HomeMy WebLinkAboutPermit Electrical 2003-09-18Status: Issued
225 Fifth Street, Springfield, OR
541:7263753 Phone
541-7263676Fax
541:1 26-37 69 Inspection Line
Buildin g/Combination Permit
PERMITNO: COM2003-00925ISSUED: 0911812003APPLED: 09/1812003E)GIRES: 03/1812004
VALUE:
SITE ADDRESS: 37517TH ST
ASSESSOR'S PARCEL NO.: 1703362403900
PROJECTDESCRIPTION: ReplacePanel
Owner: MADDOXODDIE N & pATSy JOANN
Address: 375 N 1TTH ST SPRINGFBLD OR 97477
Springfield TYPE OF
TYPE OF USE:
License
3849
Electrical Work Only
Repair Residential
Contractor TVpe
Electrical
Contractor
C & S ELECTRIC
Expiration Date
09t0u2004
Phone
541-741-2236
CONTRACTOR INFORMATI
BUILDING INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
ATTEN"iIU w requlres you to
follow rulcs Oregon UtititY
Notification rules are set forttr
in OAR oAR 952-001
0090. You of the rules b)
calling the center. (N ote: the telePhone
Overlay Dist:
# Street Trees
Paved Drive Rqd:
oh of Lot Coverage:
NOTICE:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
AUTHO SN
ONED FOR
OT
Sidewalk Type:
DownspoutVDrains
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
Street
Storm Sewer Available:
Special Instruction:
Notes:
COMMENCED OR IS ABAN
ANY 180 DAY PERIOD.
$ Per Sq Ft
or multiplier
D
Square Footage
or Bid Amount
Total Value of Project
lof2
Description Type of Construction Value Date Calculated
L-"l-tr
Valuation Description I
rl
D
Buildin g/Combination Permit
PERMIT NO: COM2003-00925ISSUED: 0911812003APPLIED: 09/1812003E)PIRES: 03i1812004
VALUE:
CITY OF PRIN
Status: Issued
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-726-3676Frx
541:7 2637 69 Inspection Line
Fees Paid
Fee Description
+ l0Yo Administrative Fee
+ 7oh State Surcharge
Perm Serv/Fdr 200 amps or less
Total Amount
Amount Paid
$6.30
$4.41
$63.00
s73.71
Date Paid
9n8t03
9t18t03
9t18t03
Receipt Number
1200200000000002165
1200200000000002165
1200200000000002165
Plan Reviews
To Request an inspection call the24 hour recording at 7263769. 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.
I 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 certiff 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 oi tn" Co-*unity Services Division,
Building Safety. I further certiff 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 llom
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
2of2
L
ircl
r(eoulreo lnsDecuons
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
16s
coM2003-00925
coM2003-0092s
coM2003-00925
Perm Serv/Fdr 200 amps or less
+ 7%o State Surcharge
+ l0%o Administrative Fee
63.00
4.41
6.30
Item Total:s73.71
Payments:
Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid
CreditCard MELISSAGEHRKE nJm 000173 018408 In Person
Payment Total:
$73.71
$73.71
--<rr--
Permits are uon-transfcrable and exqirg*
ifrvork is not started rvithin 180 davb
of issuance or if rvork is suspended for-'''
180 days.
Address
Citl'Jo
PERMIT
ULE BELOW
A. New Residentitl-Single or
per drrelling unit.
ded:
less
Each
or
Each Manr.rfd Home or
lvlodular Drvelling
Service or Feeder
B. Serlice.s or Feedcrs
Installrrtion, Altcrations or
Rclocltion:
200 amps or less
201 amps to 400 arnPs
-10 1 amps to 600 amPs
601 antps to 1000 antps
Items Cost Sum
$ 106.00
$ 50.00
$ 63.00
-
$ 75.00 _
$ 12-5.00 _
$16,3.00 __
$375.0() _
$ 50.00 _
00.00
$ 3.00
ELE(TION
Ca 7]s
CATION OF TION
LEGAL D/703 +o 316?)
N
D thel does
R
.;rizeo StEnature
2. CONTRACTOR INSTALLATION ONLY
Elecrrical Conrro"to, CIS eW
Citr
RMI
Expiration Date
Signirture of Supenising Electrician
orvners xo,^" Md u-. fhdt*y'a<
Address /7d stnrur
Cit_v pnone 74 -7 -flfl
OWNER INSTALLATION
The installation is being ntade on
properry" I or.vn lvhich is not intended
for sale, lease or rent.
Over 600 anlps or 1000 r,olts see
"B" abot'e
D. Brirnch Circuits
Ne* Alteration or Extension Per Plrnel
One Circuit
Each Additional Circuit or tvith Sen ice
or Feeder Perntit
E. Nlisccllaneous (Serrice/lceder not included)
-Each instrlllttion
Pump or irrigation $50.00
Sign/Outline Lighting $50,00
Linrited Energl'/Res 525.00
Limited Enerp/Comni
-
$15.00
Minimum Electric Permit Inspcction Fee is 545.00 a 5ut'clttr1s
4. SUBTOTAL OF ABOVE 6 3 .P
7%o Stnte Surcharge ---D-:4
/og y,Atlministrative Fce --T .-YO
TOTAL 13"7/
Ow'ners Signlture:
225 FIFTH STREET
SPRINGFIEL D, OREGON 9 7 17 7
TNSPECTiON REQUEST . 7 26-31 69
OFFICE: 126-j159
$ 19.00
1.
lc
,4ENCED OR IS
JY1
Constr Contr.3t
q
I
$43.00