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Home My WebLink AboutPermit Electrical 2004-9-24 225 Fuul STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (5~tt6."'~e. Ot,- i$;;"'f..,O ELECTRICAL PERMIT APPliCATION , / / <tl. 0' 0'0;%,,/ City Job NumberCOLN1 z..oo L( - 0 II 8 b Date 7'/? <( / () l( ~o"l;so "0/ :.s ;sovb / I i),9 ..,. 6l9Vl ~/i't. 1. 3. //~n 11)dhr(<)+rr'd LEGAL DESCRIPTION 17D3"3LfII 0 I tOO JOB DESCRIPTION ~ Sl2rlJ it P,. It I'L+ , Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 ~ onc~ Electrical Contractor A tL...r;/ e elf'- I G. ,-r;Il~IS PERMlJ'llJr ~IRE IF THE WORK / - , ~THORlljQ ~4fMI~~RMIT IS NOT Address <l.5' ? g.~-!J wLJ-t 1 So I ~MENaio. Js'~80\NQf>>lED FOR / - IA-AAf laO QM 4WQAtQoo Amps City EUttl..en.{ Phone 1 VI -0 ti'l Over 1000 AmpsNolts l) . Reconnect Only Supervisor License Number t/ 3 ~ &' S Expiration Date J b - 0 I - 0 (j Constr. Contr. Number / / S J /3 Expiration Date 7-:J-'}_o ~ Signature of Sup rvising Electrician i~ --- ./ Y ---- Owners Name c,./ -eVl J. q ~ us h Address / J;;zo ll)Cl+~f- ,5ffe-e..r- City 5{)rl '''?field Phone 13& -3 D~? OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 $ 63.00 ~ 3. 00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Am s or 1000 Volts see "B" above. D. $ 50.00 $ 69.00 $100.00 t, ,00 4. ~1,oo-+nt II [1 J b70 c:::;/ { '} oU -- 7% State Surcharge 10% Administrative Fee TOTAL Shared DriveIT: VBuildinl! FonnslElectrical Permit Aoolication I -03_doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01186 ISSUED: 09/24/2004 APPLIED: 09/24/2004 EXPIRES: 03/24/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1120 WATER ST ASSESSOR'S PARCEL NO.: 1703341101800 Springfield TYPE OF WORK: Electrical Work Only REQUIRED PARKING Overlay Dist: te~U'f9S~.~Total: # Street Trees ~regon \a'll Oregon Uti'~ndicapped: Pav : dopted bY the ~es ate set t~f.mpact: % ~ ehter. "{hose ~hO~R 952.-00., '. . Not\f\cat\OC\. ,\..QO'\Othr~g -'the fU\es"oY F: ^r:.I).OO . ..,~AS U1 ~__a I PUBLIC 1.~~'f~:'lNOte~ t~e~~~~cat\on Ga\\\ng "\0 ~.!.. oreg~\\~e: utnbef tOf \he '\-806-'!~- n center \$ Downspouts/Drains: TYPE OF USE: PROJECT DESCRIPTION: Service change and heat circuits Owner: GLENDA HOUSH Address: 1120 WATER ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Contractor . : W \\A~ \NQ~~ License Electrical ,\I!~L~-;C~~ t~~~r-~~~}~\1 \~ !g, 115113 1\,\\5 ~E~~~O UtiOt"'~I~0RMATION I ~U\\'\G'" G'" \5 ~ # of Units: CGN\N\ttiCtO PE""QU. # of Stories: Primary Occupancy GrorW?.'{ \ ~O O~-3 Height of Structure Secondary Occupancy GA\up: Type of Heat: Primary Construction Type Vlhr Water Type: Secondary Construction Type: Range Type: # of Bedrooms: Energy Path: Sprinkled Building: n/a I DEVELOPMENT INFORMA:TION-- f' ." Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: "'V, I::';";'.;J.- I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Total Value of Project Paee 1 of2 Alteration Residential Phone Number: 541-736-3027 Expiration Date 07/29/2006 Phone 541-741-0494 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Value Date Calculated '-i1i~ CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01186 ISSUED: 09/24/2004 APPLIED: 09/24/2004 EXPIRES: 03/24/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $6.90 $4.83 $6.00 $63.00 9/24/04 9/24/04 9/24/04 9/24/04 1200400000000001389 1200400000000001389 1200400000000001389 1200400000000001389 Total Amount Paid $80.73 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 Reouired InsDections I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 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 Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-01l86 COM2004-0 1186 COM2004-01186 COM2004-01186 RECEIPT #: Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add +7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Check ESTATE OF ARC ELECTRIC , 9/24/2004 r:ty of Springfield Official Receipt velopment Services Department Public Works Department 1200400000000001389 Date: 09/24/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1459 In Person Payment Total: Page I of I 2:34:43PM Amount Due 63.00 6.00 4.83 6.90 $80.73 Amount Paid $80.73 $80.73