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Home My WebLink AboutPermit Electrical 2004-01-20Status Issued 225 Fifth Street, SPringfield' OR 541-726-3753 Phone 541-726-36768ax 541-7 26-37 69 InsPection Line Building/Combination Permit coM2004-00063 01/20/2004 0r/20/2004 0712012004 PERMIT NO: SSUED: APPLIED: EXPIRES: VALUE: SITE ADDRESS: 2181 5TH ST ASSESSOR'S PARCEL NO.: 1703262102400 PRoJECT DESCRIpTION: Furnish and install new 200 Amp Service to residence. Owner: SCHULENBERGLARRYD & SM Address: 2181N 5TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORJ(: Single Family Residence TYPE OF USE: Contractor Type Electrical Contractor LR BRABHAM Expiration Date 1211812004 Phone 541-747-6638 License 8699 # of Units: Primary Occupancy Group: Secondary Occupancy GrouP: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo oflot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/I)rains: REQUIRED PARI(NG Total: Handicapped: Compact: Total Value of Project Page I of 2 INFORMA PUBLIC IMPROYEMENTS Description Type of Construction Value Date Calculated l T Yaluation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line GFTELD Building/C ombination Permit PERMIT NO: COM2004-00063ISSUED: 0112012004 APPLIEDT 0112012004 EXPIRESz 0712012004 VALUE: tr'ees Paid Fee Description + l0oh Administrative Fee + lVo Stile Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $6.30 $4.41 $63.00 $73.71 Date Paid U20t04 il20t04 U20t04 Receipt Number 1200400000000000074 1200400000000000074 1200400000000000074 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. 1 Electric Service: Approval required prior to utility company energizing service. 2 Rough Electric: Prior to Cover 3 Final Electric: When all electrical work is complete. Reou 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. unct.rd Gr. S \ r64r--rs,k-5- \) .tt-- Z d -(*)<{ Owner or Contractors Signature Date Page2 of2 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone 4!l City of Springfield Official Receipt Development Services I)epartment Public Works Department Receipt #: 1200400000000000074 Date: 0112012004 9:20:35AM coM2004-00063 coM2004-00063 coM2004-00063 Perm Serv/Fdr 200 amps or less + 7%o State Surcharge + l0Yo Administrative Fee 63.00 4.41 6.30 Item Total:$73.71 Payments:Check Number Received By Batch Number Authorization NumberType of Payment Paid By How Received Amount Paid Check L.R. BRABHAM nJm 30253 In Person Payment Total: $73.7r $73.71 as suDmitteo has the tollowing s not require specilic land use 22s FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)726-Xfi?.n,.Z ELECTRICAL Ciry Job Number -Atfate - :iutlionzeo Stgnature -- &ttl tf, 5 5 .,:., ...,.:r. ;.:.., . . .;.-.,',: ,fueef 3. CO]IIPLETE T'EE SCHEDTJLE BELOT,I/ .' ." A. 1 LEGAL DESCzuPTION 1a !.o /vat Atoft 6 8 w^eB!^^hq1aro teQgrf! ]ffi are rs not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Contractor L. R. Brabham, f nC . 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 $106.00 $ 19.00 $s0.00 B. Address Constr. Contr. Number 8699 Expiration Date t2/78/04 X Si gnature of Supervising Electrician Owners Name /apn "Jll,edAl 5du,An Address dl8 / City Phone /0 OWNER INSTALLATION The installation is being made on properry I own which is not intended for sale, lease or rent. Owners Signature AXP-I gxrom Erllbdttbil I i..'tin or less Pti{i'vli i lS l'lu I S,o.oo N II0NE[IF[]F s 6e.oo l0&s $ 100.00 Over 600 or 1000 Volts see "B" above. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconaect Only New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Perrnit TOTAL C. 6J, a0s 63.00 $ 7s.00 s125.00 $ 163.00 $37s.00 $ 50.00 $ 43.00 $ 3.00 t;!s THI AU c0 A D. C\)Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surcharges $ s0.00 $ 50.00 $ 25.00 s 45.00 u) 7%o State Surcharge 4t l0% Administrative Fee tt,30 Inspection Request: 726-37 69 4- Shared Driv(T:/Building Forms/Electrical Permit Application l-03.doc a ,/rqlo/ r bY th6 Oregu' set tod Il OAR -0010 ot the rules I calling tor the { .lvravV 73,'7t