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HomeMy WebLinkAboutPermit Electrical 2003-08-20Building/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: COM2003-00798ISSUED: 0812012003APPLIED: 08/2012003EXPIRES: 0212012004 VALUE: SITE ADDRESS: 66 SHADY LP ASSESSOR'S PARCEL NO.: 1703262300608 PROJECTDESCRIPTION: Reconnectservice Owner: CRAWFORD VINCENT JAMES Address: 66 SHADY LOOP SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Electrical Work OnIy TYPE OF USE: New Residential License Expiration Date PhoneContractor Tvpe Electrical Contractor OWNER CONTRACTOR INFOR]VIATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Type of VN Water 15 Dist: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: w PARIflNG # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage:g{ o$-{ \$ $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Page I of2 Description Type of Construction Value Date Calculated 9 $ o\ 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: COM2003-00798ISSUED: 0812012003APPLIED: 08/2012003 EXPIRESz 0212012004 VALUE: Fee Description + l0o/o Administrative Fee + 77o State Surcharge Service Reconnect Total Amount Paid Amount Paid $5.00 $3.50 $50.00 $58.50 Date Paid 8t20t03 8t20t03 8t20t03 Receipt Number 1200200000000001984 r200200000000001984 120020000000000r984 To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Electric Service: Approval required prior to utility company energizing service. Reouired Insoect By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pase2 of2 ffi.i r ees raro I 225 Fifth Street : Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 12 984 Date:9:16:36AM coM2003-00798 coM2003-00798 coM2003-00798 + 7Yo State Surcharge + l0% Administrative Fee Service Reconnect 3.50 5.00 50.00 Item Total:$s8.50 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard VINCENT CRAWFORD djb 000149 015741 In Person Payment Total: $s8.s0 $58.50 225 FIFTH STREET . SPRINGFIELD, OR97477 c P E LECTRI CAL PERMTT APP LICATION City Job Number Coc,.tZc C,S. -o <> lz 7 8 Out" I LACA'TION OF' INSTANIE?IO}T LEGAL 'H:(541)726-3753 o llli o roval Zoning i7o SZ;Zs DC lo6'6pscmpl6N 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 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 106.00 $ 19.00 $ 63.00 $ 75.00 $ 12s.00 $ I 63.00 s37s.00 $ 50.00 or Feeders or Relocation $ s0.00 $ 69.00 $ 100.00 3. I 576tr1,rr<_q Zc<> /r/e<_T 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. cotrIrRACroE INSTALIATTOATONT,T' Electrical Contractor Address Phone Supervisor License Number $s0.00 B. Services or Feeders - Installatian, Altera!iolrs or Reloratiorr: City ,O (,C. Expiration Date JV Constr. Contr. Number Expiration Date Signature of Superuising Electrician less to 400 Amps to 600 Amps or 1000 Volts see "B" above. New Alteration or Extension Per Panel 1U One Circuit Each Additional Circuit or with Service or Feeder Permit e, Owners Name Address (, (: SAa vli ' ,tD v E. Minimum City Phone 7ft/"SVIr OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners 1oh State Surcharge l0% Administrative Fee TOTAL $ 25.00 $ 45.00 Fee is $45.00 * Surcharges 'O3to ,oo <Q5ac)L)-Inspection Request: 726-3769 4. Sharcd Drive(T:)/Building Fonns/Electrical Pcnnit Application I -03.doc fiI $HHffi$N hr(rrorized stgnature A. Nerv Ilesidetrtial - Single or folulti-Family per dnclling unit. AEOI,'E w \e __-- --t - .J