HomeMy WebLinkAboutPermit Electrical 2004-12-01Bu\il\ng\ttuhrnt\\tnttt\tr\\
Status Issued
225 Fifth Street, Springfield, OR
541-726a753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PD,RMIT NO: COM2004-01463ISSUED: 1210112004APPLIED: 11/3012004EXPIRES: 06/0112005
YALUE:
SITE ADDRESS: 2289 23RD ST
ASSESSOR'S PARCEL NO.: 1703251204000
PROJECT DESCRIPTION: RElocate 200amp meter panel
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration Residential
Phone Number: S4l-owner: CHARLES REIFSCHNEIDERAddress: 2289 23RD ST SPRINGF,IELD OR 97477
Contractor Tvpe
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction
Contractor
C & S ELECTRIC
License
3849
Expiration Date
09t0u2008
Phone
541-741-2236
# of Stories:Lot Size:
Sq Ft Ist Ftoor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
PERM \ llhtri'rLL EXPI
ER lHISecondary
R\ZE# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
D UND
\S ABOR Path:
COMM ENCED
PER\OD.DAY Sprinkled Building:nla
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
%o ofLot Coverage:
AfiENTlON:Oregonlarv requlres yu, to
REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier Square Footage
orBidAmounf
Description Type of Construction
?otal Value ofproject
Yalue Dafe Calculated
N01
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0090. You
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calling the
number for
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Centeris
Utility
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: COM2004-01465ISSUED: 1210112004APPLIED: 11/3012004EXPIRES: 06/0112005
VALUE:
Fees Paid
Fee Description
+ l0Yo Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Total Amount Paid
Amount Paid
$7.s0
$5.25
$12.00
$63.00
$87.7s
Date Paid
12nt04
t2nt04
t2nt04
t2nt04
Receipt Number
1200400000000001674
r200400000000001674
1200400000000001674
1200400000000001674
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.
Rough Electric: Prior to Cover
!!ec!{c Service: Approval required prior to utility company energizing service.Final Electric: When all electrical work is compleie.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that allinformation hereon is true and correct, and I furthlr certify that any
"na au wortr performed shall be done in accordance withthe ordinances of the city of springlield and the Laws of ihe statebf oreg-on pertainin!1o trre work described herein, andthat No occuPANCY will be made of any structure without permission ortnu co--,irity s.*i.es Division, Building Safety.I further certify that only contractors and employees who are in compliance with oRs 701.005 will be us"o orit is project.I further agree to ensure that all required insfeciions are requestJ a1 the proper time, that each address is readable from the:,[t""J'rt#:f;r'#Hffi: is Iocated at the front of the propertv, and ttre approvea sui oipr"ns wlr remain oo ir," site ar a,
Owner or Contractors Signature Date
Pase 2 of2
225 Fifth Street
spiingn.rd, Oregon 97 41 1
541-126-3159 Phone
liff of Springfield Oflicial Receipt
- ;;ililient"Services DePartment
Pubtic Works DePartment
rrnlralltrl.'D
1200400000000001
Date:12t0112004 8:1?:42AM
Amount Due
63.00
12.00
5.25
7.50
-siF
674
RECEIPT #:
Job/Journal Number
coM2004-01465
coM2004-01465
coM2004-01465
coM2004-01465
DescriPtion-P.*i Serv/Fdr 200 amPs or less
AJd, Alt"r, Extend Circ Ea Add
+ 7% State Surcharge
+ l}Yo Administrative Fee
Received BY
djb
Item Total:
Number How Received
001452 In Person
Payment Total:
Batch Number
Amount Paid
$87.7s
of PaYment Paid BYType Ssz.
t2/t/2004 Page I of I
225 FIFTH STREET . SPRINGFIELD, OR97477 . PH:(541)726-3753 . FAX:
ELE C?|RT CAL P ERM IT AP P LI CATI O N
Ciry.iobNumber LO,,{,|ZjJ,O!.-AlLtbS Date l/ - 3A=O1
1.
Z
LEGAL DESCRIPTION
t703 ZSt z OYooo
JOB DESCzuPTION
fu otq z<so S{zv1
Permits are non-transferable and expire if work is
not started *,ithin 180 days of issuance or if rvork is
Suspended for 180 days.
2
i+i6:di;iidii orrNsrALterrov",.'",,,.tx,i.:Ii,ii*ilii*-'iill;ii)S;7:tLliiiAiii$t;'l::t:i":.i;:i.':;:::-;;';.:.KS 71ar =l-t/L) I L- /
}S
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to i000 Amps
Over 1000 Amps/Volts
Reconnect Only
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Arps
Over 600 or i000 Volts see..B',above.
Pump or irrigation
$ 19.00
$s0.00
$ 63.00
$ 75.00
$ 12s.00
$ I 63.00
$375.00
$ s0.00
$ 50.00
$ 69.00
$ 100.00
$ 50.00
$ s0.00
$ 2s.00
$ 45.00
Fee is 945.00 * Surcharges
J
B.
Electrical Contractor
Address Pnfux)vg>
lrzc.bs
City Phone 7U =-.-<6
tlgTt/.SSupervisor License Number
Expiration Date lc-ol -o7
C.
D
Constr. Contr. Number
Expiration Date
38 qq
1-t- c e
of Sup
a
Ele
New Alteration or Extension per panel
One Circuit
Each Additional Circuit or with ---l- $ 43'00
Service or Feeder permit L{ $ 3.ooowners Name C
'.'.^
t (t-[^.,Jr-cSc
Address Z ZK?23p St E.
citv }D.A pnon.
OWNER INSTALLATION
f,""I;?*Hx : : i::, H:.": Lo,To.*, "*dil$,fit'J I
owners Signarure: ,lTl"-'*l
7
4.
Sign/Outline Lighting
67o gfrd6q6pthgL6
7f
;7t
7fo
Fhone
Administr-ative Fee
uU-\,.r2 -2344).
TOTAL 8aI
Inspection Request: 726-3769
Shared Drive(T: ),lBuilding Forms/Etectrical permit Application I {3.doc
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NOTICE:
ERMIT SHA
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