$86.10
Amount Paid
$86.10
$86.10
8/6/2007