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Home My WebLink AboutPermit Electrical 2004-10-29Status 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: COM2004-01346ISSUED: 1012912004APPLIED: 1012912004 EXPIREST 0412912005 VALUE: SITE ADDRESS: 2166 YOLANDA AVE ASSESSOR'S PARCEL NO.: 1703244300300 PROJECTDESCRIPTION: Reconnect Owner: LONGKENNETHWJR& BARBARA Address: 2166 YOLANDA SPRINGFIELD OR 97477 spriffiyl4, TION: Ore gon law TYPE OF WORK: Electrical Work follow rul TYPE OF USE: Notificati on Center.Thosein OAR 952-00i_001 ;"Ss'$f,Jfl;to rules are set obtain copi es of the rules Residential Phone 541-895-2440 calling the center. number for the License 66894 lity Contractor Type Electrical Contractor DIXON ELECTRIC the tele phone -332-2344). Expiration Date 07n8t2005 # 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: Yo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport nla PERIOD. Sidewalk Type: Downspouts/Drains: IHE WARK OONEO Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Total Value of Project Value Date Calculated Only DU r_Lr-rll'r u rr\ r 1rr1vr4!!!v1l l Y isE: 5 PEBMII Valu ation Desctripliaa l F G Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-01346ISSUED: 1012912004 APPLIEDz 1012912004EXPIRES: 0412912005 VALUE: Fee Description + l0%o Administrative Fee + 1oh State Surcharge Service Reconnect Total Amount Paid Amount Paid $5.00 $3.s0 $s0.00 $s8.s0 Date Paid 10t29t04 10t29t04 10129t04 Receipt Number 1200400000000001s36 1200400000000001536 1200400000000001536 Plan Reviews To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. Reouired fnsnections By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is street, that the permit card is located ad the front of the property, and the approved set of plans will remain readable from the the site at aII Z Date Pase2 of2 h ees l-rrrl 225Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone -City of Springfield Official Receipt -levelopment Services Department Public Works Department RECEIPT #: 1200400000000001536 Date: 1012912004 1:52:56PM Job/Journal Number coM2004-01346 coM2004-01346 coM2004-01346 Description Service Reconnect + 7oh State Surcharge + l0% Administrative Fee Amount Due 50.00 3.50 s.00 Item Total:$s8.s0 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check DIXON ELECTRIC nJm ttTt In Person $58.50 P ayment Total : -Sssso-- r0t29t2004 Page 1 of 1 5: 225 FIFTH STRIET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541) PERMIT APPLICATION Ciry Job 1-o (?Date lo 1.LA CA'I'I A N A P' I N S'TALLAT'I O N 3 A. Ngt Residential- e{s5o -Scrz> JOB DESCRiPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. q6 Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion fhereof Each Manufact' C.Hotoe.* Sf]' ; r', Modular DweU@ SqrvjqQ, 9r,, . Feeder NotifrcalrorrUe.-,,t, New C O NT RACTOR IAIST7'I, I-AT I O N O NLY B. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $s0.00 $ 163.00 $37s.00 $ 50.00 $ 50.00 $ 2s.00 $ 45.00 City ) Electrical Contractor {C\f (p0uuoenp' Address pnoo" 1bQ5 3-q,.{o Supervisor License Number 3br t4-5 Expiration Date /u Constr. Contr. Number Expiration Date of Supervising Electrician Owners Name Address OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 201Amps 401 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olts C. Tenrporary Services or Feetlers Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 600 or 1000 Volts see "B" above, D. Minimum Electric Permit Inspection Fee is $45.00 * Surcharges dJ 5.s o 7o/o State Surcharge 10% Administrative Fee TOTAL 5 ' clct Inspection Request: 726-37 69 4. Shared Drive(T:)/Building Forms/Electrical Permit Application I -03.doc 3 al U(o u b\ c> vrr\rr I LEGAL DESCRIPTION o D E. N{iscellaneous (Service/feeder not irrcluded) -Each lnstallation !50 5r -5"