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Home My WebLink AboutPermit Electrical 2003-11-19 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · F~: ,\<;if!).,X~~~ as submitted has the tollowing ELECTRICAL PERMIT APPLICATION A Ie Zulllll\!, and does not require specific land use ' ./ G; &.f}\Jlovat j ':'..... If) City Job Number COWl 'ZOO] - 0 Jib 3 Date I I f 0 J Zoning L"W' ~ , 1. ~,:'T:#<:'O'\:'''I')f',C' ,;~, 1~10<'N'I!l':'I>,'"."-O~' ',4,~, '':,.,,:'T''''''I\.''''T':,.CO''',''J''J'',,''''i,,',..,-t'..'''','',,;i'l:' ,,:,'i;'''\,~,,'!',;'A ::',",N1',"",1,'-,O..,..i.'r'..' " ~,"~,<'''~1~..:..''F:''''''''',~r;<;"5%~,,,~~,'''~~,nN1,~F)'11~...~>..>,,~-''QI\'<1,~,'~''''''''''\':'''< ,-.;,~lJ",'::;. rI. ,?'~,. "j<"'O;,,::.< ~;'.LJ.n. . .(",li~~:LA:bLih < IN: '&';COMPEE7FEJPitr/Sen,..' ,.' ,: : ,,",,', ,,'\,:,<""'~.,''i;!tb;..,~;\,~~~~T'h;;:.'''f~ J;';..~~'if~:ll,~.(L.Ji",,~:~~l\l~~~~~;~,~~;j~~~f.*\~;ik'k; :>:; 3. $,~'0.dL"'::.;f,~.'.X>.iW;:~J~i.~0';,r~,:'!A'h~.:~~'4:):"~:>;;;.~~\:o:YK~~~~\'i~;:~~~%~1{.;.t~~~J~:~~:.i~~?;~~;[~.~ , ,,,.' ,.,-, J,...:;:;:'''~b(J ::ilgriawre' ," ." .., .... - , -,,,,. 7Z3> Cfl.t!=s. r- 1..ANt: LEGAL DESCRIPTION 17033YJ L-( I' JOB DESCRIPTION~ 073dO A. . ~~~~~~~'f~t~llit~~1~~~~~~'~)ij,~i[~1'5~~~~1&~~~l!r:{~Vuitr(~a~l'J~ .. ,'_,.J!8.\'j;,<<~d:'*~.~:r.~<,..1>;::j,.~.,;t,.'tf:'.~~A~O"~:~~).~t:"'...,~)it',;;s.,,,,, .. ^""'':':'<:<<''''''V''~': ""~;Q...~~,~,,~,o.~'''i ,-,~}':W.~,.,.,:, t~ LOW v 0 c..-,p4--G....-e 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. , l!WI"""""""'1Y!\""""'~"'"=n'c'" ,,,,,,,",,,,.<=~..,,,,,,,,-,,,,,,:-;,,,, . ~~,' - *";~.:;, .:,~~~:,,\i,:.~':.,..'''','"+~\''''''1j~<:;P....'~~,''"Ji::i);''.._,_ ;'J:w{~~6~1,.'?".-~~..,~~).'l!!';,j:~,~.;.'"'4l~_;.~,,? 2 ~;JflJ!:!f!iR4Q1J.QJ!;I!N~I.::,":~1JQJY~:fL1YlJ~~ql . ij.~~~\r;.:.a'L~~:w~>S}.fr8.ti'(~\%~i't~~;t':8~.~~~~.t~ $50.00 '~:ti'IlT8m""~""'~"'''' t>~6J;il~,~.{$y-if!~tr~;f~'--'~':_;;- B.S\;SerYlce$l;ortF ~~~.;::-,01~"'itn'N'i~ti'iAlt-;:0;h', ~;:J,~ +~"'..~,...~~~~, '-', ~' ",,:"'~lfA"""It'''':'_'~:1''''''''''''!%i~''''4''''';''?'''''_'-n,'''~''''''''~"\''~' , 'd,;!"j~r;, ,!,,,;:.. '.:ttf4~'.tq.:"l~!o:.i;'",;.$~o;.~":",',<;\~_,.::,~~tr.1?~t._1'{~~1:~"!'5:."<!1-'J'."'r<:;:.,{..'~gK~iffSiiEi,&(,;~<.'l:..,'j" ~ n'St'ammori"'fAlterafion'S'}or;:Reloc'rition!',,;: -:,:~l~~\h~A:':<f~iN}~ttQL~tk?L~~~~Y'~J1il~'i~~j Electrical Contractor \X Uef' ::)\'~le.J 6/e~k-()f\tI(S r, a . f?JO'l'- ~ os Lf't City bU0. c;'7l.fo4 Phone Lfg(y- 907.? '-J 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 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Address Signature of Supervising Electrician , C. iID1fiW!_~~~~'iers. ~ ,w""":S"'&--K-::ti~~'J~~::6.:\-;r A\'TEN\\01\1"'I')'(:t~ci by the \ r~ ",r set tori (,olnstallaltilio,eAlteration .or: -Relocation e - t') oc I \IV"'" ('/' '\' n\'. '.! It,. - () ^ n C)o?- , "I",~l .I - \ 10'" nn" ""J"'_ ,\\o-gO,0;t\fups or less '\0" 0 t\~':OU~~ '~.:_ _ ~,,\~a50.00 I" n...~:~..Ol\1-\.' '. i",S :)' \"" .. 'I" 1101tAiiips.to~00(4un,p~"\ cop." . ,,,_,,,In()$j~9.00 ~. ~"",m~'\\"),:-,,'~"'., .'(-"-"'lv',....',... I OC4.0:1..Acln.ps to.:6QO, ~p~ ~",,~ot~. . ':'" ~. _.:'fir-q$il00.OO \\:""0 't'1',v ul;:)\" , ll~'\it\, \,,"'.... ,,~ '" ~. -.., :';)i'~..I- . Over 600,Am~s-or l000,~olts)see ';B\4al)ove. "\:~-, !!,'tt,,.<>",' ',,:;'\J', ... ' ' :' .. :" . . . '.',l'''''''~'' ":;il~~"','~j :::h'" D nB'"J"";'}i"'f"" . i\lL, J;ll,!1~, ;:RIC j:~"f-:,~?i;f;~''''''';-;l#\JJfl~4 Supervisor License Number 3 ~ Q" , L r;;. f\ Expiration Date I a / I / 0 S' Constr. Contr. Number: -/ L/ L! '" r~~ Expiration Date' (..f) t :+ ~ I 0 Lf r ",^s.~ New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 , Owners Name ;'Jtf( c::.h;;-e ( /C 4 V,u I ~ C4.t--s+- U $ 3.00 , " .'''..., " Nn-m:,~""><-'J~IT~<',,n,"-ef~~,;~1~r,:e~t1fffi~~,t1~,~,'~)i~~,'fJt1~,'~~f~,'m~li1f~ T~ ~Mm'R*ACt~ljW1~E"W'(j;FtR''-:i~'~j~~~~;,:::~~r)'j AUTl-fGv{PlM$W~IR THIS PERMIT IS NOT $ 50.00 COM~~~ff16Ri~StiA~ANDONED FOR $50.00 ANY ~igUt~@1~ffiR}ID~ential ,I $ 25.00 Z \ , Limited Energy/Commercial $ 45.00 City 72> <;: f> ~/) Phone Address OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Minimum Electric Permit Inspection Fee~45.Q.Q)- Surcharger y~ ~~<t~i'rF4f~'7~~~)?U7":!'?19.Fm~1f'~~---~'" ..;. 1$:. "..l' 4.' ~~f.,?1TO,:1:,'":Xu,"iJ;()E~OVE ;,~ ')J'%,,""'11.,l':"$f&'<'0il:E;I,*~,**'lli'H::"'fC'" "5/lZ> ~d~~;;.:w..~1,;;}~~Vi+~~~~..tf-<,~r.~-";.t: - f/fo '$ 52- l:.S- 7% State Surcharge 10% Admiriistrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03,doc . . CITY OF SPRINGFIELD ,I Status Issued Building/Combination Permit PERMIT NO: COM2003-01163 ISSUED: 11/20/2003 APPLIED: 11/19/2003 EXPIRES: OS/20/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 723 Crest Lane ASSESSOR'S PARCEL NO.: 1703341407300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Low voltage Owner: KOIVULA MICHAEL G Address: 743 CREST LN SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor DIVERSIFIED ELECTRONICS INC License 144685 Expiration Date 06/23/2004 Phone 541-484-9078 I BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: VN Water Type: Sq Ft Basement: Range Type: , "' '," Li;{e~~'&\!l ~_arage/Carport Energ)::,Path:I"'\"'1'C/~30,On la\ill I ~q ,Sq 'Ft:.o.ther: (1-' \"l'\~i;,-"l\: ., 1, U"'.'tJI!'.v.....y ," '.-'" 1\'-': 0.du~"\t:1J by tdd " . "":.;I)p!P,~rvio~s Surface Area: ":~)Ht~~\1 ~ \.A ....,- i"". .~ .._~_"';\ i"l ~\~~~") ~.:\l ~ ..."'1L 1V- I DEVELOpiVIENTINF.ORM~TiON:'-I!;i ':!\~Ul~~-~V, ' I of'" ~ ,..v.... ,I \e,:) . ,: VI", ~~' ' ".~~, .:;\ rS(~',.::; :, .: ,., REQUIRED PARKING ...1 "4' '\.! , " ," \ ~'~O"''::> CngO. 'leU ,ll:--Y ~....~. f~' <",'_,,;.-:-'~v~"'r;j3~'..1 ...\0 Overlav"Dist:., '~2C"':~'S':'. \. ',0. ,. .\:,' [','o';i~'...':>)';c1?otal: ~z.l\J~ ~_~~ :.::.~ I ' ~_ ":l\. ".\; h"- \.~ ~'V':-J.:.(>~ . # Street'Ttees.Rgd:CT8:1C;'1 ,,!Uhy , \' Handicapped: nl H~i :(-~~ .,--t~ '-I - _ r r"',::-'I .')3_!lL~ n Pavetl Drh;e ~qd:,.:r, 1..;..Yk,~ - c_ ' I Compact: % of Lot Coverage: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPRqmm.l"f{S , , THIS PERM r SH~i"bJa~e~Jf THE WORK AUTHORIZED UNDER THISVERMIT IS NOT COMMENCED ofl>rjV~wln~t8Bm!fY~OR ANY 180 DAY PERIOD. Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pae:e 1 of 2 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2003-01163 ISSUED: 11/20/2003 APPLIED: 11/19/2003 EXPIRES: OS/20/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . I Fees Paid" UUI Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimuml Adjustment Electrical Amount Paid Date Paid $4.50 $3.15 $25.00 $20.00 11/20/03 11/20/03 11/20/03 11/20/03 Receipt Number 1200200000000002495 1200200000000002495 1200200000000002495 1200200000000002495 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 Reauired Inspections' 1 Low Voltage: Prior to cover, 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 Pa2e 2 of2 225 Fifth Street fr Springfield, Oregon 97477 541-726-3759 Phone ;,:"" ,,- City of Springfield Official Receipt Development Services Department Public Works Department, Date: 11/20/2003 7:49:56AM Amount Paid Receipt #: 1200200000000002495 Job/Journal Number COM2003-01163 COM2003-0 1163 COM2003-0 1163 COM2003-0 1163 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Residential Minimum! Adjustment Electrical Item Total: 3.15 4.50 25.00 20.00 $52.65 Payments: Type of Payment CreditCard Paid By ALLAN WOOSTER Received By djb Check Number Batch Number Authorization Number How Received In Person Payment Total: Amount Paid 000226 045672 $52.65 $52.65 . .