HomeMy WebLinkAboutPermit Electrical 2005-04-18Building/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: COM2005-00434ISSUED: 0411812005
APPLIEDT 041181200sEXPIRES: 10/1812005
VALUE:
SITE ADDRESS: 682 34TH ST
ASSESSOR'S PARCEL NO.: 1702312104100
PROJECT DESCRIPTION: Replace Service
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition Residential
1iliow rules adopted by the Oregon Utility
hiuiifrcation Center. Those rules are set lortt
in OAR 952-001-0010 OAR
cop
the telephone
Owner:
Address:
Contractor Type
Electrical
Contractor
PAUL'S ELECTRIC
RITZDORF ROBERT W & DENISE K
88041 TIKI LN
SPRINGFIELD OR 97478
nurr[.;er for the Oreoon Utilitv Notification
c e rrltip gtioo-s[U4i$$ign Date
162841 01t26t2007
Phone
541-746-9752
# 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:
# of Stories:
Height of Structure
Type of Heat:
Water 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:
nla Occupant Load:
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
PUBLIC IMPROVEMENTS
Description Type of Construction
Page I of2
Value Date Calculated
Ttl
Valuation DeseriUtlon l
OF SPRIN
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: COM2005-00434ISSUED: 0411812005APPLIEDz 0411812005EXPIRES: 10/1812005
VALUE:
Fee Description
+ l0oh Administrative Fee
+ 7oh 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
4n8t05
4n8t05
4n8tos
Receipt Number
2200500000000000442
2200s00000000000442
2200500000000000442
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.
Reouired fnsnections
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.
/2.,"{0
Owner or Contractors Signature
Pase 2 of 2
Date
Fees rard
225 Flfth Street
Springfield, Oregon 97 477
541-726-3759 Phone
city of Springfield Official Receipt
velopment Services Department
Public Works Department
RECEIPT #: 2200500000000000442 Date: 0411812005 10:10:02AM
Job/Journal Number
coM2005-00434
coM2005-00434
coM200s-00434
Description
Perm Serv/Fdr 200 amps or less
+ 7Yo State Surcharge
+ l0o/o Administrative Fee
Amount Due
63.00
4.41
6.30
Item Total:$73.71
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check PAUL'S ELECTzuC nJm 1007 In Person $73.71
Payment Total:
-Sffi-
,!
4/t8/2005 Page I of I
Hlx3r3,,.o
225 FII-IH STREET . SPRINGFIELD, OR97477 r PH:(541)72G3753 o FAX: (541)72G3689
PERMIT APPLICATION
Ciry Job
o.5 Date -o
I. LOCATION OF INSTALIATTON
6 trt /f. 3 {-tq
3. COMPLETE FEE
LEGAL DESCRIPTION A. New Residential - Single
i " o> 3t >1 o/tfl Servicelncluded
unit.
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
B.
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Ampsto400Amps $69.00
401 Amps to 600 Amps --_:____ $l-00.00
Over 600 Amps or 1000 Volts see "B" above.
New Alteration or Ertcmio* Per Panel
One Circuit $ 43.00
Each Additional Circuit or urith
Service or Feeder Permit $ 3'00
E. il.Iiscellaneous (Sen'ice/feeder not included)-Each Installation
%,Pf
$ 50.00
$ 50.00
$ 2s.00
$ 45.00
3o
73 '7 I
JOB
P.
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. coI\4rRACroR rNsTALrATroN 0NLY ServicelopJesde6*-
f,*\'r Ql q"*.r.200Electrical Contractor
3o.?,o ttl 201
Address 401 emn66g6Wd#Pfuv obtain copiesof $ltl0Bs ny
City Phone
ReconnectOnly Center is 1-800-332-234S[0.00
Supervisor License Number 3szo s C. Temporary Services or Feeders
hJo.lt".r', [{o 7{L-?-<L
601 Amps tedm&tgprenter. (Nqle.lhe t6}Ftffiie_
over I 000 riumbMds th e O re g o n_lllllal'fifilfffilion
Expiration Date o o(
Constr. Confr. Number
Expiration Date LD o
Signature of Supervising Electrician
Owners Name -r
Address qg o'f I T,l^
ciry <p{-A Ynone Z{7.-9231
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, Iease or rent.
Owners Signature:
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SUBTOTALOFABOVE b3"L
TYoState Surcharge
l0% Administrative Fee
TOTAL
,ff
(,
I
Inspection Request: 726-3769
Shared Driv{T:/Building Forms/Electrical Psmit Application I {3.doc
CITY OF
-0010
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