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Home My WebLink AboutPermit Electrical 2007-05-10SPFIINGFIELD I d-<-zoN INITIALS DATE SOURCE *{-*t Date &225 FIFTH STREET r SPRINGFIELD, OR 97477 r PH:(511)72G3753 ' FAX: (54 l )726-36E9 E LE CTRI CAL P ERM TT AP P LI CATI O N City Job Number @Yttl <>2 - O c->Lzo I 3 z-7 LEGAL DESCRIPTION:A. lgozoS;oo OoToo (/ s lnt) Vo(lr - S.u,-u JOB DESCzuPTION Electrical Contractor Address 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 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 Amps $ 63.00 $ 75.00 $ r25.00 $ s0.00 $ 69.00 s 100.00 s50.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ste B. v\( Br,q{ Ciry _TB.mERMII St*A[dsdd(F0a&lt THE WoRK s 50.00 THOBIZED U Supervisor License Number ol C. Exp irarionDate ? - /- o1 ANY 180 DAY PERLQPn"ot,AlterationorRelocation Constr. Contr. Number /cra?133 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs Over 600 Amps or 1000Expiration Date 5--t 3^oP of Supervising Electrician ATTENTI toll ow r'u163 forp Panel atbn c€952-00 rn 952{0 tyilbs' A.-r t--You e- Owners Name 3 Volts see "B" above $ 43.00 $ 3.00 Address i3o Ciry 5 Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature 7C{L{ -Z 6t t^Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50'00 LimitedEnergylResidential I S25.00 r Limited EnergY/Commercial Minimum Electric Permit Inspectio $ 45.00 n Fee Llf 33"8% State Surcharge l0% Administrative Fee 5% TechnologY Fee _?. ssTt Inspection Request: 726-37 69 4 TOTAL Shared Drive(T:)iBuilding FonnsiElectrical Fermit Application 8{6'doc s $106.00 s 19.00 1 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00670ISSUED: 05/10/2007APPLIED: 05/10/2007 EXPIRES: 1111012007 VALUE: SITE ADDRESS: 927 S 47TH ST ASSESSOR'S PARCELNO.: r802050000300 PROJECT DESCRIPTION: Low voltage security system TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PhoneNumber: 541-744-2681 Springfield Owner: Address: TAMMY SINDT PO BOX 1493 SPRINGFIELD OR 97477 Contractor Type Low Vottage Electrical Contractor APEX SYSTEMS INC Expiration Date 05/13/2008 Phone 541-744-8949 License 100283 # 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: R-3 VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Lot Size: Sq Ft lst Floor: \attl S HAULEXP \RE DER ilH\SP Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 7o ofLot Coverage: 800 REQUIRED PARKING Total: Handicapped: $ Per Sq Ft or multiplier Square Footage or Bid Amount v Description TvPe of Construction Page I of2 Value Date Calculated :h Sq Ft 2nd Floor: Load: \he \t Yot'l tho tol the a Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007 -00670ISSUED: 0511012007APPLIED: 05/1012007EXPIRES: 11/1012007 VALUE: Fee Description + l0oh Administrative Fee + 5%o Technology Fee + 87o State Surcharge Low Voltage - Residential Minimum/Adj ustment Electrical Total Amount Paid Amount Paid Total Yalue of Project Date Paid sn0t07 5n0t07 5/r0t07 5n0t07 5lt0l07 Receipt Number 2200700000000000716 2200700000000000716 2200700000000000716 2200700000000000716 2200700000000000716 $4.50 $2.25 $3.60 $25.00 $20.00 $55.35 Plan Reviews 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. 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 Pase 2 of 2 Date rees rard I Keourreo rnsDecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726'3759 Phone Citlr-of Springfield Official Receipt D lopment Services Department Public Works Department RECEIPT#: 2200700000000000716 Date: 0511012007 e:34:57AM Job/Journal Number coM2007-00670 coM2007-00670 coM2007-00670 coM2007-00670 coM2007-00670 Description + 57o Technology Fee + 8% State Surcharge + l|Yo Administrative Fee Low Voltage - Residential Minimum/Adjustment Electrical Amount Due 2.25 3.60 4.50 25.00 20.00 Item Total:$55.35 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check APEX SYSTEMS INC djb 34s2 In Person $55.35 Payment Totat: -Sffi cReceintl Page I of 1 511012007