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Home My WebLink AboutPermit Electrical 2004-1-8 . . CITY OF ~rKll~tJNj<,LD Building/Combination Permit PERMIT NO: COM2004-00020 ISSUED: 01/08/2004 APPLIED: 01/07/2004 EXPIRES: 07/08/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ". SITE ADDRESS: 1166 S A ST ASSESSOR'S PARCEL NO.: 1703354106602 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Add 4 circuits Owner: EXCLUSIVELY ADULT Address: % 4M MGMT INC 317 W BROADWAY STE 113 EUGENE OR 97401 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor ROSE CORPORATION License 54431 Expiration Date 09/30/2004 Phone 54 I -686-0905 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basem~~O Range Type: ~c{ltImirll~\\\l\V'ort Energy Path: ON:OlegoO la'll fICY~&. II I (\ ~1iE.~~,~s adOP\e~~!,,~ 8JIlfSvJ.~e.~~e Area: I DEVELOPMEN1:":i~Fii>>ooiliBJil~O\\'lIOUg\'\~ft;~ lules \ O~R yr:l:'~'! b\aih'Copies... \t\\ti~~D PARKING ... 'foU ma'/ 0 INo\e: \"e .\f"CaliOn Overlay Djg90.. \\'18 cenlef. \ U\\Ii\'/ WOrn\. # Street Tree!Cll~ffig I \\'18 Ofegon 33Z_z3H<\)KIicapped: Paved Drive R\!llIlbef Of ,~. Ie 1.8()O- Compact: ,...-~ SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: % of Lot Coverage: ;., Street Improvements: Storm Sewer Available: Special Instruction: I PUBLK unrKOVEMENTS, NOTIC~,idewalk Type: THIS PER?,~'1se~!I'\tip@.6ljRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Notes: I Vahiation Descriotion , Description Tvpe of Construction. $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of 2 . . CITY OF SPRIN{,1'1ELD Building/Combination Permit PERMIT NO: COM2004-00020 ISSUED: 01/08/2004 APPLIED: 01/07/2004 EXPIRES: 07/08/2004 VALUE: ";',. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $5.20 $3.64 $43.00 $9.00 1/8/04 1/8/04 1/8/04 1/8/04 Receipt Number 1200400000000000021 1200400000000000021 1200400000000000021 1200400000000000021 Total Amount Paid $60.84 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 Reouired J nsnections I 1 Rough Electric: Prior to Cover 2 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 of2 225 Fiith Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00020 COM2004-00020 COM2004-00020 COM2004-00020 Payments: Type of Payment CreditCard Paid By ROSE CORP ~' Receipt #: 1200400000000000021 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number 000271 062419 City of Springfield Official Receipt Development Services Department Public Works Department: Date: 01108/2004 7:54:14AM Amount Paid Item Total: 43.00 9.00 3.64 5.20 $60.84 How Received In Person Payment Total: Amount Paid $60.84 $60.84 . .