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Home My WebLink AboutPermit Electrical 2004-03-02Building/Combination permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 phone 541-726-3676Fax 541-726-37 69 Inspection Line SITE ADDRESS: 72S26THBL ASSESSOR'S pARCEL NO.: 1703361 PROJECTDESCRIpTION: 200amp service 3^E^BUIr No: CoM 2004_ooz3sISSUED: A3rc2t2004APPLIEDT 03t02t2004E_XPIRES| 09t02t2004VALUE: Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Owner: Address: Contractor Type Electrical llt900 $ Per Sq Ft or multiplier Phone Number: S4l- Residential Phone s4r-686-090s DALE YOUNG 725 26THPL SPRINGFIELD OR 97477 Contractor ROSE CORPORATION License 54431 Expiration Date 09t30t2004 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Side I Setback:\s0 Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo of Lot Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN \t Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: REQUIRED PARIflNG Total: Handicapped: Compact: Total Value of Project Paee I of2 Valuation Descrintion Description Type of Construction Value Date Calculated - Building/Combination permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Fee Description + l0o/o Administrative Fee + 7%o State Surcharge Perm ServlFdr 200 amps or less PERMIT NO ISSUED: APPLIED: EXPIRES: VALUE: : COM2004-00239 03t02t2004 03t02t2004 09t02/2004 Amount Paid $6.30 $4.41 $63.00 Date Paid 3t2t04 3t2/04 3t2t04 Receipt Number 2200400000000000r98 2200400000000000198 2200400000000000198 Total Amount paid $73.71 To Request an inspection caII the 24 hour recording at 726-3769. AII inspection requested before 7:00 a.m.will be made the same working day,inspections requested after 7:00 a.m. wiII be made the following workday. 1 Electric service: Approvar 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 ailinformation hereon is true and correct, and I further certify that any and all work performed shall be done in accordance withthe Ordinances of the City of Springfield and the Laws of the State of Oregon to the work described herein, andpertainingthatNO OCCUPANCywitI 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 proj ect.I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from thestreet, that the permit card is located at the front ofthe property, and the approved set ofplans will remain on the site at alltimes during construction. Owner or Contractors Signature Date Pase2 of2 -: 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone {City of Springfidid Officiat Receipt Development Services Department Public Works Department Date: coM2004-00239 coM2004-00239 coM2004-00239 + 1Yo State Surcharge + lUYo Administrative Fee Perm Serv/Tdr 200 amps or less 4.41 6.30 63.00 Item Total: Type ofPayment Paid By CreditCard ROSE CORP Received By djb Batch Number Authorization Number 0003 I 1 064220 How Received In Person Payment Total: Amount Paid $73-7t $73.7r $73.71 ( CITY OF SPRINGFIELD. OREGON Feb-11-O4 03:5lP 225 FIFTH STREET r SPRINGFIELD, OR 9i477 o pH:(541)72G37S3 o FA)t E LE CT RI CAL P E RM IT AP P I.T CArION Ciry Job Number COtn Zoa n - CDL31 Date 7 r. LocAI:roNoh'rNs'fil.neruo|3.t;sg AZ r z6+ €L LEGAL DESCRIPTION P-02 as submitted has not require specific the fo,lowing land use Zoning Z Date Authorized S A- flew Reridential - Single or IVlulri-Femily per dwe[ing unit. Service Includcd 1000 sq. fi- or less 3106.00 Each addirional 500 sq. ft. or ponion thereof $ 19.00 t7o336/ I I Igors JOB DESCRIPTION D S c_ Permits are non-transfcrable end expire if work is not ster(ed within ltO days of issurnce or if work ls Suspended for lEO days. z. corvrR4.croR TNSTALIATION ONLY Elcctrical Contractor Address 8a9- Dtut Ln. Each Manufact'd Homc or Modular Dwclling Scnice or Feeder B" Srrvices or Fseders - Insfallatinn, -lllcrelions or Relocition: $50.00 L3 ",O.Eff -- -T kl ? Pno", Supervisor Liceosc Number lst g q Expiration Darc o o o Constr. Contr. Numbet 200 Amps or less 200 Amps or less $ 50.00 201 Amps ro 400 Amps $ 69.00 401 Amps to 6fi) Amps $100.00 Ovcr 600 Amps or 1000 Vols see "B" abovc. D- ','Branch Circuits Expiration Datc 3o L Signahrrc of Supervising Elcstrician Owners Name € Address fz *t^ Ciry Phone OWNER INSTALLAI'IO}T The iqstallatioo is being made on prop€rry I own which is not intended for sale, lcase or rent. Owners Sigrrature: New or Ertrnelon Per \r V,l 1 0R \S E.induded) -Each InstaUetion Pump $ 50.00 Sign/Outlinc Lighting $ 50.00 Limited Energy,?esidential $ 25.00 Limited Energy/Comrnercial $ 45.00 Mlnirnum Electric Permit Inspeclioo Fce is $il5.lX) + Surcharges 4. SIIBTOTALOFABOVE L3 Ll'( I /rso 7 3r/ $E OBK ? 1 7o/o Slate Surcharge l0% Adminisrrativc Fcc TOTALInspectiou RrquesE 726-37 69 Slnted Div(T: lBui lding FormslElurtrita I Pcrmil Appl ication l -O.i.doc 20r law by the are obtain Sqq= telePhone Notification I