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Home My WebLink AboutPermit Electrical 2004-9-7 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)7ny,.J~89 ELECTRICAL PERMIT APPLICATION J / ~~~;f):'IJ~~if)gpro' City Job Number LDtIV12'5ol{ -OO/cX)Date r 7/0l./ oVeJ} (j(jO&:~Cf~SSlJb , / / Of r& ' tni/~ 1. 3. InstaJJation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 6 "'TENrl?O~O~!,g~~el4iB'V' hfbgWres you to D. New IrttQ,~fMl5)J--Q~lY8~ OAR 952-001- __ One ~Q.. You ~a~ obtain copie~ of th~ j81~g. by Each~~'dm~ me::~ntey!t~Note: the teJ~p!!~e TSot.,J L~f1 y servlC"l#'Ulllltre~If8~lffl~ Oregon tiliiity Notification E. /st:t c s.-t- LEGAL DESCRIPTION 170 ~3SZ3 )/~/oO JOB DESCRIPTION ZC/D/J.s~v,- c11h(e-1~/ae Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Gi'o U"vLJ Fz1 F ~~ Address 8'c~ 0". A / ;g;:r City...'\./l,l)/.:v9~'~cl_ Phone '7c:lfc:,-~'i(S'i? '/. / . Supervisor License Number -37$ t.. ,C:::; Expiration Date / <:) ) a / J c2 c-04 ( ,. Constr. Contr. Number ./S"RR{).// Expiration Date ~/ ;) -</ / .:? 0 10 ~ S~::L7;:O;~~~: _ Owners Name '7:)Avt \":::> ) ::;; 7 City 'S'?F~ s+ 73b.~/D'2.9 Address c Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. , Owne" Signature, JJ ~~// -- /' ~~ o Inspection Request: 726-3769 1000 sq. ft. or'Iess Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder I I $ 19.00 ICJ -. $50.00 B. " HIS PERMIT SHALL EXPIRE IF 200 An,ip.s or Ifl~l7- ED UNDER THIS PERMlt31~NQT 201 AmWTof\p5'f: ^ I ~ip~f\ 401 An\pQM~JO~Cffi OR IS ADnND9NE$125.00 601 ArrfWili 1~ Q~itERIOD. $163,00 Over 1000 AmpsNoIts $375.00 Reconnect Only $ 50.00 c. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ,..- 12~ <6 7~ It.-50 JL{b 'l~ 7% State Surcharge 10% Administrative Fee , TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application I-D3.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00100 ISSUED: 09/07/2004 APPLIED: 01123/2004 EXPIRES: 03/0712005 VALUE: $ 22,453.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 159 C ST ASSESSOR'S PARCEL NO.: 1703352311400 Springfield TYPE OF WORK: ReRoof TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Remodel - replace roof with trusses, upgrade electrical service and finish space uires yOU to ~ _ _;~n bw reQ '\" TFNIIUI'l. v'~"-, Oregon UlI "1 \01/\ Owner: Bo\fLSBJ::-I~t~1WrR2& B'A~f~",,, "'re set torth r"\~l.o' loW\ Address: 159 to~(}W '$Pn'Ce~~m>.cG'Rrl9m.,. 2-001- , H t..I0titicatlon -u~n thrnllOh OAR 95 L" Vt" In OAR 9~~-UU l-vbtain copies ottne IUlv.c> , . '/ 0090. You may 0 Note: ln~~(!IfOR INFO~Jllif~N:l XPIRE IF THE WORI\ calling the center. (on Utility No lie LlUIl 'tHIS p\:KMIT ~H~~L ~ P:RMIT IS NOT Contractor TYR6mbeQon'tifi.a~00_332-2344). ~9~~\ZEDffi1,Mdhb\AIRd J~~EDf1~me General ' ~~ 1-8 COMMENCED OR IS ABA Electrical OWNER .^t.IV 1 p,() nAY PE.RIOD. I BUILDING INFORMATION' # of Units: 1 # of Stories: 2 Lot Size: 7,841 Primary Occupancy Group: R-3 Height of Structure 25.00 Sq Ft 1st Floor: 856 Secondary Occupancy Group: Type of Heat: Wall Heat Sq Ft 2nd Floor: 540 Primary Construction Type VN Water Type: Electric Sq Ft Basement: Secondary Construction Type: Range Type: Electric Sq Ft Garage/Carport # of Bedrooms: 5 Energy Path: Path 1 Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMATION' Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 10.00 5.00 5.00 10.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: 45.00 I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pae;e 1 of3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00100 ISSUED: 09/07/2004 APPLIED: 01123/2004 EXPIRES: 03/0712005 VALUE: $ 22,453.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Dwellines V Remodel $41.58 540.00 $22,453.20 $22,453.20 09/07/2004 Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Amount Paid Date Paid Receipt Number $12.50 9/7/04 1200400000000001314 $8.75 9/7/04 1200400000000001314 $106.00 9/7/04 1200400000000001314 $19.00 9/7/04 1200400000000001314 Total Amount Paid $146.25 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. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When aU electrical work is complete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Wood Stove: After Installation. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Paee 2 of 3 Status Issued 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: COM2004-00100 ISSUED: 09/07/2004 APPLIED: 01123/2004 EXPIRES: 03/07/2005 VALUE: $ 22,453.00 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. ~/ D~~ Owner or Co.gctors Signat~ ----- Pal!e 3 of 3 Darlo L( 225 Fifth Street 'Springfield, Oregon 97477 541-726-3759 Phone .~ ~ ""':ty of Springfield Official Receipt velopment Services Department Public Works Department Job/Journal Number COM2004-00 100 COM2004-00 100 COM2004-00 100 COM2004-00 1 00 Payments: Type of Payment CreditCard 9/7/2004 RECEIPT #: 1200400000000001314 Date: 09/07/2004 Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 7% State Surcharge + 10% Administrative Fee Paid By DAVID BOWLSBY Item Total: Check Number Authorization Received By Batch Number Number How Received njm 133301 In Person Payment Total: Page 1 of 1 1:33:16PM Amount Due 106.00 19.00 8.75 12.50 $146.25 Amount Paid $146.25 $146.25