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Home My WebLink AboutPermit Electrical 2003-09-23Building/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: COM2003-00948ISSUED: 0912312003APPLIED: 0912212003 EXPIRESz 0312312004 VALUE: SITE ADDRESS: 228136th Court ASSESSOR'S PARCEL NO.: 1702194305800 PROJECT DESCRIPTION: Low voltage Owner: TOWN & COUNTRY HOMES INC Address: 35920 ELLINGTON DR SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PhoneNumber: 541-988-0335 Contractor Type Electrical Contractor DIVERSIFIED ELECTRONICS INC Expiration Date 0612312004 Phone 541484-9078 CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: R-3 IVHT SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: $ Per Sq Ft or multiplier Square Footage or Bid Amount REQUIRED PARKING Total: Handicapped: Compact: 0'l Total Value of Project Pase 1 of2 Valuation Descrintion Description Type of Construction Value Date Calculated License 144685 I' U ILI-'II\ U T1\ T UKIYTryJ \c) Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1HE \S r0R H\S AU1 ANY 180 DhY 1 FIELD Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00948ISSUED: 0912312003APPLIEDz 0912212003 EXPIRESz 0312312004 VALUE: Fee Description + l0o/o Administrative Fee + 7oh State Surcharge Low Voltage - Residential Minimum/Adj ustment Electrical Total Amount Paid Amount Paid $4.50 $3.15 $2s.00 $20.00 $s2.6s Date Paid 9t23t03 9t23t03 9123103 9t23t03 Receipt Number 1200200000000002188 1200200000000002r88 1200200000000002188 1200200000000002188 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. I Low Voltage: Prior to cover. 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 70f .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 Pase2 of2 reelral(t l l(eourreo lnsDectrons I 225 Fifth Street' Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #z 1200200000000002 I 88 Date: Amount Paid coM2003-00948 coM2003-00948 coM2003-00948 coM2003-00948 + 7%o State Surcharge + l|Yo Administrative Fee Low Voltage - Residential Minimum/Adj ustment Electrical Item Total: 3.1s 4.50 25.00 20.00 $52.65 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard ALLAN V/OOSTER djb 000177 055237 In Person Payment Total:$52.65 t ( $s2.6s 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: E LEC:TRI CAL P E RM IT AP P L I CATI O N City Job Number ( n,A-Lv\, ) -ac c/q6 oate ? -Z 7 '-c' 3 I. LOCA'I'ION OT INST'ALIAT'ION I'ZJbt 3(/L- Lf tr$ffyrlgtrggsPiect as submitted has the tollowing ionirig and does not require specific land use approval tToz l9 L/3 o '&6c Zoning 3. COMPLET-E *-EE Date SCIIEDL\LE BELOW Authonzed Srgnature A.Nen'Residential - Single or Multi-Farnily per drvelling unit. 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 fts 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only LEGAL DESCRIPTION $ 106.00 $ 19.00 $s0.00 2. OONTRACTOR TNSTALLATTON ONLY B.Ser,i'ices or Feeders - Installalion, Alleratiorrs or Relocation Electrical Contractor $ 63.00 $ 7s.00 $ 125.00 $ 163.00 $37s.00 $ s0.00 Address ? O. 6o* qDs qY Phone'l!u4-90-lECity Permits are non-transferable expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Supervisor License Number 3S?3 LEL Expiration Date lo lt lqs Cor.rstr'. Cor.rtr'. Nulnber 3 Expiration Date S lnstallation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Arnps $ 100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch C'ircuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit * C. E: E' $ 43.00 $ 3.00 not included) -traclt Installation G^*Lowners Name a)tY ^' Address 3{?Zd City >?FJ Phone O\\T.{ER INSTALLATION The installation is being made on property I own is not intended for sale, lease or rent. Owners Signature: .I H\S P ERMI R\ZEO $ $ $ $ 50.00 50.00 25.00 45.00 Aur Hr0 C0t'fi,ME'NC *,A}TY Limited Energy/Commercial Mininrum Electric Perrnit Inspection Fee is $45.00 * Surcharges 4. SUBTaTAL OF ABA\.8 Y ) 3/f 1BO D I 7{ 7oh State Surcharge l0% Administrative Fee TOTAL Yto :26Inspection Request: 726-37 69 Shared Ddve(T:)/Building Forms/Electrical Permit Application l -03.doc CITY OF OREGONfl JOB DESCRIPTION foui Votkc.c / a*S € r ,5 Ql./o/ rt\$ \S