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Home My WebLink AboutPermit Electrical 2005-05-12Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fa,x 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00568ISSUED: 0511212005APPLIED: 05/1212005 EXPIRESz llll2l2005 VALUE: SITE ADDRESS: 1490 sTH ST APT I ASSESSOR'S PARCEL NO.: 1703263101100 PROJECT DESCRIPTION: Work is for street lighting - One branch Springlield TYPE OF WORK: Electrical Work Only n OAR 952-00 1-0010 tho rutesbY You maY obtain copies olOwner: Address: MAINSTREAM HOUSING INC 433 W 8TH AVE APT OO1 EUGENE OR 97401 0090 the center'(Note:the telePhone isl li Contractor Type Electrical Contractor THOMAS LEE BALCOM JR License 138r21 Expiration Date 10fi9t2007 Phone 54t46t-2590 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I 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 Sq Ft Other: Occupant Load: Sidewalk Type: Downspouts/Drains: REQUIRED PARI(NG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOP PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 Value Date Calculated l,UllJl,rll\U rI\I UI(TVIA r !\,1l I Valuation Description I E TR OD Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fa'x 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00568ISSUED: 0511212005APPLIEDz 05112/2005EXPIREST llll2l2005 VALUE: Fee Description + l0oh Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Minimurn/Adj ustment Electrical Total Amount Paid Amount Paid $4.50 $3.rs $43.00 $2.00 Total Value of Project Date Paid sn2t05 5lt2t05 5fi2t0s 5n2tos Receipt Number 3200500000000000197 3200500000000000197 3200s00000000000r97 3200s00000000000197 To Request an inspection call the24 hour recording at 726-3769. AII 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired Insnecti 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 ln 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 witl 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. Ow.-€-,6l l?- lo s l-) Owner or Contractors Signature Paee2 oI2 Date rees l-atrl I $52.6s 225Fifth Street Springfietd, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT #: 3200500000000000197 Date: 0511212005 2:17:58pM Job/Journal Number coM2005-00568 coM2005-00568 coM2005-00568 coM2005-00568 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical +7o StateSurcharge + l0% Administrative Fee Amount Due 43.00 2.00 3.15 4.50 Item Total:$s2.65 Payments: Type ofPayment Paid By uheckNumDer Authorization Received By Batch Number Number How Received Amount Paid CreditCard THOMAS LEE BALCOLM JR njm 002462 Phone Payment Total: $52.6s -$ffit 5n2t200s Page I of I rl.ryffiI 225FIFTIISTREET.SPRINGFIELD,ORST4TToPH:(541)726-3753oFAX:(s41)726-3689 PERM:IT APPLICATION 5-o(fl06arc gPflITT'CF'ELE $s0 City Job N LEGAL Address Sigt DESCRIPTION E"r) A. B. c. D. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or Permits are non-transferable and expire if not started withiu 180 days of issuance or if work is Suspended for 180 daYs. Electrical Contractor 200 401 Amps to 600 Amps 601 Amps to 1000 AmPs Over 1000 Amps/Vols Reconnect Only Minimum Electric Permit 7% State Surcharge l0% Administrative Fee TOTAL be lotification 4). $ 63.00 $ 75.00p0Bo x 4zr; lrp $125.00 $163.00 $375.00 $ s0.00 $ 50.00 $ s0.00 $ 25.00 Ciry eutTr lta. Q HM""4klzsqa Supervisor License Number 3S Expiration Date Constr. Cont. Number L Expiration Date of Supervising Electrician Installation, Alteration or Relocation 200 Amps or less $ 50'00 201 Amps to 400 AmPs $ 69'00 401 Amps to 600 Amps 5100.00 Over 600 or 1000 Volts see 'T!" above' H*ff'on or Extension Per -2-$ 43.00 # '* Each Additional Circuit or with Service or Feeder Permit $ 3'00 City Owners Name # {puon" OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: .00 rcharges P 3.trcq52 Fee is $45.00 + Inspection Request: 72G37 69 4. Shared Drive(T:/Building FormVElectrical Permit Application 1-03'doc ,s BfubE mtes are 1-001 through 201 Amps to ,, Utility 4 ND tn Pump or irrigation Si grr/Outline Li ghting Limited EnergY/Residential Limited Energy/Commercial