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Home My WebLink AboutPermit Electrical 2006-04-12Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line ITY Building/Combination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006 APPLIEDz 0411212006EXPIRES: 0610412007 VALUE: SITE ADDRESS: 1915 7TH ST Springfield TYPE OF WORK: Electrical Work Only ASSESSOR'S PARCEL NO.: 1703261301900 TYPE OF USE: New Residential PROJECT DESCRIPTION: New Service Panel and Feeder and Add Replace One Plumbing Fixture BARBARA JOAN CHAFFIN 1993 TRUST 1915 7TH ST SPRINGFIELD OR 97477 PhoneNumber: 541-744-3083Owner: Address: Contractor Type Electrical Plumbing Contractor GROUNDED ELECTRIC GARY'S ROOTER SERVICE License 158804 t29990 Expiration Date 02t24t2008 06t24t2008 Phone 541 726-6858 CONTRACTOR INFORMATION IINFORMATION # 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: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Ai l tsN I ruN:LJru9:tli:[$iit's vou to f o I I ow r ur eI aoopt6orv *,?rag:J.u"l l':',tt N oliticati on cent91 lrylL''H?ih-gsC-oo r i."oncgsz-oo 1 -00^1 o-throuSl "Yfii " i, r"r I b'ogo You may obtaincoP^to: ' cal lins tn"-titni"t' q:i"'::lll" telephone number toi G O'"gon yllliy Notif ication cli'i"ii' i'6oo'ssz-zsaal Sidewalk Type: Downspouts/Drains: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD DEVELOPMENT INI PUBLIC IMPROVEMENTS Paee 1 of3 LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006 APPLIEDz 0411212006 EXPIRESz 0610412007 VALUE: Description Type of Construction Fee Description + l0oh Administrative Fee + l0o/o Administrative Fee + 87o State Surcharge + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Refund - Electrical Refund - Surcharge + 1006 Administrative Fee + 87o State Surcharge Fixture Minimum/Adjustment Plumbing Penalty Fee - BWOP Plumbing + l0%o Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Total Value of Project Date Paid Value Date Calculated Receipt Number 2200600000000000451 2200600000000000450 2200600000000000451 2200600000000000450 2200600000000000451 2200600000000000450 VOUCHER # 10326I voucHER # 103261 r200600000000000994 1200600000000000994 1200600000000000994 1200600000000000994 1200600000000000994 2200600000000001637 2200600000000001637 2200600000000001637 2200600000000001637 220060000000000r637 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $r.20 $12.60 $0.96 $r0.08 $12.00 s126.00 $-50.40 $-s.04 $9.00 $3.60 $14.00 $31.00 $45.00 $r3.50 $6.75 $10.80 $9.00 $126.00 4n2t06 4n2t06 4n2t06 4n2t06 4n2t06 4n2t06 4t20/06 4t20106 6t29106 6/29t06 6t29t06 6t29106 6t29t06 1l130/06 tU30t06 ll130/06 tu30t06 tU30t06 $376.05 tr'ees Paid Plan Reviews NOTICE: THIS PERMIT SHALL EXPIRE To Request an inspection call the 24 hour recording at will be made the same working day, inspections req day. before 7:00 a.m. 1BO DAY PERIOD Electric Service: Approval required prior to utility company energizing service. Rough Plumbing: Prior to cover and including required testing. Reouired Insnections Pase 2 of3 the following work q Valuation Descrintion I F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Buildin g/Combination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006APPLIED: 04112/2006 EXPIRES: 0610412007 VALUE: Final Plumbing: When all plumbing work is complete. 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 Date Pase 3 of 3 q wi l/ol h {{- arK lr. v a(< c I r4 /- -L \, { ( h C, AI 4UL--e d f 1 n ,&\ a 225 FIFTH STREET . SPRINGFIELD, OR97477 . PH:(541)726-3753 o FA,\: (54l)726-3689 ELECTRICAL APPLICATION )r- Ciry Job Number l"- 0o :b Date lt 3d o 1 ? \1r5 'l+* 5 k *F LEGAL DESCRIPTION 11 o7 Au r? c r9 ot A. D. E. JOB DESCRIPTION Permits are non-transferab expire if work is '' not started within 180 days of issuance or if work is Suspended for 180 days. City evG*t- ov* Pborc 5z D Supervisor License Number 4ttzS Expiration Date /O - ci- 01 Const. Conr. Number I \ Expiration Date Signature of Supervisine Electrician Owners Name (c\- 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 601 Amps to 1000 Amps Over 1000 Amp#ols Reconnect Only $106.00 s 19.00 $s0.00 ;)> B I s e:.oo i la. - $ 75.00 $125.00 $ 163.00 $375.00 $ 50.00 c. Address ltl ts 'l+r- city Spr. alArId Phorc 7 L1t4 - T4? OWNER INSTALLATION The instaltation is being made on property I own which is not inteuded for sale, iease or rent. Owners Signature: N&lrl&h'irrigation $ so-oo Autlifi8dffi0,Utio*n.ru$ PERI\,{tTm'0ilzs.oo -vrAlrlX'l$0re SY. PPEilSqns p ectio n F ee is $4 5. 0 0 * S urcha rg es Installation, Alteration or Relocation 200 Amps or less $ 50-00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "B" above. New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with 2 Service or Feeder Perrnit 5 $ 3'00 1.- r-lb $% State Surcharge l0% Administrative Fee lo x: Bg Wo 'Ttaw TOTAL b.1{ l{"1r. o.S 4. Inspection Request: 726-3769 Shared Drive(T:YBuilding Forms/Electrical Permit eppl l -03.doc 2. Electrical contractor /lti+ il < ?f = tV. Address Zfi O fyraof,wtre 74f 0l- tv-o1 -225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C-t of Springfield Official Receipt . -:lopment Services Department Public Works Department RECEIPT #: 2200600000000001637 Date: 1113012006 3:05:44PM Job/Journal Number coM2006-00434 coM2006-00434 coM2006-00434 coM2006-00434 coM2006-00434 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10Yo Administrative Fee Amount Due 126.00 9.00 6.75 10.80 1 3.50 Item Total:$166.05 Payments: Type of Payment Received By Check Number Batch Number Amount PaidPaid By CreditCard GROUNDED ELECTRIC lkw T66334 In Person $ 166.05 Payment total: -5T66ffi5 cReceint I Page I of I 1v3012006 t[il[alr3,r] Authorization Number How Received r-\ tilnu{StrILg Report lD: SPRA'|03A Voucher !D : Handling Gode: 00r03261 RE City of Springfield Voucher Accounting Date: Vendor Number: lnvoice Date: lnvoice # : Approver: Operator: Gross Amount: Account Fund Ogg SubClass BY Proi/Grant Apnll2012006 000001 3514 Aprill1212006 Com2006-00434 PUEN5597 wtLS5940 55.44 McHaffey,Eric 8089 South A Street Springfield, OR 97478 Descriptioti electrical refund 215004 426',t02 00000 821 224 2006 2006 Amount 5.04 50.40 Comments: 1915 7th Street electrical refund Ok'd by Lisa Hopper w City of Springfield 225 Fifth Street, Springfield, OR97477 541-726-3759 Phone 541-726-36768ax November 22,2006 BARBARA JOAN CHAFFIN 1993 TRUST 1915 7TH ST SPRINGFIELD OR 97477 Job Number: Location: coM2006-00434 19T5 7TH ST Project New Service Panel and Feeder and Add Replace One Plumbing Fixture Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at 1915 7TH ST which is set to expire on 1211312006. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notify you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-726-3790. Sincerely, Lisa Hopper Building Safety Management Analyst 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: COM2006-00434ISSUED: 0411212006APPLIED: 0411212006EXPIRES: 1211312006 VALUE: SITE ADDRESS: 19f 5 7TH ST Springfield TYPE OF WORK: Miscellaneous ASSESSOR'S PARCEL NO.: 1703261301900 TYPE OF USE: Repair PROJECT DESCRIPTION: New Service Panel and Feeder and Add Replace One Plumbing Fixture PhoneNumber: 541-744-3083 Residential Owner: Address: BARBARA JOAN CHAFFIN 1993 TRUST I9T5 7TH ST SPRINGFIELD OR 97477 Contractor Type Electrical Plumbing # 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: Contractor GROUNDED ELECTRIC GARY'S ROOTER eO OY tne O Those rule 10 through UtilitY Expiration Date 02t24t2008 06t24t2008 Phone s41 726-68s8S 1- U #of Height Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: SE: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: nla AY Notes Page I of3 3 *-*s r:L"l UUYU. calli hN\1 \r \S AB Type: 80D Downspouts/Drains: 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: COM2006-00434ISSUED: 0411212006 APPLIEDT 0411212006 EXPIREST 1211312006 VALUE: Descriotion Tvne of Construction Fee Description + lOoh Administrative Fee + l0o/o Administrative Fee + 8olo State Surcharge + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Refund - Electrical Refund - Surcharge + l0o/o Administrative Fee + 87o State Surcharge Fixture Minimum/Adjustment Plumbing Penalty Fee - BWOP Plumbing Total Amount Paid Total Value of Project Date Paid Value Date Calculated Receipt Number 2200600000000000451 2200600000000000450 2200600000000000451 2200600000000000450 2200600000000000451 2200600000000000450 voucHER # 103261 voucHER # 103261 r200600000000000994 1200600000000000994 r200600000000000994 1200600000000000994 r200600000000000994 Amount Paid $ Per Sq Ft or multiplier Square Footage or Bid Amount 4n2t06 4n2106 4n2t06 4n2106 4n2t06 4fizt06 4t20t06 4t20t06 6t29106 6t29t06 6t29t06 6t29t06 6t29t06 $1.20 $12.60 $0.96 $r0.08 $12.00 $126.00 $-50.40 $-5.04 $9.00 $3.60 $14.00 $31.00 $45.00 $210.00 Fees Pa Plan Reviews To Request an inspection call the 24 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 Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. I Insnecfinns Paee 2 of3 Eri}l Valuation Descriotio LD 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: COM2006-00434ISSUED: 0411212006 APPLIED-. 04n2t2006 EXPIREST 1211312006 VALUE: 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 6 -2r-06' Owner or Contractors Signature Date Page 3 of3 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Qi+', o1 Springfield Official Receipt I elopment Services Department Public Works Department RECEIPT #: 1200600000000000994 Date: 0612912006 e:30:03AM Job/Journal Number coM2006-00434 coM2006-00434 coM2006-00434 coM2006-00434 coM2006-00434 Description Fixture Minimum/Adjustment Plumbing Penalty Fee - BWOP Plumbing + 8% State Surcharge + l0%o Administrative Fee Amount Due 14.00 31.00 45.00 3.60 9.00 Item Totalr $102.60 Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check GARYS ROOTER AND PLUMBING djb 2255 In Person Payment Total: $ 102.60 $102.60 cReceintl Page I of I 612912006 zoN INITIALS DATE SOURCE S pERi,T lS I,tO. ''tllr!l'tEB pdfl oo $ 75.00 $12s.00 $163.00 $375.00 $ s0.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only C. Temporart' Scrvices or Feeders One Circuit Each Additional Circuit or with Service or Feeder Permit Purnp or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial SPP EIELD ] 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATI' 1 Cily Job Number 1. LOCATIOI{ AF INSTALL4TION Date 3.CO\IIPLETE FEE SCHEDULE BELOI,\I A. Ngw Residential - Single or lVlulti-Family per dwetling unit. Service Included 1000 sq. ft. or less $106.00 Each additional 500 sq. ft. or portion thereof $ 19.00 Each Manufact'd Home or Modular Dwelling Service or $50.00 '"*'NoTlcE: s. i Serlids +Wffil{r$fl Etl[uE Xft n*\f "T++F,W 8fl$el oca t io n : s.l- *f+'&fft',T,-olloo -= " ,I.+&hon ,ZL'CI.S& JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . CONTRACTOR INSTALI-ATION ONLYz. Electrical Contractor Address F, City Superv'isor License Number Expiration Date -o Constr. Contr. Number Expiration Date c of Supervising Electrician Owners Name Address lgl; 7#t Cify vn"rr744W OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726'3769 Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69-00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Voits see "B" above' D. Branch Circuits New Alteration or Extension Per Panel +/2.oo $ 43.00 $ 3.00 50.00 50.00 25.00 45.00 $ $ $ s Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SU'BITOTAL OF ABOVE 9. 8% State Surcharge l0% Administrative Fee TOTAL t. f1dd *o eut<hrrrf Ptr ul^^}- Shared Drive(T:)/Building Fonns/Electrical Permit Application I -06 doc Geo,^u, 3-2s G.S '5{ka I q, t4./b 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: COM2006-00434ISSUED: 0411212006APPLIED: 0411212006 EXPIRESz 1011212006 VALUE: SITE ADDRESS: 1915 7TH ST ASSESSOR'S PARCEL NO.: 1703261301900 PROJECT DESCRIPTION: New Service Panel and Feeder. Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential Owner: Address: Contractor Type Electrical Contractor GROUNDED ELECTRIC BARBARA JOAN CHAFFIN 1993 TRUST 1915 7TH ST SPRINGFIELD OR 97477 License 158804 Expiration Date 02t24/2008 Phone 541 726-6858 CONTRACTOR INFORMATION # 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: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla AUTHORiZED UN Overlay Dist; # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Total: Handicapped Compact: Sidewalk Type: Downspouts/Drains: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Tvpe of Construction Page I of2 Value Date Calculated h UtilitY Notr{icatlon )432-2314). u u l LUrN u rN r ur(vl,{_!_!l2.ll_l ALL EXPIRE I REQUIRED PARKING Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006 APPLTED| 04n2t2006 EXPIRESz 1011212006 VALUE: Fee Description + l0Yo Administrative Fee + l0oh Administrative Fee + 87o State Surcharge + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid Total Value of Project Date Paid 4n2t06 4n2t06 4n2t06 4n2t06 4n2t06 4n2t06 Receipt Number 22006000000000004s1 2200600000000000450 22006000000000004s1 2200600000000000450 2200600000000000451 2200600000000000450 $1.20 $12.60 $0.96 $10.08 $12.00 $126.00 $162.84 an To Request an inspection call the 24 hour recording at 726-3769, All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. nsnections By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the properfy, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pase 2 of 2 Date _5 1' ees rard I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone C of Springfield Official Receipt L elopment Services Department Public Works Department RECEIPT #: 2200600000000000451 Date: 0411212006 l:35:09PM Job/Journal Number coM2006-00434 coM2006-00434 coM2006-00434 Description Add, Alter, Extend Circ Ea Add + 8% State Surcharge + l0%o Administrative Fee Amount Due 12.00 0.96 t.20 Item Total:$r4.16 Payments: Type of Payment Paid By rc Received By Batch Number Authorization Number How Received Amount Paid CreditCard HOLLY MAHAFFEY ddk T13708 In Person Payment Total: s 14.l6 -fi,i-to-- cReceintl Page I of I 4112t2006 ZON INITIALS DATE 225 FIFfH STREET . SPRINGFIELD, OR97477 . PH:(541)726-3753 . FAX: (541)72C3689 SOURCE ELECTRICAL APPLICATION Ciry Job Number Date I. LOCATIAN OF INSTALL4TION 3. CAI}TPLETE FEESCHEDULE BELO$T SPFTI,T'^FIELE, : '. .. '; '. .. '' Qh, t' LEGAL DESCzuPTION 17 03 2L l3 Ot o JOB DESCRIPTION VL d- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Electrical Contractor Address $C,,f7 f.-^, . "A 'SN sl Nerv Residential - Single or l\'Iulti-Family per dwelling unit'A. Supervisor License Number 3 Z*5 C-, S Expiration Date Constr. Contr. Number o Expiration Date c Signature of Supervising Electrician Owners Name Address tqB 7-lA 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 601 Amps to 1000 AntPs Over 1000 Amps/Volts Reconnect Only 8% State Surcharge l0% Administrative Fee $ 106.00 $ 19.00 s50.00 )CONT RACT O R IN STALI,ATI O N O N L''B. Services or Feeders - Installation Alterations or Relocation: L $ 63.00 $ 75.00 $ 125.00 $ 163.00 s3 75.00 s s0.00 /2b.@ Ciry Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Ampa or 1000 Volts see "B" above. D. Branch ci.",,iti ili-"i . i:l ir;li ,f j'iE\i\r.lrr( '"- i-''':;lij,,ui New Alteration or.Extenqion,Pqf Paqel' , ' .. .,,,_,_ J.,_S!:.oo One Circuit i ., i Each Additional Circuit or with Service or Feeder Permit S 3'00 E.'Nliscellaneous (Service/feeder not ilcluded) -Each lnstallation OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, iease or rent. Owners Signature phon" 74-+-%3 Pump or irrigation s 50.00 Sign/Outline Lighting Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges SUBTOTAL OF ABOW .oD /0 .8 l?.bo rorAl 148.a8 Shared Dtive(T:)/Building Fonns/Electrical Permit Application I -06'doc $ 50.00 lnspection Request: 726-37 69 4. lq try /qr r/. C. Temporary Services or Feeders cw sPtiryfic4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Buildin g/C ombination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006APPLIEDz 0411212006 EXPIRESz 1011212006 VALUE: SITE ADDRESS: 1915 7TH ST ASSESSOR'S PARCEL NO.: 1703261301900 PROJECT DESCRIPTION: New Service Panel and Feeder. TYPE OF USE: Repair Residential Springfield TYPE OF WORK: Electrical Work Only Owner: Address: Contractor Type Electrical Contractor GROUNDED ELECTRIC BARBARA JOAN CHAFFIN 1993 TRUST 1915 7TH ST SPRINGFIELD OR 97477 License 158804 Expiration Date 02t24t2008 Phone 54r 726-6858 CONTRACTOR INFORMAT # 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 ImproYements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh oI Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMEN PUBLIC IMPROVEMENTS Description TvPe of Construction Page I of2 Value Date Calculated Nr I, u tl,t ll\ G lN r uK1vr,q._!_!!-r.l'! il\r(rKlvtAlt(Jl\ I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 I nspection Line Building/Combination Permit PERMIT NO: COM2006-00434ISSUED: 0411212006 APPLTED| 04n2t2006EXPIRES: 1011212006 VALUE: Fee Description + l0o/o Administrative Fee + 87o State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Total Value of Project Date PaidAmount Paid $12.60 $10.08 $126.00 $148.68 Receipt Number 2200600000000000450 2200600000000000450 2200600000000000450 4t12t06 4n2/06 4n2t06 Paid Plan Reviews To Request an inspection call the24 hour recording at 726-3769, All inspection requested before 7:00 a.m. witt 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. 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. DateOwner or Contractors Signature Pase 2 of 2 ry 225 Fiftb Street Springfield, Oregon 97 477 541-726-3759 Phone CiF of Springfield Official Receipt L ,lopment Services Department Public Works Department RECEIPT #: 2200600000000000450 Date: 0411212006 ll:03:50AM Job/Journal Number coM2006-00434 coM2006-00434 coM2006-00434 Description Perm Serv/Fdr 200 amps or less + 8% State Surcharge + ll%o Administrative Fee Amount Due 126.00 10.08 12.60 Item Total:$14E.68 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard ERIC S. MAHAFFY ddk T36842 In Person Payment Total: $ 1 48.68 -mr8.o-8- cReceint I Page I of I 4^2t2006