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Home My WebLink AboutPermit Electrical 2004-02-06Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00153ISSUED: 0210612004APPLIED: 0210612004EXPIRES: 08/0612004 VALUE: SITE ADDRESS: 2378 19TH ST ASSESSOR'S PARCEL NO.: 1703252113300 PROJECT DESCRIPTION: 200amp panel Owner: VALERIE FITZGERALD Address: 2378 19TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORI(: Electrical Work Only TYPE OF USE: New Residential Phone Number: S4l- Contractor Type Electrical Contractor NEWWAYELECTRIC INC License 51088 Expiration Date 06t27t2005 Phone 541-686-2365 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Total: Handicapped: Compact: on law requlres You to R-3 Vlhr Street Improvements: Storm Sewer Available: Special Instruction: Notes: NTION:Oreg Center. Those rules are set fort N OAR oAR 952-OO 0090. You m obtain of the rules I calling the one nufiber forthe Oreg on UtilitY Notification a r:nt*r is 1 -80t)-332-2344' $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Yalue of Project Pase I of2 DEVELOPMENT INFORMATION Description Type of Construction Value Date Calculated l,ulr-ulr\ u rN r uruYrA, ullNl Frontyard SHALL Side I Side 2 UNDER OR IS ffi [F J[I'T,:,HJ1!.[, *::, .*, ABAND0NED h$b\eo Drive Rqd: Rearyard DAY PERIOO.%o ofLot Coverage: Solar Valuation Description I 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: COM2004-00153ISSUED: 0210612004APPLIEDz 0210612004EXPIRES: 0810612004 VALUE: tr'ees Paid Fee Description + l0o/o Administrative Fee + lYo State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $6.30 $4.41 $63.00 $73.71 Date Paid 2t6t04 2t6t04 2t6t04 Receipt Number 1200400000000000176 1200400000000000176 1200400000000000176 To Request an inspection call the24 hour recording at 726-3769. AII inspection requested before 7:00 a.m. wiII 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. Reouired Insnections 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 witl 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 Paee2 of2 2LiSFifth Street Springfield, Oregon 97 477 541-726-3759 Phone -{City of Springfiela elficiat Receipt Development Services Department Public Works Department Receipt #: 1200400000000000176 Detet 0210612004 2t1tt27P:l{ coM2004-00153 coM2004-00153 coM2004-00153 + 7Yo State Surcharge + l0o/o Administrative Fee Perm Serv/Fdr 200 amps or less 4.41 6.30 63.00 Item Total:$73.71 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard NEW WAY ELECTRIC djb 000294 0s6404 In Person Payment Total: s73.7r $73.71 a ) 225FIFTHSTREET . SPRINGFIELD, OR97477 . PH:(541)726-3753 oF ELECTRICAL PERMIT APPLI CATION CityJobNumber (a',,t1Zt <)rt -OO/:{i Date f).,.' ;t (>c'r'1 l. 23" r t 9+^ LEGAL DESCRIPTIONi1c3 zsz I / <300 Date 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 as submitted has the following not roquire sPecific land use $ 106.00 $ 19.00 $s0.00 approval Zoning A. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Contractor Address JOB DESCRIPTION "zc> Dft afr*4 Ph""" 5{/ 686 7Q& Supervisor License Number 3e fas Expiration Date Constr. Contr. Number 5 /08J Signarure Owners Name &l Z3-7 g I 7+..^S} 3PF O 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601Amps to 1000 Amps 5 Or", 1000 AmpsA/olts Reconnect Only C. D. B. Ciry s 63.00 $ 7s.00 s125.00 s163.00 $375.00 s s0.00 $ 100.00 $ 43.00 $ 3.00 63 Installation, Alteration or 201 Amps 401Amps Over 600 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Address City E. Phone OWNER INSTALLATION The installation is being made on properfy I own is not intended for sale, lease or rent. Owners Signature: Pump or irrigation v Ebitar 10% Administrative Fee TOTAL ou to $ s0.00Utiliry $so.oo 6et telt-- e52-q-$ 2s.00 s 45.00 is $45.00 * Surcharges ,1 Lll t30o 7s7! ATTENll rl rU|j:C#- noA c090 ca Inspection Request: 726-3769 nutlber Shared Drive(T:/Building FormsrElectrical Permit Applcation 1-03.doc *s. :. dnrelling En,f " Expiration o"" ln -R 7 -O 5 200 5