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Home My WebLink AboutPermit Electrical 2007-9-4 ZON L.J)2.., INITIALS rJ M DATE <1 -I G.. t11 SOURCE ~ ,/ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT MPLICATION City Job Number Q/l.. ::(..If_) G l.M180~~TI&f- LEGt10srl({~S OSO(V ; y.-C ~ ? /t?/ t!> I / ..;2.U-6 ";-- Installation, Alteration or Relocation { I 200 Amps or less Constr. Contr. Number l' /J"" 2.. () -c; 201 Amps to 400 Amps Exprration Date 0'" / :J-b~!r~~: . ~:::''::~~~~~:Volts ,eo "B" above. Signature of Supervising Electrician nms . Ik~Al1mmtlfitTHE WORK' .~ . ~ /~. A. U. TIi...O~IZfp "..&.'~:.'..\!'i.'..;J.'" * .USl~'&~LS~~&Tper Panel . ~ ~ C.~~~~;t\;C~O ~~. ,~UV~\II;;lfl'\5i1 l $ 48.00 ~- .' ~ b-~c\'\ 0 P.. ~~ 'dditionalCircuitorwith IJ .. \ ,~ L 7.- Service or Feeder Permit . L--$ 4.00 Owners Name U \ V z:::.-.. Address An..~, ~ ~r~ ~ E. l\fiscellaneous (Service/feeder not included) -Each Installation Ci~~ Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 OWNER INSTALLATION Limited EnergylResidential $ 28.00 The installation is being made on prope~ I own which Limited Energy/Commercial $50.00 is not intended f~;l~~nQHn.~!JfI '~$ \!!;~JgiY~ ~~imum Electric Permit Inspection Fee is $50.00 + Surcharges fcl!'~ ~~~D ~~@~8@ ~V OJ'('JtJ~n UUiffY Owners Signa~~~ill@!ij C@T!tCJ. n~~S~ az$J IIt1$t f~J1 SUBTOTAL OF ABOVE !31.o r;o in OM (9J~~"@@~Q@~10tt!roM@h r',h12'0~~1'" 8% State Surcharge ~ .4-tJ.. iY~O. ')j@:.~u.:!iJli @bt2~~~~. :.;:;,~1 by 10% Administrative Fee 1)_ I" ~~ li~'"" ~~..iQi~0, 0 - . ~ tno Of@,.~@Ji) \JJt!i1~ 5 Yo Technology Fee l G-alv - Inspection Request: 72~lM ~SJ 1~~@~~~~4}" TOTAL V Sh'~Dri"~)~~;~~ JOB DESCRIPTION: ~")/ J .J -~ Permits are no -t ansferable and expire if work is not started witH 180 days of issuance or if work is Suspended for 180 days. ...J1 CONTRACTOR INSTALLATION ONLY ,,2. Electrical Contractor LlOeI' ee? r t; te. { Address ~4f P-b ~/!Ce.ld r~ City ~~ Phone ~ i~.~ W?.> Supervisor License Number Expiration Date Phone Date ~-Y..-d1 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 $117.00 $ 21.00 $55.00 B. Services or Feeders - Installation, Alterations or Relocation: 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 $ 70.00 $ 83.00 $138.00 $180.00 $413 .00 $ 55.00 C. Temporary Services or Feeders $ 55.00 $ 76.00 $110.00 ~pO 8~ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2007-01306 ISSUED: 09/0412007 APPLIED: 08/3012007 EXPIRES: 03/04/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2278 33RD ST ASSESSOR'S PARCEL NO.: 1702193405000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION: Electrical permit for family room addition issued under job C6-1663 Residential Owner: Address: BANTZ JEFFREY D & JO ANNE M 2278 33RD ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor LADCO ELECTRIC INC License 80250 Expiration Date 04/10/2009 Phone 541-726-9847 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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 Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pae:e 1 of 2 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: cOM2007-01306 ISSUED: 09/04/2007 APPLIED: 08/30/2007 EXPIRES: 03/04/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid' Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Inspections - Investig. Electr Penalty Fee - BWOP Electrical Amount Paid Date Paid Receipt Number $21.20 $10.60 $4.48 $48.00 $8.00 $100.00 $56.00 9/4/07 9/4/07 9/4/07 9/4/07 9/4/07 9/4/07 9/4/07 1200700000000001151 1200700000000001151 1200700000000001151 1200700000000001151 1200700000000001151 1200700000000001151 1200700000000001151 Total Amount Paid $248.28 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Reouired Insnections I 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 Pa2e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01306 COM2007-01306 COM2007-01306 COM2007-01306 COM2007-01306 COM2007-01306 COM2007-01306 Payments: Type of Payment Check cReceilltl RECEIPT #: 1200700000000001151 Date: 09/04/2007 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Inspections - Investig. Electr Penalty Fee - BWOP Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By J BANTZ Item Total: Check Number Authorization Received By Batch Number Number How Received llh 7378 In Person Payment Total: Page 1 of 1 2:29:55PM Amount Due 48.00 8.00 100.00 56.00 10.60 4.48 21.20 $248.28 Amount Paid $248.28 $248.28 9/4/2007