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Home My WebLink AboutPermit Electrical 2005-3-4 . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2005-00256 ISSUED: 03/04/2005 APPLIED: 03/04/2005 EXPIRES: 09/04/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1029 QUlNALT ST ASSESSOR'S PARCEL NO.: 1703264101900 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Service change and I circuit TYPE OF USE: Repair Residential Owner: SY LISTER Address: 1029 QUINALT ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MY ELECTRICIAN INC License 87506 I BUILDING INFORMATION I ATTENTION, 'UltlYUI/ ,,,.. requllW you 10 # of Units: follow rules adoptlalll:&tQle~regon Utility Primary Occupancy Group: Notifidt..13:ln Center.llilIgll/alftll\JsIdlUllet fDrtIl Secondary Occupancy Group: in OAR 952-001,{)Oro>~I1!Oj~AR 952'()()1- Primary Constructio? Type 0090.~u may obtcWli!ll!'~<<Il<<a1 the rules by Secondary Construction Type: calling the cente~~tfrllW telephone # of Bedrooms: number lor the Or~~~~l~:~o.tification Center is 1~~~~-~~f.g: nla . , DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: f\.n.....II"'C. Street Improvements: Storm Sewer Available: Special Instruction: T'His 'PE-Rh" .,1:IBlDI.GJMPR0VEMEN"FS iRK AUTHORIZED UNUtH 1 MI" n:n,vlI' 1'-' "OT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, Sidewalk Type: DownspoutsfDrains: Notes: I Valuation DescriDtion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal1e I of2 Phone Number: 541-741-1010 Expiration Date 11/20/2005 Phone 541-729-1454 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated . . CITY OF ~rK11'\j1.1'mLU. Building/Combination Permit PERMIT NO: cOM2005-00256 ISSUED: 03/04/2005 APPLIED: 03/04/2005 EXPIRES: 09/04/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fe"s~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Ea Add Perm ServIFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.60 $4.62 $3.00 $63.00 3/4/05 3/4/05 3/4/05 3/4/05 1200500000000000290 1200500000000000290 1200500000000000290 1200500000000000290 Total Amount Paid $77.22 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. Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover 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 Pal1e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-37~ Phone Job/Journal Number COM2005-00256 COM2005-00256 COM2005-00256 COM2005-00256 Payments: Type of Payment CreditCard 3/4/2005 . RECEIPT #: ~~.~..........._._.-..... $ .\ .~,.. ., ' . . ,-,..-.""'''"..-. ........ ~ of Springfield Official Receipt .elopment Services Department Public Works Department 1200500000000000290 Date: 03/04/2005 Description Perm ServIFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By EDWARD GUIDRY Item Total: Check Number Authorization Received By Batch Numher Number How Received djb 008319 In Person Payment Total: Page I of! 9:23:57AM Amount Due 63.00 3.00 4,62 6,60 $77.11 Amount Paid $77.22 $77.22