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Home My WebLink AboutPermit Electrical 2005-1-19 ~I '1. -'- O~SPRINGFIELD . ~~ ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (5fJir16-368~' ELECTRICAL PERMIT APPLICATION ::h~~ ~~~ 0 tS CityJobNumber~~L-~0"15B-6'\ Date ~\- l~-(!)S &~n ,~~ 1''''&^<Si;..6 "/. p;) Y0' ~/ . ~'"' ~S' "'", ~'<' 1. .', L~CATION OF INSTALLA~ION. I 3. I COMPLETE FEE SCHEDUtE~~~>S;~(;1(>~.s>0 I 4~~o ~'Stc-~~: A'.-'&,{C,'U> . "'\,~\Sf'<~ _~-?:{,:" L.EGAL DESCRIPTION \.. (> '- ~ ~.;'O eo 0,01\- A. I New Res;dentlol- Single or MUlti-F. a' _j~Pd~~. g ufij;'~.J $~\Il(t. \.fJOO\::> ~t:...1l~~ I ~S'""' ServiceIncluded, . 'LA' '.. A ,00 JOB DESCRIPTION' 1000 sq. ft. or less '-t $ 6.0 :\. Each additional 500 sq. ft..or .- Ne."", Po U.e.PL.L-)C portion thereof $ 19.0 CITY OF SPRINGFIELD, OREGON '~,"". ..-: ..... 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. I CONTRACTOR INSTALLATION ONLY I Electrical'contracto(bp,~ Address ~( 'RcJ . .f\i*'-< ..' . ~'"' ~"\ City ~ \txxn \1 Phone 54t~ ~~~SY4 / '. <:<:-'<.-. 9::-~" \'-J . ~:~~~~~~ Supervisor License Number ,\>'~;;~;r(~~~::) Expiration DateA\"'~:o.,,~a1~~t~~. ~'~ $.v~v~v, '-J k,<'<:-'- . ~. \.,\S ,$~ ....." .... ~'\ 2- Constr. Contr. N,l!lmbt\\, ..<.-,.... .--. ~ ~ ."\" "'-\'V <'I. V 1:(.'0 ~,. .'V' .' Expiration Date\J\J~A~d-l.o I ~n ~' Signature of Supervising Electrician ~ , @~ " ~ Owners Name '-C E.~-{ T~-s~~c;. Address (4. C? 5 Q ~~ ~ 'l'--e..~-:( City :7'(~\.t\~ ~ c.e\..:\) Phone 1..1. \-~ Q40 OWNER INSTALLATION The installation is being made on propertY I own which is not intended for sale, lease or rent. . Owners Signature: Inspection Request: 726-3769 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B.I Services or Feeders - Installation, Alterations or Relocation: ~ )Ie. $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 I~ v:-Jj c-' 1G.... -'/ lJTT , 200 Amps orless 201 Amps to 400 Amps 401 Amps to 600 Amps. 601 Amps to 1000 Amps . Over 1000 AmpsNolts ,0 Reconnect Only ~o'> ~><::A ,,'(\ ..eC::J ^~ ,0' ~' ." o';.......e; I"' 0_ C. I J~~Jl9rary ~&'"&i&CF~~\~\je~'O:\=---_ ~ - 0.0_' ~r-o,~~~c~,J ,ro: C\:'e ~eC::J ~<0 ,~ ~e Installati~n~~~f~iO~~Re!&a~ ~o" 200 ~61P~~9~~0~0'>:eC::J a'e '\.~~~\'f ~j_ $ '50.00 ~~~~~~~Og$'mes>~ e~~~ t';.~' '_ $69.00 .(~~o~~D$S'1~;dOO~n~~o\": o\J~ ~f"!) $100.00 ~"\ ,.},." -. ,,~ R) ~ . ~ ~ ~'1,: ~ ~O:-?J>.~~'A~P~<~~r~@.<f~~ee "8" above. ~~t~~ <ei~~~ts}J ",'8 ~. _O~-~o ~. '\}' '''' . '~e~~ratl~'o~tension Per Panel &~CC#C ~ (Jlj $ 43~00 Each =onal Circuit or with .. M- ~ , ./, Service or Feeder Permit . ~ $ 3.00 ~J { (--.--- -.1 ,S 1,5Q_DQ_~ 1 -.-("i .;-'U.,. E. I Miscellaneous (Service/feeder not included) -Each Installation I Pump or irrigation Sign/Outline Lighting $ 50.00 $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric PermitInspection Fee is $45.00 + Surcharges 4.1 SUBTOTAL OF ABOVE .A 4 001- ':ll'"l . J' , 11r/) ~ 1. I \..XJ~., o~~tlP1. :?:3,'B.C}{ 2>~~\L'$ 41.",0., \,'),/) S~ ~ 5S4~<:f&-~5~, 8':5 \~1:t~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FOfn:s/Electrical Permit Application I-03.doc .: " .~ ~.~ {;:' I . . .' CITY:OF"SPRINGFIE:' -~'OREGbN . ':--c/ ... . .. .' /':" . '::. ... .?, . ~. .. . SPRINGFIELD 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ,-., ELEt:l.KlCAL PERMIT APPUCATION City Job Number~ OL..60\5B-o \ Date (~) \ - l ~ - C> ~ -~.~. 1. LOCATION OF INSTALlATION ~ '-'.~"~ 4~'Z.o t-...S\c(L~' A.'B\C.,\). LEGAL DESCRIPTION \ \ 0 7"L. ~ 'Z. 00 00 ') Ct-", A. New Residential- Singl~'~r Multi-!.~I~'per d,well!ngu#. .F~\A~ WOO~ 11...'LTh~1~T ~S' . S"rviceIncluded JOB DESCRIPTION~, 1000 sq. ft. or less \ Each additional 500 sq. ft. or fV \J ~ Pt.L-)'O'", portion thereof Ne-'-'" .. 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. CONTRACl'OR INSTll~~ATION ONI.:r.. 't '. Electrical Contractor ~ Address ?j.-I~( R(J<~~; ;!:' :. ""\' ~~ ~:~~" City ~ \ tn.n \1 Ph~ne ~ \.~:'~tol~L} { (t' ...'.( .... "~. ....-v '~~: ,,~:<-."'" ." <....' .''''' " $' ..}'-. c.-...." v\) :cl. (,.~::-. ,c... '" :<~\V Supervisor License Number ,'. ~(~~ (............ \:.'! .,...,\:.~> ':'- ......j' Expiration Date. -:.'~:- \Ol.~'~ ~f;.), . ..' /,z1v"S" Constr. Contr.N~in~er':-:~':,~;.~~\ ~ ;.- ..)--:;t~ Expiration Date.._,-~1 .;}lo I a.o :,~' . ,*'. Signature of Supervising Electrician ~()~ ~: II ~ Owners Name ~ E~'t 'T\z.~~ ~S,.S Address li:\'?5 C~~ '7tlZ-C-~ City ~~\.~(' (e\...i)p~one 1.4 \ -~q40 ~ . OWNER INST ALLA TIONt :'~;' The installation is being made oh property I own which is not intended for sale, lease or'rent. .f' :~:' Owners Signature: ~; k' ~~ )i. '~'~ '. Inspection Request: 726-3769 ; ,. J~: ';~ ~ ),1. o;Ilf 3. ,- .,.-, .. COMPU1.~ FEESCHEpULE BELq:w' 4- ~4~ $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 ". ., . - '.. "'I . B. Services or Feeders -:-}~~~~~.n~ AIt~r~ti~~s ?:'r ~~I~a~,~~:L:: 200 Amps or less lI: $ 63.00 201 Amps to 400 Amps ~ $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts.....O $375.00 Reconnect Only ~). ..~~ ",<, $ 50.00 s ) .. ,. ;. . ,'21 -(\ v ,0' ,:,.; C. Temporary Se~~i&'~~~ 'Q-\ ~ ~~~?~~ - .S:".i\~;~~l/~'t~~~ _ ~\'''''-O~,?><:P''(ffJf1':'.e~ - .,.... ......''",...,N '(z;' ",0 ,e"J ~ .....~ ~0 InstaIlatiQn;'AUe)~tio~~R~a~ ~O<::- 200 t.:nip~~f~O"J:O o'-~ S 0\ .....&0_,~f $ 50.00 _$0 00_ .......)" . ,-..'<. ,," ,,~ 0,,0 ~0 ,e- .. *~,,:~'t~<40~...~, e~ .~~~~tY:\' _ $ 69.00 ~~~~J~~~~;~~;::abovo:.$IOO.:. " . ~~\,,~~..,,&ii~_eto;.. C5 . ~ ",,"'"V''-'''''''~''''' .,,;~' .......... .- '.:~' ~~ 'C em Xi .._ -.; ~ _ '. '.,!:,'~:_;.;;:''''~'''; ~:r:;,::)>:':',F)_"::-~ ',_:_ . -<:"~~ >..,_.." -, ~--~ 'f ~'::.:;..>-.' ~ ~ --\0 .:s' ~ .:s' 'f;l'" - .. ",. ~. ~...-,-"._... .,... .. .,<R~~~t~~ of..$xtension Per Panel ~ ~c~0 (} Each ~tional Circuit or with ~ '" '../ .. - ..... Service or Feeder Pennit ..La.. $ 3.00 ~ I~ ~':~ ~ , $ 43.00 E. Miscellaneous (Service/feeder Dot included) -Each Installation ' Pump or irrigation $ 50.00 SigpJOutl1ne Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 414.00-~c).o~;tlP1 :?=',\B. ~l. .~~~\L~ Ac1.~O, \'VJ c:;~ ~~ 554. ~~s~, 8~\~1 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: 02-00758-01 ISSUED: 01125/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4920 Aster St A-D ASSESSOR'S PARCEL NO.: 1702320000904 Spr TYPE OF WORK: Four-Plex TYPE OF USE: New PROJECT DESCRIPTION: Land Use: Retirement Home, Zoning: HDR, Applicant for project is Sunwest Management Residential Owner: Terry Travess Address: 1495 Cheek Street Springfield OR 97477 Phone Number: (541) 747-9940 I CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone Architect Patrick Bickler (503) 588-7046 General KDA Construction Inc (503) 587-8700 Electrical AC & E ELECTRIC Mechanical JET HEATING INC 3944 05/31/2005 503-363-2334 Plumbing JRT MECHANICAL INC 98808 05/04/2007 360-666-0330 I BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 8 # of Stories: 1 Height of Structure 16.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Energy Path: Path 1 Sprinkled Building: n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 155,945 3,449 4 R-l VN I DEVELOPMENT INFORMATION' Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Page 1 of 6 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: 02-00758-01 ISSUED: 01125/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818.00 I Valuation Description I Description Tvpe of Construction $ Per Sq Ft or multiplier $82.00 Square Footage . or Bid Amount 3,449.00 Value Date Calculated Apartment Hous V Wood Frame Total Value of Project $282,818.00 $282,818.00 09/02/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Commercial Plan Check $578.92 6/24/02 9716 -Mechanical Issuance Fee- $10.00 9/23/04 2200400000000001201 + 10% Administrative Fee $212.54 9/23/04 2200400000000001201 + 7% State Surcharge $148.78 9/23/04 2200400000000001201 Addressing Assignment $31.00 9/23/04 2200400000000001201 Appliance Vent $48.00 9/23/04 2200400000000001201 Building Permit $1,160.40 9/23/04 2200400000000001201 Dryer Vent $24.00 9/23/04 2200400000000001201 Exhaust Hoods $36.00 9/23/04 2200400000000001201 Fixture $560.00 9/23/04 2200400000000001201 Furnace - up to 100,000 btu $48.00 9/23/04 2200400000000001201 Gas Outlets 1-4 $4.00 9/23/04 2200400000000001201 Gas Outlets 4+ $12.00 9/23/04 2200400000000001201 Plan Review Comm/Ind/Public $754.26 9/23/04 2200400000000001201 Planning Final Occy Inspection $110.00 9/23/04 2200400000000001201 Sanitary Sewer - 1st 50 Feet $45.00 9/23/04 2200400000000001201 Sanitary Sewer - Improvement $1,243.04 9/23/04 2200400000000001201 Sanitary Sewer - Reimbursement $1,634.72 9/23/04 2200400000000001201 SDC MWMC Administration $10.00 9/23/04 2200400000000001201 SDC MWMC Improvement $3,461.24 9/23/04 2200400000000001201 SDC MWMC Reimbursement $328.12 9/23/04 2200400000000001201 SDC Sanitary/Storm Admin $317.69 9/23/04 2200400000000001201 SDC Transpo Admin $278.21 9/23/04 2200400000000001201 SDC Transpo Improvement $3,089.96 9/23/04 2200400000000001201 SDC Transpo Reimbursement $700.52 9/23/04 2200400000000001201 Storm Drainage Impervious Area $1,450.49 9/23/04 2200400000000001201 Storm Sewer - 1st 50 Feet $45.00 9/23/04 2200400000000001201 Temp Power 200 amps or less $50.00 9/23/04 2200400000000001201 Vent Fan $48.00 9/23/04 2200400000000001201 Water Line - 1st 50 Feet $45.00 9/23/04 2200400000000001201 WiIlamalane Apartments $2,768.00 9/23/04 2200400000000001201 + 10% Administrative Fee $30.50 1/19/05 2200500000000000071 + 7% State Surcharge $21.35 1/19/05 2200500000000000071 Add, Alter, Extend Circ Ea Add $54.00 1/19/05 2200500000000000071 Perm Serv/Fdr 200 amps or less $126.00 1/19/05 2200500000000000071 Perm Serv/Fdr 201 to 400 amps $75.00 1/19/05 2200500000000000071 Pal!e 2 of 6 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: 02-00758-01 ISSUED: 01125/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Temp Power 200 amps or less + 10% Administrative Fee + 7% State Surcharge Other Electrical Permit $50.00 $16.90 $11.83 $169.00 1/19/05 1/25/05 1/25/05 1/25/05 2200500000000000071 1200500000000000108 1200500000000000108 1200500000000000108 Total Amount Paid $19,807.47 I Plan Reviews I Ene:ineerine:-C/I/P 07/24/2002 Wait PO . Telephone calls to Patrick Bickler and Ron Jackson trying to determineUmits of construction. (Left messages, waiting for return calls.) Ene:ineerine:-C/I/P Fire Marshal-C/IIP 08/09/2002 08/01/2002 Appr PO APP AG Plan review - 4plex Senior garden apartments 3450 sq ft, VN , R3 Initial Review-C/IIP 06/25/2002 Appr LH 1. Provide address numbers for each unit and provide a building address number on the main building. Numbers to be clearly visible from the street fronting the building. 2. Provide a 2A-I0B:C fire extinguisher in each unit - mount extinguisher with handle 3' to 5' above the floor. No SUB review required per Don Moore Plannine:-C/IIP Structural Review 06/26/2002 Appr WE LM JMP noted gas-fired water heater in storage closet is not permitted. Called architect, who is to look into a direct vent unit. Approved as noted 03/03/2003 Structural-C/I/P 11/15/2002 APP TR Pae:e 3 of 6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural-C/I/P 08/12/2002 Info Pa2;e 4 of 6 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: 02-00758-01 ISSUED: 01/25/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818.00 LH Faxed letter to Patrick Bickler from Tom Rogers on Preliminary plan review which included the following information. See job file for letter and code references. Building/Planning 1) It appears thaI the proposed occupancy type is Group R, Division 1. Please verify this is accurate or specify the proposed occupancy classification. Note that the following review comments are based on a R-l classification. 2) The walls between units must be of one hour construction. Specify the assembly that will be used. 3) Indicate on the plans the location of all draft stops. 4) Indicate on the plans where the accessible parking serving this building is lcoated. 5) The mierowave show in detail 2/ A6 is not within the maximum height speciifed in OSC. Incidate how compliance will be achieved. 5) The microwave showin detail 2/ A6 is not within the maximum height specified in OSSC. Indicate how compliance will be achieved. 6) Kitchens with counters or appliances on three sides must be provied with 60 inches clear space. Verify that 60 inch cleraance is provided between the refrigerator and opposing cabinets. 7) The clear floor space at the kitchen sink must extend 15 inches past the sink centerline. Please verify. 8) Specify the wall assembly used between units that meets the sound transmission requirements of OSSc. 9) The drawing notes on sheet Al do not consistently correspond to thE numbered items on teh plans or include all the referenced numbers. Please clarify. 10) Special inspection is required as outlined in OSSC. Please complete the enclosed special insepction schedule and obtain applicable signatures. Special inspection appears to be CITY OF SYKlNGFIELD Status Issued Building/Combination Permit PERMIT NO: 02-00758-01 ISSUED: 01125/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line required for, but limited to: Epoxy anchors. STRUCTURAL I)Calculation page 2B-I0 evaluates t x 12 beam with allowable bending stress of 1300 psi. Sheet S1.2 specifies DF-L #2 beam. Please confirm that a #2 beam is acceptable. 2) The roof framing plan on sheet S1.2 references notes 23 and 25 for the firder truss support. Where are these notes located? 3) Provide calculations for the privacy screen shown in detail lIA6 demonstrting the ability to resist wind loads. MECHANICAL 1) Provide mechanical shop drawings and equipemtn specifiications for review. Include details for appliance venting, combustion air and ducting. 2) Fuel fired applicance may not be installed in the bedroom or adjoining closet unless metting the specific exceptions of the OMSC. Provide suppplemental information information demonstrating compliance. 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. ~eouiredJnSDections I Site Inspection: To be made after excavation but prior to setting forms. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. . Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Firewall: Located and constructed according to plans. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Roof Sheathing/Nailing: Before covering sheathing with finish material. Pae:e 5 of6 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: 02-00758-01 ISSUED: 01125/2005 APPLIED: 09/02/2004 EXPIRES: 07/25/2005 VALUE: $ 282,818.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone '541-726-3676 Fax 541-726-3769 Inspection Line Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Building: After all Conditions have been completed as required on Development Agreement. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill~ Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Floor Insulation: Prior to decking. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Underfloor Plumbing: Prior to insulation or decking. . Underground 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 Ordhiances 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 imide 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 co~struction. . 'Owner or Contractors Signature Date' Paee 6 of6 2'25 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone S"""'NQ.F...'li1;..L..D...iiiI........ '.. WtL... : ..' , - .... -- ',-..'.- -- " -'.-, C'ity of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 2200500000000000071 Date: 01/19/2005 2:43:12PM Job/Journal Number 02-00758-01 02-00758-01 02-00758-01 02-00758-01 02-00758-01 02-00758-01 Description Temp Power 200 amps or less Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Check Paid By BENTON ELECTRIC, INC. Item Total: Check Number Authorization Received By Batch Number Number How Received Jmp 82092 In Person Payment Total: Amount Due 50.00 126.00 75.00 54.00 21.35 30.50 $356.85 Amount Paid $356.85 $356.85 1/19/2005 Page 1 of 1 . -225'}i'ifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number 02-00758-01 02-00758-01 02-00758-01 RECEIPT #: Description Other Electrical Permit + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Check BENTON ELECTRIC 1/25/2005 City of Springfield Official Receipt velopment Services Department Public Works Department 1200500000000000108 Date: 01/25/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received lIh 82124 By Mail Payment Total: Page 1 of 1 7:50:57AM Amount Due 169.00 11.83 16.90 $197.73 Amount Paid $197.73 $197.73