HomeMy WebLinkAboutPermit Electrical 2005-9-26
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US'd' n STREET. sPRlNG'lELD, OR "'" . PH'I'''''''''''' . PAX, I""=""~ s;~s. IV;..,:
ELECTRl~ PERMIT APPliCATION " 'k!.V7
CityJobNumb~m;(02)<;" ~ tJ/g09 Date ~-dCO-G~ J
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('ITY OJ' S ,ING/,'I!:!.!),OI{!:(JOi\
. .
1. I LOCATION OF INSTALLATION
/6o~ 1<Ot",VlJ-oLdf)(',
LEGAL DESCRIPTION
/7()~ ,;;:)-7~';'< O/()D(p
JOB DESCRIPTION
Sc J {}J/.e,i5' {/ S (p; k/,p, "i i !'1
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Permits are non-transferable and esplre iiwork is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
Electrical Contractor JB Electric. Inc,
Address 4685 Isabelle Street
City EUl/;ene
Phone 687-5770
SupelVisor License Number 3782-S
Expiration Date 10/1/07
Constr. Contr. Number 37587C
Expiration Date 7/1106 (CCB 104929 3/14/08)
Signatu e
"'
I """'" "~
Owners Name -:-)od, \P Ct }(,\c:Y1J
Address j{()(34 Ro,;Y\ hnlJJ 1)->_
City Spf" i vj-~'J el d Phone
OWNER INSTALLATION
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. I COMPLETE FEE SCHEDULE BEWW
A. I New Residential- Single or Multi-Family per dwelling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft, or
portion thereof
$106.00
$ 19,00
Each Manufact'd Home or
Modular Dwelling SelVice or
Feeder ATTENTION: OregDn 10", ,on!_';'')sSfBJ%
fnlt"I~' .."In.... .,rl"'....f......... h.. .h~"":-:-: l~..:ll-
B. I Servim or Feeden ~ lo,taUa#ou, Alte~~Of'~cation:
In Ui" ~,,~-OOl-0010 through OAR 952-001-
200 AmpS:orJessJU ntay obtain I'nn;p~ nf t1t.-6i\P.l?s 1;-1'
201 Amps toAoo~Ainps~enter, {Note: the tE.ji~~~I~e '
401 Ampsto:6oo!Aiopshe Oregon Utilitv Nt$;lfM<ilibn
601 Amps to 100({Anijrsr is 1-800-332.234<$163.00
Over 1000 AmpsIVolts $375.00
Reconnect Onty $ 50,00
C. I Temporary Services or Feeden
Installation, Alteration or Relocati@
200 Amps or less $ 50,00
20~!&vqtte~00 Amps $ 69.00
4<>t1'tt3lj3~wtPr':ffi'ALL EXPIRE IF THg ~bO~~O
O-M-JlI~E}rU~IJHl9' P!JtWlff'lS..ll:CT
D. ~Mrm~R IS ABANDONED Ftl~
NN'JX.i\,~~i~'t,.ijfJUI~1D Per Panel
I
Lj
'-\300
\ 'd. 00
One Circuit
~ Each Additional Circuit or with
SelVice or Feeder Pennit
$ 43,00
$ 3.00
E. I Miscellaneous (Service/feeder not Included) -Each Installation I
Pump or irrigation $ 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. I SUBTOTAL OF ABOVE'
55.GO
2,,~5
..c:; 60
-0.-'-1.35
7"10 State Surcharge
10% Administrative Fee
TOTAL
SITE ADDRESS: 1604 RAINBOW DR Springfield TYPE OF WORK: Accessory Building
ASSESSOR'S PARCEL NO.: 1703274201006 ", nr non law requires you, to
ATTENTICTYPE(;'?l.:l '!.~~he O\d!!lllblt1tihty
PROJECT DESCRIPTION: Electrical for storage building follow rule~ aOop Those rules are set lorth
Notification cent:~,,, ....r""nh OAR 952-001-
in OAK :,JO"'-VV' -- , copies oltne rUII:::> Vl
0090, You may obtalO Note: the telephone
calling the center. ( Utility NDtilicattDn
_, .~hpr lor the OregDn _ _~ N" A)
CAnter IS \-OVV-v-- -
I CONTRACTOR INFORMATION I
-~
, Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Owner:
Address:
WOOD JODIE
1604 RAINBOW DR
SPRINGFIELD OR 97477
.
Contractor Type
Electrical
Contractor
JB ELECTRIC
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
~ Frontyard Setback:
, Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
.,
Description
Type of Construction
.
. CITY OF SPRIr~tJNJj,LD'
Building/Combination Permit
PERMIT NO: COM2005-01309
ISSUED: 09/26/2005
APPLIED: 09/26/2005
EXPIRES: 03/26/2006
VALUE:
License
104929
BUILDING INFORMATION I
Expiration Date
03/14/2008
Phone
541-687-5770
# of Stories: ,~.. ~ Lot Size:
Height of Structure Sq Ft 1st Floor:
T~6~!: Sq Ft 2nd Floor:
WilN ,'I: ef.lMIT SHALL EXPIRE IF T~I! ~~>>ll.ument:
R' !r Il'tlJilllage/Carport
E.ti! . ED UNDER THIS PERM I it~er:
sPjLv ~~~~~~~~~.BAmlONEikf!ia&\>ant Load:
r DEVELOPMENT INFORMATION I
\j REQUIRED PARKING
.
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDrains:
I Valuation Descriotion ,
$ PerSq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paeelof2
225 Fifth Street
'3pringfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-01309
COM2005-01309
COM2005-01309
COM2005-0 1309
Payments:
Type of Payment
Check
iI'
"
Ii'
"
,.'
9/26/2005
e
RECEIPT #:
.r-~--_l1!',~-- ,
1tI;:" !
,- -:a.. "
~ '
......_._..._... _._.....-f ,t
3200500000000000576
Description
Add. Alter. Extend Circ
Add. Alter. Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
18 ELECTRIC. lNC,
Received By
njm
Check Number
Batch Number
Page 1 of I
016338
City of Springfield Official Receipt
evelopment Services Department
Public Works Department
Date: 09/26/2005 '
Item Total:
Authorization
Number How Received
In Person
Payment Total:
I :38:07PM
Amount Due
43,00
12,00
3,85
5,50
$64.35
Amount Paid
$64,35
$64.35
.
. CITY OF SPRIr"l\.Jl'lJ!,LU
Building/Combination Permit
PERMIT NO: COM2005-01309
ISSUED: 09/26/2005
APPLIED: 09/26/2005
EXPIRES: 03/26/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
[..Ff'f'S PaldJ
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Aller, Extend Ctrc
Add, Alter, Extend Clrc Ea Add
Amount Paid
$5.50
$3.85
$43.00
$12.00
Date Paid
9/26/05
9/26/05
9/26/05
9/26/05
Receipt Number
3200500000000000576
3200500000000000576
3200500000000000576
3200500000000000576
Total Amount Paid
$64,35
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.
~rf'd Insn~
Rough Electric: Prior to Cover
Final Electric: When aU 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 wllh .
tbe 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 wilhout 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 slle at all
times during construction.
j;l~_ 7h&#cA,cu~-
Owner or Contractors Signature
Date
Pa!!e 2 ofl
I