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Home My WebLink AboutPermit Electrical 2005-8-10 !.; 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: ~~~6;;.3689 ELECTRlCALPERMITAPPUCATION ~'0 ,(}O~,,&<:-O ,~~ . - ',' ~.:-" ~ City Job Number Co Y"'t z..OOS- - D I 0 7.s Date ~ 10 0 r ~.<', ~~ ~0~'C' 1,..0 / / ' ,.:)~ 1. 'H\,~im~tir'e:::_..ill~" -- 'f'3Z:b Ce-AC,A.-r t3LvJ LEGAL DESCRIPTION )7037.b3Lf ObZO.D JOB DESCRIPTION j ~PtC?# 3. <:' ..".J'" A. 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 $106.00 $ 19.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $50.00 :T\ON:1O }o)_ /' ~/ \\ )'6 fU\es ado p. u\es are se Electrical Contractor _ 00 ( . c( ec.- 0 .~JGtion cen2Gtl.At't?~~~ leM OA.R 952-001- ( ,~ol(hu 952_00110oA~~rg~g drl~ ru\es bY Address 3 if Cf- Co--. Gy ,,~ 0 \~~r'{ou maY40~Wffi-)~<<tlP6~~l'ephO~a UV . '09 the c~E?tm ~~~~\1iicatlon Phone 51'1"s- g-'3 ~~bedor t~Q1lQij8_1.'2~)' .. centme~dn~~nry- 2. $ 63.00 $ 75.00 $125.00 $163.00 . $375.00 $ 50.00 ,c;);JtJ (j City Supervisor License Number 3 r.( 5 L( 5 Expiration Date I tJ '" 0 ( - ~ 7 C. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1 000 Volts see "B" above. D. $ 50.00 $ 69.00 $100.00 ISI; C(::> <6 Constr. Contr. Number Expiration Date 7--.2 S- - (;) 7 Signature of Supervising Electrician ' Gu-~~~ ... Owners Name s:c (;..OC) I ~ i S kt-\. c.. +-;tr 7 52 ~ /h : I " ~\- City S?e~ New Alteration or Extension Per Panel One Circuit X Each Additional Circuit or with J / Service or Feeder Permit 7 'Y5'~ $ 43.00 $ 3.00 - 12- E. Address Pump or inigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 25.00 The installation is being made on property I own which Limit~ Ene~(Q'dfrlfa~cial $ 45.00 . . d d fi r, ~?\,C':\c" ," ' j;:'l(?\'nt \r .~, - Ie:. \\\0\. . IS not mten e or sale, lease or rent. hI \ ". \. l \~". .,. eL '.MinllDum Elec:tr.lc\~erihifInspectIon Fee IS $45 00 + Surcharges Ii\.0 . fi\ \ vI \f' \;\\S rt:f\'"....., . Ownen S;gna...,. ~~:~;~~~oU~~f~~' s S- CO~\\~i\~Cl Dj.\'f ?t~\090/0 State Surcharge J> :r j\N 10% Administrative Fee .sr0 foLj.zr. Phone TOTAL Inspection Request: 726-3769 Shared Drive(T:)IBuilding FonnsIElectrical Permit Application 1-03,doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01075 ISSUED: 08/09/2005 APPLIED: 08/09/2005 EXPIRES: 02110/2006 VALUE: $ 4,296.00 ~&,'F'i"A,,', ',:N' ,G,'~ ",m.o, ' · iii, ",,",... """,l".". WfL'~ ! " , f , '-" ~1Ir __, j ~'" r .~ .. 'iIIF # -0. . ,.. .~__......_~_....--._.""'",. - Status Issued 225 Fifth Street, Springfield, OR 541-'726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 326 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703263406200 Springfield TYPE OF WORK: Interior PROJECT DESCRIPTION: Replace drywall in kitchen TYPE OF USE: Repair Public Owner: SCHOOL DISTRICT #19 Address: 525 MILL ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Electrical Contractor License MO~~~lY GEN CONTRACTOR IN 32772 BIG!9~~~!:f~;ufmtgon law req~'res VOII fA56428 Notification cen~~~F~/llroN' In OAR 952-001-0010 I__.w Q'I'Hit:ttrOrtn # of Units: 0090. Yo a ob . ~tu~Rt9AR 952-001- Primary Occupancy Group: Calling ~ ! tal~g\W%~~mtles by Secondary Occupancy GrouPnumb enter. (~@~~tfdephone Primary Construction Type ~r th~ OregWhUtilitytNotification Secondary Construction Type: enter IS 1-8Q1)aag€~). # of Bedrooms: Energy Path: Sprinkled Building: I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Expiration Date 12/11/2005 07/25/2007 Phone 541-687-2287 541-744-8946 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: tr.r:.::r ElF 1\1E \NO~ownspouts/Drains: ~M]II MbRM\1 S~I\Ll E)(P\~' ER~rl- \5 NQ1 ll\\g PE 0' DNOER 1\-\\S P - .' 'FdR'u \ ~~TH3~~&EO OR \~. ABAN,99~t~ CUI' ~OM p' of\'< PER\OP. ,f\~~ ~~9.~." \ ~\ " J -', Notes: Pae:e 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2005-01075 ISSUED: 08/09/2005 APPLIED: 08/09/2005 EXPIRES: 02/1012006 VALUE: $ 4,296.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriution , Description Tvpe of Construction Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 4,296.00 Value Date Calculated Total Value of Project $4,296.00 $4,296.00 08/09/2005 ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Building Permit + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $6.84 $4.79 $68.40 $5.50 $3.85 $43.00 $12.00 8/9/05 8/9/05 8/9/05 8/10/05 8/1 0/05 8/10/05 8/10/05 Receipt Number 1200500000000001160 1200500000000001160 1200500000000001160 2200500000000001072 2200500000000001072 2200500000000001072 2200500000000001072 ~ Total Amount Paid $144.38 I Plan Reviews' 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. l..ReouiredJnsnections . 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 CITY OF SPRINGFIELD' Status Issued . ~ Building/Combination Permit PERMIT NO: COM2005-01075 ISSUED: 08/09/2005 APPLIED: 08/09/2005 EXPIRES: 02/10/2006 VALUE: $ 4,296.00 225 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. Owner or Contractors Signature Date Pal!c 3 of 3 J:.~; ~,. . WtLIj 225 Fifth Street , Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number i COM2005-01075 ;"COM2005-01075 COM2005-01075 COM2005-01075 Payments: Type of Payment CreditCard I }-, ,\ :! .. ': ~ t-~.J ;' '" , .:$ " .i~ _ : 8/10/2005 City of Springfield Official Receipt ~velopment Services Department Public Works Department RECEIPT #: 2200500000000001072 Date: 08/10/2005 lO:24:02AM Description Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 7% State Surcharge + 10% Administrative Fee Amount Due 43.00 12.00 3.85 5.50 $64.35 Paid By BIG C ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 272420 In Person Payment Total: $64.35 $64.35 Amount Paid Page 1 of 1