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Home My WebLink AboutPermit Electrical 2005-10-04Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 I ns pe ction Line Building/Combination Permit PERMIT NO: COM2005-01359ISSUED: 1010412005 APPLIED: 10/0412005 E)PIRESz 0410412006 VALUE: ' SITE ADDRESS: 410 36TH ST ASSESSORS PARCEL NO.: 1702311302900 PROJECT DESCRIPTION: 200amp service upgrade Springfield TYPE OF TYPEOF USE: Electrical Work Only Alteration Residential Owner: Address: Contractor TVpe Electrical RALPH ENGLAND 410 36TH ST SPRINGFIELD OR 97478 PhoneNumber: 541-736-7470 Contractor DEREKSHAUN STEPHENS License 164124 Expiration Date 04t08t2007 Phone s4t-726-8498 ]ONTRACTOR INFORMATI ON # of Unib: Primary Ocgupancy Group: Secondary Occupancy Primary Secondary # of Bedrooms: AUT ANY lOO DAY Frontyrrd Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Sohr Setbacks: Street Storm Sewer Available: Special Instruction: Notes: R-3 # ofStories: Height of Type of Heat: nla Overlay Dist: # Street Trees Paved Drive Rqd: Y" ofLot Coverage: o law requires You,to follow ru rth Onn SSe-001 -001 0 throug Sidewalk Type: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: DownspoutJDrains tn s o{ the rules bY 0090 You maY obtain coPle calling the center' (Note numbe r for the Oregon Uti lity Notitication Center is 1-800-332 -2344\ the telePhone REQUIRED PARJ(NG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or BH AmountDescription Tvpe of Construction lof2 Value Date Calculated VN Valuation Descriotion I Building/Combination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:1 26-37 69 Inspection Line PERMIT NO: COM2005-01359ISSUED: 10/04/2005APPLIED: 1010412005 E)PIRESz 0410412006 VALUE: Fee Description + l0o/o Administrative Fee + 1Yo State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $6.30 $4.41 $63.00 $73.71 Total Value of Project Date Paid r0t4t05 t0t4t05 t0t4t05 Receipt Number 1200500000000001449 1200s00000000001449 1200500000000001449 Fees Pa Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certi$ that any and all work performed shall be done in accordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wilt be made of any structure without permission of the Community Services Division, Building Safety. I further certiff 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 Reouired fnsnections Owner or Contractors Signature 2of2 Date =qE ir?- 225FIFTHSTREET.SPRINGFIELD,0P.qT TToPH:(541)726-3 753 . FAX: (541 ELECTRICAL Vto LEGAL DESCzuPNONDZ 3/tj oz?oo JOB DESCRIPTION ?oo s*( s Dvc (.A,.\{ Permits are non-transferable and expire if work is " not started within 180 days of issuance or if work is Suspended for 180 daYs. ) Electrical Contractor 4 Address City Phone 4 5*l .fac1 Supewisor License Number Lt bqr < Expiration Date Constr. Contr. Number L( Expiration Date L(l*l n> OWNER INSTAILATION The installation is being made on Property I own which is not intended for sale, lease or rent. Owners Signature: )Date Each additional500 sq. ft- or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder E- 200 AmPs or less 201 AmPs to 400 AmPs 401 Amps to 600 AmPs 601 AmPs to 1000 AmPS Over 1000 Amps/Vols Reconnect OnlY s 19.00 s50.00 /oCity Job Number 1. .:. 3. ,t vJ A. New Resideutiat = Single or lVlultlFamily per drvelling utrit. . Service Included 1000 sq. ft. or less $i06'00 B. C. tl' 1 ron $ 63.00 $ 75.00 $ 125.00 s r 63.00 s375.00 $ s0.00 67 -_-__' - \sru( Amps New Alteration or Extension Per Panel $ s0.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above' D. Branch Circuits One Circuit Each Owners Name t 0r*Gu\n/\Service or F Address Q t D 36 L st- E. Ciry S>t\ Phone 7 il.-7r7o P,^p u\es a ed center obtainrnay ote the g Ore9 on 0.00 Limited 1-80,0-$ 2s.00 Limited $ 4s.00 Minimum Electric Permit lnspection Fee is $45.00 * Surcharges \s s4. 1Yo State Surcharge l0% Administrative Fee TOTAL L: -V''r-6r- "/Inspection Request: 726'37 69 Shared Drive(T:)/Building Forms/Electrical Permit Application l -03.doc ^/r,, ln ) : Signature of Supervising Electriciau 22SFiftb.Street . Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT#: 1200500000000001449 Date: 1010412005 t0:29:274M Job/Journal Number coM2005-01359 coM2005-01359 coM2005-01359 Description + 7o/o State Surcharge + ljYo Administrative Fee Perm Serv/Fdr 200 amps or less Amount Due 4.41 6.30 63.00 Item Total:$73.71 Payments: Tlpe of Payment Received By Batch Number Authorization Number How Received Check Number Paid By Amount Paid CreditCard DEREK STEPHENS djb 313122 In Person Payment Total: $73.71 -587r '( 'I 10t4t2005 lofl arfltlD