HomeMy WebLinkAboutPermit Electrical 2003-7-2
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.- 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]
.
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