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Home My WebLink AboutPermit Electrical 2003-10-16 ojec! as submitted has the following s not require specific land use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (S4lPJ926l3689 ELECTRICAL PERMIT APPLICATION . / Zoninc City Job NumberC0ri12Cf63-Q/D 5"5 Date IO/16~3 Date 1. LOCATION 'OF INSTALLATION, 909 S sf- LEGAL DESCRIPTION /703 26/3 D 8'300 JOB DESCRIPTION L-o'~ VO{~(E I Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . y~.~ " 2. ,CON'!RAfTORINST~0TION'pNLY Electrical Contractor -DI- DF/€L1:>'s Address /~~ S I~. 77'1 City /::; U(, ENE:: Phone '/1)5 - &'000 Supervisor License Number 3 7 0 I L f:.71 Expiration Date 10/01 /2CX)) Constr, Contr. Number 1.;< 9 /' ~ to , - Expiration Date 0/9,heoCa Signature of S4f)ervising Electrician J . /7cL, ~~ Owners Name :DM I ~ 'C.Le / AI Address flY- S L-/Lf f'.- ~ t- City <s f P'D Phone OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 l DR lO-n-o.3 I t<.JJ , "', AuthOriZed Signature 3. 'COMPLETE FEE SCHEDULE BELOW A. ,New Residential :-:-Single or Multi-Family per dwelling unit. 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. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75,00 $125.00 $163.00 $375.00 $ 50.00 C.Temp~rary S,ervices or,Feeders InstNl5rr~q;&.1teration or Relocation ~WORK 200 4\f\1IJS ~R4'~IT SHALL EXPIRE IF TH ~~ 201 ~~WHij~~fi~NDER THIS !ch~rtT .00 T 401 ~AAtml€!@t.GR IS ABAI~uUl~tL) ,00 Over~Wr'A1AA~'6?cF~~HPsee "B" above. D. ' Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 .. . . -. . .". E. ~s~ellane() uS(~ervice/feeder not incl ~~:g~ylbtf\1dnstalla tion N'Oregon laW req IItmty Pump qi\liiIi~O doptsd by the ore~.~ tc:i Sign/Qiqj~i~'~~~~nter. Those rules ~~O~_co Limitd(!)HH~WR~~~6~ti~01 0 thfO~gh p~lmieS-\ 2~ Limite'd<Eee~~~tlW1Vt1l!1ta'n COpies 01tg,~~ne M. . OI090:,~. I ~..er 1~~~M :..111'Ol2tinn llllmum E eCc'afln ''9 rme fl~n."rorl ee 1 'l'l\cJtPIWl6RlI'rgeS , . . ..' ,.. dqrJ~e Of~g .,' 344) 4. SUBTlWJ1bO~f'&1:800-332-2 . 4) 7% State Surcharge 10% Administrative Fee -:::::>/~ ..> J '-I.TD S-Z6r TOTAL Shared Drive(T:)/Building Fonns/Elecl1;cal Pennit Application I-03,doc . . CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2003-01055 ISSUED: 10/16/2003 APPLIED: 10/16/2003 EXPIRES: 04/16/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 909 S ST ASSESSOR'S PARCEL NO.: 1703261308300 SPRINGFIE TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Low voltage Owner: DAVID KLEIN Address: 1165 S 44TH ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OLD FIELDS INC License 129736 Expiration Date 06/09/2006 Phone 541-485-6000 VN BUILDING INFORMATION I # ofStJfn;nCE: Lot Size: . Height 1i.ff~p;fm~ Sq Ft 1st Floor: -- Type oA~rNDRIZEIT SHALL EXPIRE~.Ji',t,2nd Floor: Wate~~ffi.1 D UNDER THIS P tft1id4<<ilR,l{t: Rang'1\ ~. ENCED OR IS ABANDO~l ciSrf.;g,e'(Carport Energy' tl'l~O DAY PERIOD ISqCFfQAter: , . Impervious Surface Area: # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS I DEVELOPMENT INFORMATION' ' Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: OA}Tilli~fR)f.S~oe: fOl/ow ru' . regon law re '1"'4i~' es adnnt",,..J L. qUire:::: ,,,..... ~_ I PUB~h~OVENlfiN~t~~r ;:,uregon' Uiilit~ vu O. You m~8, -UU1.O throu!1M~~<!fe.pC.tl.ort , calling th Y obtam Copie,~,..., j,::.....~i-oo: n e center (N V6'WI"'ll"JI&.1~l\lDS: Umber for the O' ote: the teleph r C regon Ut.,. one enter iS1-800_332"ty Notification -2344). Notes: I Valuation Description I Description Type of Construction ,$ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa\?:e 1 of2 ~~J.~@'~~~I.~;;:91i" "."~_". , l, , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Total Amount Paid . L Fees Paid I Amount Paid $4.50 $3.15 $25.00 $20.00 $52.65 Plan Reviews I . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-01055 ISSUED: 10/16/2003 APPLIED: 10/16/2003 EXPIRES: 04/16/2004 VALUE: Date Paid Receipt Number 10/16/03 10/16/03 10/16/03 10/16/03 1200200000000002326 1200200000000002326 1200200000000002326 1200200000000002326 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. 1 Low Voltage: Prior to cover. L Reouired InsDections I 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 Page 2 of2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1055 COM2003-0 1055 COM2003-01055 COM2003-0 1055 Payments: Type of Payment CreditCard Paid By OLDFIELDS Receipt #: 1200200000000002326 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Residential Minimum! Adjustment Electrical Received By djb Check Number Batch Number Authorization Number 000196 016801 City of Springfield Official Receipt Development Services Department Public Works Department Date: 10/16/2003 9:38:00AM Amount Paid 3.15 4.50 25.00 20.00 $52.65 Item Total: How Received In Person Payment Total: Amount Paid $52.65 $52.65 . .