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Home My WebLink AboutPermit Electrical 2004-7-21 if ' , ~~, '" '}c '~h< : r ' , ' c' "J' ~ ~" '~~f'':'~' '{:@I~'tY t:~F'8'PR:IN'~FfE[I) eRMG@N~" ":" --:tii', 'i' '!' .~.: f!""," 'Y" J , "-'" - ",' p, , . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATIO,lf ~:"efOII. City Job Number CbVv\ 'J..OOt.\-- OO"'5b;ib -r (~t 0 4 q/J/J~II}Il. ::Ii}ll/Jr. . , OV<11. (/ C1. Ole 2. E]ectrica] Contractor ~ Gu( ',1L "P\~\ 200 ~RtpQ{}fle~~2'001.001 ~ thro~gh OA~S?&001. J D 20] AR,~~9d.4od~~~t obtain CUI-JIt:;::; uf Lr~%6s by Address ~:)-\:KJ ~~Nd\\' , (" 401 Am ~~~lgoo~N,~enter. (Nult:,.l.I't: le~W~.~8e C' '- - ~ . ....' gumCGt fe-I' me Oregoll Ulillly f4otlncatlolt ,.,.- <... \ (<:h -'-l'\\1 U~O] Amps to 100SC:l~8F is 1-800 33~ 2G4~~63,OO CityC. ",' .l~",,- Phone -:::::::. '06 I \) Over 1000 AmpsNolts -'~375.00 ) Reconnect Only $ 50.00 1. \..j~f) ~ \ ~LVL. S; ~ IN Lr LEG~L -DESCRIPTION I,.0,3.;t3 .~: ot~i..I U S?() ~"~$'\'^ '"C)C ~ Lit} JOB DESCRIPTION .1~:OIL R~b.L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 3. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modu]ar Dwelling Service or . $50.0 Feeder ATTENTION: Oregon law It:YUIlt:~ you ~O - ,. B. Supervisor License.Number ]0 \ ~ l t l\ C. /J < 1'.. . NOTICE~ew Alteration or Extension Per Panel I ~ ~ THIS PEr~'fCifJ:h!itLL EXPIRE IF THE WORK · a AUTHORrlEW~je~rrtl'Ri~c3ti~~ffiHn IS NOT Owners Name ~'.$~. ,)CA \ 'l~ ST(: (~ COMMEI~t~\5edl:ffSdgffJfmJbNED FOR Address 4 ~ 1) ~'\':>GVL. S \.'.J~"'- ANY 1 i9 Cit~r\~\'r\~\c\. Phone~L,'\ <::\D ~~d-3 ~:porirrigation Sign/Outline Lighting Limited EnergylResidentia] Limited Energy/Commercia] Expiration Date \ u-a\ - u::::::., Constr. eontr. Number I ~ <;: 10 I '3> \\)- \~ -CJ~ Expiration Date Signature of Supervising E]ectrician OWNER INST ALLA 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 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $]00.00 Over 600 Amps or 1000 V o]ts see "B" above. D. $ 43.00 $ 3.00 x $ 50.00 $ 50.00 $ 25.00 $ 45.00 d-S.OO Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. t1.fbloD '~-15 L-/.S-O z:; 1-. luS- 7% State Surcharge ] 0% Administrative Fee TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application 1-03.doc -~~!!~,~J~i~~J~~',._ ~, .~ :~ ?;. Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 04/16/2004 APPLIED: 04/0712004 EXPIRES: 10/16/2004 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 DESCRIPTION: Interior only remodel (creating master bedroom from two smaller bedrooms. Adding new bath and relocating existing bath - also converting single upstairs be~ro~m into two bedrooms) " Owner: Address: SPIRY ARTHUR W III & JULIA L 420 BLACKSTONE ST SPRINGFIELD OR 97477 l,nl"':M~mf'\~;r;. "rnO"'.... r...... .,:,-:;:.,r.i: ~"8e: ~ I CONTRACTOR I~O."', "'~.~'i'ii~N~Pted by the Oregon Utility u er. Those rules are set forth C t t iWil@,\.(~.R'..952-001-001,Q t~r.oUM~~ Q"2-M1. on rac or .' . ..lcenS"e' EX In,ta:O 'Date'" rmme TRACY ROBERT SMiTH i(lllvO,: '~~'fY obtaln ~g}r~&~e rule~iV-741-0042 SECURITY PLUS ALARM & PROTECTI,~It'l~~73center. (Nq\)7i f4'~~ho~~41-687-6474 SHAD CHASAN SURRETT Iillir:rdi~r. J~.t~r.e..?~e~2'bY1Lij~~0( ~tlflcatlcsnl-741-3553 _...t'~"'~'~ I_~., ~ e.S e._ CO i i). I BUILDING INFORMATION I , Contractor Type General Electrical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: R-3 nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist:r" I C~' Total: ~\IU # Street ~ee R :' Handicapped: Paved Dri~1 'cfiRM1T SHALL EXPIRE IF THcMl~~~: % ofLot~t~~itJ:ZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR I\~~\': OQ 12i\ ' rcnIJf). PUBLIC IMPROVEMENTS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Page 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , Description CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 04/16/2004 APPLIED: 04/07/2004 EXPIRES: 10/16/2004 VALUE: $ 25,000.00 I Valuation Description I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 25,000.00 04/07/2004 Estimate Tvpe of Construction 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 MinimumlAdjustment Electrical Total Amount Paid Initial Review Public Works Review Structural Review 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 $638.37 I Plan Reviews I 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. 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 Pae:e 2 of3 $~AIN,GFIm;.Q.. '_-,-~'T'>l~""'~~"'~1S~,,$~"1""~ 1(; f r Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Final Mechanical: When all mechanical work is complete. Low Voltage: Prior to cover. CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 04/16/2004 APPLIED: 04/07/2004 EXPIRES: 10/16/2004 VALUE: $ 25,000.00 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. Owner or Contractors Signature Pal!e 3 of 3 Date 225 Fifth Street i Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 Payments: Type of Payment CreditCard 7/21/2004 RECEIPT #: 2200400000000000956 Description Low Voltage - Residential Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee r'ity of Springfield Official Receipt ;velopment Services Department Public Works Department Date: 07/21/2004 Item Total: Check Number Authorization Batch Number Number How Received Paid By SECURITY PLUS Received By ddk Page 1 of 1 000448 252803 In Person Payment Total: 1:19:08PM Amount Due 25.00 20.00 3.15 4.50 $52.65 Amount Paid $52.65 $52.65