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Home My WebLink AboutPermit Electrical 2004-7-21 . Status Issued * . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00906 ISSUED: 07/21/2004 APPLIED: 07/21/2004 EXPIRES: 01/21/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6828 MAIN ST ASSESSOR'S PARCEL NO.: 1702344106609 PROJECT DESCRIPTION: Reconnect Service Springfield TYPE OF WORK: Electrical Work Only /.n:::NT:"N. n'~C1(1n 18w rrquires you to .0 "".'~_' L'.I, TYPE OF USE: O;\ddition, .,. ..... ;> ~ ~ LIIOIV rule~ ac."JfJ1eu uy ,he I "\,juT. utllty Notification Center. Those rules are set forth ~_ ..........................1"1""... o,....".l-~...,,_l....r\^Dnl:t")"n... ... --- - -. - - _. -. J 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Owner: OR DEPT OF VETS AFFAIRS Address: 6828 MAIN ST SPRINGFIELD OR 97478 Owner: JOY PHILLIPS Address: 6828 MAIN SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BUILDERS ELECTRIC INC License 4296 Expiration Date 12/1012007 Phone 541-485-0922 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I BUILDING INFO~~~I~~li~v11T SHALL EXPIRE IF 1HE ~~OHK # of Stories: AU1HORIZED UNDEFLiksiZJ?ERMI1IS N01 Height ofStruct'E5MMENCED OR IS&lItJ1tttOOillliiil:FOR Type of Heat: ANY 1 BO OAY PERI~ Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: I DEVELOPMENT INFORMATION I Front yard Sethack: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS. Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00906 ISSUED: 07/21/2004 APPLIED: 07/21/2004 EXPIRES: 01/21/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project F....f tlWU Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 7/21/04 7/21/04 7/21/04 3200400000000000177 3200400000000000177 3200400000000000177 Total Amount Paid $58.50 I Plan Reviews I To Request an inspection call the 24 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 R..nlJ~..n..diOl&l Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 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. ~~~L~ Owner or Contractors Signature l-2\ - Lcv4 Date Paee 2 of2 225 .fifth Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2004-00906 COM2004-00906 COM2004-00906 Payments: Type of Payment CreditCard 7/2 i/2004 RECEIPT #: Description Service Reconnect + 7% State Surcharge + 10% Administrative Fee Paid By BUILDER'S ELECTRIC ~[ ..... . 8Y of Springfield Official Receipt 'velopment Services Department Public Works Department 3200400000000000177 Date: 07/21/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received njm 000448 092382 In Person Payment Total: Page 1 of 1 8:45:14AM Amount Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50 G · >0 '0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(541)726-3753 . FAX: (541)726-~ il,,"'19 q/ '(J' ..01:; ELECTRICAl- PERMIT APPLICATION Oill. ~. %G"'%~I City Job NumbeCf)/??.;</iV4 - Gill 9~Date / - d.../- ~ OV~ & 0",;, "01;...."6 .' ~ \ :_ i;..- . '.~'" '-I .. _ o"~<SlO' :> ~ 690;'\9"'1;'1$ 1. . LOCA110N OF INSTALLA110N "j, 3. COMPLETE FEE SCHEDP};lE "'.0 Q'~<i> tP<{" ~ '3 fJn i YI <s t .. ~%'G :~;, ~:~G'~I,>~ '-, O',,~. . ."'~ '?^ YC ng ume" or LEGAL DESCRIPTION )70A.34 <-f-( 6~ (P 0 7 Service Included A. New Res.idential- Single or Multi-Fa JOB DESCRIPTION 1000 sq. ft. or less O=>rr-..^ nO-- .' <:::,,., Vv \'r ,0 Each additional 500 sq. ft. or 11....\ I IV I c.\.;T -JC \...;c. portion thereof $ 19.00 ATTENTION: Oregon law requires you to Permits are non-transferable and expire if work is Ep",h,-M...~~[as~!:I~rn'q'l5Y the Oregon Utility not started within 180 days of issuance or if work is Modula'tDwe!IJJ/ll NICe. OL M.",,,,, ~VII ...." . IIlu:;tHUles Bre setformsO.OO Suspended for 180 days. 6a"6<J!iR 952-001-0010 through OAR.952-OO1o . ' "CQNr!U1,(;[OR INSTAL~TION.ONLY B.CZ?YPJ'\i~ m<wep,\',tAiQ.IJRRiIlmQf,mfAI~aoillVs or, ~elocali()n: 2.., 'N"",. , , . . . .' calling the center. (Note: the telephono .. Electrical Contractor Rt) \ 'Idees Uec+r t'C InC 2~~pS !l?rl~~ Oregon Utility Notificatiosl63.00 20 I Amphg14'6l5 ~~00-a32.2:344). $ 75.00 Address IClS MaclJ,')Qr'\ 401 Amps to 600 Amps $125.00 60 I Amps to 1000 Amps $163.00 City r::tJjfne Phone 4~S-CA~2. Over 1000 AmpslVolts $375.00 Reconnect Only $ 50.00 '5C)' elf ) Supervisor License Number3"J9 0 -. S Expiration Date 10, 1- 04 Constr. Contr. Number 4:;)q { 0 .>',\, ...... . -.". C. TemporaR'crnvi~ or Feeders., .'/". .... .. , . ," . IS ~~RM\1 SHA~~ ~XPIRE IF 1HE 1'.vUhl\ Installallon'~~R'Jw:tgO%"l'8~l,ipI!HIS PERMI11S NU r 200 Amps or~~MENCED OR IS ABAND($~!ieR><fOR 201 Amps to DAY PERIOD. $ 69.00 40 I Amps to 0 Amps. $100.00 Over 600 Amps or 1000 V olts see "B'" above. D. :. B;'a-~c~h Cir~~it~". l ';"',_ ~:. ;, .'.':~' ,'-1,; '~~.~ -~. ' .; ; Expiration Date \ J. - I a - Or , .' ,'~ "'. . .'\"';" -,-' SigiJofsupervising Electrician Jdr-!AA1lllltJ t: _ Owners Na~e ,\riy 'P h}~ 1 Ii' P S Address (0<(:: d-'X M Ii r Y\ ~ ~ City ~,'~\;-d n. Phone OWNER INSTALLATION ., , ~ .:.. ~ New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. : Miscellaneous (Service/feeder not inc1udedl,-Each Installation The installation is being made on property I own which is not intended for sale, lease or rent. Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7l}~ State Surcharge 10% Administrative Fee tJ 0. 00 :3 :'SO 5,00 SfS.50 Owners Signature: 4. SUBTOTAL OF ABOVE . Inspection Request: 726-3769 TOTAL Sh..red Drive(T:)lBuilding Fonns/Electrical Permil Application l-03.doc