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Home My WebLink AboutPermit Electrical 2005-9-30 sp~Ur"ijOF~SLO 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ~S- -- 00 (,,,~ Date q - at> - 0 ~ Owners Name 7:....,' 'f( t3BfOt~ . ,. Address cr~ ~ City qr " n;-1~ _ Phone 2!/!f- / (,,1.") Pump or irrigation $ 50.00 ... Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 25.00 The installation is being madeNm~ I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease 'PHmtpERMIT SHALL EXPWPf~llwtJpurermit Inspection Fee is $45.00 + Surcharges Owners Signature: CAOUTMHMOERNllcEeDoUoNRDESR THIS f'N.~g:bP.x'. .1./' 5 - I ABANOO <SJ/NRfFi>t< '-IP (p . ANY 180 DAY PERIOD. 7% State Surcharge ~ II. tl 10% Administrative Fee .j. ,ft,. 30 TOTAL If /9~. 7(- 1. q>>-.. ('0 ,ctL.1<-L.iJ. ~ LEGAL DESCRIPTION 17.03. 2C? 43 . O~O-OO JOB DESCRIPTION ~~ Permits are non-transferable and expire if work is .r not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor '.,-,; e; ~'1'1e..Ic..... Address pl>. bD~. /113C, City (?f (/ b~e. Phone <; i/- 6JJ ?fib Expiration Date Z::t7 3 C; 5".3 S folDS 5~f"7 V & S/6b , Supervisor License Number Constr. Contr. Number Expiration Date Signature of Supervising Electrician CI- / ,/ioM ~ 1/ In'pecnno R"Io,,': ;26-3769 tOO ~~ tj. 3. A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Horne or Modular Dwelling Service or Feeder $106.00 $ 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 AmpsN olts Reconnect Only ATTENTIO . I 63.- $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. Notification Center. Those rules are set forth InstallatWft.,F3\.lftci:aOOn-QfJ~I~~~h OAR 952-001- 200 AM~~Qr i~~ may obtain copies of th~r1Oewbv 201 Ampsqgiijebtjljbp~mter. (Note: the teleJPd>Q:l~ - 401 Amg~rnl6~b fRfn\h8 Oregon Utility Notltiwuioon Center is 1-800-~3~-2344) or 1000 Volts see B wove.. New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit 19 $ 43.00 ./3.- 57..- $ 3.00 E. Shared Drive(T:)/Building Fonns/Electlical Pennit Application I-03.doc _~-:;G:..~.g:...LO l.~.... ............ . ~ ' - . ~. ~.,' ....... __,_._._ ." .__ ~ m Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00664 ISSUED: 09/30/2005 APPLIED: 06/03/2005 EXPIRES: 03/30/2006 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 922 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264302000 Springfield TYPE OF WORK: Foundation TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace foundation on west side only. Approx 25lfstorm sewer connection and rewire. Owner: ERIK BERGLAND Address: 1311 G ST SPRINGFIELD OR 97477 Phone Number: 541-744-1642 I CONTRACTOR INFORMATION' Contractor Type General Electrical Plumbing Contractor OWNER LITE ELECTRIC SERVICE OWNER License Expiration Date Phone .541-688-8996 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Vlhr n/a I DEVELOPMENT INFORMATION . Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: . Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer *y~~~I,e,:ON: Oregon law requires you. ~o .... Special Instrqction: rulo'~ adoQted by the Oregon Utility ~ TOIIOW ... , t forth . . Notlflcntion Center. Those rules are se _ Notes. . o^n 952-001-0010 through OAR 952-001 . In F\\ , . f the rules by 0090. You may obtain copies 0 calling the center. (Note: the tel~~ho~e number for the Oregon Utility Notification Center is 1-800-332-2344). Sidewalk Type:. .. . Downspouts/Drains: NottCE: tXP\RE \F THE WORK 1HIS PERM\' S~~i~ 1HIS PERM\1 IS N01 AU1HORIZED Uoo IS ABANDONED FOR COMMENCED n "NY 180 DAY PER\OO. , Pae:e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description + 10% Administrative Fee + 7% State Surcharge Encroachment Permit Foundation Permit Storm Sewer - 1st 50 Feet + 10% Administrative Fee + 7% State Surcharge Fixture Minimum/ Adj ustment Plumbing + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Total Amount Paid Structural Review CITY OF SPRINGFIELD- Building/Combination Permit PERMIT NO: COM2005-00664 ISSUED: 09/30/2005 APPLIED: 06/03/2005 EXPIRES: 03/30/2006 VALUE: $ 5,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $11.34 6/3/05 3200500000000000283 $7.94 6/3/05 3200500000000000283 $130.00 6/3/05 3200500000000000283 $68.40 6/3/05 3200500000000000283 $45.00 6/3/05 3200500000000000283 $4.50 7/13/05 3200500000000000432 $3.15 7/13/05 3200500000000000432 $42.00 7/13/05 3200500000000000432 $3.00 7/13/05 3200500000000000432 $16.30 9/30/05 2200500000000001357 $11.41 9/30/05 2200500000000001357 $43.00 9/30/05 2200500000000001357 $57.00 9/30/05 2200500000000001357 $63.00 9/30/05 2200500000000001357 $506.04 I Plan Reviews I 06/03/2005 06/03/2005 APP DJB 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Storm Sewer Line: Prior to filling trench. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Paee 2 of3 Status Issued CITY OF SPRINGFIELD. . Building/Combination Permit PERMIT NO: COM2005-00664 ISSUED: 09/30/2005 APPLIED: 06/03/2005 EXPIRES: 03/30/2006 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 3 of 3 225 Fifth Street , Siuingfield, Oregon 97477 541-726-3759 Phone ~~ City of Springfield Official Receipt evelopment Services Department Public Works Department Job/Journal Number COM2005-00664 'COM2005-00664 COM2005-00664 CbM2005-00664 COM2005-00664 Payments: Type of Payment CreditCard , ;1_" ~( :c ~ l .' l t \. 9/30/2005 ., RECEIPT #: 2200500000000001357 Date: 09/30/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received LITE ELECTRIC/TONY KOTH Ikw 0001 079321 In Person Payment Total: Page 1 of I 8:22:00AM Amount Due 43.00 57.00 63.00 11.41 16.30 $190.71 Amount Paid $190.71 $190.71