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Home My WebLink AboutPermit Electrical 2008-1-24 . ZON \ ,Q e...-- INITIALS ~ ~ DATE \... '::'\ q -elK SOURCE~p0 1- 'Zt.{-O? >- , _ '" >,t" ~ ,-"'" .. '" "'. .; '" ~. , ; t ~ i ,'~'~~, pJJ:~:QR,~~;~Ql.J~P;~Q~qQ~::',' ::: , ~'. 225 FIFIlI STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number (OIAA ~OO }?-o c lOt{ Date 200 Amps or less 1 $ 70,00 201 Amps to 400 Amps $ 83,00 401 Amps to 600 Amps $138,00 601 Amps to 1000 Amps $180,00 Over 1000 AmpsIVolts $413,00 Reconnect Only $ 55,00 n I~'" reguires you 10 .5't/<f5"S ATTENTION: orli~Q,-~~, ~"'!IJll_" ~"21i,",~J"1miJiI'..' "!,!I1'lk.;..U_0FlliiliFl!III Supervisor L[cense Number I Go ro~ ~esro. !:ellerslWdl.!l!*.!1irlE",!ffi,''''''"" .. , ' , '-11-" ~u es atl L,<"""",,_r, . EWlfl...'... ,r.$!" -- ~.....j"'~_. -~ . / / N~tificalion Cenler, Those ru e(),AR 952-001- Expiration Date /0 ~ C)-O /0 ;n nML952-001 'IB\i~I!I1~~~~gfmg~lllg!i\3rocation I 0090., You may '21!/i~I?~ll\'!ftelepho~e Constr, Contr, Number c:ltJ " '/ ~g L calling the ce~ ~~\!JlitlllP~illatlon numg",r for Ih All'" ....."s38~ps Center IlJ'l_ Over 600 Amps or 1000 Volts see"B" above, D. Expiration Date It,>II/dcJ10 Signature of Supervising Electrician I --14-- ~ i?k. tH ~ E. i1~~ImL~~1fsY?ffiSt~~~'~a1W:6t~iriiaij:d~a6~Eia;~T~~u~liijri1~ Address cr ~!! S' G, 6+rce.- ' ",.."....'.."~_AW;;'''HRik(",''''''''r_''lfSj-w''..'''l]iil"':.:t1[W'''''''i0='''=,,,.,''''~'..00i-:'~7"''0i0..,fi'-"'''''J'''''_,'',i""'-"',i..''':1 City~.-ml {!,JJl Phone J''1t.-333NOTICE' Pumporirrigation $55,00 , } 'THIS PERM~~W THE WORK $ 55,00 OWNER INSTALLATION , . AUTHORIZE~I!PI"f~tp~MP:lIS NOT $ 28,00 :ne m,stallation is being made on propertY I OWII w~MMENC~~~@ll)~eiroR $ 50,00 [s not mtended for sale, lease or rent. ANY 1 rm&'ccc.!c!1.2~~.~=~:c~,~~::,~, :~,i~.n ~:'~,~j5,,!iTIi~ ,~~. +,_,surcha~eOs O S' 4 's.DBrOrA'lJrOEi1t80l7E~millillW"~.lillzilicJiw,aj / wners' 19nature: __ . . H'qL:00!lli;r?iiihT:'25.;;',i#Ir:?Hti;g~;lii!i,m~,;/#mr1Jz::i.151' . 12% State Surcharge S If \;) 10% Administrative Fee -, 5% Technology Fee 7 rO 66~ 1. i!EOGATiO.MDE1NST~ONf1r~';1!IIiji~, ;\tb.",,~,,',,*-i'-i"""'''''''''';U''''''~=;''''~~''''''''''''''"'''''1'''''_,,''',"m'""....<;"0,,,,' '" ;"..,e>,1;;, ";"",:", k 5' ~ TN skrt> '1t. Ii LEGAL DESCRIPTION: 170z.33f { oJboO JOB DESCRIPTION: $bLII' ,-!:O crtAN6-E' 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 ~W\H Oe..<-:r1Ue,c:' ~ 57 7rI s+~f- City 7'130' Svr-,,<; ~..pI I ( Phone, L:) I 7 - 305'1 Address .:1)" ----- ; YM ' OWIlers Name 7:".dPMe-J,1!- Inspection Reqnest: 726-3769 3, 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 ' $117,00 $21.00 $55,00 B. 7U $ 55,00 $ 76,00 $110,00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48,00 $ 4,00 TOTAL Shared Drive(T:)/Buildmg FormslElectrical Permit Application 1-08.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00104 ISSUED: 01/24/2008 APPLIED: 01/24/2008 EXPIRES: 0712412008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 968 56TH ST ASSESSOR'S PARCEL NO.: 1702331103600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION:, Service change Owner: RITA BARDOUCHE Address: 43971 MCKENZIE HWY LEABURG OR 97489 Phone Number: 541-896-3337 I, CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DONALD MARVIN HORTON License 116021 Expiration Date 07/25/2009 Phone 541- 726-9021 BUILDING INFORMATION I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Units: # of Stories: Primary Occupancy Group: R-3 Heigh!.of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VB wa,ter~(l'J'to Secondary Constructio'Af-Yl!~iTION: Oregon law rllo et;iity # of Bedrooms: follow rules adopted by the ~ a @n6rth Notification Center, Those r ~~ 1~~:!!aiJ~ing: , ~.n~O~ flfI1_DD1I) lhroua ,'0 . 0090:' You may obt~ii~dii~~iirORMA TlON I nc:~i~2r \~~ ~:;~~~gon Utility NOtifiC,atiOn , Center IS 1-800-33~DlSt: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage:. Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla REQUIRED PARKING Total: Handicapped: Compact: 1 PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Availabl~: , Special Instruction': Sidewalk Type: Notes: . \ E Downspouts/Drains: ~~;';E~MIT ~~~i~ ~~~~J~~~{,~~~~ ~~:~~~~~~~n OR IS ABANDONED FOR "..' y rE~\l;;l,;. ' ANY 18P~~~ation DescriDtion I Description Type of Construction $ Per Sq Ft or mnltiplier Sq nare Footage or Bid Amonnt Valne Date Calculated Pa2e I of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 12% State Snrcharge + 5% Technology Fee Perm ServlFdr 200 amps or less Total Amonnt Paid Amonnt Paid $7,00 $8.40 $3,50 $70,00 $88,90 Total Valne of Project Fees Paid' Date Paid I Plan Reviews I 1/24/08 1/24/08 1/24/08 1/24/08 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00104 ISSUED: 01124/2008 APPLIED: 01/24/2008 EXPIRES: 07/24/2008 VALUE: Receipt Nnmber 1200800000000000069 1200800000000000069 1200800000000000069 1200800000000000069 To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~ Rellllired Tnsnections' Electric Service: Approval reqnired prior to ntility company energizing se/vice, By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is trne and correct, and I fn.'ther 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 nsed on this project. I further agree to ensure that all required inspections arc 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 Pa2e 2 of2 Date 225 Fifth Street " Springfield, Oregon 97477 54i-726-3759 Phone Job/Journal Number COM2008-00 1 04 COM2008-00 1 04 COM2008-00104 COM2008-00 I 04 Payments: Type of Payment Check cReceintl City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1200800000000000069 , Date: 01/2412008 9: 13:43AM Description Perm ServlFdr 200 amps or less + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Amount Due 70,00 3.50 8.40 7.00 $88,90 Paid By DMH ELECTRIC CO Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb In Person Payment Total: . $88.90 $88,90 1302 Page 1 of 1 1/24/2008 '