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Home My WebLink AboutPermit Electrical 2004-10-4 ~ 0.,; ~!;'nNOFIElLD ""0 ~; o~A t-\if. ~\.7. ~~=~~~~~~~~;;~;, PH:(541)726-3753 · FAX: (541l7,2",,~Z ;:p ~:',_ City Job Number CO.1-1l,ODt{ ~ 01 z zb Date /C;~ y ~~~.o" \9 i""'<99,oS'''<5~. . /. ~. 0",&% 3.::COMi:L1jfF}'Fi:i:ffcH.fBr.Fii:~"'..' , ,',,_",,' ,,~;: ,.:,'::..,"c,\,;",:''''''<"",',,'~',<'<-:: ,{,:::,?,/:,:\,,,,": .:,:" ,c.";",:'_ ,:_;-,;,~,:":,:_:,:,::,,, ","_:,: _.. ,:,....x;,;e>""./:'"""c",:'.. ,,,-:',::''''''',,, Uv.:, '-I 7.2 7 s _ . c. NU \ \C8 \" S\-\P\ll MIl IS WYi 1r\\S pt.~M\ IjN~f\lq4*lanPllitatf~~r Relocation {\U\ liVt'lIItOo O~~fb~~PQtlt.O 117 7 7 0 COMMt.NCt.~'i pe~\gijnps to 400 Amps J\N'i \'~O 0 401 Amps to 600 Amps 1. .' LOCATIO~,~F INSTALLATION. . . I 30b ~4~+~~'tv~II-4-~";fslvd. LEGAL DESCRlPTION 170'~ ZS3~:3> JOB DESCRIPTION A PI~ I C I au.\. ,+ o 70 C) 0 Permits are non-transferable and expire if work is .' not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor E AS rs / Dc t; LEe. Address 3~~5 3 g05CAGf L-fJ. City 5P~LD 77Y7% Phone 7 V (~/Yc;Cf Supervisor License Number Expiration Date JO~O/- 07 Constr. Contr. Number Expiration Date /0" 0 1- OS Signature of Supervising Electrician , ~,.~~ ~ t J Owners Name ~jl ~ r ( Ey G (' J\y Address 1 '3L-) b (:co/I., {Ct1..t I~Q" f City 'S fJr'''''' Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A.;~ e~R~~i<!~P!~aI0,~iIlgle9i~!~lti..~~~ily ,j:; ,; ,'",,::~ '._" :";;,,,,"::,:';: "::,'.,,,,,', ,,' "':':;:_"''''-"-;,W,, ,.,:,';:" :',:A'" ',:;,: ,(~;::,;;:;: ::'v,_ ....- '. ",' . ': >",', ":::,~~,'i-'",,,: "',:',:',: ',:,"'," ",: '.'" ,..c.""',:",',,> "'--:'.' ::,..~,:' -"'-: ,,;-, <' 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 " $ 19.00 $50.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit I $ 43.00 l.( ] Each Additional Circuit or with Service or Feeder Permit ! - 'lIduit90 law reqUlf~ 7 . . E.'i:~~f)~~\. > .........~~~~.In~t~~~tion. .,O\\OW.~. "1'Y\O$etU~~~~"i" .........,............. H.. . ..... PU~\~~'~1~~10 thro~gh ~~:a9r~; Si~ftSJ. im!obta\n COpIes u .._~"'~ . nnQf),~o fI<!, "'-'o\e: \\ 10 ~~\ IV':- Llm~ffffi~~\en \I~n Uti\i\)' t-lotiffcliiicnn Limitel~/~~.lJf.[tloo- - 4 .$ 45.00 Minimum Electric p~\':pection F is $45.00 + Surcharges 4. L/~- 5/i~ l/ yo $ 52cS- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T: )/Building FonnslElectrical Pennit Application I-D3.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01226 ISSUED: 10/04/2004 APPLIED: 10/04/2004 EXPIRES: 04/04/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1306 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703253307000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential 'PROJECT DESCRIPTION: Add 1 circuit Owner: GRAY SHIRLEY M TE Address: 1306 CENTENNIA~ BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type . Electrical Contractor EASTSIDE ELECTRIC INC License 11777.0 T' ,f''1,\Y. N01\C~:. BUI A. 01 1\-\\~:;~2EO ~t>>i)~J~~~OONEO rOR ~3 MENCEO~~6t''5tructure COM O~~f\~ileat: }'\1'i'l ~8a Water Type: Range Type: 'Energy Path: Sprinkled Building: Expiration Date 10/04/2005 Phone 541-915-9828 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 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. REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: tet\u\feI~ - a^ft \a'If e ,..('Qt\ . o!!l ~. ",.-e "'" I. - s8\'Ul\a I PUBLIC IMPRO~~!l ~do?t8d ~se (U\as ate 952-00'. 'o\~~~ ~oo cet\\~itl{W~P~ecu\es~' Not\,\ca: 95'2..o0'\~~~~~e~one \n O~R f(\a'i gg ft.\ot8~ .~galOR 0090. 'IOU c,en\e'f-~" \)\\\\\'1 tldU c;a\\\n9 \~ef \l\e Ofe9~~~ t\\){(\oef ~0\8~ \$ ,\-80 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I f,: Description Type of Construction . $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01226 ISSUED: 10/04/2004 APPLIED: 10/04/2004 EXPIRES: 04/04/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax I 541-726-3769 Inspection Line l.Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $4.50 $3.15 $43.00 $2.00 10/4/04 10/4/04 10/4/04 10/4/04 1200400000000001428 1200400000000001428 1200400000000001428 1200400000000001428 Total Amount Paid $52.65 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 Insoections I Rough Electric: Prior to Cover 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 Pae:e 2 of2 225 Fifth Street . Springfield, Oregon 97477 541-726-3759 Phone ~:,.,}~.:p.:~.!lLD ='1, "..'Iii..."....... .. l.~....:.. wr. 'f., ~ ,. ~ """~ ~ ~. . ,,!l "'~..:'.~~,....,"!'-""'-~:--,. '.,... ':ity of Springfield Official Receipt jevelopment Services Department Public Works Department RECEIPT #: 1200400000000001428 Date: 10/04/2004 11:40:30AM Payments: Type of Payment Paid By CreditCard ROGER KING Item Total: Check Number Authorization Received By Batch Number Number How Received djb 035988 In Person Payment Total: Amount Due . 43.00 2.00 3.15 4.50 $52.65 Job/Journal Number COM2004-01226 COM2004-01226 COM2004-01226 COM2004-01226 Description Add, Alter, Extend Circ Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Amount Paid $52.65 $52.65 10/4/2004 Page 1 of 1