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Home My WebLink AboutPermit Electrical 2005-07-29Buildin g/Co mbin ation Permit Status: Issued 225 Fifth Street, Springfield, OR 541:126-3753 Phone 541-726-3676Fax 541.:7 2637 69 Inspe ction Line PERMIT NO: COM2005-01019ISSUED: 0712912005 APPLIEDz 0712912005E)CIRESz 0112912006 VALUE: SITE ADDRESS: 537 4TH ST ASSESSOR'S PARCELNO.: 1703352406000 PROJECT DESCRIPTION: Change shop panel Springfield TYPE OF TYPE OF USE: Electrical Work Only Repair Residential Owner: Address: PERRY CRA]VIBLIT 537 4TH ST SPRINGFIELD OR 97477 tollow rules Notification Phone Number: 541-726-2918 Contractor TyDe Electrical # of Units: Primary Occupancy Group: Secondary Occupancy Ptimary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: se rules are set Conh&0&es2-001-0010 through OAR 952- obtain number for e Expiration Date 06n0t2006 Phone 541-744-8935 YN Center is 1 R-3 -s0093ear+a) Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees 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: Occupant Load:nla Sidewalk Type: DownspoutMDrains REQUIRED PARKING Total: Handicapped: Compact: Street Storm Sewer Available: Special Instruction: Notes: $ Per Sq Ft or multiplier Square Footage or Bful Amount DEVELOPMENT INFORMATION Description Type of Construction lof2 Value Date Calculated IMIT SHALL EXPI ZED UNDER THIS Valuation Descriotion I 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: COM2005-01019ISSUED: 0712912005APPLIED: 07129/2005EXPIREST 0210812006 VALUE: Fee Description + l0o/o Administrative Fee + 77o State Surcharge Perm Serv/Fdr 200 amps or less + l0Yo Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid Total Value of Project Date Paid 7129t05 7t29tus 7t29t0s 8/8/0s 8/8/05 8/8/05 Receipt Number 1200500000000001114 1200500000000001114 1200s00000000001114 2200500000000001058 2200500000000001058 2200s00000000001058 $6.30 $4.41 $63.00 $0.90 $0.63 $9.00 $84.24 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. Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover 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. Owner or Contractors Signature Pase2 of2 Date r ees raro 225 Fifth Street Springfield, Oregon 97 47 7 34l-726-3759 Phone '-r1y of Springfield Official Receipt --, eYelopment Services Department Public Works Departrnent RECEIPT#: 1200500000000001114 Date: 0712912005 1:31:22PM Job/Journal Number coM2005-01019 coM200s-01019 coM200s-01019 Description + 7%o State Surcharge + l0% Administrative Fee Perm Serv/Fdr 200 amps or less Amount Due 4.41 6.30 63.00 Item Total:$73.71 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard VIRGINIA CRAMBLIT djb 073550 In Person Payment Total: $73.71 -mrr 7/291200s l of I 225 Fifth Street Spring{ield, Oregon 97 477 541-726-3759 Phone ^'ty of Springlield Official Receipt -evelopment Services Department Public Works Department RECEIPT#: 2200500000000001058 Date:08/08/2005 8:46:1lAM Job/Journal Number coM200s-01019 coM2005-01019 coM2005-01019 Description Add, Alter, Extend Circ Ea Add + 1Yo State Surcharge + l0% Administrative Fee Amount Due 9.00 0.63 0.90 Item Total:$10.s3 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Cash Change PERRY CRAMBLIT PERRY CRAMBLIT djb djb In Person In Person Payment Total: $20.00 ($e.47) $10.53 Job/Journal Number coM2005-01019 coM2005-01019 coM2005-01019 Description Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0% Administrative Fee Amount Due 9.00 0.63 0.90 Item Total:$10.53 Payments: Type ofPayment Peid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Cash Change PERRY CRAMBLIT PERRY CRAMBLIT djb djb In Person In Person Payment Total: $20.00 ($e.47) $r0.53 8/8/2005 Page I of I l*anlffis 6a 225 FIFTH STREET . SPRINGFIELD, OR97477 ' PH:(541)726-3153 o FAX: (54 E LE CTIdiI CAL P ERMIT AP P LI CATT O N City Job Number Coyuzco\-- O I o(?Date 1 .o 3. +5j|- LEGAL DESCRIPTION 1"o33 5Z..{ JOB DESCzuPTION sttcf Permits are non-transferable and expire if work is '' not started within 180 days of issuance or if work is Suspended for 180 daYs. 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 A. C. $ 106.00 s 19.00 $s0.00 B.", Electrical Contractor Address n/, Phone 744 _397L in OPfi 200 Amps or less s 63.00 $ 75.00 the Or 1orlfi25.66rules 'ough o 95 ho:.oo coPies ol e Szs.oo : the $ 50.00 tho c8nter. Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 One Circuit Each Additional Circuit or with $ 43.00 1,.) t"*t.. or Feeder Permit 7 63-4 City 47 57 S'to/r/os*n Supervisor License Number v Expiration Date Constr. Contr. Number Expiration Date Signanrre of Supervising Electrician Owners Name Address 5,3 ) .1+h gT City l:lO Phone 1ZL 'L9LBs OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -----7-----t-- n 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits t New Alteration or Extension Per Panel Ol ,F b E. Pump or irrigation S 50.00 Sigrr/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Minimum Electric Permit Inspection Fee is $45.00 * Sureharges a) 7%o State Surcharge D q, to 4. l0% Administrative Fee TOTAL to!,73 "(Inspection Request: 726-37 69 Shared Driv{T:/Building Forms/Electrical Permit Application l'03'doc- t, ,i^t $ a y?t CAMPLETE D6Coo ?+ tol /r/ g Q"t' {} 1\1\ii ,69 ,?oAN\