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Home My WebLink AboutPermit Electrical 2007-01-29Status 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: COM2007-00086ISSUED: 0112912007 APPLIED: 01/1912007EXPIRES: 0712912007 VALUE: SITE ADDRESS: 2288 9TH ST ASSESSOR'S PARCELNO.: 1703261201109 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Emergency Service Repair/Replace Owner: Address: Contractor Tvpe Electrical HAASE DALE E 2288 N gTH ST SPRINGFIELD OR 97477 Contractor MY ELECTRICIAN INC License 87s06 Expiration Date 1u2012007 Phone 541-729-14s4 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh 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 Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Description Tvpe of Construction Pase I of2 Value Date Calculated D U ll-r-rll\ (, 11\ r rrKlv!A._!_! (2Nl Valuation Description 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: COM2007-00086ISSUED: 0112912007APPLIEDz 0111912007 EXPIRESz 0712912007 VALUE: Fee Description + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Service Reconnect Total Amount Paid $5.00 $2.s0 $4.00 $50.00 u29t07 u29t07 U29t07 u29t07 Total Value of Project Date PaidAmount Paid $61.s0 Receipt Number 1200700000000000087 1200700000000000087 1200700000000000087 1200700000000000087 tr'ees Paid Plan Reviews 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 Owner or Contractors Signature Pase 2 of 2 Date t5L- To Request an inspection call the24 hour recording at 726-3769. All inspections 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. l(equrreo lnsDecuons I gPFlhlGi.-!D €n225 FIFIH STREET r ELECTRICAL City Job Number SOURCE z 0 zoN INITIALS DATE SPRINGFIf, LD, OR 97 477 . PH:(541)7263753 o FAX: (541)726-3689 PERMIT APPLICATION - oao6e 3. A. COLIPLETE FEE SCHEDULE BELOW Date l. LEGAL DESCRIPTION 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. 2. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof 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 Electrical Contractor Address errone 72 { 19 q( Signature of ectrrcran Owners Name z Address Z City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature Inspection Request: 726-37 69 Each Manufact'd Home or Feeder B. Services or Feeders - Installation, Alterations or Relocation: $ 63.00 $ 75.00 $ 125.00 $163.00 $375.00 $ 50.00 u-L City ry w Supervisor License Number Eq 23 > C. Ttntporat'v Scrlices or Ft'ctltrs Expiration Date to Installation, Alteration or Relocation 200 Amps or less . $ 50.00 Constr. Contr. Numbe, b-7 201 Amps to 400 Amps 401 Amps to 600 Amps $100.00 Expiration Date $ 69.00 Over 600 Amps or 1000 Volts see "8" above. D. Branch Cilt:uits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. lliscellaneous (Sen'ice/l'eeder not inclrrded) -lirrch InstaUati<ttt Pump or inigation Sign/Outline Lighting L imited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45'00 * Surcharges 4. ST]B'IOTALOTENAVE 8% State Surcharge l0% Administrative Fee 5% Technology Fee 5-o $ 50.00 $ 50.00 $ 2s.00 $ 45.00 # ---+#-- *-To 1r-r-of TOTAL Shared Drive(T. )/Building Forms/Electrical Permit Appl 8-06. doc *\tnU L/- / 703,2J '.Z e,|O7 CON{RACI'O R INSTATJArION ONI.Y $ 106.00 $ 19.00 <'?./fr\ 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C-rv of Springfield Official Receipt - relopment Services Department Public Works Department RECEIPT #: 1200700000000000087 Date: 0112912007 1:52:0ePM Job/Journal Number coM2007-00086 coM2007-00086 coM2007-00086 coM2007-00086 Description Service Reconnect + 57o Technology Fee + 8% State Surcharge + ljYo Administrative Fee Amount Due s0.00 2.50 4.00 5.00 Item Total $61.50 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard GUIDRY dlm 022091 In Person $61.50 Payment r:otat: -$6 ilSid- cReceint I Page I of I v2912007 *lrrrr{oF,*LD