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
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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