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Home My WebLink AboutPermit Electrical 2005-5-6 SIPI:'lIl'lZG!FaElLD 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (.c:wIA. '2.00 'S""'..... 0-0 54. ( 1. LOCATION OF INSTALLATION AS+e:tL ~\- I ~O ( LEGAL DESCRIPTION t7033 boo DoJCC> 3. Date '5/ b ~ 5" _ ~(")"1@~ . I ~ '-;.,' 'O/- COMPLETE FEE SCHEDJ}IE ~ . "9. i@ ':" 0- <9..0 % t ~'O o~. . o? .6'\1' 7@(\, A. New Residential - Single o~lu '-F~liIy p~ ~velling unit. . ~^ ~. ~~:V6~ .~ ~'~ 't @ ~ "'@ f'T.1 06.~C1'1" \" ~.'<l'~ o C'/.~@ ~~. 00_ _..,~O\ ~~~ " B. Services or Feeders -Installation, Alterations orRelocation: Service Included JOB DESCRIPTION 1000 sq. ft. or less AlIV';" / ~ ~ ID /L Each additionalSOO sq. ft. or 2 $'"0 Y&b'o 't u~, '1' portion thereof ( Permits are non-transferable and expire if work is ..' not started within 180 days of issuance or if work is Suspended for 180 days. [v...w\lo6L 20 I". : Ei . Miscellaneous (Service/feeder not included) -Each Installation 1. .." .. l" ( ~ ThiS PEfl'kll"~,:im.,.\~~tib'"ri;"."":":"",'" ~..' " . j" U i 1--' 0 P - - . I I' :.. . . F :.:......... .. ..1 ..:. S. utlme Ltghttng . ~O\I\I;I~.\I~~:~ ;r~QJ.~,:;~.,iw,.~ .)Re'si~~~ti~i '0':' r\1 I ell 01.\\/ '.:1'.. . I" The installation is being made on property I own which . . Lmlited Energy/Commercial is not intended for sale, lease or rent. CONTRACTOR INSTALLATION ONLY 2. Electrical Contractor /f,1c DIW/J1lc/ ec/?Jtp/ ~ Address 8"9>-791 ~b'V 9?' < City eur~ (/ Phone ~ill-77~ -/tJ/7 Supervisor License Number Z B (!;7(!? 5 Expiration Date JD---I --07 Constr. Contr. Number 77 t!J 2, ~ Expiration Date / (J -2#- CJ b Signature of Supervising Electrician aA~~~~ 1 ( Owners Name "2.0-::> loca.o 70 City SpF~ Address 1So~ Phone OWNER INSTALLATION Owners Signature: Inspection Request: 726-3769 Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less $ 63.00 201 Amps to 400 Amps , $ 7S.00 401 Amps to 600 Amps $12S.00 601 Amps to 1000 Amps / $163.00 Over 1000 AmpsNo1ts $37S.00 Reconnect Only $ so.oo ATTENtiON- 0 ,l8!~~~~d;m~'~WM~lisas y6tl to ~C...!Gdtlcn Ce t ,. Y the Oregon Utif'ty ~~J~?f&1~~~vJf~'hS81itlqlioa(Q)8et f~rth ....J21d'~~ bStafn c~a~ghOAR 952-001$ SO.OO ~~ )WA~~It0.0rA~r.u.)pj.es Off~e rUles b'f$ 69.00 nun JJe~frir th · \'"VOte. the tSJepn 4 n '. trrl'~dMQt)~Uff'UtilitYN '_, one, $100.00 enmr is 1 f" ,. . Otincauon Over 600 Amps op~{j~lOO~~B" alioVe. D. Branch Circuits 7:.-) /63 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 30 I 0 $ 3.00 $ SO.OO $ SO.OO $ 2S.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE Zbf I ~ 7'" Z--' BD 3/1 s~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc . CITY OF SPRINGFIELD' Building/Combination Permit' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2005-00541 ISSUED: 05/06/2005 APPLIED: 05/06/2005 EXPIRES: 11/06/2005 VALUE: SITE ADDRESS: 1801 ASTER ST ASSESSOR'S PARCEL NO.: 1703360000300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair PROJECT DESCRIPTION: Replace 1-250amp panel, 1-800 amp panel and 10-branch circuits Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: NOTrC%.ofLot Coverage: C. T~~~ ,~~R_MIT ~~~, I ~VD!n[:r TII: 'N~nl\ f. lpUBmaIMP.RON:.em1tff~ RMIT IS NOr c lVI/VI I~ut HI' A ANDONED &'" "" ANY 180 DAY PERIOD: ~i!J~~alk Type: Downspouts/Drains: Owner: ROSBORO LUMBER CO Address: PO BOX 20 SPRINGFIELD OR 97477 I CONTRACTORINFORMA.TION I. Contractor Type Electrical Contractor License MCDIARMI~~rolft~twflnn 'calAl rcq' "JJo.'7:.~. & TOIIOW = ... ~ L.:..-..:.. \ '0 - ~3 . . fTn...."tN~lI!W<'01RN1JN.IJ~i1ity Notltlcatl CCllltl'., nose rUles are set forth in OAR 952-0Qjloiit,SH~rough OAR 952-001- 0090., You maJI(~1gtainfCb~~fthe rules by calling the ~rof(tfJ~: the telephone number for tlWlCDJe~mRttJtility Notification Cent~ftpge~S32-2344). Energy Path: SPJ:!!JlQed Building: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: n/a' I DEVELOPMENT INFORMATION 1 . Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal!e 1 of 2 Commercial Expiration Date 10/24/2006 Phone 541-726-1677 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid J Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 201 to 400 amps Perm Serv/Fdr 601 to 999 amps Amount Paid Date Paid $26.80 $18.76 $30.00 $75.00 $163.00 5/6/05 5/6/05 5/6/05 5/6/05 5i6/05 Total Amount Paid $313.56 I Plan Reviews, CITY.OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00541 ISSUED: 05/06/2005 APPLIED: 05/06/2005 EXPIRES: 11/06/2005 VALUE: Receipt Number 2200500000000000545 2200500000000000545 2200500000000000545 2200500000000000545 2200500000000000545 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 Electric Service: Approval required prior to utility company energizing service. 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 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 Pal!e 2 of 2 Date 225 Fifth Street ~. ~ . . Sprin'gfield, Oregon 97477 . 541-726-3759 Phone ~..f?':'-L.l!!lg..=.'iiii.'~""" '.'. wr. .; f :f; t. "- ""<;".~ '!;,~-.,.", .~,. i'~' ,~ ,. .'- r "",_'_.""'~ _ If; '.r Pity of Springfield Official Receipt .:velopment Services Department Public Works Department RECEIPT #: 2200500000000000545 Date: 05/06/2005 3:31:58PM ., Job/Journal Number , COM200S-00S41 COM200S-00S4l COM200S-00S4 I C,OM200S-00S4 I COM2005-0054I Description Perm Serv/Fdr 201 to 400 amps Perm Serv/Fdr 601 to 999 amps Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard JEFF BROOKS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 617~ 11 In Person Payment Total: Amount Due 75.00 163.00 30.00 18.76 26.80 $313.56 Amount Paid $313.56 $313.56 ,; ~. ;.", 'i d \. ? 5/6/200S Page 1 of I