The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-07-12Status: Issued 225 Fifth Street, Springfield, OR 541:1263753 Phone 541-726-3676Fax 541.':7 26-37 69 hupe ction Line SITE ADDRESS: 3150 WAYSIDE Lp ASSESSOR'S PARCEL NO.: 1703224104100 PROJECT DESCRIpTION: Upgrade service and add I circuit Buildin g/C o mbin ation P ermit PERMIT NO: COM2005-00887ISSUED: 0711212005APPLEDt 07112/2005 E)(PIRES: 0111212006 VALUE: Springfield TYPE OF TYPE OF USE: Electrical Work OnIy Addition Residentiat Owner: Address: Contractor TVpe Electrical Frontyrrd Setbaclc Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Sheet Storm Sewer Available: Speciat fnstruction: Notes: CAROLYN LAPPING 3150 WAYSIDE LOOP SPRINGFIELD OR 97477 Contractor OWNER yott Phone Number: S4t-746-97gg to License Expiration Date phone tu\es Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: $ Per Sq Ft or multip[er Square Footage or Bitl Amount nla I Sidewatk Type: REQUIRED PARKING Total: Handicapped: Compact: Sprinkled Path: IRE \F 1 Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: 0ltcE:ALL EXP DER lHJ \S ABA E WOR\ \S NO H [\1N 1 H\S P M\I SH ED UN S PERN Downspouts/Drains tfOOUf D TOR t\UlHO R\Z ENC ED OR CO lYllr PER\ Description Type of Construction D I of 2 Value Date Calculated I L: # of Unib:btto{f Secondary Construction # of Bedrooms: Buildin g/Combin atio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541-7263753 Phone 541-726-3676Fax 5411 26-37 69 Inspe ction Line PERLIT NO: COM2005-00887ISSUED: 0711212005APPLDDz 0711212005E)GIRESz 0111212006 VALUE: Fee Description + l07o Administrative Fee + lYo State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $6.60 $4.62 $3.00 $63.00 s77,22 Total Value of Project Date Paid 7n2t0s 7n2t05 7lt2t05 7n2t0s Receipt Number 1200s00000000000979 1200500000000000979 1200s00000000000979 1200500000000000979 Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. By signature,I state and agree, that I have carefully examined the completed apptication and do hereby certify that all information hereon is true and correct, and I further certify that any and all work perf'ormed shall be done in accordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the wonk described herein, and that NO OCCT PANCY win be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ 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 2of2 Date H pes rard I Reouired llsnections I Construction Contractors Board Permit x, COru At{-OO&&7 700 Summer St I\fE Suite 300 PO Box 14140 Selem OR 97309-5052 Phone: 503-3784621 Web Address: !Elq.g$1]g!4 Address:Jro rF Issued by:>6 Date: -y'zbf--7-' Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constructton permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, etcemptfrom ltcensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: &, w K I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction conhactor if the stnrcture is sold or offered for sale before or on completion. t] 3A.. My ge,neral contractor is (ccB #) I will instruct my general contractor that all subconfractors who work on the strrcture must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reyerse side of this form. ofpermit (Date) (White copy to issuing agency perrnitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 approval 225 FIFTH STREET . SPRINGFIELD, OP.g7477 . PH:(541)726.3753 O FAX: (541 E LE CTRI CAL P ERM IT AP P LI CATI O N City Job Number Col/vl zbo s-oo 8K7 Date 1. LOCAT'ION OF INS'I'ALLATION 3. COMPLET'E T;EE SCHEDULE BELOW 3l5o U)ossr-&'* **"* ytz6.31;8i" v(ct.- v\( Permits are non-transferable and if work is not started within 180 days of issuance or if Suspended for 180 days. 2. COI\ITRACTOR INSTALTAruON Electrical Contractor Address Cify Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name W"a Address City Phone 7 4a^?z gs 05 Nerv Residential - Single or lllulti-Famity per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or $ r 06.00 portion thereof $ 19.00 to 600 Amps s 12s.00 --____LEGAL DESCRIPTION (Zo3 ZZq I w 77 r77^ JOB DESCRIPTION -L ctku<f 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less $ 163.00 $37s.00 $ 50.00 $ 50.00 $ 69.00 $ 100.00 $ 43.00 / $ 3.oo $ 50.00 $ 50.00 $ 2s.00 $ 45.00 7 E' *riscellaneous (service/feeder not incruded) -Each Instanation OWNER INSTALLATION The installatioa is being made on property I own which rs not rntended for sale, lease or rent. Owners Signature: Pump or irrigation Sign/Outline Lighting Limited Energy,/Residential Limited Energy/Commercial Minimum Electric permit Inspection Fee is $45.00 * Surcharges 4. suBrorALoFABow L6 7%o State Surcharge € t0% Adminisrrative Fee TOTAL q62 O 77 23Inspection Request: 726-3769 Shared Driv{T:)/Building Forms/Electrical pennit Application I _03.doc NOTI Amps to IT lHE PERMIT Neu'or Extension per One Circuit Each Additional Circuit or with Service or Feeder perrnit CITY OF OREGON 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone oity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT#: 1200500000000000979 Date: 0711212005 e:44:41AM Job/Journal Number coM2005-00887 coM2005-00887 coM2005-00887 coM2005-00887 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0Yo Administrative Fee Amount Due 63.00 3.00 4.62 6.60 Item Total:$77.22 Payments: Tlpe of Payment Paid By CheckNumber Authorization Received By Batch Nunrber Number How Received Amount Paid Check JOY LAPPING DJB 4427 In Person Payment Total:$77.22 $77.22 7/1212005 lofl 5l