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Home My WebLink AboutPermit Electrical 2005-9-22 .~~ ,<.' i~~'- - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689~~0~f~ - - , ELECTRICAL PllRJ!!I1; ~PLICATION ~~",:~,0' ~ity ~~0::~u.mT~be9~r!tNO:~\. ~\T'(\~Ktl ;('fvl~ 3. I COMPlETE FE~~!:~7J 0' ill' ,. ~'<J- / ,,'<" r-'<::' ~?i- .-.0<::' 0 ~O lO V .'l: LEG\~Yf10~ ('\)\~ A. ~e~v~~e ~:::::::al~ S::~~~~:,,~~~!t~~~milY per dwelling unit, I JO~BD\~ES(\CRktIPT~. \~ ~Ql)t, ~ 1000 sq. ft. or less \'-'" \ $106.00 \~'~l Each additional 500 sq. ft. or 11 dO V'" portion thereof 7"", $ 19.00 ,.:Jb, Permits arl)on-transferable an~xpire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Snspended for 180 days. Feeder , , CITY OF SPRINGFIELD, OREGON . ',," 2. I CONTRAcrORINSTALLATIONONLY I Electrical Contractor 7. 2t'/J/ .u ) 0 ~ Address fb ;) cJ Y c;- /J 4 V City f:// cY - U Phon, ~ 9r..~:?-CJ~~7 1nr7S Supervisor License Number Expiration Date //1..- /...- 6 tt Constr. Contr. Number //;::, < ~ 9 Expiration Date /0 - /- " t, , - Signature of Supervising Electrician bh~J;d Owners Name Address City ~Phone!W'[~L OWNER INSTALLATION The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: -, i<.,v I..J ~ Utj IS "I,U 1-(';' Ii)' ,t' J\C.. ' 'oJ Inspection Request: 726-3769 c $50.00 B. I Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. I Temporary Sen'ices or Feeders Installation, Alteration or Relocation \ $ 50.00 $ 69.00 $100.00 f:I) .oj 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. I Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Serv~e'or Feeder Pennit fnll' ,(:--,. "- 1f/~4\'"i-~cellaneous (Service/feeder not included) -E:lch Installation l "'U ., OrB io1l?, " . $ v wnp or Imgatlon 50.00 C.s~6utline Lighting' , '''~Q. ,. $ 50.00 I}J. ""'}r) , . JVlJ "Ii~niited EnergylResidential; ': 'c'" . '" " $'<25.00 : tit: f.. ' " . 0!J l ~ -,1//, LIl)llted linergy/Commerl'.tal; 0..; ~ "'",', $'45.00 "'till'H 'l,_, (IV,I.... '-"0/__ .',:..'''..... 'VrtA Minimum Electric Permit Inspection'Fee is'$45.00''' Surcharges 'w l-r"~IIII', "'e~_. "'I/J/~/.. 4.1 SUBTOTAL dF ABO.VB' ',", '. ':Jt I ...._'l "'/""" It:] ! "~q). -qllOI} $ 43.00 $ 3.00 , 7% State Surcharge I - lit !'~10%AdministrativeFee . ,. \#pD t~ :S~ -2!L lo ~<6 TOTAL Shared Drive(T:)lBuilding Forms/Electrical Pennit Application I-03.doc .""......'''''""~..'..'"'..l...... (541) 726-3753 FAX (541) 726-3676 Notice to Permit Applicant Soils stabilization required for subdivision sites Nameofowner~Of\.~ , Permit: ~~~.lnS Address of Project: ~QCYL1. ~ 1\ l~ Tax Map: 19lflJ55!:A Tax Lot:.OOl <iA Subdivision ~l.\b~ u.~ The building site at the above address is located on property that has soils prone to shrink-swell or other potential movement. Excavations, placement of fill materials and drainage for this site must be done under the direct supervision of a properly licensed Professional Engineer or Architect to verify the stability of the resulting building pad and the site. The owner, or the owner's qualified agent, is responsible to obtain the services of the appropriate professional engineer or architect (design professional). The design professional shall provide direction for the stabilization methods to be used for the building pad (and surrounding site, when site stabilization is also necessary). The geotechnical report, which was prepared for ihis subdivision, may be utilized to provide appropriate guidance for the methods of stabilization and required compaction for the specific site. The engineer or architect shall prepare a report to be submitted to the City stating how the soil stabilization is being accomplished, including requirements not yet completed (if any). A signed and stamped report from the engineer or architect must be received and aporoved bv this office before footin~ or foundation ins,?ection Ol!proval will be l'ranted bv the Citv Buildinl' Insoector. ACKNOWLEDGEMENT: The undersigned acknowledges the forgoing requirements for soil stabilization, including excavation, fill, soil compaction and drainage, as provided in the geotechnical report for the subdivision. The stabilization will be accomplished under the direction of a licensed professional engineer or architect as noted above. Signature Name ;}-/4_ ~~ ~s..J- Affiliation to owner Date 9/Z() k....- S€N"''''~ . f........ _ ~25 Fifth Street. , .' Springfield, Oregon 97477 541-726-3759 Phone . .j:~~~ Wit. i " J';'l/Journal Number C:OM2005-0 1175 COM2005-01175 COM2005-0 1175 COM2005-01175 COM2005-0 1175 COM2005-01175 COM2005-0 1175 COM2005-0 1175 COM2005-0 1175 COM2005-01l75 COM2005-01175 COM2005-0 1175 COM2005-0 1175 GOM2005-0 1175 , COM2005-0 1175 C:pM2005-0 1175 C'bM2005-0 1175 cibM2005-0 1175 COM2005-0 1175 COM2005-01175 COM2005-01175 COM2005-01175 COM2005-0 1175 COM2005-0 1175 COM2005-0 1175 C:OM2005-0 1175 COM2005-0 1175 COM2005-0 1175 COM2005-0 1175 COM2005-0 1175 (,-bM2005-0 1175 P"yments: TJpe of Payment CreditCard ;i , ~ ~~.. ,r 9/2112005 RECEIPT #: 1200500000000001373 Description Addressing Assignment Wmamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea AddU 500 Temp Power 200 amps or less Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit (Street) Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Plan Review Major - Planning Building Permit 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Heat Pump -Mechanical Issuance Fe.... Appliance Not Listed + 7% State Surcharge + 10% Administrative Fee Paid By HAYDEN HOMES Received By IIh I of I ~ty of Springfield Official Receipt .velopment Services Department Public Works Department Date: 09/21/2005 Item Total: l:heck Number Authorization Batch Number Number How Received 097992 097992 Phone Payment Total: 10:02:08AM Amount Due 31.00 1,000.00 106.00 38.00 50.00 80.00 80.00 (30.00) 664.73 501.40 381.40 182.69 805.70 82.03 . 865.31 10.00 106.59 68.07 150.00 633.90 254.00 12.00 18.00 9.00 6.00 4.00 12.00 10.00 9.00 80.63 115.19 . $6,336.64 Amount Paid $6,336.64 $6,336.64