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Home My WebLink AboutPermit Electrical 2005-01-03Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00009ISSUED: 01/03/2005APPLIED: 01/0312005 EXPIRESz 0710312005 VALUE: SITE ADDRESS: 4078 E 19th Av ASSESSOR'S PARCEL NO.: 1803031100400 PROJECT DESCRIPTION: Trenching for branch circuits Owner: WILLAMALANE PARIG & Address: 200 S MILL ST SPRINGFIELD OR 97477 TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public Eugene Contractor Tvpe Electrical Contractor KENNETH D RANDALL Expiration Date 10t0u2006 Phone 541-7364044 License 4023S CONTRACTOR INFORMATION # of Bedrooms: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o 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: ICE:{AtL EXPI H\S ON IS ABAN RE IIIHE PER$l1ll SI PERM\1 nla THIS IENCED Frontyard Setback: BO DAY PERIOD $ Per Sq Ft or multiplier Square Footage or Bid Amount REQUIRED PARKING Total: Handicapped: Compact: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: to Description Type of Construction Total Value of Project Value Date Calculated l, U tL|-rrl\ U rN r Ur(rYl.q f lgN_l E COM G 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: COM2005-00009ISSUED: 01/03/2005APPLIED: 0l/0312005 EXPIRESz 0710312005 VALUE: Fee Description + l0o Administrative Fee + 1oh State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid Date Paid u3t05 u3t05 u3t05 U3t05 $5.20 $3.64 $43.00 $9.00 Receipt Number 1200500000000000003 1200500000000000003 1200s00000000000003 1200s00000000000003 $60.84 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. Underground Electric: Prior to cover Owner or Contractors Signature Date Paee 2 of 2 nees raro I t(eourreo lnsDectrons I 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 construction. 225 Fifth Street Springfield, Oregon 97 477 54L-726-3759 Phone C:+v of Springfield Official ReceiPt elopment Services DePartment Public Works DePartment RECEIPT #: 1200500000000000003 Date:01/03/2005 11:15:58AM Job/Journal Number coM200s-00009 coM2005-00009 coM20Q5-00009 coM2005-00009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0o/o Administrative Fee Item Total:$60.84 Amount Due 43.00 9.00 3.64 5.20 Check AuthorizationPayments: Type ofPayment Received By Batch Number Number How Received Amount PaidPaid By Check WILLAMALANE PARK AND REC djb 55 107 In Person $60.84 Payment Total:$60.84 1/3/200s Page I ofl lrelo'l3,.ll 225 FIFTH STREET ' SPRINGFIELD' OR91477 P*(54r)726-3753 o FAX: (541 E LE CT RI CAL P E r.III IT AP P LI CATT O N Job Nunberfi)Yl^Z\ar:.f -Ccoo? Date O I LO C{TI ON O F IN S'TALI-AT I ON 3. COMPLET'E T-EB %es %4o7b LEGAL DESCRIPTION3()3//YOS JOB DESCzuPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. ", Electrical Conffactor Address City Pl.rone Supervisor License Number *oz 3 Expiration Date (O- t-O I Constr. Contr. Number N/ A Expiration Date Signature of Supervising Electrician Owners Name L Address Zc> o S. City >? N 0T$ Eir"mporary se^'ices or Feetlers THIS PtRf\'1lT SHALL EXPliiE lF Tt-lE \l;urii. A U T H 0 lhifituU&[, 6ft"]Ht$rPri*ft1ldch$iotJ i c 0 ur l,,i Ebl0tr a# B.lErs u A r',J D u i\,i r rl F,.lL_ $ 50.00 AN'/ 1e&ilAX,f'hB[d0a*p, $ 6e.oo 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel A. Ncw Residential - Single or Service lncluded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 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 One Circuit Limited 7o/o State Surcharge I0% Administrative Fee TOTAL i COMRAC I:OR INSTALLArION ONLI' B' Services or Feeders - Installation' Alteralions or Reloc:rtion 00 s50.00 $ 63.00 $ 75.00 $ r 2s.00 $ 163.00 $375.00 $ s0.00 &L $ 43 oo 4.3.OO 1, oo Installation 25.00 $ 45.00 r Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature Minimum Electric Permit lnspection Fee is $45.00 * Surcharges 4. SUBTOTAL OF ABOVE #. - )" 5Z,oO 3,61 5,zo # 6 o-04Inspection Request: 726-3769 Sharcd Drive(T:)/Building Fonns/Electrical Pcrrnit Application I -0l.doc C)r Ooze Each Additional fuloE