HomeMy WebLinkAboutPermit Electrical 2008-1-7
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225 FTFnJ STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
CIty Job Number ('Alm2D07 - ()/S I /P Date
1 LOCATION OF INSTALLATION:
~~ ~ ->. ~
'foPo Nt-'AU}) $) ~OI"L-/)
- r /
dEGAL DESCRIPTION
~ J',y ,,*, 3
JOB DESCRIPTION
1 ,
3 r'COMPLJ<:TEFiiscimDULEBELOW'-
ZON
INITIALS :j-' "-
DATE i - "'- 0'6
SOURC~ f::3(),/
(-If 97'07
t ~'''~:: ~-~~~,"" ~
A L ~~_~~S1dent~! - S.'.~gle_~r,-~u't'--Fa~lly per dwelhllg umt.
.-,-
:.L A/SPhL
GJr'rJi'c.F
!../,tJJ}ljlr45lw't:,
Permits are non-transferable and expire If work IS
not started wltbm180 days of ISsuance or ,fwork IS
Suspended for 180 days
2
CONTRACTOR INSTALLATION ONLY
Electrical COlltractor
, -
1Cr nbo CJ't("W
fSeJ,,( l!Jf
Address /- ()
City vevL1J!-
Phone 93 j";;J50~
SupervIsor LIcense Number tl77D S
Iv I 10
Constr Contr Number /c;~ :3t::l!?
,-
7- JlJ- () 9'
,
ExprratlOn Date
ExpiratIOn Date
----
/ LEE,<! -! tJ I} ,. r,<:;
Address? 76 Ct?b'P?:e y fJv). Ifv
CIty r;vC'&l/E Cd77<- Phone
NOTICE: J . 10/
OW"N~ ~~EXPIRE IF THE WORK
The At!ltji\'\<@lii~~<:WlM!liIeT""-lw~RMlli>tS ~iIh
IS nqt;B)t;,wlE1.JEUJOOerse.Al!lA'flJDONED FOR
O~N~I~&\J)f.Y PERIOD.
InspectIOn Request 726-3769
Service Included
1000 sq ft or less
Each addll10nal 500 sq ft or
portIOn thereof
Each Mannfact'd Home or
Modular Dwellmg ServIce or
Feeder
$11700
$2100
$55 00
B
ServIces or Feeders - Insf"llatlOlI, AlteratIOns or RelocatJon
} "'_~ -"-: 1 ~~ ,~
I
$70007000
$ 83 00
$13800
$]8000
$41300
$ 55 00
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
C TemporarY Services or Feeders
i ~~_ _ 4"- ~
InstallatIOn, AlteratIon or RelocatIOn
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above
j' ~-
D Brancb CIrCUIts
,.1 h ~~_--'- v
New AlteratIOn or ExtenSIOn Per Panel
One CrrcUlt
Each Add1l10nal CIrCUIt or wIth
ServIce or Feeder Perllllt
$ 55 00
$ 76 00
$110 00
$ 48 00
$ 400
E MIScellaneous (Servlce/feeder not mcluded) -Eacb InstallatJon
Pump or IlTlg1.lffENTlON' Oregon la'.'! rllqt~~Sl~oll tt\
SlgnlOutIlOe fdiffiWfules adoptor! hy fh". cAegOO Utility
LImIted Ene1ll~i\Jenter. Those rulEli9:mllloet forth
LUllIted Ene~eQgl-0010 througil OMlAlP2-uu 1-
no!:ln You m!l)!,obl.<!.., yvnoo ofiI\eVul~'
MIII~mum E;Ie."tfll!l'JlIllh~lmll~llwthf. etlibfElOtl\% t~~f/!.lmles
4 SUBTOTAlft(Ml~QMl:IeOregoll Utility Notlflcemm DO
'1 . oo? S h' Cellterls 1-S00-332.234~l. a ,,"'"
I... ,.., ,0 tate Surc arge 0, '1"'-/
10% Admmlstratlve Fee 7. nO
5% Technology Fee ~k7,>
TOTAL
Shared Dnve(T )/BUlldmg FormslElectncaJ Perrmt Application 7-07 doc
9,~. ql)
-~~
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO
ISSUED.
APPLIED.
EXPIRES:
VALUE.
cOM2007-01516
10/1712007
10/08/2007
06/2012008
225 Fifth Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
54J-726-3769 InspectIOn Lme
SITE ADDRESS 4080 NORTH ST SPRINGFIETYPE OF WORK SIte WOI k Only
ASSESSOR'S PARCEL NO WHITE PART NORTH S
TYPE OF USE New
ReSldenllal
PROJECT DESCRIPTION SIte work for partJtlOn approval
Ownel TERRY WHITE
Address 696 COUNTRY CLUB RD
EUGENE OR 97401
Contractor Type
Electrical
Plumblllg
I CONTRACTOR INFORMATION I
Contractor License
TURNBO CARTER ELECTRIC INC 156308
ROYAL FLUSH ENVIRONMENTAL SERVIC153694
BUILDING INFORMATION'
ExpiratIOn Date
07/14/2009
1212312007
Phone
541-729-8409
541-895-2072
# ofUmts
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
Spnllkled BuJldlllg
Lot SIze
Sq Ft 1st FloOl
Sq Ft 2nd F1001
Sq Ft Basement
Sq Ft GaragelCarpol t
Sq Ft Othel
Occupant Load
nla
I DEVELOPMENT INFORMATION I
Frontya. d Setback
SIde 1 Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
Overlay DlSt
# Street TI ees Rqd
Paved Dnve Rqd
% of Lot Coverage
REQUIRED PARKING
Total
HandIcapped
Compact
NOTICE: I PUBLIC IMPROVEMENTS IATTENTlON Oregon law requires you to
Street THI~ fvF.~MJ~ SHALL EXPIRE IF THE WORK 101l0vsrbl!MI~cIAm~d by the Oregon Utility
Al'WHoRIZED UNDER THIS PERMIT IS Notification 'Center Those rules are set forth
StormL~~mil~~r~11'J NOT in OAIW~1tOOl&.ffil!Ough OAR 952-001-
SpeCial W~fUC1IP'IJ,\1 R IS ABANDONED FOR 0090 You may obtam copies of the rules by
/-\1 bU UAr PERIOD. calling the center (Note the telephone
Notes number for the Oregon Utility Notification
Center IS 1-800-332-2344)
Paee 1 of 3
-~iij
- ~ .
Status
Issued
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769InspectlOlI Lllle
DescrIPtIOn
Tvpe of ConstructIOn
Fee DescriptIOn
+ 100/0 AdmlDlstrahve Fee
+ 10% AdmllllStratJve Fee
+ 5% Technology Fee
+ 5% Technology Fee
+ 5% Tecbnology Fee
+ 8% State Surcbarge
+ 8% State Surcharge
Curbcut PermIt
Samtary Sewer - 1st 50 Feet
Samtary Sewer Each Addtl100'
Storm Sewer - 1st 50 Feet
StOl m Sewer Each Addtl100'
Water Lllle - 1st 50 Feet
Water Lllle - Each Addtl100'
In LIeu of Assessment
+ 10% AdmllllStratJve Fee
+ 12% State Surcharge
+ 5% Technology Fee
Perm ServlFdr 200 amps or less
Total Amount PaId
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO' COM2007-01516
ISSUED: 10/17/2007
APPLIED. 10/08/2007
EXPIRES: 06/20/2008
VALUE:
I v alu~tion ne.scn'ltlO~1
$ Per Sq Ft
or multJpher
Square Footage
or BId Amount
Value
Date Calculated
Total Value of ProJect
Fpp<, P'YdJ
Amount PaId
Date PaId
ReceIpt Number
$660
$13 20
$330
$425
$660
$528
$1056
$85 00
$50 00
$1600
$50 00
$1600
$50 00
$1600
$3,42000
$700
$8,40
$350
$70 00
10/17/07
10/17107
10/17/07
10/17/07
10/17/07
10/17/07
10/17/07
10/17/07
10/17/07
10/17/07
10/17/07
10/17107
10/17/07
10/17107
12/6107
1/7108
117108
117108
1/7/08
1200700000000001314
2200700000000001600
1200700000000001314
1200700000000001313
2200700000000001600
1200700000000001314
2200700000000001600
1200700000000001313
2200700000000001600
2200700000000001600
2200700000000001600
2200700000000001600
1200700000000001314
1200700000000001314
3200700000000000791
2200800000000000012
2200800000000000012
2200800000000000012
2200800000000000012
$3,841 69
I Plan Reviews I
To Request an inspectIOn call the 24 hour recordmg at 726-3769. All mspectlOns requested before 7 00
a.m. wTII be made the same working day, inspectIOns requested after 7'00 a.m. WIll be made the followmg
work day
I J;>P?\"rr'VnsneclIolIs I
Sanlta. y Sewel Lflle Prior to filling trench alld lIIc1udlllg reqUIred testlllg
Storm Sewer Lllle Prior to filhng trench
Paee 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2007-01516
ISSUED: 10/17/2007
APPLIED. 10/08/2007
EXPIRES: 06/20/2008
VALUE'
225 FIfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Curbcut - Standard Aftel forms are erected but prior to placement of concrete
Watel Lme Prior to filhng trench and IlIcludmg reqUIred testmg
ElectriC ServIce Approval reqUIred prior to utlhty company energlZmg servIce
By SIgnature, I state and agree, that 1 have carefully examllled the completed apphcatlOn and do hereby eel tlfy that all
mformahon hereon IS true and correct, and I further cerhfy that any and all work performed shall be done III dccordance WIth
the Ordmances of the CIty of Sprmgtield and the Laws 01 the State of Oregon pertammg to the work desCribed he. em, and
that NO OCCUPANCY WIll be made of any structure WIthout permISsIOn of the Commulllty ServIces DlVISIOU, BUlldmg Safety
I fUI tber certJfy that only contractors and employees who are m comphance wltb ORS 701 005 WIll be used on thIS proJect
I further agree to ensure tbat all reqUIred mspectlOlls are I equested at the pI oper tJme, that each address IS readable from tbe
street, tbat tbe pel mlt card IS located at the Iront of the property, and the approved set of plans WIll remalll on the SIte at all
tImes dunng construction
Owner or Contractors SIgnature
Date
Paee 3 of 3
225 Flftlj Street
Sp~llIgfield, Oregon 97477
541-726-3759 Phone
~,
City of Sprmgfield Official Receipt
Development Services Department
PublIc Works Department
Job/Journal Number
COM2007-0 1516
COM2007-0 1516
COM2007-01516
COM2007-0 15 I 6
Payments
Type of Payment
CredltCard
cRecemtl
RECEIPT #.
2200800000000000012
Date' 01107/2008
DescriptIOn
Perm Serv/Fdr 200 amps or less
+ 12% State Surcharge
+ 10% Admllllstratlve Fee
+ 5% Technology Fee
PaId By
SCOTT CARTER
Item Total
Check Number Authorization
Received By Batch Number Number How RecClved
ddk
348745 In Person
Payment Total
Page I of I
11 29 08AM
Amount Due
7000
840
700
3 50
$88 90
Amount Paid
$88 90
$88 90
11712008