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Home My WebLink AboutPermit Electrical 2004-1-27 '~. 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job NumberC-.ovVIZOOY.-oO 110 Date f - Z 7 - 0 r S . L' N b I L-t\~li\tt C r upervlsor lcense urn er '-r f1~irFEnfViII SHALL EX ff Expiration Date 10 - () l/ AUTHORIZED UNDER THI~Pabilltlh1 ~~9tTon or Relocation . GUMMtl\lGtU Uti IS AB~~..Qh\tPJfJfi Constr. Contr. Number -2-0 >t~ @O DAY PERIOD. 201 Amps to 400 Amps I / 401 Amps to 600 Amps Expiration Date I 0 - 0..., , Over 600 Amps or 1000 Volts see "B" above. ' D. 1. no LEGAL DESCRIPTION 170"3 2b -:s.-S JOB DESCRIPTION 6~ H et6 ooS-sg Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor ~o:i?,Pl 7J1AncL ~I.t Cr J n c Address 1-~Z~ vVf I(on&\. br- City e-4 Phone 3114 - $7 tt~ Signature of Supervising Electrician 3. A. 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 $106.00 $ 19;00 $50.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63,00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100,00 ~~ L New Alteration or Extension Per Panel ~ f Il_'~- l ' . ~Unl One Circuit $ 43.00 yo::> / Each Additional Circuit or with 111 /1 YJ _ Service or Feeder Permit $ 3,00 Owners Name II{,l- JIlty' ,GO ~ ATTENTION:Ore on law re '.' r Address /134 not jf! pll4U,fo~~?w ~ules adm < _ultliL;i:::lhLit I Center. (9 , City ~PJ'/( (j Phone I OAR 95~-001-0B\i1diPtMdltig!ti6)AR 952-00 $ 50.00 o.Q90. You may o~:gtdoi.ltf1pteBi@it~ ru'GI~ I $ 50.00 OWNER INSTALLATION' calling the cen~k~~~e~~\@~f1e $ 25.00 The installation is being made on property I o~~~~~or the. q,m~pJ1EY~~kt1~~mtR~yPk1 $ 45,00 , . ,-~~"''''''' 1-pnn-~~2~2344). IS not mtended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: Inspection Request: 726-3769 ."al( ~\ ~ ~~~~ 4. /(s" Sf) I 'tI~ $ r{;"2 ~ 7% State .surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03,doc Status Issued CITY OF SPRINGFIELD C Building/Combination Permit PERMIT NO: cOM2004-00110 ISSUED: 01127/2004 APPLIED: 01127/2004 EXPIRES: 07/2712004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1134 1ST PL ASSESSOR'S PARCEL NO.: 1703263300538 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Install gas h20 heater Owner: NANCY ROSE Address: 1134 1ST PL SPRINGFIELD OR 97477 Phone Number: 541- I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor JOSEPH BUNCH ELECTRIC INC License 156761 Expiration Date 08/21/2007 Phone 541-344-8745 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 I, DEVELOPMENT Il~~ORMATION I ' SETBACWQ1\CE: EXP\RE \F 1 Ht 'Y'Yur" Front yard Setback=ni\S PERM\1 S~~~ lH\S pme'\\iI.~%~Rl Side 1 Setback: P\ljlHOR\2EO II BP\ND~Jt~es Rqd: Side 2 Setback: COMMENCED OR \S A. Paved Drive Rqd: , P\'{ PER\OD. Rearyard Setback: P\N'l ~ BO 0 % of Lot Coverage: Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVE~ ION:Oregon law reqUIres you to fo!,?w ~ules ~l9 by>ffie Oregon Utilit "ot,flcat,on C~sifJortlm>paJlas are set fo~r I OAR 952~90J,-q010 through OAR 952-00. :l090. ,You may obtaih copies of the rules ~ calling the center. (Note: the telephone number for th~ Oreoon I Jti/it}1 I\It'\t;I:^')~:R I . .. II"'.....,+M I~ 1-AOO-332-2344) ValuatIOn DeSCrIptIOn . Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pal!e 1 of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L Fees Paid I Fee Description ' + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid $4.50 $3.15 $43.00 $2.00 Total Amount Paid $52.65 Plan Reviews I Date Paid 1/27/04 1/27/04 1/27/04 1/27/04 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2004-00110 ISSUED: 01127/2004 APPLIED: 0112712004 EXPIRES: 07/27/2004 VALUE: ' Receipt Number 1200400000000000116 1200400000000000116 1200400000000000116 1200400000000000116 To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made thesame working day, inspections requested after 7:00 a.m. will be made the following work day. ' ~l:. '. I Reouired InsDections 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 arid 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. . I \.;~, Owner or Contractors Signature 1 'j, Pal!e 2 of 2 Date 225 Fifth Sti:eet Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00 11 0 COM2004-0011O COM2004-00 110 COM2004-0011O Payments: Type of Payment CreditCard Receipt #: 1200400000000000116 Description Add, Alter, Extend Circ + 7% State Surcharge + 10% Administrative Fee Minimum! Adjustment Electrical Received By djb Check Number Batch Number Authorization Number Paid By JOSEPH BUNCH ELECTRIC 000285 642903 City of Springfield Official Receipt.... Development Services Department Public Works Department. Date: 01127/2004 11:58:09AM Amount Paid Item Total: 43.00 3.15 4.50 2.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65