HomeMy WebLinkAboutPermit Electrical 2005-5-22
Address .8Cl8"9 .~, 'A/ 'SF
City.~
./
Supervisor License Number ~ /':5 <c. S
10///107
'/ .
Constr. Contr. Number /5/?'ih,,4I'
Expiration Date
~ / b2.f/J/ (<) ~
, {
SiD O~S~ming Electrician
. ~~
,
Expiration Date
City
2. ., ro
s?p~
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent. .
Owners Signature:
Inspection Request: 726-3769
7% State Surcharge
10% Administrative Fee
TOTAL
S 43.00
. Shared Drive(T:}'Building FonnslElectrical Pennit Applicatio.n I.03.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF SPRIl'Ij~t<lJi,L1J
Building/Combination Permit
PERMIT NO: COM2005-00334
ISSUED: 04/19/2005
APPLIED: 03/25/2005
EXPIRES: 11/19/2005
VALUE: $ 5,900.00
SITE ADDRESS: 2950 HAYDEN BRIDGE RD
ASSESSOR'S PARCEL NO.: 1702190001101
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Patio cover
Owner: STARK JAMES L & NANCY E
Address: 2950 HAYDEN BRIDGE RD
SPRINGFIELD OR 97477
Contractor
OWNER
GROUNDED ELECTRIC 15~.80.41\11'-\<-
L .BUlLDING INFORMATI()N1IS ~O I
~01\~- II ';)D"~- 1\-11'.:) p.,.. rOI'-
:'i\-lIS \'t.I'-~ft?f~tori~~ t;\\l\~\)O~t.\)
U l\\),\-IOI'-I:I.-'!rllNll'fStructure
w.Wlt.I;'.Type of'HeatD.
VN C~'{ "\ ~\,wl/t~r Type:
l\ Range Type:
Energy Path:
Sprinkled Building:
Contractor Type
General
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Pbone Number: 541-726-7811
I CONTRACTOR INFORMATION I
License
Expiration Date Phone
02124/2006 541 726-6858
nla
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other: 324
Occupant Load:
, DEVELOPMENTlNFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
,.;
-,
"oU\O
QU\les J '\i\'!..
,_.., "8_. - "t\ tot\ll
I PUBLIC IMPROVEl\!J;.l'Ii.~,t-I.. Ole;ud'b~ \l\e Olts;~~se\ to ,
r1 lules adO\> :;lilil.Sil tu\~ t-~ 95Z.(\0 .
Partially Improved tol~O>tl \\On ce~' ~ 0 \hlOOO' ~ \he tuleS b'/
No t-Io\lflca 95Z.00<D;\Q;hSR<etWBFlli'tl{: \e?hone
In Ot-\". 'lou ll\a,/ ob\~\ tNo\e'. ~~e ~O\I\ica\lOn
0090.. \he cen\e. on \.1\\\1\'/
callIng \he Oleg Q-a3Z-Z344).
nUll\beI6~n\el is ,-80
Existing slab no SDC fee's 3/29/2005 CAS
Paee 1 of3
.
. \..-11 i' VI:' ~rj(Jl'1ul:'l~LlJ
Building/Combination Permit
PERMIT NO: COM2005-00334
ISSUED: 04/19/2005
APPLIED: 03/25/2005
EXPIRES: 11/19/2005
VALUE: $ 5,900.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I Valuation Descriotion I
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
5,900.00
Value
Date Calculated
Description
Total Value of Project
$5,900.00
$5,900.00
03128/2005
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $49.53 3125105 3200500000000000108
+ 10% Administrative Fee $7.62 4119105 1200500000000000471
+ 7% State Surcbarge $5.33 4119105 1200500000000000471
Building Permit $76.20 4119105 1200500000000000471
+ 100/0 Administrative Fee $5.00 5119105 1200500000000000643
+ 7% State Surcharge $3.50 5119105 1200500000000000643
Service Reconnect $50.00 5119105 1200500000000000643
Total Amount Paid $197.18
I Plan Reviews I
Initial Review 0312812005 03/2812005 APP LLH
Plan nine Review 0312812005 0410112005 APP TAJ No Planning review required.
Public Works Review 0312812005 0312912005 APP CAS Existing concrete slab no SDC Fee
312912005 CAS
Structural Review 0312812005 0411412005 APP RJB
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.
Rpnnirptf In~,np,..UI&IY.I
Footing: After trenches are excavated.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Building: After ail required iuspections have been requested and approved and the building is complete.
Electric Service: Approval required prior to utility company energizing service.
Paee 2 of3
.
. CITY OF SPRINGFu,LU
Building/Combination Permit"
PERMIT NO: COM2005-00334
ISSUED: 04/19/2005
APPLIED: 03/25/2005
EXPIRES: 11/19/2005
VALUE: $ 5,900.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspectlon Line
By signature, 1 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.
1 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 ofthe property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Page 3 00
225 Fifth Street
Spl'ingfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00334
COM2005-00334
COM2005-00334
Payments:
Type of Payment
Check
1I
"
5/19/2005
.
RECEIPT #:
1tIit.....'~.~!"''''.'/!LD . "'..' ... '.'......'
" ,__'H."
,,: ~
i:-'~ '
wr::. :i
->...,,--,. '''''','''. ~: ,-"", .','
,Ji,lty of Springfield Official Receipt
.velopment Services Department .
Public Works Department
1200500000000000643
Date: 05/19/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Service Reconnect
Paid By
GROUNDED ELECTRIC
Received By
djb
Page 1 of 1
Item Total:
L'heck Number Authorization
Batch Number Number How Received
1066 .
In Person
Payment Total:
10:17:45AM
Amount Due
3.50
5.00
50.00
S58.50
Amouut Paid
$58.50
S58.50