HomeMy WebLinkAboutPermit Electrical 2003-8-28 (3)
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CITY OF SJ..~.1NGFIELD, OREGON \"_; ,
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
dill. ,/.1 G- t'7I-., ~,. ~orFeederPermit
Owners Name f'IA/'I1/1!"IIn (21'" rr'Yy,IL'7 I fCA.<.",,"'
Address 770 N P.6-rL~ )V I E.I M~de~~ne~lir(sliatwr~'~~~~~e~~~~~~h~K
City ~&t-N(/ Phone Pump or irrigation 1HIS PERM [; ~tl~p=lsrW..9<flERMI1 IS N01
Sign/Outline Lighting\U1HOR\ZEf;._ ~;., I" $ !in oo'(lNEO FOR
MMENC..' 'II" /Ion"'"
Limited Energy/Resi[~,al 80 OA~ P~J\\O[,f5.00
Limited Energy/Com.Mllc~a1 $ 45.00
J. I LOCATION OF INSTALLATION
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o 7Lf G a
LEGAL DESCRIPTION
{703 3b L{ Z
JOB DESCRIPTION
~f2- ~
Permits are .4n-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 Contractor ~9- ~
,
It') C( 2..- 7~ ~
Address
City
~~~
Phone
72-"1-/500
Supervis.or License Number
9' Cf[;~ 5
Expiration Date
16-/ -D'f
65/:3 ?
Constr. Contr. Number
(011/0],
I
Signar;;;riS;;;'ectri~
Expiration Date
i
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
Authorized Signature
3. I COMPLETE FEE SCHEDULE BELOW
J
,
A, I 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
$106.00
$ 19.00
$50.00
B. I Sen;i~~s or F~ed~rs - Installation, Alterations :or Relocation:
I
2..7:IU!!.
'1<5
200 Amps or less tf $ 63.00
201 Amps to 400 Amps I $ 75.00
401 Amps to 600 Amps # $125.00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsNolts $375.00
Reconnect Only , ",,,,s '1($--~O-:Of
la\N {"'':: "on \.I\II~~
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C. T,em,p' orar.vS~hqces.m:i"eeders"'..> ' 'liP.' ~"'~t
t~\~t,y,,,, ~rl''''. J"" a~ ".., .,.
(>....'\"1 \,\Ias aO "'O'lose '. ;.;- o(>..? \:l "" eS \.
InstaUatioJ, Alteratiollfor RelocatiOn \ \"a {\,\\ e
'~",',.a\\o" - '\ OOlV" ias 0 hOn
20Plgmps or,leg;.OO - 'Otain co? ."'''' \elr$~o..oo.on
""d~'B ~'-I ,...." 0 ""Oll:" ... ...\ L,hr"Ci.\
201,?illips t~tPJl'Amps ter. ~I~ ....'.,"1 ,,,($69.00
401 ~np~ tOfOo,~p~n oregon ':'~'~JJ'3L\$loo.oo
ca,11I ''''.. \C' \"e 9.0' h';'-
Over 60Q <\WPSlor IO_QO>~.olihee "B" above.
D, I Bran~~ Ci~c~~':;"
$ 43.00
$ 3.00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
f'" ,..".,'" .."..,.,,,.
4,'SUB, fofAf][i()i!;il11J,/:)VE;
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3T7
271'9
'32,,0
'S 7J Z S"r
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive{T:)IBuilding FormslElectrical Permit Application l-03.doc
.
. CITY OF SPRLl'lv1'lJ<..LD
Building/Combination Permit
PERMIT NO: COM2003-00838
ISSUED: 08/28/2003
APPLIED: 08/28/2003
EXPIRES: 02/28/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2015 1/2 S A ST
ASSESSOR'S PARCEL NO.: 1703364207400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
Commercial
PROJECT DESCRIPTION: Change service
Owner: MAINWARING FAMILY TRUST
Address: 970 N PARK AVE EUGENE OR 97404
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~\~0 ~ \0
;'>~ _ (\.0 _p,," ...(\
.o,,~' _ 0'- ~~" :"~'l:- _ \
I. CON'[RAC'I0R'INFORMATIeN.,
~~.y ~0u' 0""" ~~ ~ ~ '1)'- O~u' . 0<:-
Contractor ~.<\o hOO~, ~'<' ."(\~OoS. h"" 0 Idc'ense-~ Expiration Date
~,\ " 0"" ,,' ,,\v 0' ",.
RALPH W I.!R.O ",,0"" re<:-"1 ,,(\,\u. ~ c,O':h'.'S' ..~3.1'.l7, 02/15/2004
r ~. ~ - -" ..-, ,..' ....-. ..00".
\O'V-O 'l'l;BUI~DINGmr"nMATlON I
'i..~\c, ..,,';lJ ~v' h\" 0~- ,,;:>-
_\0 "''' ~ r,V ()~ R)"
,~ or' -{ 0 #~9f'Sl~[ie.sl ",'?J
,<:- ",,~(). \\,<:-C'Heighf pf,Structure
'-.Jv ~, -\' ..-:'~
C, ~'OTYP.e;ofHeat:
<:-oS Waler Type:
Range Type:
Energy Path:
Phone
541-729-1500
Contractor Type
Electrical
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2ud Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
'f>~
I DEVELOPMENT INFORMATION I '\\\~ ~\J~<;)\
~~ ~ ~\ {;) ~ REQUIRED PARKING
Overlay Dist: \.. ~~:'O '(~~~~\) ,~ Total:
# StreetATr~es ~~\~~~" \~ ~\)~ Handicapped:
Paved DrT;;e, Rqu: "...\'i) Co .....'O~ Compact:
. ~:~" 'i;.'"'" \) \)\~ \'>> r
./~o~\I{otS~J,~b <;)\~<;)\).
~\):~~~'i;.~ ~~ '(
.
. 'I.' l....~
I PUBLIC IM~QVEMENTS I
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Palle 1 on
.'
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00838
ISSUED: 08/28/2003
APPLIED: 08/28/2003
EXPIRES: 02/28/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I ~r~s tiilU
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 201 to 400 amps
Amount Paid
Date Paid
$32.70
$22,89
$252,00
$75.00
8/28/03
8/28/03
8/28/03
8/28/03
Receipt Number
2200200000000001444
2200200000000001444
2200200000000001444
2200200000000001444
Total Amount Paid
$382.59
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.
I RI'i"I,Jired Tnsoections I
III" II
1 Electric Service: Approval required prior to utility company energizing service,
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 fnrther certify that any and all work performed sball 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
tbat NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project,
1 further agree to ensure that all reqnired inspections are requested at the proper time, that eacb 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
Page 2 of2
225 Fifth' Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00838
COM2003-00838
COM2003-00838
COM2003-00838
Payments:
Type of Payment
Check
-~",.'~'~"'."".,..
~.
. ,
. .
. , '_",_ l .
Receipt #: 2200200000000001444
Description
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 20 I to 400 amps
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
HERITAGE ELECTRIC
Received By
djb
l.:heck Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department.
Public Works Department'
Date: 08/28/2003 IO:21:13AM
Amount Paid
Item Total:
252.00
75.00
22.89
32.70
$382,59
How Received
In Person
Payment Total:
Amount Paid
$382.59
$382,59
.
.