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Home My WebLink AboutPermit Electrical 2004-09-28Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676F2x 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-01199ISSUED: 0912812004APPLIED: 09/2812004EXPIRES; 0312812005 VALUE: SITE ADDRESS: 3780 OREGON AVE ASSESSOR'S PARCEL NO.: 1702314208000 PROJECT DESCRIPTION: Service upgrade Owner: DUANE HARRISON Address: 3780 OREGON AVE SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential Phone Number: 541-726-0841 LicenseContractor Type Electrical Contractor C & S ELECTRIC Expiration Date You tooglolzoos Phone 541-741-2236 # 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: are sBt forth Sprinkled Building:nh OccupantLoad: R-3 VN $ Per Sq Ft or multiplier Square Footage or Bid Amount REQUIRED PARI(NG Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Valuation Descrintion Description Type of Construction Total Value of Project Value Date Calculated L(rl\ r -l(AL l (,K rN r' !lg!LrL:ll_.] OAR h lst Floor: 2nd Floor: Basement: Sq Ft Garage/Carport Sq Ft Other: r0R Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-01199ISSUED: 0912812004 APPLIEDz 0912812004 EXPIREST 0312812005 VALUE: Fee Description + l0o Administrative Fee + 7oh State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $6.30 $4.4r $63.00 $73.71 Date Paid 9t28t04 9t28t04 9128t04 Receipt Number 1200400000000001399 1200400000000001399 1200400000000001399 Plan Reviews To Request an inspection call the24 hour recording at 726-3769, AII 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. Electric Service: Approval required prior to utility company energizing service. Reorr By signaturer l 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 Springlield 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 Date Page2 of2 r ees ralo I 225Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT #: 1200400000000001399 Date: 0912812004 e:45:39AM Job/Journal Number coM2004-01199 coM2004-0r 199 coM2004-01199 Description + 7o/o State Surcharge + l0% Administrative Fee Perm ServlFdr 200 amps or less Amount Due 4.41 6.30 63.00 Item Total $73.71 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard MELISSA GEHRKE DJB 028381 In Person $73.71 Payment Total: -$E f 9128/2004 Page 1 of I |lg:u*cxrIlra lTcz)/'{z cwo JOB DESCzuPTION SPtzc- ^V6,-ro*\{Permits are non-transferable and expire if work is not started within 180 days of issuance or if 'rvork is Suspended for 180 days. 2. Electrical Contractor }S Address Phone Supervisor License Number Expiration Date o 225 FIFTHSTREET . SPRINGFIELD, OP.97477 o PH:(541)726-3753 . FAX: E LE CTRICAL P ERM IT AP P LI CATI O N Ciry Job Number LC,urr, ?r5at4' OU 7 7 Date 3. ,€ LEGAL DESCRIPTION A. Ot 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 Amps Amps Alteration or Relocation less 400 Amps 401 Amps to 600 Arnps Over 600 or 1000 Volts see "B" above. Nerv Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Pump or in'igation Sign/Outline Lighting Limited Limited Minimum B. $l $ $50.00 $ 63.00 $ 75.00 $ 12s.00 $ 163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $ r 00.00 00 00 bs/-rzc, Ciry Constr. Contr. Number 3sye q 1- Ob $$= Expiration Date Signarure of Supervising Electrician c D owners*",,,)rn o u\(L+\d*/ E. ciry S?i)a7b'oEt/ Address Phone O\ANER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: s s0.00 s s0.00 $ 2s.00 $ 4s.00 7% State Surcharge 10% Administrative Fee TOTAL is $45.00 * Surcharges 3 L(q 3o a3 1 Inspection Request: 726-37 69 4 Shared Drive(T:)/Building Forms/Elecrical Permit Application l -03.doc Amps or ?r"J[-