HomeMy WebLinkAboutPermit Electrical 2006-5-25
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CO'^^- Zt:x:><'=> - OOb L.. 7 Date
1.
LEGAL DESCRIPTION
1701.. J L{l{l(
JOB DESCRIPTION
Nt~v ()A-V\.f:!"( t Z c.(I"(.,^:~
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.
o of,(t.{
2.
3.
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
_ 'l"U "r)
Each Manufact'cl H~m~ ~r::,"\\j
Modular Dwelling:S~r;,ic~orJ"('I.\\
d ' ,\r;r::e-""" 0'\-
Fee e~ ' _ (\..\,.. ,"", ~t;2-0
'.J' - r"\ -',..J'-
$50.00
. -B.
( I ,,' '.c." V Ir',nl(1 , \!:> V v, .
. C /:' _ L ' ,"':';";:- " '10';'0. '~e' \:i\v ." a\\On
EleGtrical Contractor _ ._' a ,_.J 'CiJ~C::1't:Y-J~~~~2~~d~~p~\QP1~M\\) NO\I'IC
\jIJ r"\'"I::" \.0-J201rA1tip~ro~OQr.Aur~A).
Address i'J 0 BDX } Y ~ "d- ~~~\'O~"( 'O~~~~i\'mpJ3t~068gAmps
r l \ . ce\\\
C'/).I r./,/ 70J.- I '?6 601 Amps to 1000 Amps
CitY-7j/tl fJqpe/o Phone / I d d~ over, 1000 AmpsNolts
If J Reconnect Only
LJ<t9 V s
/ 0 - oJ - d c'tJ 7 Installation, Alteration or Relocation
200 Amps or less
Constr. Contr. Number~ 6 Y C; 20 I Amps to 400 Amps
. . a) 401 Amps to 600 A~ \\t. '-Nat\~
EXpl1<ltlOn Date I - - ;;)00 g>" Over 600 A . ~&r \10 1~~s~g~"B" above.
S(~nature of Supervising Electrician \'t\f\\\S:.~~~,\'
, ' /"; ~ D /J /: \\\\'0 ~~\\\lt.~ \S'~~r Extension Per Panel
~~ ~ ~'0~\\ ~t.~c,~e '"W1\). .
fI ~ <60 @a'Jh~ kdditional Circuit or with 2
^ r <:" ~~"{ '\ Service or Feeder Permit
O",ners Name . I-+" ./{JJ t.?:/A l=:'-J
/.J7r C(61{tAI~ LN
S +> F ~ Phone "7 f.( 7 - l{ rJ 0
Supervisor License Number
Expiration Date
Address
City
OWNER INST ALLA nON
The installation is being made on property J: own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection ReqUl~st: 726-3769
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c.
$ 50.00
$ 69.00
$100.00
$ 43.00
$ 3.00
6
E.
Pump or inigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
b7
S ~'2.
b'O
81C(z
-
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T: )/Builc1ing Forms/Electrical Permit Application 1-03 .doc
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2006-00629
ISSUED: OS/25/2006
APPLIED: OS/24/2006
EXPIRES: 11/25/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6835 Aster St
ASSESSOR'S PARCEL NO.: 1702344400614
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: 200amp service upgrade and 2 circuits
Owner: HAROLD SWEENEY
Address: 1518 CLEARWATER LN
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
C & SELECTRIC
License
3849
BUILDING INFORMATION',
Expiration Date
09/0112008
Phone
541-741-2236
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range 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:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
n/a
I DEVELOPMENT INFORMATION.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# .street Trees Rqd:
\_1 f !Paved Drive Rqd:
h:~) o/J:~-flnbt Coverage:' I' -: '.it we
'-\U-;-r1C}r-('(izr~[) ut~[)[~:~ THi }~ch[","1T i~'~'
REQUIRED PARKING
Total:
Handicapped:
Compact:
( 1(\ .\!:.! t' \ i'l ~~ r\ l: (,
-.J'._)(Vfl"IL-.'l\../.._~' V" ......... "~
I fiMlJLIC Il\1PR(;WlJ1\\1j~,NTS .
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation DescriPtion'
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paj!e 1 of2
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2006-00629
ISSUED: OS/25/2006
APPLIED: OS/24/2006
EXPIRES: 11/25/2006
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 J
$6.90
$5.52
$6.00
$63.00
5/25/06
5/25/06
5/25/06
5/25/06
Receipt Number
2200600000000000654
2200600000000000654
2200600000000000654
2200600000000000654
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Total Amount Paid
$81.42
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.
Reouired InsDections I
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all 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 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 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
C:L_, of Springfield Official Receipt
l dopment Services Department
Public Works Department
Job/Journal Number
COM2006-00629
COM2006-00629
COM2006-00629
COM2006-00629
Payments:
Type of Payment
CreditCard
cReceint I
RECEIPT #:
2200600000000000654
Date: OS/25/2006
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
C&S ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 242290 In Person
Payment Total:
Page 1 of 1
8:00:32AM
Amount Due
63.00
6.00
5.52
6.90
$81.42
Amount Paid
$81.42
$81.42
5/25/2006