The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-07-28\)- F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01012ISSUED: 0712812005APPLIED: 0712812005EXPIRESz 0112812006 VALUE: SITE ADDRESS: 52 S 17TH PL ASSESSOR'SPARCELNO.: 1703363107000 Springfield TYPE OF WORJ* Electrical Work Only TYPE OF USE: Repair Residential Owner: Address: Contractor Type Electrical Contractor GROUNDED ELECTRIC JOHN WILLIAM FERGUSON TRUST 1863 PIONEER PKWY EAST #129 SPRINGFIELD OR 97477 License 158804 Expiration Date 02t24t2006 Phone 541 726-6858 CONTRACTOR INFORMATION m # of Units: Primary Occupancy Group: Secondary Occupancy Group: tn R-3 0090 You maY calling the center number lor the Or C enter is 1 # of Stories: Height of Structure Type of Heat: to forth 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: Occupant Load:nla Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Pase I of2 Value Date Calculated T rll PROJECT DESCRIPTION: Replace meter base Rqd: Valuation Description I 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: COM2005-01012ISSUED: 0712812005 APPLIEDT 0712812005EXPIRESt 0112812006 VALUE: Fee Description + l0o/o Administrative Fee + 7o/o State Surcharge Service Reconnect Total Amount Paid Amount Paid $s.00 $3.50 $50.00 $58.50 Total Value of Project Date Paid 7t28t05 7t28t05 7t28t05 Receipt Number 2200s00000000001002 2200500000000001002 2200500000000001002 ees Paid 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 Insnections 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 streel 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 Pase 2 of 2 Date 225 Fifth Street Springlield, Oregon 97 477 541-726-3759 Phone l-ity of Springfield Oflicial Receipt _ .:velopment Services Department Public Works Department RECEIPT#: 2200500000000001002 Date: 0712812005 11:54:26AM Job/Journal Number coM2005-01012 coM2005-01012 coM2005-01012 Description + 7o/o State Surcharge + lo%o Administrative Fee Service Reconnect Amount Due 3.50 5.00 s0.00 Item Total:[i5E.50 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard EzuC MAHAFFY djb R45793 In Person Payment Total: $s8.50 $58.s0 7/28t200s Page I of I aFBrtanr.o ct'fY o RINGFIE[-D. OREGON ! 22SIITTHSTRIET . SPRINGFIELD, ARyItm . pHi(3fl)726.3753 . E LECT RI CAL P ERM I T APP LI CATT ON City JobNnnrber COY|.,?POt- O lO(Z I. INCATION OF INSTALIATION 3. COLWPLETE5LS+r gt (- BELOW ..)' 2. 0oNTRACTORINSTALTATTON ONLY B. ,i-" Services or Feeilers - Ins^tsltatioH, Alterations or Relocation Electrical Contractor Gruvlt J <l Address 9097 5- rl City 9( fL w,,"" 726 6VCb ---F- Supervisor License Number S C.T Expiration Date ^o Constr. Contr. Number )t s 0L/20r ,+01 Expiration Date Z.Z Over above. Signature of Supervising Electrician ownenName furri * ?.- *'l- $ 43.00 $ 3.00 tr E Miscellaneous (Service/feeder not included) -Each Installation LEGAL DESCRIPTION Do336) (Ozooo JOBDESCRIPTION o Permits erc non-transferable and expire if work is not started within lEO days of issuance or if work is Suspended for 1E0 days Address city SFP\Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ,., A. New Residential - Single or Multi-Famil1, per d*,elling unit. Senice Included 1000 sq- ft" or less $106.00 Each additional 500 sq. ft. or portionthereof $ 19.00 Each Manufact'd Home or Modular Dwelling Service Feeder or $5o.oo 716 2(X) Amps or less 201 Arnps to 4fr) Amps 401 Amps to 6fi) Amps 601 Amps to 1000 Amps Over 10fi) empV'fotts Reconnect Only New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 7o/o State Surcharge 18lo Adminishative Fee TOTAL $ 63.00 $ 75.00 $125.00 $163.00 $ 50.00 $ s0.00 $ 2s.00 $ 4s.00 D.Bra Srzl Pump or irrigation Sigr/Outline Lighting Limited EnerryiResidential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.{X} + Surchargcs 4. SUBTOTALOFABOVE 5o 3 s-(2 54" sBs9-Luspection Requesh 72G37 69 Shared Drivdt:/Building FormJElectrical Permit Application l-03.doc ...p _CA ru\es