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Home My WebLink AboutPermit Electrical 2004-7-22 r Supervisor License Number 2 ~. 7/.5 /i> II / vcf." " ~10~~9nstallation, Alteration or Relocation I' S\ ,\\\~ {:) ~ 200 Amps or less ..2 6 (7 S\Q..~ ~_o.~ (.\:j~ 201 Amps to 400 Amps , 0'.'<". <{~;~~\>" 401 Amps to 600 Amps Expiration Date I J'A~{~ ~\j Over 600 Am s or 1000 Volts see "B" above. ("~. ~ '0' ~'V\ ~'(' Signature of supe~.rgw~~~'c~\)~ ~ {o ~\>' D. ,,~~~'->\:.-\> to<(\:.-~t0 New Alteration or EX6..~~o~~e~~f!\' /~~0.~ One Circuit ~\ (,.eJ o(,.er:::t>~e cao~7.:<S~i'\ $ 43.00 '<...--r r('(\."\\\'~ ru \ .... ~~ "",G ~O:;; tJ .- ( '-J-0" ,uv Each Addition~\:!r'\."";, ~~; ~ <..~ da 1\ _ _:-...~~ Cr;:? ( Service or~ca~~\nlli\~ ~ 0 .;se ~C5'I'..~~ 3.00 Owners Name h~I:~- :7~ lR.."- .0 e; O<:::J~ Q) ~ e~. ~ Address 4 '2.0 'e>~.(S"t6t{E.. ~, E. ~ ~ = ~<() (,.~ ~ ()!. . "'~ ~\.riY ~o ,,>& ,nf?:) City::;;;', 'P-(~ fC~1) Phone f- n.~~,';f ~tJcm..... '= ^ v n'lI' $ 50.00 ~{)tUl~ r_r):~~'V e<". 0" r:!:J':>lI' ".0 ~ ~~~~rg~gOi,e~CO\)~ $ 50.00 ~<[i@l'fie~e~~~~M $ 25.00 "fi$U~~~~ww5~~rcial $ 45.00 M. . E~4A~'O pve;'t I . F . $ IDlmUm ,\,-"""IIC erml nspechon ee IS 45.00 + Surcharges City Job Number 1. LEGA~D SCRIPTION A. R~"'~ l'lO'3>Z3>3~OISCO , JOB DESCRIPTION W";/<"p -'Re,,!I~obmi ,qri.J ,.Q>.47J.! ;eO'Vl'lj 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 ~J k6 t:=!e;R... "t I?{)~ Ie 3'7 - a4.~:S <2..,/L (; ,- 1./ Phone 't Address City ~~ Expiration Date Constr. Contr. Number 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 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. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. $ 50.00 $ 69.00 $100.00 t.q3,,,,,q (LI.sf) 4. 5S,OQ 3,~S -5,SO b4,3S 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Permit Application 1-03.doc -~r!l;~~n'!L~J ~~,,~_..' " il Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 07/22/2004 APPLIED: 04/07/2004 EXPIRES: 01/22/2005 VALUE: $ 25,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 420 BLACKSTONE ST ASSESSOR'S PARCEL NO.: 1703233407500 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRI~TION: Interior only remodel (creating master bedroom from two smaller bedrooms. Adding new bath and relocating existing bath - also converting single upstairs bedroom into two bedrooms) Owner: SPIRY ARTHUR W III & JULIA L Address: 420 BLACKSTONE ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor License TRACY ROBERT SMITH 155561 SECURITY PLUS ALARM & PROTECTION 125673 SHAD CHASAN SURRE~'t- ' 158295 Jc-Jllii~~G INFORMATION I x-~7 \)~ # of Units:, ' -:ft.~ ((X,,<0 &..~Of Stories:" Lot Size: Primary Occupancy Group: ~\,~~S <N\:J~ Height of Structure.' Sq Ft 1st Floor: Secondary Occupanc~ Groups'0~ S:.,~ ~~~ ,Type of Heat: Sq Ft 2nd Floor: Primary Construc..t.~~m~' \:)~\j ~ Water Type: ~~ Ft Basement: Secondary co~t~i'cg~~~ '\) \:J~ ~\:J~' Range Type: ':' 0c:, ~o ~~~~arage/Carport # of Bedrooms: '\~ ~~\S ~\.;~ ~ ~~ Energy Path: ' ~ PJO~ ~~~~er: ~\:) ~~~ ~ ~"f. Sprinkled Building: ~ \~<3<..e f(}0 ~p~'Ql\Load: -I' .~ Yl> r~' ..c" (I. \~ '-.l~~ . I DEVELOPMENTINF~j0t~0:~0'~~O~~0~ O~. >>..0'< ~ ~o. ec:, 0 ,r?f.e ~$,ltEQUlRED PARKING ~~ '?>-v ~e\' rv.;:so. 0<:<" ..;s-e ~o Overla)(~t:~ec:, c.e<:' 5::P" . ~ G ~e' .~\\.'\ tl<~'Total: # Str~'t~~~lr!.:pV ":S:),~ ~o ~ $~ 9.:~'?:J Handicapped: pave~~'tfx~~'1: ~'?>-'\ 0 ~,e<'" e0.>O r;yf?:>rs Compact: % of ~(oFl\2e} e (,e eO' '\ 50\:) o '\V'.;:so. .;:so. . ~ ' .\~ "Cbrv. . ~0.> ,0<" eo!... " ~') ,\\;< /,'V'. I PUBLIC IMPROVEij~JS r'O' Contractor Type General Electrical Plumbing Expiration Date 05/19/2005 10/13/2004 01/14/2006 Phone 541-741-0042 541-687-6474 541-741-3553 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setbac~: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Pae;e 1 of3 -~,fJ:~!~e~I~J! >,,..... .;t j' /,{ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Building Permit Fixture Minimum/Adjustment Mechanical Vent Fan + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Initial Review Public Works Review Structural Review CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 07/22/2004 APPLIED: 04/07/2004 EXPIRES: 01122/2005 VALUE: $ 25,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 25,000.00 04/07/2004 Value Date Calculated Total Value of Project $25,000.00 $25,000.00 ~ Amount Paid Date Paid Receipt Number $145.86 4/12/04 1200400000000000465 $10.00 4/16/04 1200400000000000496 $36.74 4/16/04 1200400000000000496 $25.72 4/16/04 1200400000000000496 $224.40 4/16/04 1200400000000000496 $98.00 4/16/04 1200400000000000496 $33.00 4/16/04 1200400000000000496 $12.00 4/16/04 1200400000000000496 $4.50 7/21/04 2200400000000000956 $3.15 7/21/04 2200400000000000956 $25.00 7/21/04 2200400000000000956 $20.00 7/21/04 2200400000000000956 $5.50 7/22/04 2200400000000000964 $3.85 7/22/04 2200400000000000964 $43.00 7/22/04 2200400000000000964 $12.00 7/22/04 2200400000000000964 $702.72 I Plan Reviews' 04/13/2004 04/13/2004 04/13/2004 04/13/2004 04/15/2004 04/16/2004 APP LLH APP DJW APP DLM No SDC fee required. See documents for plan review comments. 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. Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Pal!e 2 of 3 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 07/22/2004 APPLIED: 04/07/2004 ,EXPIRES: 01122/2005 VALUE: $ 25,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underfloor Plumbing: Prior to insulation or decking. 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. Low Voltage: Prior to cover. 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 Paee 3 of3 225 Fifth Street . Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department Job/Journal Number COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 Payments: Type of Payment Check 7/22/2004 RECEIPT #: 2200400000000000964 Date: 07/22/2004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By KIDD & COMPANY Received By Item Total: Check Number Authorization Batch Number Number How Received 505 In Person Payment Total: Jmp Page 1 of 1 3:17:05PM Amount Due 43.00 12.00 3.85 5.50 $64.35 Amount Paid $64.35 $64.35