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Home My WebLink AboutPermit Electrical 2004-12-15 u 225 FIFTH STREET · SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION a+-ojL{37 Date i Z) );;//1 I City Job Number 1. 3. ' zt:-t L -~,13f:::l/Efl"L7 S'T 1 LEGAL DESCRIPTION . 17P'3-,Z.:-7 2- L 07 YOS. JOB DESCRIPTION Mall~ _1Y1U1)- aJ 6~ Permits are non-transfera Ie and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. A. ~ 'i~~jt~t ' Servi~e Included E>-O's{9. ....-::> I ~eOir;;:il)e ,," '::'~ - ~-".'., 'I'J<'lt, s:.. , '?/) 0-70 1000 sq. ft. or less tire 0 ..... $lOo.8'Q,.s-.If-'i)(' Each additional 500 sq. ft. or "'- ~~~ -~- portion thereof ~ ~~ Each Manufa~rdW..ppt~~N~ Oregon law req . s yo to Modular Dw~8H~~.."SftfiYe<seg[jopted by the Ore~ tilitv Feeder f.,.I.....,jI-;{,' h ~. a')j'V"'I)~C2;uOn Center, Those rule are B. Electrical Contractor ~E ~,L15.f! nle Sf.etllCE.. 200 Amps or ~~ling the center. (Note: thE$te.one 201 Amps to ~H81.R~ 2.~or the, Oregon UtilitY~~atjoo Address /.2() m()III~6 ~. 401 Amps to 600 Am 5'senter IS H:SUU-~2-2i41b.00 ' 601 Amps to 1000 Amps $163.00 City EattNE Phone 3L/l./- 3b~1 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 ~-:23~{t Supervisor License Number 0 T ....::> V Expiration Date ( () J, / ,J."CJ 0 + I I Constr. Contr. Number 9 (,? :J. CJ D Expiration Date .3 ./ I T / " :: '~4':,~"" .~.. '\;i-O. . c W!f'"'''''''' . i$~9~J.1l Signature of Supervising Electrician NOtiCE' Ins'ltallation;:;AII t~:,l#9nlo[r Relocation nfv t"tn VIII ~HAL tXPIRE IF THE \A/{}QI(_ 20~~p'~?flletf) UNDER THIS 2ci1fviff1 .~ ~CJ!VU 20t6PvWv~ ~9IJtO~rNY~s IS ABANo-Of~tu fus.s ~~~O 40AfW1~sara t9~tAIOD. i100.00 Over 600 Amps or I 000 Volts see "B" above. ~~::?~<ts~~l~1!?;t:W" D. [~~ra611<@1 ~A~ fZZA~ ' U . Owners Name :DA-NICL vJ;4-L-~e-fL Address 2- 'Z \ L De:-ll trfl-Ly City :> ? I::: .b Phone New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit L1 $ 43.00 $ 3.00 (2- E. OWNER INST ALLA nON Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 The installation is being made on property I own which is not intended for sale, lease or rent Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: 7% State Surcharge % Administrative Fee Il~' .Iti / to 1'1 o~ 4. Shamf Drivc(T:)lBuilding FormslElcctrical Permit Application 1~3.doe ,".' " Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01437 ISSUED: 12/17/2004 APPLIED: 11/22/2004 EXPIRES: 06/17/2005 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2212 BEVERLY ST ASSESSOR'S PARCEL NO.: 1703272207505 Springfield TYPE OF WORK: Fire Damage TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Service change - Fire Damage. Replace insulation and drywall in garage Owner: DANIEL WALKER Phone Number: 541- Address: 2212 BEVERLY ST SPRINGFIELD OR 97477 uires you to "JTEt.1TII'"II\I' nreaon law req UL'J''''l ,.' db tne Ul~!:IVII (... I cdNTrd.cf~iWj3.ilON~re set forth ''IU.lLw,(f 0010 through l!AR 952-001-' Contractor Type Contractor in OAR 952-001~btain MpWtJteftheEM&~ion Date Phone General XXL INC 0090. You may (t1.l~M'fhe telepho'O%/26/2007 Electrical EUGENE ELECTRIC SEIt:V~~iR~~;~~~~(1B~ility Notificat\P.fh712005 541-344-3561 I BUlLDi~G'<tiNEQRl\:t.A"P~i2-2~44J' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 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: R-3 n/a Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I h~O YlGL:: THIS ro.:v7&.lliy fiis~,LL EXPIRE IF THE WORK AUTH@i&trffi Ufll~tn:lIiJHIS PERMIT IS NOT COM i'"ft~l~t<<t.Qfty~ ~9ct:\ SA N DO NED FO R ANY 1~orm~t ~~~(1l~~: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per SqFt or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD ' Building/Combination Permit PERMIT NO: COM2004-01437 ISSUED: , 12/17/2004 APPLIED: 11/22/2004 EXPIRES: 06/17/2005 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 ~ 726-3769 Inspection Line Bid Amount Use Bid Amount $1.00 2,000.00 $2,000.00 $2,000.00 12/09/2004 Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less + 10% Administrative Fee + 7% State Surcharge Building Permit. . + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Amount Paid Date Paid , $6.30 $4.41 $63.00 $4.50 $3.15 $45.00 $1.20 $0.84 $12.00 11/23/04 11/23/04 11/23/04 12/9/04 12/9/04 ' 12/9/04 12/17/04, 12/17/04 12/17/04 Receipt Number '2200400000000001439 2200400000000001439 2200400000000001439 1200400000000001718 1200400000000001718 1200400000000001718 2200400000000001532 2200400000000001532 2200400000000001532 Total Amount Paid $140.40 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. . Electric Service: Approval required prior to utility company energizing service. 'Wall Insulation: Prior to cover. ' . Drywall: Prior to taping. "" . Final Building: After all required inspections have been requested and 'approved and the building is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. ' Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01437 ISSUED: 12/1712004 APPLIED: 11/22/2004 EXPIRES: 06/17/2005 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. ~ 0::tt~0't ~ 1~/l{1 OLf W t'-.- Owner or Contractors Signature Date Pa2e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-01437 COM2004-01437 COM2004-01437 Payments: Type of Payment Check 12/17/2004 RECEIPT #: Description Add, Alter, Extend Circ Eli Add + 7% State Surcharge + 10% Administrative Fee Paid By ~ity of Springfield Official Receipt nevelopment Services Department Public Works Department 2200400000000001532 Date: 12/17/2004 2:15:09PM Item,Total: Check Number, Authorization Received By Batch Number Number How Received Amount Due 12.00 0.84 1.20 $14.04 Amount Paid EUGENE ELECTRIC SERVICE nJm 10849 , By Mail Payment Total: $14.04 $14.04 " Page 1 of 1