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Home My WebLink AboutPermit Electrical 2004-11-03Building/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: COM2004-01366ISSUED: 1110312004APPLIED: 1110312004 EXPIRES: 05/0312005 VALUE: SITE ADDRESS: 935 22ND ST ASSESSORTS PARCEL NO.: 1703361208100 Springfield TYPE OF WORI(: Electrical Work Only TYPE OF USE: Repair Residential Phone Number:sii-l{blatt IION: Servicrichzlrige t, : C)wner: BRIAN ROSEBROOK Address: 935 N 22ND ST SPRINGFIELD OR 97477 /.i: I Contractor Type Electrical Contractor BEAR MOUNTAIN ELECTRIC LLC License 136298 Expiration Date 08/06/2005 Phone 541-953-6747 CONTRACTOR INFORMATION # 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: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 \rN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0090. You maY o calling the cen numbe r lor the Center i Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla w reqruires You to REQUIRED PARIilNG Total: Handicapped: Compact: the Oregon UtilitY forth $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION Description Type of Construction Total Value of Project Value Date Calculated l, U l|:-l-rll\ (r rN r U[t1v!.q. f rlllu rules bY Valuation Description ITY OF 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: COM2004-01366ISSUED: 1110312004APPLIED: 11/0312004EXPIRES: 05/0312005 VALUE: Fee Description + l0Yo 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 Date Paid tu3t04 tu3t04 tU3t04 Receipt Number 1200400000000001563 1200400000000001563 1200400000000001563 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. 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 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. Owner or Contractors Signature Date Pase2 of2 Fees rard I r(eoulreo rnsDecu 225Bitth Street Springfield, Oregon 97 477 541-726-3759 Phone -ity of Springlield Official Receipt -revelopment Services Department Public Works Department RECEIPT #: 1200400000000001563 Date: 1110312004 1:53:37PM Job/Journal Number coM2004-01366 coM2004-01366 coM2004-01366 Description + 7%o 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 Check BEAR MTN ELECTRIC djb 4033 In Person Payment Total: $73.71 -sE?r 1U3t2004 Page I of 1 *allEti,n 225 FIFTH STREET . SPRTNGFIELD, OP.97477 . PH:(541)726'3753 o tr'AX: (541)72 ELECTRICAL P ERMIT AP P LI' City Job Number <)Q CATIONli66 Dare //1r)ua 3.COMPLETE D. I LEGAL DESCRIPTION 1703 36r Z C 6teo JOB DESCRIPTION *.av'rc€c-*i'YNC€ Permits are non-transferable and expire if work is ' not started within 180 days of issuance or if work is Suspended for 180 days. A. Neu'Residential - Single 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 $ $ $s0.00 . B. Services or Feeders - Installation, Alterations or Relocation: 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 $ 63.00 1 (_b)Electrical Address City Supervisor License Number Expiration Date Phone Z $125.00 ? $163.00 $37s,00 $ 50.00 Usu C. Temporar-v Serrices or Feeders \iIUU IIf,U r $tls.oo $ 43.00 $ 3.00 t- Constr. Contr. Number Owners Name Address City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, Iease or rent. Owners Signature:4. SUBTOTALOFABOVE ] New One Circuit Each Additional Circuit or with Service or Feeder Permit 7o/o State Surcharge l0% Administrative Fee TOTAL Those rules€{€€et 0 through-OAB95€ 'd'thborrdes b lan TI-IAN DoseblL'='stc ?S S ZZ*L SI E. l'liscellaneous (Serviceifeeder not included) -Each lnstalla tiorr =P i:r\ pr,oo. rl4tD I Pump or irrigation Sig:/Outline Lighting Limited Energy/Residential $ s0.00 $ 50.00 $ 2s.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 63 LILI I L'70 7 2-7 I)-Inspection Request: 726-37 69 Shared Drive(T:)/Building Forms/Electrical Pennit Application l -03.doc ( unit. /3r t