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Home My WebLink AboutPermit Electrical 2007-8-20 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION ' City Job Number CO""'" 2..-c::Jc:::>"7 - C> I '-, L... Date ~ - 2.0 --0/ . ", ,';",. .'. ;",..-..' --.:." 1. .LOCATION OFINSTALLATION 3. COMPLETE FEE SCHEDlILE BEL01V c..(l 8iG-l~'iEJlV;t~ 41 'iD LEGAL DESCRIPTION I&C>L 052.-2 JOB DESCRIPTION oSZOQ Sc=(l.Vl(R lA -fG-rtAdE 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. CONTRACTOR INSTALLA110NONLY Electrical Contractor f2,oh 'J .E/d-I,../n i. ::J:fqC- Address ~,O, !? .</X 2- f 2- I t:fw(.J'/-(., Or.. If 7 '/0 2. City [",-~ e-i'te.,. Phone f<-i t) & f/;- S' Lj c.f Lf Supervisor License Number '(7'1l/5' Expiration Date I () - i - 00 Constr. Contr. Number / 5 t, t 7 g Expiration Date ~ - / ~ - 2 () 0 -, Signature of Supervising Electrician ~ ~ ~ Owners Name '(, Address 2- City tJ,& LLL/ c-f ttf~ IA-W.?d / / ~ne _ / Inspection Request: 726-3769 A. 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.>Servicesor Feeders ..:In~t:dlation, Alterations or Relocation: 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 / 7Z> $~OO $ 75.00 $125.00 $163.00 $375.00 $ 50.00 70 ~-::. -';~-", . '-,\{""-.;: . ~ " < .,-:-, C.;Tem~orary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B:' above. D. Branchpircuits , New Alteration or Extension Per Panel $ 43.00 ~~~~iJ~iial Circuit or with SerTltf~~MtlPm4All EXPIRe Ir mE Wbm< AUTHORIZ~ UNDER THISPERMJI J9, NOr E. .. l1OM~MC!~ff~im'IArfAN.f)tjNt:tf~ :-1rach Installation pu~~hr ~~ag~J' PERIOD. $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges '-',<', ',--. --- ><~' 4. SlI1!TOTAL'OFABOVE. ~',':.., ....'\: -:-D / Sf-b 7/7~ ~6'O $/0 State Surcharge 10% Administrative Fee 5% iC~tf ~. TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application 1-03.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01212 ISSUED: 08/20/2007 APPLIED: 08/16/2007 EXPIRES: 02/20/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4188 Glacier View Dr 4190 ASSESSOR'S PARCEL NO,: 1802052205200 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Service upgrade Owner: 2J LLC Address: 29404 CLEAR LAKE RD EUGENE OR 97402 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor ROBS ELECTRIC INC License 156678 Expiration Date 08/14/2008 Phone 541-686-5444 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Overlay Dist: Side 1 Setback: # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar SetbaCkStATTENTlON: Oregon law requires you to ol~ow rfJlAR ArlnptAti ~' thr ~1.:J:ili b/lt:l:t:r.' Notification Center. Those rUI~~~iMI$ovEMENTS I In OAR 952-001-0010 through -e".n l:10;:::-UU1- Street Impro~!~ou may obtain copies 01 the rules by Storm Sewer ^n1J~IMR}he center. (Note: the telephone Special InstructIoID er 10r the. Oregon Utility Notification Center IS 1-800-332-2344). Total: Handicapped: Compact: Sidewalk Type: Notes: Downspouts/Drains: NOTICE: THIS PERMIT SHAll EXPIRE IF THE WORK ~U!~ORIZED UNDER THIS PERMIT IS NOT iJ/VlIVICl'IJvtU UK J~ ABANDONED FOR I Valuation Description NY 180 DAY PERIOD. 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: COM2007-01212 ISSUED: 08/20/2007 APPLIED: 08/16/2007 EXPIRES: 02/20/2008 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 8/20/07 8/20/07 8/20/07 8120/07 2200700000000001318 2200700000000001318 2200700000000001318 2200700000000001318 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 . 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 Pae:e 2 of 2 225 Fifth Street . ' Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01212 COM2007-01212 COM2007-01212 COM2007-01212 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200700000000001318 Date: 08/20/2007 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DA VID LAWLER Item Total: Check Number Authorization Received By Batch Number Number How Received djb 075143 In Person Payment Total: Page 1 of 1 2:03:54PM Amount Due 70.00 3.50 5.60 7.00 $86.10 Amount Paid $86.10 $86.10 8/20/2007