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Home My WebLink AboutPermit Electrical 2004-08-05Building/Combination Permit Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00968ISSUED: 08/05/2004APPLIED: 08/0512004EXPIRES: 0210512005 VALUE: SITE ADDRESS: 403 16TII ST ASSESSOR'S PARCEL NO.: 1703362407500 Springlield TYPE OF WORK: Electrical Work Only th.ry 6r, oF usE: Addition Residentiar pRoJECr DESCRTpTTON: Four Circuitr+ sgtu(gg Owner: DURR pAMELA LEE Address: 403 16TH ST SPRINGFIELD OR 97477 Contractor Type Electrical Contractor GROTJNDED ELECTRIC License 158804 Expiration Date 02t24t2006 Phone 541 726-68s8 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: # 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 Notes:DUN Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo ofLot Coverage: RMIT IS NOT Notification Center. Those rul REQUIRED PARKING Total: Handicapped: Compact: Street Improvements:Sidewalk Type: Storm Sewer Available: Special Instruction: ALL EXPIRE IF THE WORK bllor rules adoPted bY the Oregon Utility nrrElhumror€Drurr Gqrdt€syotrto OR IS ABANDO ANY 180 D es are set lorth in OAR 952{01'001 0 throtgh oAn 952-001- oalling the center.(Note: the telePhone for the Oregon Utitity Notilication THIS PER MIT SH DER THIS PE NED FOR $ Per Sq Ft or multiplier Square Footage Center is-1€00'332'23441' or Bid Amount Value Date CalculatedDescription Type of Construction Total Value of Project EEI DU rLrrll\ lJ rr.l r Lr_rllvlA I t (r1\ | Building/C ombination Permit PERMIT NO: CO M2004-00968 Status Issued 225Fitth Street, SPringlield, OR 541-726'3753 Phone 541-726'3676Fax 541-7 26:37 69 InsPection Line Amount Paid $5.20 $3.64 $43.00 $9.00 $6.30 $4.41 $63.00 ISSUED: APPLIED: EXPIRES: VALUE: 08/05/2004 08/0s/2004 0210512005 Receipt Number 3200400000000000195 3200400000000000195 3200400000000000195 3200400000000000195 1200400000000001215 1200400000000001215 1200400000000001215 Date Paid Fee DescriPtion + lloh Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 10oh Administrative Fee + 7o/o St*e Surcharge Perm Serv/Fdr 200 amPs or less Total Amount Paid To Request an inspection call the24 will be made the same working day, day $134.5s hour recording at 726-3769' inspections requested after 7 All inspection requested before 7:00 a'm' :00 a.m. will be made the following work 815104 8lsl04 8lsl04 8lsl04 8t13l04 8l13l04 8t13l04 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete' By signature,I state and agree, that I havetarefully examined the completed application and do hereby certify that all information hereon is true and correct, and r fufihlr certify that any uno "u woix perrormed shall be done in accordance with the ordinances of the city of springtield and the Laws of ihe State of oregon pertaining to the work described herein' and that No occupANcy will be made of any structure without permission of ttr. colnlnunity 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 ir.ieciion. are requestea at ttre proper time, that each address is readable from the street, that the permit card is locatet at the front of the property, and the appioved set of plans will remain on the site at all times during construction. 'i (2,) Owner or Contractors Signature Pase 2 of2 Date 3natxotl3.o crty of Springfield Official Receipt velopment Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone RECEIPT #: 1200400000000001215 Date: 0811312004 11:03:04AM Job/Journal Number coM2004-00968 coM2004-00968 coM2004-00968 Description Perm Serv/Idr 200 amps or less + lYo State Surcharge + lDoh Administrative Fee Amount Due 63.00 4.41 6.30 Item Total:$73.71 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard GROUNDED ELECTRIC dlm 000473 r87417 In Person Payment Total: $73.71 -mrr 8/t3t2004 Page I of I RINGFTELD, OREGONCITY OF 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)72G3753 o FAX: City Job Number 3. q6 A. New 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 Permits are non-tratrsferable and if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. ,, Electrical Contractor Address &cS>s5.h 57, % 6PlllI}'l TIELD Qs $l $s0.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 43.00 $ 3.00 lr3. t4o JOB DESCRIPTION B. vnone 7Q6'{YSY Supervisor License Number 37.rA S C Expiration Date l r> )ot / P eott 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601Ampsto 1000Amps Over 1000 AmpsA/olts Reconnect Only New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 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 Volts see "B" above Zg- ---7----7Constr. Contr. Number Expiration Date a of Electrician Owners Name OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Pump or irrigatron Sigrr/Outline Lighting Limited Energy/Residential Limited Energy/Commerci al Minimum Electric Permit Inspection Fee is $45.00 * Surch 7%o Stale Surcharge 10% Administrative Fee TOTAL D. City $ 50.00 $ 50.00 $ 2s.00 $ 45.00 a) nixl- a Inspection Request: 726-3769 4. Shared Drive(T:/Building Forms/Electrical Permit Application l-03.doc Altdrations or ,/*lRR a 4 Services or E. Miscellaneous (Service/feedernot RINGFIELD, ORECONCITY OF 225 FIFTH STREET . SPRINGFIELD, OR 97477 o PII:(541)726-3753 O FAX: (541 PERMITAPPLICA 6 CCiry Job 7 LEGAL DESCRIPTION A. Service Included 1000 sq. ft. or less B. Address Ynone 7&G^f,VSY Supervisor License Number 37rfa ,S C. Expiration Date Constr. Contr. Number Expiration Date of Supervising Electrician D. FJ ST iit [:IrfllB'Prntffrs,nner WfiPTF THE WORK20fl$nqemiFpn ur,il ?9CCrrnt:ePomouA,trqdO$flfpwr 200 Amps or less Center iS 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only One Circuit Each Additional Circuit or with Service or Feeder permit Pump or irrigation Sigr/Outline Lighting Limi ted Energy/Residential Limited Energy/Commerci al Lil THtS PERf'llr Bs$gt iS AEAI{UONEOJOHg.OO t0D. Over 600 or 1000 Volts see ..B"above. New Alteration or Extension per panel SPR'Il,(3FIELI' $l $50'00 $125.00 $163.00 $37s.00 $ s0.00 $r00,00 $43.00 4 o1-) $ s0.00 $ 50.00 $ 2s.00 $ 4s.00 3. DESCRIPTION 'rL,; 15-Each additiona.! 500 sq. ft. or . portion therdof j Each Ma4ufact'd Home or Modular Dwplling Service or Feeder lt'.',t . o Owners Address Ci OWNER rz*63q\?$ 3.00 TION Il-e inst:llalo1r^is being made on properry I own whichrs not intended for sale, Iease or rent. Owners Signature: Minimum Electric permit Inspection Fee is $45.00 +Surcharges a 7%o State Surcharge l0% Administrative Fee TOTAL -3 Inspection Request: 7ZG376g 4. shared Drive(T:/Buirding Forms/Electricar permit Apprication t-03.doc 6?) Branch or Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. t.. Electrical Contractor W a- -S tA '/.sa- $ nc:;s :"ules are set forth E' Misce'aneous lServicelteeder not incruded) -Each Instaration Status Issued 225Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00968ISSUED: 0810512004APPLIED: 08/0512004 EXPIRESz 0210512005 YALUE: SITE ADDRESS: 403 16TH ST ASSESSOR'S PARCEL NO.: 1703362407500 PROJECTDESCRIPTION: Four Circuits Owner: DURR pAMELA LEE Address: 40316TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential Contractor Type Electrical Contractor GROUNDED ELECTRIC License 158804 Expiration Date 02t24t2006 Phone 541 726-6858 CONTRACTORINF( # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 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: oh of Lot Coverage: $ Per Sq Ft or multiplier Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla NOTICE: Street Improvements: Storm Sewer Available: Special Instruction: Notes: THIS PERMIT SHALL EXPIRE IF THE WORK AUIHORIZED UNDER THIS PERMIT IS NOT COMMENOED OR IS ABANDONED FOR ANY 180 DAY PERIOD. REQUIRED PARKING Total: Handicapped: Compact: mberforthe O Center is ' Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Description Type of Construction Total Value of Project Value Date Calculated r:r [},- -1, UILI ll\ (, lI\I (rI(rYI4!.1!!|ll l Valuation Descrintion I Status Issued 225Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-36768ax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00968ISSUED: 0810s12004APPLIED: 0810512004EXPIRES: 0210512005 VALUE: Fee Description + l0%o Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $s.20 $3.64 $43.00 $9.00 $60.84 Date Paid 8t5t04 8t5t04 8t5t04 8t5t04 Receipt Number 3200400000000000195 3200400000000000195 3200400000000000195 3200400000000000195 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. Rough Electric: Prior to Cover 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 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 OCCUPAIICY 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 tirne, 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 Pase2 of2 L m liees Prirl I Kequrreo lnsDectrons I 225 Fifth Street Springfield, Olegon 97 477 541-726-3759 Phone cify of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 3200400000000000195 Date: 0810512004 2:10:50PM Job/Journal Number coM2004-00968 coM2004-00968 coM2004-00968 coM2004-00968 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 77o State Surcharge + l0%o Administrative Fee Amount Due 43.00 9.00 3.64 s.20 Item Total:$60.84 Payments: Type of Payment Paid By Received By Batch Number Number How Received Amount Paid CreditCard EzuC MCHAFFY nJm 000464 R46330 In Person Payment Total: $60.84 -$60-54- 8/5/2004 Page I of I sxf,aa