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Home My WebLink AboutPermit Electrical 2003-11-06F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-01120ISSUED: 1110612003APPLIED: l1l0512003EXPIRES: 05/0612004 VALUE: SITE ADDRESS: 1432 WIMBLEDON PL ASSESSOR'S PARCEL NO.: 1703342200810 PROJECT DESCRIPTION: Add 2 circuits Owner: NICHOLAS WAGGONER Address: 1432 WIMBLEDON PL SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential \o CONTRACTOR INFORMATION Contractor Tvpe Electrical # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Settrack: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Contractor NORTHWEST ELECTRICAL CONSTRUCTI #of R-3 VN Date Phone 541-914-81003t2005 REQUIRED PARIflNG (\ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: %o of \ $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: Total Value of Project Pase I of2 Description Type of Construction Value Date Calculated D- f ffi t- Valuation Description I Floor: 2nd o\ $.o Ft Ft Sq Sq Floor: Basement: Garage/Carport Other: Area:SurfaceImpervious$.e ie seq\ S.apPdapped: To"t' OF Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-01120ISSUED: 1110612003APPLIED: 11/0512003EXPIRES: 05/0612004 VALUE: Fee Description + lUYo Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $4.60 s3.22 $43.00 $3.00 $s3.82 Date Paid tU6t03 tU6/03 ru6t03 tu6t03 Receipt Number 2200200000000001728 2200200000000001728 2200200000000001728 2200200000000001728 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. I Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. 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 Pase 2 of 2 th- Bees rrrfl I Keourrcq rnspccuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfielu Official Receipt Development Services Department Public Works Department Receipt #z 2200200000000001 728 Date: 1110612003 8:28:4SAM coM2003-01120 coM2003-01120 coM2003-01120 coM2003-01120 + 1Yo State Surcharge + ljoh Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add 3.22 4.60 43.00 3.00 Item Total:s53:8t Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard MICHAEL RODOLF djb 000214 0068 l9 In Person Payment Total: $53.82 $s3.82 225 BIFTII STREET SPRII{GFIELD,OR97477 o PII:(541)726-3 753 o FAX: (541)?26-3589 a ffir ELECTRTCAL PEP*MIT APPLICATION ilzD put" I c o3/5 City Job Number (iIs tt"l 1 LEGAL DESCRIPTION zoo3 - C2 3. A. I 7o33qZZ oo FrD Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 7%o State Surcharge l0% Administrative Fee TOTAL JOB DESCzuPTION $106.00 $ 19.00 $s0.00 hoto W 4,r. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Electrical Contractor Address Supervisor License Number Ei1@\>C. Expiration Date Constr. Contr. Number 3*'{r Expiration Date Signature of Supervising Electrician D. Sqrvices oi,FeedCrs - Installation, Alterations or Relocation: --l -r\ tr{t7 " i.(J'1- _-nO = i-t(t'v1.ts- ^a{.,\23 *, .$.groo S'i*.oo bi'x.tot $,tr5?dd' .$ize.MEci., hL*\ba illq. *"'" s4/4(t63apl :tffiil:i#ff- "t7li-? ReconnectOnly %"r\isnon: Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "B" $ 43.00 $ 3.00 V) Owners Name I tJn Address IUSZ LJ,r^bl I c -{7- (L EJ City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Minimum Electric Permit Inspection Fee is $45.00 * Surcharges $ s0.00 $ s0.00 $ 25.00 $ 45.00 4 ,/6 32" y6i Ss3EzInspection Request: 726-3769 Shared Drive(T:)/Building Forms/Electrical Pennit Application l-03.doc t//91tr/ - o ::t-.:: : .j t:::a.:::::::i.i -,r t:.:.-r,. i: : :. co}flRAmanIjttsretrIarroN 0.NLY B.Z. I \att{ g'j o .::'-::.:: . r i ,. a.'. l,l n New