The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2004-10-06Building/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: COM2004-01232ISSUED: 1010612004 APPLIED: 10/0512004 EXPIRESz 0410612005 VALUE: SITEADDRESS: 252435THST ASSESSOR'S PARCEL NO.: 1702194200500 PROJECT DESCRIPTION: Two circuits for Heat pump OwneT: MEINYCHUKKENNETH P & PATRICIAA Address: 2524 35TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential Contractor Type Electrical Contractor DELLS EBTTHIF. Expiration Date 0u14t2005 Phone 541-935,2154 License r09864 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: THIS PE AUTHORI COMMENCED ANY 180 DAY RK PERMIT IS NOT D FOR nla Square Footage or Bid Amount Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo ofLot Coverage: $ Per Sq Ft or multiplier REQUIRED PARJ(NG Total: Handicapped: 6PomPact: DEVELOPMENT INFORMATION Description Type of Construction Total Value of Project Value Date Calculated 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: COM2004-01232ISSUED: 1010612004 APPLIED: 10/0512004 EXPIRES: 0410612005 YALUE: Fees Paid Fee Description + lOoh Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $4.60 $3.22 $43.00 $3.00 $53.82 Date Paid t0t6t04 t0t6t04 t0l6104 r0t6104 Receipt Number 1200400000000001441 1200400000000001441 1200400000000001441 1200400000000001441 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 Final Electric: When all electrical work is complete. By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that aU 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 OCCUPAIICY 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 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. Owner or Contractors Signature Date Page2 of2 l(eoulreo lnsDecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ^ity of Springfield Official Receipt ,evelopment Services Department Public Works Department RECEIPT #: 1200400000000001441 Date: 1010612004 10:06:38AM Job/Journal Number coM2004-01232 coM2004-01232 coM2004-01232 coM2004-01232 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0% Administrative Fee Amount Due 43.00 3.00 3.22 4.60 Item Total:$53.82 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check Cash DELLS ELECTRIC DELLS ELECTRIC djb djb 5506 In Person In Person Payment Total: $s3.80 $0.02 $53.82 Job/Journal Number coM2004-01232 coM2004-01232 coM2004-01232 coM2004-01232 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7oh State Surcharge + l0% Administrative Fee Amount Due 43.00 3.00 3.22 4.60 Item Total:$s3.82 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check Cash DELLS ELECTRIC DELLS ELECTRIC djb djb 5506 In Person In Person Payment Total: $s3.80 $0.02 $s3.82 r0/612004 Page I of I ulllL CITY OF zuNGFIELD, OR EGON 225 FIFTH STREET o SPRINGFIELD, OP.97477 c PHz(541)726-3753 o F AX: ELECTRICAL PERMIT APPLICATION ( City Job Number (bfil ?rroL( - O/ Z3 Z Date o 3. LEGAL DESCRIPTION A. l"oz (rL/ z C)o t<5() JOB DESCRIPTION luto ; (UL; +S t-/Z Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. 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 h* s106.00 $ 19.00 $50.00 $ 63.00 $ 75.00 t4l B. Electrical Contractor Address o o7 $125.00 City Phone Supervisor License Number Expiration Date to/oq Constr. Contr. Number /0q16/ Expiration Date o5 {uQ eh€____T-. NOTICE:ct l(rf,A#a 601 Amps to 1000 AmPs N4 lT SotAilotrRlmAF"ilH E AUTHORIZ 63 $ffife{ffirPERlIlT tS NOT OMMENC OD C. : fbmporary Services or l'eeders WOBK $ 163.00 $375.00 Signature of Supervising Electrician 7Q."1,*- k^LLh Owners Name /.rt ulelonc-Ffut-( Address City S Zgz 3 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "8" above. D. Branch Circuits New Alteration or Extension Per Panel , One Circuit /$43.00 13 $ 3.00 3 e-)E. Miscellaneous (Servicelfeeder not included) -Each Installation Pump or I Each Additional Circuit or with Service or Feeder Permit l0% Administrative Fee TOTAL 50.00 50.00 25.00 45.00 * Surcharges qb L 6o Inspection Request: 72637 69 Shared Drive(T:)/Building Forms/Electrical permit Application l-03.doc s2 1. LOCATIONOFINSTALIA'TIANd-5 unit. ) 0N ,{a CONTRACTOR INSTALIATION ONLY