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HomeMy WebLinkAboutPermit Electrical 2004-7-22 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line / _: CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00913 ISSUED: 07/22/2004 APPLIED: 07/22/2004 EXPIRES: 01/22/2005 VALUE: Status Issued SITE ADDRESS: 512 C ST ASSESSOR'S PARCEL NO.: 170335241090aS 'YOU to ,. . ,Qreg,on \aW reqUlr on UtlliW PROJECT ~~eltlp9llia6p~ttVytt~QfiJJ set iorth iollow ru~es ~...tor Those rules ~~ o~?-OO~~ Owner: ~~~~~?~h[~~~~'~e fules b'J Address: iftVlr1~q&'y~ta~~t9ili~lUDf\e, Owner: O~~~~9.e center. (NOMWA-'JA ~~~i~~n Address: 63l\ll~1D~if~~~~~:97477 : ,~ ,; r. i.: centei\i Springfield' TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential Phone Number: 541-741-4676 ~ , ", ;;:~~ , . :,~ 'reI . '::': I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor REYNOLDS ELECTRIC License 17252 Expiration Date 02/08/2005 Phone 541-343-7297 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: watlltE' Sq Ft Basement: Rang r~€j5ERMIT SHALL EXPIRE IrsqlttEtW~carport Ene.r t' QMizt.D UNDER THIS PE~Mfli ~tMQ:r Sprm rnMM~Nr.~;D OR IS ~NDO~t1I0P.t Load: IDEVELOP~lNF~i~, REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pal!e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00913 ISSUED: 07/22/2004 APPLIED: 07/22/2004 EXPIRES: 01/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 . $63.00 7/22/04 7/22/04 7/22/04 Receipt Number 1200400000000001126 1200400000000001126 1200400000000001126 Total Amount Paid $73.71 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 Insoections I , 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 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. ' '- ~ayV fulLQ)5\ Owner or Contractors Sign~re )0' l~ . ~-O '( /~d--I Ol/ . I I ~(~ Date Pae:e 2 of2 225 Fifth Street . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-009l3 COM2004-00913 COM2004-00913 Payments: Type of Payment CreditCard 7/22/2004 RECEIPT #: rity of Springfield Official Receipt velopment Services Department Public Works Department 1200400000000001126 Date: 07/22/2004 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By REYNOLDS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 000450 022915 In Person Payment Total: Page I of I 11:32:52AM Amount Due 63.00 4.41 6.30 $73.71 Amount Paid $73.71 $73.71 )-.. 225 i'Jl< IJ:1 STREET 0 SPRlNGFIE ~ OR 97477 · PH:(541)726-3753 .. FAX: (:l -:fo~9 ~.o ~0 o~o ELEt;l1<IC# PERMIT APPUCATIO~ / "'r. ~ ~ City Job Numbe(' D., m 2I-_rf)1l - m q~.~ 11').d.. L-cro tL'~ '.0'~~^'l1 -r 7 I "I & {~ &-s- &"1 '.,. ,> ~'. ~"..._~'.-,- ':' _"~..."...,_,,~.l_''''''l!''~...'',_,, ,..'..,. , '. 3. ;:.if,X,C",'",'.',P'w'-'~_"'" __.~~'b:..'_:" "','"...l,.',_i:.,,',.::~,~"..,' d..",~-~:.,'~, :~".~,.",~..;B.'_- ,',,:'~ 1. }fLOG4::r1Q~Ql~$r4T~~2m~ =--- -~.-- .=-- ~-- f5 rI'~~"t ::5 \ ;;-'P61 .- (y ~~ > '"&~.o &(y~ """, :"~':7.;",""" ."f"''''''''''~. """,,,,,,,,,<;-.~. 'S''''.''''~''''".;...,,-,i%.",~lJ;l ~[,,;,.;,r... ~""" ;;Q-;:.,/~~.~;.~,;+".",:, ' ''". '.:....';-',- A. fiNew.Residential?" iIi'leJ,t::1wlti" ' . " l'et.dwetJ" 't.~;;:f\!\ ~::~~3S L'f IOq{JD =::.:=,g-~b~~:- Each additional 500 sq. Ii. or ~ "- ~u~~~tr'~fZ1::workh :,:o:::'dHomeor $ 00 not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder $50.00 ~tl:"!,'3!7~~~~~rt.!;"l'lf~;, ONrRA.t3':'Ci A' 2.. . .~~.. " '"' L) , follow rules adop,ted by the Oregon Uti1'" Electrical Contractor /TewhO/e/S E1~d. -Ar<:'Notificla~SfhosefUlesare_~~ ; . in OAJ;~t06~iHtWiugh OAR 952.,gOf.. Address :J / 75" W L I't t;/ Ave. 0090AWH'iVi'j tJtSi(i~es of the ruI- hi; . ..' . call~ tM_EIltlO~sthe telephone Phone 3 cf3 -72- , 7 num~~JqO~~QtlJtJlity NotiflCiltkJll Re&0emtfll'~.2344)1I n::ff.1e1~:ID'i~t~;gt!1:,~;};[~~,;';:~"::~~~~~)"""iF;.~~~~..,<-.A '1'2'ebltions'oi'RelOcitio' - " ""'~",",""'fv,a;,::1. 60 $ 63.00 ~ 3. $ 75.00 $125.00 $163.00 $375.00 $ 50.00 City Eut:'/ene v Supervisor License Number r;t S,;J... t) - 5 /o/(;)~ /' Constr. Contr. Number Installation, Alteration or Relocation 200 Amps or less / 7 z-5"" Z-- 201 Amps to 400 Amps 40 I Amps to 600 Amps e:>2-/ oS;- r Over 600 Amps or 1000 Volts see "B" above. ~':':'l~.::p-:'\!.....".......~- Signature of Supervising Electrician D. ~1!~~p'Cf /) N eN 8In&B~n or Extension Per Panel ~~ ~ <::<' OnU:tl&tRERMIT SHALL EXPIRE IF THE \\1~ wners N(pame0F;ffLO'aJ!E:, 5~~ ~=~=~DO,Pl~,,~,"~~.~'<'::i'''',,"i''i~'''W';;'''"~''';;~'''-' Address .:::;/ / ) Il~ I . C E. ~r"nsc~llaneo fmcludedl(-;Eachmstallatlon:. . f~4lh~t:- '''',hM;;O:,,;,ol'., ,~#""........ '~"'.;'~; .~' .,', ''':lia~~~~~!^'_'4c'/'..-:' ~.~ ;,l'.: City ~."...... Phone 7 4" J ....4(0 7" Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges :..-:;;;;;; ~':i' ,;:-~-:!i!:';:L'::::,:~;.'!,:P.;.~~:~f:,!;~:,::;:'.-#;-.:'f..~ f.;...~,:.~ .~,., 4. -~:Srm.TOTAL~:Q.f:ABO ...~. ~*~~~;.:~~.:l"::;...l..",:;f.:,;,;;~::;,.:~~:-:;,":~~Jri~'~ $ 50.00 $ 69.00 $100.00 Expiration Date Expiration Date OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: {17~3. OD If.<fl t.o. :-:s 0 ~ /6. II 7% State Surcharge 10% Administrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)!Building Forms/Electrical Permit Application l-03.doc