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Home My WebLink AboutPermit Electrical 2007-11-13 ('.\1 ZON ! U INITIALS N {VI DATE 11-- 13 ~ 0:1 SOURCEffiVSp . 225 FIFTH STREET" SPRINGFIELD, OR 97477 " PH:(541~n6-37S3 0 FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ,LC? {"::."! ?_t:::> c.J 7 -016 7 Z- Date 11- I <(~:- 7 'Z(?';:,',;/.' \:-\ .;!.:: 'r-~, -;--(;y -~,'....:_:-:-.{;. '~}:)":;';'_' .~:,;.~,~:_,_,::-:,.t,,~,F.-,;,:, ::'~':~~'ij'to;:. ~"~:"'i,"+ ,'I <<:';'" ".' ,~,,;::~ 3. ;\f.COMPLJ;;, JJ;;, EEESCHEDVLEBELOU 1:.h":-,,,,'-\i!::-;i~'~..;:.,.'.';i';, -<,,,i..:...:c;:,:.;;:A':"",'.":;:>;:':.':':' :;~~>~~~';;'~8{:i;,i'f.'i-;....,ti';.";~;:~"i<ii~'~~ij. ;.;,:;,;;,,',,'w..-';~,;;:k, Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25.00 The installation is being made on property 1 own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. lVlinimum Electric Permit Inspection Fee is $45.00 + Surcharges NOTICE"" ..... "..' ...'. ... ,....' , ,.., ' , ,... -, Owners SianatureT. HIS P . 4.:.S.TJ1!IQT1fOF1138:KB..., " to ERMIT SHALL EXPIRE I ..,,,...,,,,,,._.,.,.,,,,,~ ....,...-',' AUTHORIZED UNO F THE WQJilIttate Surcharge COrVIMENCED 0 [:t-fHtS PERMIT IS NlIDfo Administrative Fee ANY 180 DA R IS ABANDONED FOR 5% Technology Fee Y PERIOD. Inspection Request: 726-3769 1. ;'~iO'C.4TiaN'OIrINs1:4LLATiON..' ,,\ ".:i.'~; ,,::,,;;,,_ ':~,~ ~<i?-:,:::_i ";;':"':*,,:.:f,';N;,,~;JJ..~:Y; :.;':~;~~~ .;;;ai~...b;."::~:. '",~i..: ',' ::~;,ji:l,*; ;, <L:l~i).:, .:;;;: c,~D ibilii\.f S'1 c;.pW; LEGAL DESCRIPTION: /7DZ33t( I ~ c:"j14 7g 07000 JOB DESCRIPTION: ~~ ()~ 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 I\. 'I." -, r-(- -.-u. I n 1'11',,\'1'(, 1-',,- ....nv Address '1. 7 S~ ~ .v'f(Il4."'r. fLt. City 5 M. Phone 54 r <;"2';- S~'1I Supervisor License Number LIlt J.. ') Expiration Date . / O~C,o i~~7 Constr. Contr. Number l4(.74<:;' Expiration Date 1- I~-",.f Signature of Supervi~ing Electrician k/ X:;~ ~ .~ c-' - ~/Y {,'/ --.",~ Owners Name ~ ~ l2.. L-l-C Address ":it( 7L( S?I!.,Al6- 31.v'A City t'-t..L~E Phone A. 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. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only 70 $ 75.00 $125,00 $163.00 $375.00 $ 50,00 c. Notification Center. Those rules are set forth Installa tion, Al~!lhGMh~ through OAR 952-001- 200 Amps or leB090. You may obtain cOPlp~.Mhe rules by ~U~g the cenlgh (Note' e . etepm",.;, 201 Amps to 400rftffl1lJer for the Oregon uti qlotifiooOOn 401 Amps to 600 Amps Center. ia.1..-800~)" O"er600 p:illp,sor 1000 Volts see "B" above. D. '!B;~AthCifdfr' New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 t.{ $AO '/D 10 E. 110 1fgu / I(JI~ s- ro I J r;)O TOTAL Shared Drive(T:)/Building FOlms/Electrical Permit Application 8-06.doc Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01672 ISSUED: 11/1312007 APPLIED: 11/13/2007 EXPIRES: 05/13/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5640 Main St ASSESSOR'S PARCEL NO.: 1702334103000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Replace panel Owner: PSMMR LLC Address: 3474 SPRING BLVD EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MITCHS ELECTRIC INC License 146745 Expiration Date 0111812009 Phone 541-521-5690 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 Frontyard 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: NOTICE: I PUBLIC IMPROVEMENTS I Street Improvemen~/S PERMIT SHALL EXPIRE IF THE WORK Storm Sewer Avail~THOR/ZED UNDER THIS PERMIT IS NOT Special InstructionCOMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: Downspouts/Drains: Type of Construction ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth ... '?^9 ?3~ 2~1 'SEI S U;.,....~I, e,;;; Je,.uu I_ I Valuation Description I 0090. You may obtain copies of the rules by - calling the center. (Note: the telephone S F t number for the Oregon Utility Notification quBa.rdeA 00 agte Center:iIb~-800-33212S4..flillculated or I moun ~ Notes: Description $ Per Sq Ft or multiplier Pal!e 1 of 2 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01672 ISSUED: 11/13/2007 APPLIED: 11/13/2007 EXPIRES: 05/13/2008 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 I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $11.00 $5.50 $8.80 $40.00 $70.00 11/13/07 11/13/07 11/13/07 11/13/07 11/13/07 Receipt Number 1200700000000001388 1200700000000001388 1200700000000001388 1200700000000001388 1200700000000001388 Total Amount Paid $135.30 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. Reauired Insoections I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 ofthe property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pae:e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01672 COM2007-01672 COM2007-01672 COM2007-01672 COM2007-01672 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 1200700000000001388 Date: 11/13/2007 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add Paid By MITCHS ELECTRIC INC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 091165 In Person Payment Total: Page 1 of 1 9:33:52AM Amount Due 5.50 8.80 11.00 70.00 40.00 $135.30 Amount Paid $135.30 $135.30 11113/2007