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Home My WebLink AboutPermit Electrical 2003-10-2 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number Cb'I1 7.003 -cO 9 g)' Date . ..... -_.~. ,__ ....-- ,-~l:-'-", h..._.._: .........,...~., ''"'"1 1. ILOCAfiONOFINSTAiiA'1iol'i,'.;..i.... ';l ;":;.(:i,;':- MJJ..~~_.;.::..:.~~_ '-~,:_.._~~~.:._'tl.,___;:'l.._' '_ ~::...;.:. _, 10 7(9 r; (g -'^" T <5'- 'itp, Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. r-::-_' - -..----..-.-~.._--~__:-~-------- --, 2. L!if!rit~H!P1!-'IN~"{AU.AT!.~~ ONLY I Electrical Contraclor'11,' ( (,~ 2' I~ ~1 ~ ~ '-- I / /I/' oUW / ~ 71 oS ( 601 Amps 10 1000Am~U\(es~ (I:~~J $163.00 Phone (j d Over 1000A~tl;0(~O(\U \~~d $375.00 ~~fQP~~"\,,O sate G'U. ..nL $ 50.00 <.,-z:::, (>;~\~~\~el:~0~\~$.~-:~ tI~ri.~ -:-~' - \O\\O't>l~d(\~~';-{~~~~:~ey~o~ _;.~_ '....<;L ~_ .____J :-.\O\i\iC~~1tf?'\ .~\Wr c~~,~"19 \e\Gl~\\O(\ . O~O '{20'b ~~!-,,~~.\~~ (\ U\\~\I}~A,). 009' \fl91...' 0 n....Z.Z~ C~\~{@~~ flQ.e.ffiP?" (\\l~ ~Ilh '600 Amps Over 600 Amps or 1000 Volts see "B" above. ""'I' --:;-7""'-- ...."..~r.---.-- ._- --------..--. --.----.~~- -.- -~, D. ~..l!!:..anc.hCiTCui~_~....___~__~_~::.._____.' . ..L _ ___ LEGAL DESCRIPTION /70 <, Z("L( I JOB DESCRIPTION -JU/}uI -A, -<- '1.u" ClYS<Ja Address 111 0 City cz...... Gi I "IJ , 'jT Supervisor License Number CfYO S Expiration Date I D - /...-- b ~ Constr, Contr, Number ;;l (""1.<i I Expiration Date / 0 - / -- A ~ ~:;;;"Z Of. o~rsName J?obh'{~ f I~ 1"---1-:- Address 1076 ?.v ,.cO Phone City l -'., .' OWNER lNSTALLATION The installation is being made on property lawn which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 9 - '30 -::b""5'lIowlng project as submitted '=' ......,U \Joes not re' has the 'OlJowing 3. :E~ilJ.il!f{1J"i:io~~ED]JY1JlWd~~r:. ':~=~,~;,;~,! "'" pat:-:- . '" ..Z-:-.. .__. A. !,c.~e)Y,~~li!!~~;gt:t\flul\le ooL Mulli~. at,,.: llin~;~Ai!:, .' J: - 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 Service or Feeder $50.00 r-- ~--~._--~.._- .~.~..,._---:- .---;-~~-. B. ~":Services'-or Feeders - Installation,.Alferations or Relocation: L.-"',~.-;: '_-<':':.:_..~ ...:.-____~....:.,,_:~_..:-._ " ~_ _...-.::..:.;.. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps * $ 63,00 $ 75.00 $125.00 $ 50.00 $ 69.00 $100,00 New Alteration or Extension Per Panel One Circuit $ 43.00' Each Additional Circuit or with ~~ Service or Ft~der Permit ~~\\\e \f 11:'11= 'tJ ~01 ~011C_..! u~'Sr\t>-\.\. ~\t::~t.w.A\1-\S-. -..--.... - - . E. j'~~~I\1/iAjl\iS' Ser,'dcf!ft~HI t:Illcl~flI)~Eacl\[nstallation" ~- \l"lr\O?il1t -u~R\S~1>.~ 1\,)\'41:.__, - h_____ ---- pum~I~\l!\1,&EO tRIO\). $ 50.00 Sign! ~~1f'Wj'gIllIh'i: ~ $ 50.00 Limite. EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges "-.'.;;- ---:--'-' '-- - --::-- ~ _.- -.- --_. - ---~. 4.i'SUBTOTALOFABqVE . I." __~::_"_ _____---"-.__.. ..__.<..~.. 50 7% State Surcharge 10% Administrative Fee "5'= 500 58'5'::' TOTAL Shared Drive(T:)JBuilding FonnsJElectrical Permit Application l-Q3.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00985 ISSUED: . 09/30/2003 APPLIED: 09/30/2003 EXPIRES: 03/30/2004 VALUE: SITE ADDRESS: 1076 PLEASANT ST ASSESSOR'S PARCEL NO.: 1703264104500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service relocate Owner: BOBBY NOTT Address: 1076 PLEASANT ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BILLS ELECTRIC Phone 541-501-5650 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: License 21351 BUILDING INFORMATION I Expiration Date 04/28/2004 # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Vlhr Water Type: Sq Ft Basement: Range Type: i~IbFt GaragelCarport Energy Path: U$eS ,/0 Jt Other: n \~'l'l te~O(~g(\ $ mgf'f"ious Surface Area: ",..onO ~....e<I _ ~ , - to ... I DEVF.wl'MOO ~F.oRM1:iil~1>~ es&~ \ r'~o'l'll~IJ~ce(\\~f. / \,,~u~.. ~ \~ (\1\'0 0 REQUIRED PARKING \0\ _>lOn ..00'\0 ~GS 0 9~on ~0~~rt3Y,I!Gtl'\ ~e\n co9 . \~S \e\~ ea\\onTotal: djSfl:~i'Ifff.~~: ( ~~o\6' ~"'rI ~o\~ Handicapped: ~~fci~lY.f~}~1l1l~6(~on ~~-2-#)' Compact: ~~~~Clfml~~s ,\_eO(T . nUfl\ ('.p(l\P ,\'It: ~~f,:W I PUBLIC IMPRo.~~MIf,l'i:FS , \. Ey-?\\\E If IS ~OI 1~IS ?ER~~~ ~r~l\li1k1~g~~~g fO? "'1J1I-\OR~CH) W1~Jp~fiYsmrains: COtJItJIE Ot-.'{ ?ERIOO. t-.~'{ ,80 I Valuation Descriotion I . $ Per Sq Ft or multiplier Square Footage or Bid Amount Description Tvpe of Construction Value Date Calculated Total Value of Project Paee 1 of2 e. . CITY OF SPRI1~l>NJ<.,LD Building/Combination Permit PERMIT NO: COM2003-00985 ISSUED: 09/30/2003 APPLIED: 09/30/2003 EXPIRES: 03/30/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L.Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 9/30/03 9/30/03 9/30/03 1200200000000002233 1200200000000002233 1200200000000002233 Total Amount Paid $58.50 I Plan Reviews , 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. I Reouired Ins.rections I 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 tbe 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 eacb address is readable from the strcet, 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 Pa!!e 2 of2 225 Fiftn Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00985 COM2003-00985 COM2003-00985 Payments: Type of Payment Check -' J7':~~.' ' ~.. ' " j :.A!. I ~' : -_-....-,,"'....., .,",- Receipt #: 1200200000000002233 Description + 7% State Surcharge + 10% Administrative Fee Service Reconnect Paid By BILL GRAY JR Received By djb Check Number Batch Number Authorization Number City of Springfield OfficiaI'Receipt Development Services Department. Public Works Department Date: 09/30/2003 11:43:39AM . Amount Paid Item Total: 3.50 5.00 50.00 $58.5U How Received Amount Paid In Person Payment Total: $58.50 $58.5U . .