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Home My WebLink AboutPermit Electrical 2004-10-20Status Issued 225 Fifth Street, SPringfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 InsPection Line SITE ADDRESS: 303 16TH ST ASSESSOR'SPARCELNO.: 1703362408200 PROJECTDESCRIPTION:Service,subpaneland5circuits Owner: MELISSA HALL Address: Joilorn sr SPRTNGFTELD oR 97477 Building/C ombination Permit PERMIT NO: COM2004-01299 ISSUED: 1012012004 APPLIEDz 1012012004 EXPIRESz 0412012005 VALUE: Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential 01 $,a1 (.i\gB o $ Per Sq Ft or multiplier o\ of Structure of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o oILot Coverage: Expiration Date 0u1412005 Phone 541-935-2154 b''l 5$Contractor TYPe Electrical # 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: $e License 09864 nla g*q Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARI(NG 1 Square Footage or Bid AmountDescription Type of Construction Total Value of Project Value Date Calculated m u\ .\i tt\ o\ |,Lurryll,N r II\I (J NYTA T I Valuation Description I Type: \t Downspouts/Drains: Status Issued 225 Fifth Street, SPringfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 InsPection Line Fee DescriPtion + l0o/o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amPs or less Amount Paid $14.10 $9.87 $15.00 $126.00 Date Paid 10120104 10t20104 10120104 10120104 Building/C o mbination Permit PERMIT NO: COM2004-01299 ISSUED: 1012012004 APPLIED: 1012012004 EXPIREST 0412012005 VALUE: Receipt Number 1200400000000001488 1200400000000001488 1200400000000001488 1200400000000001488 Total Amount Paid $164.97 To Request an insPection call the 24 hour recording at726-3769. 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 rtectric 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 application and do hereby certify that all information hereon is true*and correct, and I furthlr 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, thatlhe 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 Plan Pase2 of2 ry L l'ees Paio t 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone rity of Springfield Official Receipt - :velopment Services Department Public Works Department RECEIPT #: 1200400000000001488 Date: 1012012004 3:48:24PM Job/Journal Number coM2004-01299 coM2004-01299 coM2004-01299 coM2004-01299 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0% Administrative Fee Item Total: Amount Due 126.00 15.00 9.87 14.10re Payments: Type of Payment Check Number Received By Batch Number Number How Received Amount PaidPaid By CreditCard DELLS ELECTRIC djb 010264 In Person Payment Total: $164.97 -5t-6I57 t012012004 Page I of I aflefalD CITY OF SPRINGFIELD, ORE GON 225 FIFTH STREET . SPRINGFIELD, OR 97477 O PH:(54I )726-3753 o FAX: ELECTRICAL PERMIT APPLICATION oq o^c/6 City Job Number - otL?1 Date 1. JOB DESCRIPTION Qv L 6 66tt-^il: Permits non-transferable and expire ifwork 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 {6' $1 $l $50.00 .{lterations or Relocation : Z $ 63.00 tz6 $ 75.00 $12s.00 $163.00 $37s.00 $ 50.00 LEGAL DESCRIPTION taos3bzq O6Z0.o B Electrical Address Contractor Date i ,,"1 f le Q,'c Amps or less to 400 Amps to 600 Amps to 1000 Amps 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Each Additional Circuit or with Service or Feeder Permit o(0 City e- Phone Supervisor Expiration License Number f- 0 o Constr. Contr. Number /oq8Q 4 Expiration Date 05 Signature of Supervising Electrician l0-,1* owners N^ " illls(f,ss/t *bil Address <o3 /6fl^ >+ city slf s Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: or Relocation $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit $43.00 It- \t:$Dc )\ $ 50.00 $ 50.00 $ 2s.00 $ 45.00F Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. SUBTO'TALOFABOVE I Iffi t L// 78-7%o State Surcharge l0% Administrative Fee TOTAL y/o Inspection Request: 726-3769 Shared Drive(T:)/Building FormVElectrical permit Application l_03.doc ? LOCATION OIl IN STALIA'TION 3. COMPLETE A. New Residential - Single,or E. Miscellaneous Limited Limited o'a J6 (l- S{- or or Feeders Pump or \5 Sigr/Outline Installation