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Home My WebLink AboutPermit Electrical 2007-8-24 ZON LP2- fNITIALS tV M DATE 8'/;7,n/O,/_ SOURCE r'tvf ~ 225 FIFTH STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 - FAX: (541)726-3689 ELECTRICAL PERMIT APPUCATION City Job Number ~12-7.0 ~: ';""" '<:;~~;"rJ~;.:;~~.)?~~F.'t~-"'NM~~:~..?P:t7".(," ~'f.~'<\t;,'!'t';~>-<"1D~:r;.~~1:W~J\rt.~f(\n:;J? !?7~~2f-'-;'-~lX,~;\:(~N~:tS::P;7:;::-?f^i:rr:'~"..1'{',~~~~,t~;W":':/5;Y;;:":f;"" "',l'- ~;~;(': s~:~--,~ ~ 1. .,'LOCA.TION'OF'1NSTALLATIONr~f;i:;:~",;,~;;:':. 3. !,tCOMRI5ETE'FEE:S€HED;UeEBELOm>c~;' 4.J,,~ '"-''''_,''Ci!'~.t...:{":,:::,:~l;.(;''"",&:..ii;~~~.t~I''::''~~;1.:.t.:-.,a.D.O.:....~,,i..~}~~;'' ~~1 ~:"'#;-?J.;..'.J(...~""~;~).:':;';~(~:;.t~,(.~;.i~t~~:':"";:"'~'- . '-- "/'" ",-,;:: .-...tr~ .';~-:;~9tf~'~:' ~OO ~ It) (fa-f- r Si- LEGAL DESCRIPTION: --'.'CC"O','-'F'.y-c '." <.'''''.''-' .~" \..., 0 r; '3(p "3 \ 0 Lf&b3 JOB DESCRIPTION: s.~)-(___.l?_ C J.-e."" '''V: Permits are non-transferable and expir~ if work is not started within 180 days of issuance or if work is Suspended for 180 days.. ~_.~ :;..~" ..:*'"::'J;.%F~ - ~:?:"::;:1:;,~n::~:t'~~'?,~f-'!:;i1'f':~.\:~~J:f~J~~".;';;'~_Y~~~ 2 ,;;"C0N1}1U1C1l0R;INS1WL1JATLON'QN.ft:Y;(~ . ;;!..~,~'/:iilJj'?i*,~+YJ~"''tJ!i;fi1fi,;I&ii?1.~fifu.t>fl~di~~~dtJ.I~!tb:~ Electrical ContractliRffiON [~ffiffilC 3[riVIC[ P.O. BOX 2237 tULitNt, UK }.l (4U, Phone~( (n'll r-- Address City Supervisor License Number /~1.., q ~ S Expiration Date t()-l- OJ J(n (5 r'X Constr. Contr. Number Expiration Date q ,.,,:) ~ -0 ') 7r::'~Z~ { Date ~ -~<t-O} ; 0:}i'''~>(~".'o..:. ,< t:...... f':/,;t:-)9fJf::~b."~"':'J::1:'~r:'iJ;?~~"""'}0-:;';~.f~-~:"/t:'....;::"-~"..... '~uIti;Famil';rer'awelliii '~urilt;.':::;:S. , i;:2L~;>~:,':!t""':.:ntb'::~~J/;,,~~;R....: w.:':;;.&i;;;'Z:::..E&~.:,~.1;~;,.~-k',~..r:: ::.:~l';:\;,; B. ~~~~~;K~I~i!~~~ilJ:~]~J!~'[~?~!11~~:t~t:~2L~~j!I~1fc 70~~ f-..-":~~--Y~-;:':<'7~<~ A:- F.;N~~-Resl(i'en 'itJ~j:2;1~)b.~,t.\<'"~:::;;' :;;~"%<)~.;~l1j Service Included 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117,00 $ 21. 00 $55.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only I $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 iV}1j[$;~Gf~:i:StZTfr~tYN;~}rr~f:*if~:':A:'rr;r~. C. ~fJ,,~-!Jl\?,~~~rXf,~~f:.n~t~.;~~2:~'''~"i':," Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. ;';'_~'::~";i\:'~-~ . -J. .:A","",\j~,' - D. PLBriiii, ;~<qJts ,~t",t;~~"t:.< -"u_",,"Hi~I.. $ 55,00 $ 76.00 $110.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48.00 $ 4.00 }Y\.J~X(\~ (Y\ J~ ; ~ ~~ E. Phon;)rl!(') ~ Y, Of) Owners Name Address C" ~ City~ OWNER INST ALLA nON The installation is being made on property I own which ~m\e~:ded for sale, lease or rent. Tms.fff~bn1U&HAlL EXPIRE if THE WORK AllTHORIZEO UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Inspection Request: 726-3769 .'j.' ..,.................,0:.:.'.......:.'....,. .' Y,~;R7~~%~~~1rr;:{:',f}~t~;'1i0,'0:F,F~ ~;';;:':'jr:7~C50;\4{n1?;;~~0~'\:;~i:.~0<*"t~"r:~ <~T~ :,t'~: :,> ous;.(Ser,viCe/feeder n.ot'inclu(led)f:':'KachSln'stalla:tion' '.;Wi.;c:./l~k~!~;Jt41,\.t~~~,tk-.i.jf...;;<'dthc,.';~~:J:".:..,"";i:;~ti!.:~:~~ .;~.f::"i~, .,". ~:;,;"\:.?r~.;::~~;, ~.;.;..~.: ..,,"-, Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Lif!ti.t~~~tw~b1\~aw ra Min~~.. ~. ,~. ' ~!~'~~!'~"'f.:~~ij>. iMi '", " ., .. iRrGilh' 4 ~f .. ,.' ,. .,' 1"M . 5.~ ... ., ,. 2~(ftf1' II. ~P.t~~IfMaybbtain copies of the rules tr 1 O~_~lmle~.e (Note: the telephone 5~_Wf)tilieeOregon Utility Notification Centall' 8m 1 a800-332-2344). TOTAL 10 tea ~ ~--o 1-9=0 ,""1.., so Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07,doc ~6 It) . . .;~;, .:. _: '~f,~,'.'..;';",'~: :.. ... - . .' '".... '.i:l..,:.~~:,;;~,..:~:~.';.H:';>: :~ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01270 ISSUED: 08/27/2007 APPLIED: 08/27/2007 EXPIRES: 08/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 200 1/2 16TH ST 1 ASSESSOR'S PARCEL NO.: 1703363104603 Springfield . TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service Change Owner: R & R PERKINS LLC Address: 326 MAIN ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION. Contractor Type Electrical Contractor OREGON ELECTRIC SERVICE License 161518 Expiration Date 09/28/2008 Phone 541-343-1681 BUILDING INFORMATION' # 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: 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: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Sidewalk Type: ' AI I I:NTI0~Qmgel1tl~1~H~lres you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by N~Tlr~~ ':E.lliflrl tJ:Je eeflt::". (~I~t:': ~hl tglg~ReRi THIS PERMIT SHALL EXPIRE fF T ~~WQitIhJ D . tnun$er for the Oregon Utility Notification AUTHORIZED UNDER THIS PERM,I I\:> IIJU I n escnp IOn... Center is 1-800-332-2344). D . ~ ~~MENf~W nr:u~ AhAMnnNEDfCft Sq Ft Square Footage Value escnp I I T e l1f C'Ohfit'lR't'ib'IY I' I' B'd A \ 180 D PERIOD. or mu tip ler or I mount Storm Sewer Available: Special Instruction: Notes: Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01270 ISSUED: 08/27/2007 APPLIED: 08/27/2007 EXPIRES: 08/27/2008 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 I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Perm ServIFdr 200 amps or less Amount Paid Date Paid Receipt Number $7.00 $3.50 $5.60 $70.00 8/27/07 8/27/07 8/27/07 8/27/07 2200700000000001354 2200700000000001354 2200700000000001354 2200700000000001354 Total Amount Paid $86.10 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Reauired InsDections 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 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 Pa2e 2 of2 225 Fifth ,Street Springfield, Oregon 97477 541:726-3759 Phone Job/Journal Number COM2007-01270 COM2007-01270 COM2007-01270 COM2007-0 1270 Payments: Type of Payment Check cReceint 1 City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200700000000001354 Date: 08/27/2007 3:18:59PM Description Perm ServIFdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 70.00 3.50 5.60 7.00 $86.10 Paid By OREGON ELECTRIC SERVICE, LLP Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid ddk By Mail $86.10 21147 Payment Total: $86.10 Page I of 1 8/27/2007