The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-2-16 LEGAL DESCRIPTION (70Z. fCr3Cf S?RINCFtELD '~~.~1 ~ 4. ~ J . ;{,) ...,;,..,.:~.,~ .J 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541~7~o!~~89 t:~':S~~ "'i;:'{~fl ELECTRICAL PERMIT APPLICATION / / ~...1>01o~ -,,""A..< 'U;:~ ~1'1 .~ CityJobNumberCOW\-uX'>T'-OO/g7 Date 'Z//b/O f>- ()<$> o~;<$>.,;~.o . I I ""1. "& % "'0. .,~,~.~-... "'~'''-'-''''''.' 3, ".~COiIPiETEFfrEt (;~~JtdI~t~w-': -- .,....,. -~--_._~._~ - -~{g>-.."-'---.;.r-,~oS'-. ~ 0' ~~6 15).. 9". ~. ~'7' ';:F.,~' .~~<-t;<[,': ~':;.~'~~""~~~~',~'?,r:"y;. ""~~;';~'." ' ~" ."1.'~."~~'~$",:,~~:.,<,.:~?,.r.."Ct" ..':"...., 7!:"'\~~.' "'; :-'-If' ') A.~e'Y~R~sid~nti~I,:~.~irfg!.~i;, Iti- aII1i1y~~welli~g unit. ,,', ..'..-l.........._.....>oi<;1,""'""_~'M,.....'.,,""',~~:..1...;.:J~~_=,..~_.~~~ ...,."""'-<__,,,.. --'_.....'..,_._"--~-'"~.~c~:........:,.-~"'-~.._"-';...;.I_.~..tJ N ?;.oS'~ Service Included '\ 'cr '0 ,,/~& , <i><?, 'o~ 1000 sq. ft. or less ~ 106.~ olt.. Each additional 500 sq. ft. or ~' il'&'~ portion thereof "L 00 Each Manufact'd Home or Modular Dwelling Service or 50.00 Feeder '~.."_~>r.,_r..\.~,"~~'IA<:" _ ""'--"1;; ,. 00 7'00 JOB DESCRIPTION T t::Wl P /VI../ b-Il- Ot/'- l., I Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. :"i.~t""'~(""<<~'~~"~"~i;V".)'''''"''!',.'1)~, :'~'''r~,,,,,?:,, ":"'....::~,:.",;,..,:;;i: .#n~.t~~~2':"'rc CONTRACTORINSTALEATIQN;PNLEt~ 2. .;,"; :.:\~ ',;, fi ~~;l:;:i,L.~~~,i:;::~.,d.~;;: '. :::(,,', ;~':,",';.:c;i~.,..';.~~~,.~$>~~-i'!~J.i~,u,",;~ Electrical Contractor i.f'\1 ~ 'c' In "":" E\{rty ,e I - ~ '.. ,~f'\(\ j-\. _ Address ~~ \ -)=) L,-' ,_....; -\ \;'\:: ;tV:~':;~7. ..;v,'::r~J0:!1>.;m'~~~~:~:'7::-.!~~;t;~;'.,:;<F":'~;;,:,'!f;7;,,"~:~, ,. '~~"(::-;;0:""fT't~""~':,0~.?;:>!:~0'~':;.>."'-'~.~~.-'7 B. '. ServiceS or Feeders'r:Jn~talIatio~;Alterations or Relocation:- j ...-...,."". ,,,;,~'~'>k~""'" ;"".,i;~ ' ,:..~~~L,,,i;;..':':";~;~-a..:;~:.."':'~~~!~~>~, <., ;,;......,:.. --",:--^...,,,,_.:_~:".....,,;.s..;:...~,,.~; .: ,_>,..-~";;~~,4i.,;.~i_;,/~ Supervisor License Number .;~ S~ C cJ 200 Amps or less $ 63.00 \'-'201Amp~<~<6490AmBs. . $75.00 401All:lp.S;i9IRo8~rit~gulres yo~ ~o $125.00 " . ",...Jl:;Y melQregon Utlhly _ _. .~' -, ,. 60.tAmP.~ tpH8g~-MPgs are set Rxth $163.00 -;-:-;+;').lo(Cl I : -'~:QYl~Ii 19(1~ e.~~OAR 952-GDt- $375.00 ", . JU ~lffiSfaf?p66pies of the rules-b $ 50.00 n~~~~I~~I~~~~~~~1~~tmPs~!"~;?(:'~"'lr'(p~f':~~~;~>.>;:,\,W'"j;l ., . ~lOJ~~Uli~f_IO'rt''''~' """~.c..._..,,,,...c,,,,,,,,#.">~=.,... ~._.,WJ Center is 1-800-332-.2344\. Installation, AlteratIOn oflRelocation 200 Amps or less I $ 50.00 S- D 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 ~- City r- l. \f\ ~ ,"',-( j Phone Expiration Date I D I (") \ / ~),C,cj I Canstr. Contr. Number \ 'l~~:) ';:::). Expiration Date C ~/c. '3 / ;).C':t: '\ I I OWNER INSTALLATION Over 600 Amps or 1000 Volts see "B" above. ,~...,,,~ '~"'. ~;.'J'~::''1'7''':''ry, S. f S .. EI .. D.BrancIiCircuits;; . Ignature 0 upervlsmg ectnclan ,,,,,,,~__.,,,,,,~,,--_,,,,-,,,;,~~,~, /J ~ ~ New Alteration or Extension Per Panel ~ One Circuit ~' ~ ; Ea()~ Additional Circuit or with o rs Name .Ar1e(t4-1 rJvt kJ~d SGkI CJR' S~~i~;;:'~~;r~:i~~~~~~~~'!1'r'j:~~y.~1 $ 3.00F<~~~'" "":"~~ Address h Z S- ( W1 ,4- (I'(( S" L. ' E..- !ly!,I;~~~t~~f~'~~~~~~~f~~18U'ft;~~clUded~.~E~~!!.:!~stallatlon.; City S \:>)~ Phone . l>ump...or,'irn~atio):l!J. $ 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 $ 43.00 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 4. SUBTOTAL OFABOVE: 7% State Surcharge 10% Administrative Fee '-0 .J J~O 500 58)~ _~.;,...;.. c...~-,.._ '_. ....:.:;..:....F....:~_ _ ~,..... ';:'. c.: .._Io<~.;~, -"'- '-.__.:_.;;;;_..:,..... Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application] -03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination. Permit PERMIT NO: COM2005-00189 ISSUED: 02/17/2005 APPLIED: 02/16/2005 EXPIRES: 08/17/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6200 ASTER ST ASSESSOR'S PARCEL NO.: 1702343400900 TYPE OF WORK: Use Initials TYPE OF USE: New Residential PROJECT DESCRIPTION: Temp power only Owner: Address: WULLSCHLEGER ADELAIDA D TE 6251 MAIN ST APT 1 SPRINGFIELD OR 97478 \ r '--;!'!T!ON: Oregon law requires you to I\':'~' W.';UjJLl:;J Ly d IlJ C,1l::l:jUII ULlIUY I CONTRACTOR~iN'F<iRMw!fI~NJI8 rules are set forth I. "_'" I voJc"-uv ,-vv I v L111~ugh OAR 952-001. Contractor' 0090. You may Jljreeitlseopie~pnea"rfm;i>)tte REYNOLDS ELECTRIC calling the cef"'~~2 (Note: the tfdfhOS/.ZO07 Vll'l" '''''l. L' 'J...J.l.\r . '.' \:l:jUI I VLllILY I~ULlII~i::Ulon BUILDING INFO~l'lON 1300-332-2344). Phone 541-343-7297 Contractor Type Electrical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: ~ange 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: n/a I DEVELOPMENT INFORMATION I . REQUIRED PARKING Overlay Dist: N())l~tlE: !,otal' WORK # Street Trees Rq~HIS PERMIT SHAll EXPIRHJ~d\~JPP~d:OT Paved Drive Rqd:AUTHORIZED UNDER THIS C6~~'YJt~0 I'J % of Lot CoveragC=OMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I PUBLIC IMPROVEMENTS I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: , Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value .Date Calculated Pae:e 1 of 2 -'~ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00189 ISSUED: 02/17/2005 APPLIED: 02/16/2005 EXPIRES: 08/17/2005 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' Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 2/17/05 2/17/05 2/17/05 1200500000000000212 1200500000000000212 1200500000000000212 Total Amount Paid $58.50 " , 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, I Reouired Insoections , Temporary Electric: Approval requiredprior to Utility Company energizing pole. 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 proj~ct. 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 Pal!:e 2 of2 225 Fifth Street Sprin"gfield, Oregon 97477 ~41-726-3759 Phone Job/Journal Number COM2005-00189 COM2005-00 189 COM2005-00 189 Payments: Type of Payment CreditCard 2/17/2005 RECEIPT #: Description + 7% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less Paid By ELLEN REYNOLDS r;ty of Springfield Official Receipt velopment Services Department Public Works Department 1200500000000000212 Date: 02/17/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 057168 In Person Payment Total: Page 1 of 1 7:49:30AM Amount Due 3.50 5.00 50.00 $58.50 Amount Paid $58.50 $58.50