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Home My WebLink AboutPermit Electrical 2003-11-10 , " .' ,," '.~, <;" ,_: ~ -t-} ".." ,.... . .' "C,: u', , ,. " '" CITY OF'Sl. ~<INGFIELD, OREGON ~,) " .~ " -'- ' ~ . '225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726-3753 . FAXTt(54:1i~~ct as submittad has the toliowing ELECTRICAL PERMIT APPLICATION v: zoning, and does not require specific land use / approval. CityJobNumber COW/z.ooJ~OIl2'7 Date /;//0 03 Zoning 17~---""""~""""-- -'-.,..-~ ',"" -~,--.-.- 3',' ~~"'?C',','O"'M-,',;;",'.r",-"-I7-T''E''F','E-DaI, t:..:v-'v' ',' H:, -~L--U'W-' ",:',~."--",:," ',',"'-"'-" ,.,,' 1. ;;'LOciTIONOF'INStALLAl1C)N',,:, ""~ -; I',.L.L lil:>..~ ~ ~~ , ': . 7 t;f'r~ ~-t;~~[}~-- ~C__' '-:^-'='~V',~~-Aot:.o"ze(f:~gn~tur&-',. -"---- ,-- LEGAL DESCRIPTION A. :l.~e.i~cnii,!!.: S~~le ~~}I~~~-F~~}2; p.fr~:v:II,i11g~jt" '.. 17{) 33Lf / liS Z.OO Service Included Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or $50.00 Suspended for 180 days. Feeder \0 2. : "i?~1'{I:M9iOR"INspiL~1!~f.: ONLY i B. Ei;rXices~; ie~d~~~ 7~~~~~~1~~~~~~Reloc~~~~;:" : /' /", 'I 01'\3' eO\ leS nO Electrical Contractor (<?'-t:> Ac- 11 c.JJ;:h.. b ~, 200 Amps or.l91S'316 Ii '0'1 \\\ 1\)\eS a: _ o.~'l"$ 63.00 201-#lp9~j.90\~p~\Ose .,1\\\ Ot":..:." 1\)\'S~J'OO J/ I /" ,,~'to- ",S 'roC \ "10"'"" 0\ ,. ~c\\ Jf....t2L--L~ ..401 AQ1ps.to.@O,}\ffiI1~\\' ,,\eS~\"'~ $ltS\OO $)\\O"'. I'v ('\$ \ CO.. ~e ,- ~ Ca-t 60hbID'Ps iO.l!Jo<io~p.s~ 0\0"'< ,,\0\\\ $163.00 ~5'br-:ro&~ropsW?'lts~I"~ I' \)\\\\\~",~t.~. $375.00 \Re(ig&!e~?()~y~ce\'O~e~O r::/!J'?;t..~. $ 50,00 ~~~~~wt~~&~.._-~. - -.---, c. l>_I~~a~~~.~_~s o~;Fee~ers~.. ':L ~_,:...:- __....,~__~ _._~_....;..J JOB DESCRIPTION ! A.J I /l...e-. L k.()~ . Address R I- (')c:( L Phone b A ~ 7 S7.7 City pu fa........ ./ Supervisor License Number 3> g / (;' S Expiration Date IO/D c..,L /Os677 / / DC! Constr. Contr. Number Expiration Date Signature of Supervising Electrician ~ V V Owners Name ~d ,el, Ai-... G-,f$S Address 7 '7 ~ f fZe,-s c:,,--tt-- City S~ I q) Phone ! -.~, OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 1000 sq, ft, or less Each additional 500 sq, ft, or portion thereof $106,00 $ 19,00 Installation, Alteration or Relocatio~O\ll\\ 200 Amps or less ~\\lIt \f ,,~t fw Mnj $ 50.00 1:\~~pst~~~ \,~\lI~\\- \' $69,00 ~~\~~~~td'~~~~~~~O~~\) r~ . $100.00 \.~~~:t~PJ~~~~~~~ ~~e .~~~ a~ve,__ _.__ 'C~~~1~~!;~;ensio-;;-;er p~~el/-.-"':"C -~;--; , -, One Circuit $ 43.00 '-{..;> Each Additional Circuit or with / ., Service or Feeder Pennit $ 3.00 \ r-- .-':--.-----:---~._--...-~-- '~.- ._~--,;- ~.~......,... E. i.Miscellaneous (Servicelfeedernot included) ,Each Installation L_--:::......~.-::.____._____.___ ~.:-._.._.:.... _~____ ____... -'--__.J Pump or irrigation Sign/Outline Lighting Limited EnergyfResidential Limited EnergylCommercial $ 50.00 $ 50.00 $ 25.00 $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges fie-- ------,--' ---,--- ----- .'--" 4. ~ "SrmiotALOF ABOVE " . , , ,____ '.' _.._ _.. _____ _,____..___ ,__,.:.... . .I L/i 32-7.. l(6C> 5"3 gz... 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding FonnslElectrical Permit Application I-OJ.doc . . CITY OF SPRINGFIELD I Building/Combination Permit PERMIT NO: COM2003-01129 ISSUED: 11/10/2003 APPLIED: 11/10/2003 EXPIRES: 05110/2004 VALUE: Status, Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 798 PRESCOTT LN ASSESSOR'S PARCEL NO.: 1703341215200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Add 2 circuits Owner: JEDIDIAH GASS Address: 798 PRESCOTT LN SPRINGFIELD OR 97477 Phone Number: 541-741-6986 Contractor Type Electrical _0,,0 _~n'IIIt:l" ,- iliW I CONTRACTOR INFORM'A'fIONI<f \.1\ \01 ~\IO\'l'~' \ed \)~ "'-'lleS ale S:,,_oo Contractor Jl..i\E: <IlleS adO? \\"Ios~IJi.$~~!l-f\ 9'E~pj"ation Date GLOBE BUILDINq(~\Ei!,1]:,~.1:~le(\\':~.() \\"11(1'0.3:/;,17,\ \\"Ie I~ :'"P)104/2004 <1~iuii:DING-[NFORMl\ IioN" "(le \el"1;~a\iOI'\ II' - '(0\)"'--' tel. \' - \.I\\li\'1 ~O\I 009011 of Sto'rief:eI'\OlegO\'l "'''_2.344). Lot Size: C21"",~ . ,,'ne 00-3"c- He",ht of Structu'ice Sq Ft 1st Floor: 'oml:1~' "."", I'\lType of1UliI: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Sq Ft Other: Impervious Surface Area: Phone 541-683-7077 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN SETBACKS I, DEVELOPMENTINFORMATION . REQUIRED PARKING Overlay Dist: E ~I%\~ # Stre'a~rt~R~d: p..LL EY-PIRE It 1\'1 a,m'i"apped: Paved \'R~ ~~,Mli SI'I OER i\'llS PERM\'\" Impact: % OfL<f.,Ijfp,v.ffilg1,~O U~R IS M~M~OONEO to COMM~~~~~ PERlOO. I PUBLIC IMPJi6'VEKf~NTS I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutsfDrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Datc Calculated Total Value of Project Page 1 of2 _.~";" iiiI.--. :.' ~." ~..~ J . . Ll1 i' OF .srKlI"luNIi.LD Status Issued Building/Combination Permit PERMIT NO: COM2003-01129 ISSUED: 11/10/2003 APPLIED: 11/10/2003 EXPIRES: 05/10/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Pllid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Numbcr $4.60 $3.22 $43.00 $3.00 11110103 11110103 11110103 11 11 0103 1200200000000002437 1200200000000002437 1200200000000002437 1200200000000002437 Total Amount Paid $53.82 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 Insnections I 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By signature, I state and agrce, 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 arid 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 thc site at all times during construction. Owner or Contractors Signature Date Pa2e 2 012 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01129 COM2003-01129 COM2003-01129 COM2003-01129 Payments: Type of Payment Check , FP:;~ ~ ~ --,; Receipt #: 1200200000000002437 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By BARI SWARTZ Received By Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 11/10/2003 10:12:11AM Amount Paid Item Total: 3.22 4.60 43.00 3.00 $53.82 How Received In Person Payment Total: Amount Paid $53.82 $53.82- . .