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Home My WebLink AboutPermit Electrical 2008-07-08Status 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: COM2008-01019ISSUED: 0710812008APPLIED: 0710812008EXPIRES: 01/0812009 VALUE: SITE ADDRESS: 280 23RD ST ASSESSOR'SPARCELNO.: 1703361405500 PROJECTDESCRIPTION: Servicechange Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PhoneNumber: 541-868-4411 License Expiration Date Phone Owner: Address: Contractor Type Electrical SAUNSARAE EMPREY 280 23RD ST SPRINGFIELD OR 97477 Contractor OWNER )R INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy 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 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: ED N{Y 180 DAY nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: IS REQUIRED PARKING Total: Handicapped: Compact: fs, $ Per Sq Ft or multiplier Downspouts/Drains: Square Footage or Bid Amount Description Tvpe of Construction Page 1 of2 Value Date Calculated D U rLr,rl\ U 11\ r UI(rVlA..l.!!lN_l may the Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line CITY F FIELD Buildin g/Combination Permit PERMIT NO: COM2008-01019ISSUED: 0710812008APPLIED: 07/0812008EXPIRES: 01/0812009 VALUE: Fee Description + lOoh Administrative Fee + l2oh State Surcharge + 57o Technology Fee Perm Serv8dr 200 amps or less Total Amount Paid Amount Paid Total Value of Project Date Paid 7t8t08 7t8/08 7t8t08 7t8t08 Receipt Number 2200800000000001044 2200800000000001044 2200800000000001044 2200800000000001044 $7.00 $8.40 $3.s0 $70.00 $88.90 Fees Paid Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Buitding Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. 127 a$ Owner or Contractors Signature Pase 2 of 2 Date r(eoutreo lnsDecuolls ] SPNIT{GFIELD ZON \M INITIALS DAlL1 225rIFTIISTREET o SPRINGFIELD,OR97477 o PH:(541)7X-3753 oFAx:(541)726-3689 E LE CTRI CAL PERJUITT AP P LI CATT ON City Job Number C,ouvra<5O&o rof 1 1. ZTO Z 5P LEGAL DESCRIPTIoN' l?O 3 3 I oSsoo' o Z3 CD Date 7 o 3. JOB DESCRIPTION ,/2, Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less to 400 Amps r@lgh t04ft tain copbode$t&ll0s by 1 y'1 q7?7 7 $117.00 $ 2l .00 B. $ss.00 $ 70.00 s 83.00 $138.00 $r80.00 $413.00 $ s5.00 $ 55.00 $ 55.00 $ 28.00 $ s0.00 70 cjilron Center. Tho City Phone City Sr,n,, L'nt,l Phone 1 JJ' OW\IER INSTALLATION The installation is being made on property I own which is not for sale, lease or rent. Signature: r. (Note: the Installation, Alteration or Relocation 200 Amps or less $ 55.00 201 Amps to 400 Amps $ 76.00 401 Amps to 600 Amps $110.00 Over 600 or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit $ 48.00 $ 4.00 Each lrngatlon Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 12Yo State Surcharge l0% Administrative Fee 5% Technolory Fee Minimum Electric Permit Inspection Fee is $50.00 * Surcharges fllt u rnay obr the cente for the OrSupervisor License Number Expiration Date ovConstr. Contr. Number Expiration Date c4 {:k 0Tl,CE: Owners Name Address ZbO Z3 PD 7o go -___7_--_w-s8?Inspection Request 726-3769 4. TOTAL Shared Drive(T:/Building Forms/Electrical Permit Application I -08.doc - .CITY.OF sr rmluonncutl .COMP.LETE FAg Nerv nesia+rtial -= ,singli'6r,mtiii-f'adily per dwelling unit. :@ crofir rsr ?rol\r,olvLv Service* oi::f'*eder$.. Installation, Al- teration$ or Relocatiosr f ?'ri:\lTlOf!: Oregon orF*ederc Brabch:Cifcuif$ DAY \ Sigrature of Supervising Electrician SUBT.O:TALOgAg,fiVB Construction ContraCtors Board Permit #: 700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:ryfu1lglg4q Address: 29o 23'e Issued by: oo - o tot? Date: 1 c) Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. Thts statement will befiledwith the permit. Fill in the appropriate blanks and initial boxes I and 2, md either box 3A or 38: d 1. I own, reside in, or will reside in the completed structure. d Z. I understand that I must become licensed as a construction conhactor if the sbrrcture is sold or offered for sale before or on completion. n 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR d 38. I will be my own general contractor. If I hire subcontractors, Iwill hire only subcontractors licensed with the Construction Contractors loard' If I change my mind and hire a general contractor, I will contract with a contractor who islicensed with the ccB and will immediately notify the office issuing this building permit of thename of the contractor. r hereby certify that the above information is correct and that r have read and do understand the rnformationNotice to Property owners about construction Responsibilities on the reverse side of this form. (Signature ofpermit @ate)(White copy to issuing agenq/permitJile, pink copy to Properfy_owner. doc 06_0 I _04 applicaw.) (on Ae*&xxffi es Y*uer ffwm #exxeraX Crritr*ct*r? ilr";-; ;11 1""liiii"!-li]1+-.4{i-lli *r ";ir:i i!r*i;'t"a:}: ,l'' I " '-.i' - :'1" *'k$ie,"** f..ie:;,;;:a,;rsggei*F*Xg$q.t*g &gfAi &y;i:;f t-.i #'$'i.-.**"e;:hl *'&lgt r;$?LE )\"!.;1$lt 1i:iji.liitl:;il,jti1, ;iitl.:.i ii-1.:i" r-:arr:lrl;ilti ;l!;-!-!i.i:j.l: ,l'll.'l':1r''r":1i'"r"i; !' r,,,',1:i,q l.l::.i:. i i:li'i:i. :'ril l- : '-ii rj iir: 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt _ )evelopment Services Department Public Works Department RECEIPT #: 2200800000000001044 Date: 0710812008 2:29:20PM Job/Journal Number coM2008-01019 coM2008-01019 coM2008-01019 coM2008-01019 Description Perm Serv/Fdr 200 amps or less + 5%o Technology Fee + l2%o State Surcharge + llYo Administrative Fee Amount Due 70.00 3.50 8.40 7.00 Item Total:$88.90 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Cash Change SALINSARAE EMPREY SAUNSARAE EMPREY djb djb In Person In Person Payment Total: $90.00 (sl.1o) $8s-30- Job/Journal Number coM2008-01019 coM2008-01019 coM2008-01019 coM2008-01019 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + l2%o State Surcharge + 10oh Administrative Fee Amount Due 70.00 3.s0 8.40 7.00 Item Total $88.90 Payments: Type ofPayment Paid By Check Number Received By Batch Number Aut[oiization Number How Received Amount Paid Cash Change SAUNSARAE EMPREY SALINSARAE EMPREY djb djb In Person In Person Payment Total: $90.00 ($ 1.10) $88.90 cReceintl Page I of 1 7/8/2008