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Home My WebLink AboutPermit Electrical 2004-11-15Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/ C o mbination p er mit PERMIT NO: COM2004-01409ISSUED: llll,St2004APPLIEDz llll5l}004EXPIRES: 05/1512005 VALUE: SITE ADDRESS: 1051 28TH ST ASSESSOR'S PARCEL NO.: 1702312202000 PROJECT DESCRIPTION: Temp. Electric Owner: NORTHUpRANDy Address: PO BOX 70624 EUGENE OR 97401 Springfield TYPE OF WORK: Commercial Miscellaneous TYPE OF USE: Alteration Commercial Contractor Type Electrical Contractor MITCHS ELECTRIC INC License 146745 Expiration Date 01/18/2005 Phone 541-747-4483 CONTRACTOR INFORMATION # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay s Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # 10 Square Footage or Bid Amount REQUIRED PARKING Total: Handicapped: Compact: Frontyard Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street ImProvements: Storm Sewer Available: Special Instruction: Notes: .$s tso Sidewalk TYPe: DownsPouts/Drains: $ Per Sq Ft or multiPlier Description TYPe of Construction TotalValue of Proiect Value Date Calculated # of Units: Primary Occupancy GrouP: Secondary OccuPancY GrouP: Primary Construction Secondary # \ PUBLIC I MPRov LlYlr-N,! U - Building/Combination permitStatus Issued :?i lif,h Street, Springfietd, oR 541-726-3753 phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Fee Description + l0%o Administrative Fee + 7%o State Surcharge Temp Power 200 amps or less Total Amount paid PERMIT N ISSUED: APPLIED: EXPIRES: VALUE: O: COM2004-01409 tut5t2004 tut5t2004 05ns/2005 Receipt Number 120040000000000r6r8 r2004000000000016r8 1200400000000001618 Amount Paid $s.00 $3.s0 $s0.00 Date Paid tut5t04 tUt5t04 tUt5t04 To Request an inspection call the 24will be made the same working day, day. $s8.s0 hour recording at 726-3769, All inspections requested after 7:00 requested before 7:00 a.m. rmade the following work inspection a.m. wiII be Temporary Electric: Approvar required prior to Utility company energizing pore. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that allinformationhereon is true and correct, and I further that any and all work performed shall be done in accordance with certify the Ordinances of the City of Springfietd and the Laws of the State of Oregon to the work described herein, andpertainingthatNO OCCUPANCywitl 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 201.005 wilt 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 thestreet, that the permit card is located at the front of the property, and the approved set ofplans wiII remain on the site at aIItimes during -D Signature Date Pase2 of2 m- 225 FIFTH STREET . SPRINGFIELD, OR97477 o PHz(541)12G3753 o FAX: (54 ELE CTRI CAL P ERM IT APPLICATI ON City JobNumbelosvt Zd)*.o \&oq Date 3. LEGAL DESCRIPTION l.-1 OZb\ 7-'L ozoc<:. I JOB DESCRIPTION Permits are and expire if work is not started within 180 days of issuance or if work is Suspeuded for 180 days. 2. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feedsr B. $s0.00 $ 63.00 $ 7s.00 $12s.00 $163.00 s375.00 $ 50.00 Electrical Contractor 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps 1000 AmpsA/ols Olly Supervisor License Number Expiration Date )o -Al-"D7 (( (< /Q 62t8- Constr. Cont. Number <C Expiration Date -s4 Signature of Owners Name Addres{ojr phorc 4rqtZ- l&s- OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: lustallation, Alteration or Relocatiou 200 Amps or less 201 Amps to 400 Amps 10 401 Amps to 600 e+ Over 600 D. New \? t$" s 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 $ 50.00 $ s0.00 $ 2s.00 50.oo 5 o.cq'r F g s City Limited Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges SUBTOTAL OFABOVE 7o/o State Surcharge 10% Administrative Fee TOTAL fr.€o 3,sO 5.oo Inspectiou Request: 72G37 69 4. Sharcd Drive(T/Building FormVElectrical Permit Application l-03.doc /ox-l *, ?*th l?to n"ef e>qz7 {n&Az ar rp, Address Zft O fut*ar,rNr"r ,r+u* ciry €ukfu,r P1,on" €AFs'zl'i\?o Electician 225 Fifth Street Springlield, Oregon 97 477 541-726-3759 Phone City of Springlield Official Receipt r,elopment Services Department Public Works Department RECEIPT #: 1200400000000001618 Date: llll5l2004 11:19:28AM Job/Journal Number coM2004-01409 coM2004-01409 coM2004-01409 Description Temp Power 200 amps or less + 7Yo State Surcharge + lU%6 Administrative Fee Amount Due s0.00 3.50 5.00 Item Total:$58.50 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard MITCH'S ELECTRIC INC.jmp 332500 In Person $58.50 Payment Totat: TE-so- tUts12004 Page I of I .IilTIEilI,'I