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Home My WebLink AboutPermit Electrical 2005-06-16Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line PERMIT NO: COM2005-00743ISSUED: 0611612005APPLIED: 06/1612005 EXPIRESz 1211612005 VALUE: SITE ADDRESS: 265 21ST ST ASSESSOR'SPARCELNO.: 1703361305700 PROJECT DESCRIPTION: Service change Springfield TYPE OF WORIft Electrical Work Only ATTENTION: Oregon law requires you to f o I I oT,XBE 9td6!fr o oltnuo re go n Uti I itlesidential Notification Center. Those rules are set forth '' Owner: Address: RAY BURCH 265 2rST SPRINGFIELD OR 97477 0090. You may obtairnmdordsba ru0qr$y calling the center. (Note: the telephone number for the Oregon Utility Notrfication Contractor Type Electrical Contractor ALERT ELECTRIC INC Expiration Date 0512212007 Phone 541-747-2213 License 12772 CONTRACTOR INFORMAT # of Units: Primary Occupancy Group: Secondary Occrtpancy 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: # of Stories: Height of Structure Type of Heat: \Yater 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: R-3 VN nla Sidewalk Type: Downspouts/Drains: REQUIRED PARIilNG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount LOPMENT INFORMATION PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 Value Date Calculated T I, U lLull\ ti rN I UI(Yrr\l !!lN_.] Valuation Description I Building/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: COM2005-00743ISSUED: 0611612005APPLIEDz 0611612005 EXPIRESz 1211612005 VALUE: Fee Description + l0o/o Administrative Fee + 77o State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $6.30 $4.41 $63.00 $73.71 Total Value of Project Date Paid 6n6t05 6n6105 6n6t05 Receipt Number 3200500000000000358 3200s000000000003s8 3200500000000000358 ['ees I Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. wiil be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. nsnections 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 Springlield 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. IL G Owner Signature Pase2 of2 Date rq tLi 225 Flfth Street Springfield, Oregon 97 477 541-726-3759 Phone ^ity of Springfield Official Receipt --revelopment Services Department Public Works Department RECEIPT #: 3200500000000000358 Date: 0611612005 2:0e:01PM Job/Journal Number coM2005-00743 coM2005-00743 coM2005-00743 Description + 7Yo State Surcharge + l0% Administrative Fee Perm Serv/Fdr 200 amps or less Amount Due 4.41 6.30 63.00 Item Total:$73.71 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard ALERT ELECTRIC nJm 016212 By Mail Payment Total: s73.71 -wr 6n6t200s Page I of I ryID ., 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541 E L E CTRI CAL P E RMIT AP P LI CATION City Job Number&r,raz=o J.- tjrc> 7 Li Date I 3 ZL f z( sts s+ LEGAL DESCRIPTION 170 33 6t: csToa A. JOB DESCRIPTION S Ftv t Le-c*AN(r€- 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 Contractor Address Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwellins Service Feed*TTEIJTION: Oreg Sfi tu* s 106.00 $ 19.00 B. in OAR 95 ulres rego n uflftyl$o'tifi 1-800-3322344r. Hro p ?8rrl Sr.401 Anpfi-h$0hAth$O 20 I Are6ttsdQn€lo$ter. (l zag 601Amps to r0ffil,\Qfrffi Over 1000 Amps/Volts Reconnect Only Supervisor License Number 2435 C 200 Arnps or less coples or tlre r$lBtff L3 Notealhe Gle-P ( h%$o $t!900 City $ 163.00 $375.00 $ s0.00 Expiration Date Constr. Contr. N, Expiration Date D- umber S- Z Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00-c Over 600 or 1000 Volts see..B"above.of Supervising Electrician Name rU t Address Z6 t ?t\r SI city : P i:=\:Phone D. New Alteration or Extension per panel One Circuit Each Additional circuit or wirh $ 43'00 Service or Feeder permit $ 3.00 OWNER INSTALLATION The installation is beinr is nor inrended fo. rur;I::""::#r.rrv I own which Owners Signature: E. Pump or irrigation $ 50.00 $ s0.00 $ 25.00 Sign/Ourline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric permit Inspection Fee is $45.00 * Surcharges L3 7%o State Surcharge I 0%o Adminisfrative Fee TOTAL 7/ 4 63o\_ Inspection Request: 226_3769 Shared Driv{T:/Building Forrns/Electntal pennit Application I {3.doc CITY OF**1 OREGON a1 'lor qw