HomeMy WebLinkAboutPermit Electrical 2006-3-21
.'
,,~~~l~..,~if<; ';, ~:f~;... <B'Iill&i'OF'SPRIN"GFi'EiJ::f"ORECi'(jN :' ::""",;: :1',', ,."
(~!t~\~~~~':'~~ij~:'1;:f~~~"':~~: :{~,:;~ :\,,', "],",',,' ,r ; ...;',;: ' ,0';'/"': '<>0:' ,',.' ,"', .,: ';", "
seta
not'"
fJfJ
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
Laning
ELECTRICAL PERMIT APPLICATION 0
~ ate
City Job Number C.O~'ZoO b - 00"'34 b ATi1mgn..c:u ~y;;-a~/ - Ob
-' ~,'; ',' -~:.';;"...~.f1':-f"~;'''-'<''';~F''3;:'~''~F~~.1~~
1.':coq119~OE:1NSt~'tTfr{iiu
':l.' " f1c~'" "",'-' ~'I/;"i.;j~Ii,"'l;~I""'''Nt'''''_ ,~~,.,~.oo:st'.~'~MI'~~
3.
, ,Y(~,~ ,~=- S~,
'L€ci1~~~~I~'~~'" ", dItO~ -TrCA;~niC' Included
J08 DESCRIPTION 1000 sq. ft. or less
Each additional 500 sq. ft. or
S C..O.... .A I ~ .... n, 0 J ~ " portion thereof
Permits are non-transferable and eXPi~ if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
I C1'C, ,-
Suspended fO~ l~o~a:s.., " Fee~:c->i~~P,S ~ 0\\\\\~ .
2. ;;~P~~~!l,~'co", 'cnOO/,
VICEr"" v _j,0) ~~:j) ~;:)';) \)~
Electrical ContracGREGON ELECTRIC ,SER" ,:. 'C:;.C'I' ~v \\2{)O~ps '6rles~ ~0\eS
PO BOX 2'!.jl '<G' '.'o'>! \'-'('\ce0\~~'\C2\W~Slia\~6l>(APipfe ('\
.. " \ \\0\' \_\J\J rQV' h,\V\ ~\Ol'
Address 1:1I~1:t.l1: no n7An2"r\\\\\c,o. ~c,f)-ClCl o:-O\2-401-'~p~'t(l'600r~~
~El%, ~ \. ~\"\ ~- ~ I~O' '\'\" \~'-
\00.... .::t00 ~e: ce,,\e60~~}lS~to }fJ>Jl*,mps
Phone..34~\C/~K(r\ \\\e fIe CO~erdO.Q03~psNolts
G'O\\":-o~~ \O~ \: ~ \~ec'8~ect Only
01j~ Ce0\e ,_....,
~e,',r.;, mrl~:~~,'{-";:"""'lJ.i:l,'~~
C!' """,.,,
f<.cl.q~ "" .~,'
i~<{~~!~.L:':;~
$106.00
$ 19.00
$50.00
I
$ 63.00 I n.-~ ot:()
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
City
Supervisor License Nwnber
Expiration Date -L.o - I.- 6 'J
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 "8" above.
D.
New Alteration or Extensi~ ~i\ ~ ~\)\
One Circuit l.. \ t,.1-:'?\?' Qt,.\\*\ ~\3'?-- $ 43.00
~~ddi,tio~l\~Ht',qit\~\iith ~t,.\) ~
\\t)3~~~~f'e~~~~Thi~~~~\)<J
,'0
~ IX
~ 9_~~ A o.(\.\) .
r~ ONttigatlOn
S~~Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
Constr. Contr. Nwnber 1(0 (.s ( f{
$ 50.00
$ 69.00
$100.00
Expiration Date Cj -~ - () 0
Signature of Supervising Electrician
7~~ ~NP~
OwnersName I ~ ~L'
Address 'XX"'h:J.S (;l)_r~ IL ~
City~~i ,~d Phoue 7wJ5- 'is D r~
OWNER INSTALLATION
$ 3.00
~12~1~~~:
$ 50.00
$ 50.00
$ 25.00
$ 45.00
The installation is being made <;>n property I own which
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Owners Signature:
~~~
.....c::. 0 t./
t.o .:3 0
jLl ~<..J
4.
8% State Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FonnslElectrical Permit Application] -06,doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF'SPRINGFIELD, ,
Building/Combination Permit
PERMIT NO: COM2006-00346
ISSUED: 03/23/2006
APPLIED: 03/23/2006
EXPIRES: 09/23/2006
VALUE:
~SITE ADDRESS: 4151/2 F ST
ASSESSOR'S PARCEL NO.: 1703352401500
I,CON'f.RAG1\OR(I.lSFO~l'ION ".JU ~o
/,' t dbyme\..J'I;;~v"Utlllty ,
Tollow rules adop e , t TMth
Contractor ,'", tion Center. Those rl1icense se Expiration Date Phone
OREGON ELEci'I!i~r,~~l.!~Jg~)1_001 0 throu~6[5Y8R 95~~~~~: - 09/28/2006 541-343-1681
'" - . . _:_ ___r"\IOl..:. 111 \.II~ I VII""''''' -1
rlniBUnmIN€t )INFORMATIOl~t.te\ephone
calling tne ~~~I~"' \~~'Utility Notification .
numtfJQf Stomes: reg 2-2344). Lot SIZe:
Heigb.tro~Stilulct~9Q-33 Sq Ft lstFloor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
PROJECT DESCRIPTION: Service change
Owner: LINDA KA YE
Address: 88425 PARTRIDGE LN
SPRINGFIELD OR 97477
Contractor Type
Electrical
~" # of Units:
,,,,,Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
" Frontyard Setback:
" Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
"
" Street Improvements:
,", Storm Sewer Available:
Special Instruction:
Notes:
- Description
,
Type of Construction
r
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
Phone Number: 541-746-8016
R-3
VN
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Total:
Handicapped:
Compact:
'.
.
Sidewalk Type:
DownspoutslDrains:
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page 1 of 2
-~=-~~~t~effi'@"e'
~ '.
r \"
~ < ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00346
ISSUED: 03/23/2006
APPLIED: 03/23/2006
EXPIRES: 09/23/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I . Fees Paid I
';:;:; Fee Description
+ 10% Administrative Fee
, + 8% State Surcharge
"' Perm Serv/Fdr 200 amps or less
Amount Paid
v
~
Date Paid
Receipt Number
1200600000000000339
1200600000000000339
1200600000000000339
$6.30
$5.04
$63.00
3/23/06
3/23/06
3/23/06
;:o:'f
Total Amount Paid
$74.34
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.
LReouired Insoections 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
,.'
'\
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.,
.'
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
, COM2006-00346
, COM2006-00346
CpM2006-00346
,"'~
Payments:
Type of Payment
Check
"
'.
;.
I,.
,,'
..,
:-r
.;.~;
la',
,~ '
"
"
"
J
;(
It}'
"
"
"
':C
3/23/2006
RECEIPT #:
1200600000000000339
Date: 03/23/2006
Description
Perm Serv/Fdr 200 amps or less
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
OREGON ELECTRIC SERVICE
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
19543
In Person
Payment Total:
(
Page 1 of 1
2:58:11PM ..
;.
Amount Duef' ,
63.00
5.04 .
6.30
$74.34
Amount Paid
$74.34
$74.34