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Home My WebLink AboutPermit Electrical 2003-8-22 Wo 4. \ " . " '" 'I,.', ." CITY OF ~--,UNGFIELD,~OREGON' \, /' . ' . ..... . as submitted has the tollowing t require specific land use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAXm{!\>I'~l726-3689 ELECTRICAL PERMIT APPLICATION Zoning City Job Number LOW' zoe) -00 pO '7 Date tJ p; /2/ / l)<; Date Authonzed Signature 3. COMPLErE FEE SCHEDULE BELOW 4iL 'is- 22--03 '1'<0 I. LOCATIONOFINSTALLATION 7110,5 ?/?E-5Co'T'T 1703 >'-/1'1 09 ')1 Z. A. New Residential - Single or Multi-Family per dwelling unit. Service Included LEGAL DESCRIPTION R<E-S;'D~IT,Al.- JOB DESCRIPTION $106.00 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder Low Vo I t-A'G-c-<" $ 19.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $50.00 B. Services or Feeders - Installation, Alterations or Rclocntion: CONTRACTOR INSTALLATION ONLY 2. !)LJJh'etJ)<..., W.74 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNol~~~ Reconnect On~~ ~ ~\)\ ~~ \'{ ~\' \S Supervisor License Number :~9 OJ Le:/7 C. \:t~~~~~~r Feeders C~. S'l\~\; ~ ,1(\ ~\)~~ /0 h ') '<Ar:::,"\'I. n"'~~~ ~~\f~sta\l~' Alteration or Relocation ','1\\'::1 ~C\~\1..'i:.~\) libb~~ps or less Constf. Contr. Number /,;? 173~ b.~' ,t~{'~Ci ~ ~'il-~Amps to 400 Amps c,C\\;"\ 'O~ \) 40 I Amps to 600 Amps / CJ / i') h t>.~ Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits Electrical Contractor Address / f?5 C()C:h-J('- City .5!lf;J--(, r't5 - (gOOD Phone Expiration Date $ 50.00 $ 69.00 $100.00 Expiration Date Signature of Supervising Electrician /yt:,c~ ~~ Owners Name ~ J'JK r-<., . JE r F Address <gr, j 'PR~<.,cdTr City 5~K;.JGF;ELn Phone $0) - /'1 ;;:0 New Alteration or Extension Per Panel One Circuit ee.' ..reS )'OU$'43.00 Each Additional0reuitl6r~l\hr oregon utilit)' seMcet6;J:Fe~\fe8P';";;'it '0)' t\'le _~ ~~~Ian'lo !allOW rule~~ 0;;:1\1.o5e ru~e~;~ 952-00 F<.:, MisccllaiieoiJs1~erl".i!',<i(fe.de?llot Jncluded)!,SEach Installation I'.D\I"~- 00 ,_\IV ~ \e5 o. ""'-' .- '... O}l.f', 952- " obtain cop telep\1one \P'Cl".J6~)fji[rigiiiign tar ~Note: tM . '~'''i.!<ilO;OO . ~ig'15Q!1\!iI1,e\iJigi\i~or~gon Uti\\W ~~~~ $ 50.00 I"d\1'" 33'l-(."/~ r Liml't...J1BnergYIKesidentia~00- $ 25.00 I Ut' center "" ' Limited Energy/Commercial $ 45.00 zr::- OWNER INSTALLATiON The installation is being made on property lawn which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges LIS 3/J LfSO 52~ 4. SUBTOTAL OF ABOVE Owners SignalUre: 7% State Surcharge 100/0 Administrative Fee TOTAL Inspection Request: 726-3769 ~ Shared Drivc{T:)/Building Fonns/Eh.'Ctrical Pcnnil Application I-OJ.doc Lit r OF SPRINGFIELD Building/Combination Permit . . -iit- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2003-00809 ISSUED: 08/21/2003 APPLIED: 08/21/2003 EXPIRES: 02/21/2004 VALUE: SITE ADDRESS: 863 Prescott Ln ASSESSOR'S PARCEL NO.: 1703341409512 Springfield TYPE OF WORK: Electrical Work Only Total: Handicapped: ':IcG6Mp.act: \l$aS \,\\i\\\:j % of Lot Coverage: \~'Il (a6(a~0('\ " \0(\ (139:>.0('\ \\\13 ~(a Se .QO' , ,.r.O . _A '0':1 _. ,\as ~ Oo~rz. , I fUJ)L'C IMP~(;)vE~i~"'SI~\~~ .i\\o;(~\l<&\\ ~~~\\a (\l~;a ~\u" v- ,,(\~O~ ~\"'S V</~\\. ('\ \0 . 0-\\0('\ 0'" -v Side",aIk Type: \13 .,' e~\\O ~o\\\\e 9r';;,rz.-Q O'O\~\':...\o\a'. "',~, ~o\l'\ . O"'~ \l ((\~':I &s",nspouy!DralD~"l' \~09Q. ~o ~ \\\13 ea a O(a~o~_'3'3rz.-rz.'3 e~\\\('\ \01 \\\ . ... _roIJ .....,Oel \e( \s ('\\l'" Ce('\ TYPE OF USE: PROJECT DESCRIPTION: Low voltage Owner: NOAKES JEFFREY L & SUSAN R Address: 2833 VILLA WAY SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTu", ",.ORMATION I License 129736 BUILDING INFORMATION I Contractor OLD FIELDS INC # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height o.!:~~ucture Typt o!\Hear\ VN ~et ~p~ i\~'\:. ~ri~ w.: '\:.~ CO- <<E':i'~r.gy ath: ~\.. ~'oJ 1:)'-' .<'.' A c,~'Y'_(.~ "\ n"'~\S ~~,\\~~~"'~~ $~~'l>JVELOPI\"",j'l u-.ut{MATION I SETBACKS '\~\S ~\)~1) R.,'\:.\) <<'\:.'<"- Frontyard Setback: ~\)\~~~'\:.~~ \)~ Overlay Dist: Side I Setback: "'\) >\ \'U # Street Trees Rqd: Side 2 Setback: ~~ Paved Drive Rqd: R-3 Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Paee I of2 New Residential Expiration Date 06/09/2006 Phone 541-485-6000 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Value Date Calculated . . Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00809 ISSUED: 08/21/2003 APPLIED: 08/21/2003 EXPIRES: 02/21/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Ff'f'S~ Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $4,50 $3,15 $25.00 $20.00 8/21/03 8/21/03 8/21/03 8/21/03 2200200000000001421 2200200000000001421 2200200000000001421 2200200000000001421 Total Amount Paid $52.65 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 Reouirf'd Insof'ctions I I Low Voltage: Prior to cover. 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 Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number C0M2003-00809 C0M2003-00809 C0M2003-00809 C0M2003-00809 Payments: Type of Payment CreditCard ." .~"....... . " ~~."".._~- '""~' 1. ' , .~~ . - ...._....~ ....,0 . Receipt #: 2200200000000001421 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Residential Minimurn/Adjustm~nt Electrical Paid By MICHAEL RIMMER Check Number Received By Batch Number Authorization Number djb 000151 021551 City of Springfield Official Receipt Development Services Department _ Public Works Department Date: 08/21/2003 lO:06:03AM Amount Paid Item Total: 3.15 4.50 25.00 20.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65 . .