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HomeMy WebLinkAboutPermit Electrical 2003-7-2 . .- CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00636 ISSUED: 07/02/2003 APPLIED: 07/18/2003 EXPIRES: 01/02/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line unes you to ~ _"\ ,. ho"'''''f"'n I;::tW re5\. .... A' ,t:I'.... II~' .; ,:...l. k1dna breaoll VU"'" SITE ADD~~~ rUlll~i~Iihi!\ll)wps are sel\\l11 ASSESSO~\ti\i.~~.~StH~~ci\ 1.0~~1I11l!!brrooll,R 95~-OOI. in OAR 9 " , olbtain copies of the ru es. PROJEC1lJQBSc~!flON: ,t1eF"{f~6'/!!,.~1l3 tel9pho~e calling the .~e.n ~_:':lnn Iltilitv NotificatIOn Owner: numotll 'u, ...- -..._aOO-332-2344). W1EGAnm.~N.G. :J' Address: PO BOX 5:1"418 ATLANTA GA 30355 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential Contractor Type Electrical Contractor BUILDERS ELECTRIC INC NOTIl;t: . L EXPIRE IF THE WORK 1HlS PERMIT SU~~~R lHIS PERMIT IS NOT .lITunRI7ED . ._~ rnn 'n-"!H'F.J'W~[) OK I::' fl,O/-lI~UV"~U . -.. I CONTRACTOR INF~#T~OlS, 'Ii PERIOD. License Expiration Date 4296 12110/2003 Phone 541-485-0922 BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I Frontyard 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 Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Type of Construetion $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculatcd Total Value of Project Paee 1 of2 . . CITY OF ~rK.lJ~ljNELD Building/Combination Permit PERMIT NO: COM2003-00636 ISSUED: 07/0212003 APPLIED: 07/18/2003 EXPIRES: 01102/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line [..Ff>f>S PairlJ Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $4.41 $63.00 7/21/03 7/21/03 7/21/03 2200200000000001281 2200200000000001281 2200200000000001281 Total Amount Paid $73.71 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. L-Rf>ouirf>rl Ins,I'f>ctionsJ 1 Electric Service: Approval required prior to utility company energizing service. 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 wbo 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, tbat each address is readable from the street, that tbe permit card is located at the front of the property, and the approved set of plans will remain on the site at all tr;uri~ ~ ll~ ht Owner or Contractors Signature 1 7 IJ-I f n"3 Date Pae:e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00636 COM2003-00636 COM2003-00636 Payments: Type of Payment CreditCard -tji'F1~. Wi ; "":'''".= '~',." i ,.."'.. I ,- .~. ..1 ...,-... -,..-..........' .-......-~,., .~ Receipt #: 2200200000000001281 Description Perm ServlFdr 200 amps or less + 7% State Surcharge + 10% AdminiSlralive Fee Received By njm Check Number Batch Number Authorization Number Paid By BUILDERS ELECTRlC 000124 064302 City of Springfield Official Receipt \ Development Services Department Public Works Department, Date: 07/21/2003 2:04:30PM Amount Paid Item Total: 63.00 4.41 6.30 $73.71 . How Received Amount Paid In Person Payment Total: $73.71 $73.7] . .