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Home My WebLink AboutPermit Electrical 2003-10-3 . .. 225,FIFTH STREET :-, .\ r'.' .": ~., ..- -I ,.'j i" EL.CAL PERMIT APpLICATION SfRjNGFIELD, OREGON 97477 i __J t ,I ,__J [! , . INSPECTION REQUEST: 726,3769 . : : I L_.; , ;'CitYJobNumbel"l:ow2oo3-00 9'J'f ;' .o~FicE 7f6-3759, '" : \ :; i__: I \ '_; : !i:" i '* " : - ,! \ i \'. !, t, I I... ,3 COMPLETE FEE SCHEDULE BELOW , ,~ .;. \ '! ( . \ I. LOCATION OF INSTALLATION i. II it '-. J?;.bC~Lm/h)v~rh L.sf''-b(--..!~. N~;YR~identiaJ-Singleor .~_.- --- -._- Multi-Family per dwelling unit. LEGAL DESCRIPTION Sen'iee Included: 170s SS'lf( 0(5700 . " JOB DESCRIPTION Th, following pro ~Au~' 1000 sq.ft. or less h,... r.... .s \.. IA 1::"" r &.c~inQ";;;"d ""'~~d~eQUi~~i~I:JI!i~!t~~p 500 , approval. sq. ft or portlOn Permits are lion-transferable and expire Zoning --bDl< thereof if work is n?t'~tarted withinI8%1l;s In-O"i-I) !il:)ch ManufdHome or of Isstmnce ,or-,lfwork IS suspen1,ed fo~. J. , lVlOUUlill U\\I".UJlig 180 days. ' uthorlzed SIgnature '" N ~p.n,irp or F~eder " .<\' 2. CONTRACTOR INSTALLATION ONLY B. Seniees 01" Feeders /'I f:1 L. Installation, Alterations or Electrical'Cont;?cto~ l/~ (\ V '("61ft? Relocation: / . Address i '126 f3/'))(. I!j.~)_ /' """ . 200 amps or 1es/ '-' ',' ,'f'l., I" /., 201 amps to 4PO amps City s:ip~'. Phone ;}J(-22.3V.,:~: ~:::~~ :~~~~~l~;~~S Supervisor Licen~e!NllInber ~ . b~er 1000' amps/volts , , ,. " I ' EXPirati~n Date co' ID hiD lJ. Reconnect Only . ,/ ~o Q C. TemlJOrary Scn'icesorFee~'<ls, . L..Constr ContL Number V t) 4 I Installation, Altenl~iog, 'lfl'R&-\~ation , " --------_ 0 I J' '. , o.~\\0 . ~VJ~ 'O~~ -" - . '-Expiration Date --~, J D C/ . 200 a\'!l1S~ l:J.!?1:!!,o es0\ 1:j~\' ---.: $50.00 _ , . . '-.:'" - - - \e~\} ~~1RS!Jl~~'?J":J?; ~ 'O'l ----.': $69.00 - Signatnre of 2"flel"vising Electrician -\~Q. gO 1lO~@1ll 0 ~,,<~ ~e .~" . ,,_. .A'(;,~o(" roe.~. ~~(GQ \\1ll'P~~~~5 ~Y-o~('f's~o~ , . .. A "" _ 0 /J /l 'f-\ ' ~ \~\e Ortf.B ~~~ COQ\\~0 \0 . 'i..~\c'lj: " . ...~ .60./.s!"" ~ 'fl\\O e.~O~ .~~.... ',9~\~ ~O\0' . '~'l ~O \ - . - ~\'O~,\C.ll~rB1an~Ji elrcnifs VJ\~\ ,,~'1' ; ~ ---r-- \~ "'''' .",. ,n'~ 0(\ ?". Owners Name fO.~..,.A- J..."",-~,,,Or -{O~ ~#All.'Jififfi~lSflJh~enslOn Per Panel , "o.~'?J~' ~\~Q, ~, \\";"'0, ,,'ll ' : "; Address 12b~ VUkl/v 11 b. C~~'00\CJO~~~lt' ~ $4,300 ~ f (\'V , Phone b06 -7270 Each Additional Circuit or with Seivice r r\~~ J or, Feeder Permit \\f..~'ll~~ , . . ""Q.,r,,\'" :-,,\\S. E. Mis,ceIIaneous (Service/feedel" ~'l-~nCr~'t~ ,,~~ , -Each ins~llation ~~\.\. ,\y,.\S ~~'i;.~ . . . PI~~~\tlig1t~~ S ..\\j'i;.~ ~~$5000 _ SiAtOOitll~Ili.'ii'l'<l,,)1ttJ~\' \S ~~ _ $50.00 -'-- . Lcin~~i\~we?_\j \)~ ~\j. _ $25.00 _ Liinit~~~~~~ ~'i;.~ _ $4500_ Minimum El,ec~~~~ Insflcction Fcc is 545.00 + S~II'Charges 4. SUBTO~AL OF ABOVE LIb 7% State SUl"ehal""e "3 z.Z- " 8% Adminisiratire Fcc' 460 :5S~ '. ., ; " ;,' , ., $ 63.00 ~ ." ,-$.75.00 ' . -$125.00~ $163.00 $375.00 ~' $ 50.00 . City 5 f,:: a'. OWNER INSTALLATION The installation is being made on property I own which is not intended for s111e, lease or rent O""ncrs Signature: TOTAL . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY (JI< ~rK11'\jld<1Ji,LU Building/Combination Permit PERMIT NO: COM2003-00994 ISSUED: 10/02/2003 APPLIED: 10/02/2003 EXPIRES: 04/02/2004 VALUE: SITE ADDRESS: 1263 MAIN ST SPACE 61 ASSESSOR'S PARCEL NO.: 1703354108700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Furnish new receptacle in mobile homey Owner: TONY A INMAN Address: 1263 MAIN ST SP 61 SPRINGFIELD OR 97478 Contractor Type Electrical Contractor C & SELECTRIC # of Buildings: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type Vlhr Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of CODstructioD Phone Number: 541-606-7270 I CONTRACTOR Im'uKl>'lATlON I License 3849 I BUILDING INFORMATION I Expiration Date 09/0112004 Phone 541-741-2236 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: StiJt 2nd Floor: 'S Basement: .~~~q' ~aragelCarport >tI.<<~~'tIier: _ ~~~.~~~J>e~litIi Surface Area: I DEVELOPMEN'],:'Jl'/j,x'ii~~XfFie-N;,i~"O~~~' - '. ~':.o.";";:~'-(t:.,qtj~" ~__'~QUIRED PARKING \W~'('O IQ)"'~.~~~~~ . Ove~f~~~ gfltJ~ ~.~~~\\"~~\ . Total: # S~~~\:rr::..~~~;/liil""~~'~~~ Handicapped: paveirnt.l\le.Rqd'~~ r:fjt~~rM~~~!1l- Compact: .,.=, ",,-" , ...p,.WJ ~" 0("".. GI. .' \\"~'. '\' % of mlt'Coi&'ilge~O~' .P~ \". Co :0"" ~,,,,, (\~~ (je I PUBLIC IMPROVEMENTS' ..\\:)~'+- . '-\~ ~, ~"\ SIdewalk Type: S:. \'\- '\\' l\ f;l ~ Downspouts~~ \l~\'~~ '\-\:)~ ~~"\\f\,~~~\,\ ~~~~~\' ~~~~\;)~~~ "\~\~~\\~\1.~~\\ \:)\' \~(,)\), ~\l \. ~y.l-. ~ (JI I Valuation Descriotion I ~\:)~ \~~ \)~ ~~'\ $ Per Sq Ft Square Footage V I or multiplier or Bid Amount a ue Date Calculated Total Value of Project Pa~e 1 of2 . . Ln y OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00994 ISSUED: 10/02/2003 APPLIED: 10/02/2003 EXPIRES: 04/02/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Feec~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $4.60 $3.22 $43.00 $3.00 10/2/03 10/2/03 10/2/03 10/2/03 1200200000000002259 1200200000000002259 1200200000000002259 1200200000000002259 Total Amount Paid $53.82 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 Renuirerl Insnections I 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. 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 ofthe 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 readahle 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 Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00994 COM2003-00994 COM2003-00994 COM2003-00994 Payments: Type of Payment CreditCard -- J:-;_ WiE~f"_,_. .__."--".,',., ,Ii., ". .:. -,-"- - c. ! , .. j .......-;.,..,,."'. .,' """"<-'"," Receipt #: 1200200000000002259 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb l:heck Number Batch Number Authorization Number Paid By C & SELECTRIC 000185 002782 City of Springfield Official Receipt .. Development Services Department Public Works Department Date: 10/0212003 2:04:37PM Amount Paid Item Total: 43.00 3.00 3.22 4.60 $53.82 How Received In Person Payment Total: Amount Paid $53.82 $53.82 . .