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Home My WebLink AboutPermit Electrical 2006-11-2 Date LD1- SPRINQPI"L~/XJa V ~'FtlJ~j I(-Z-O~ . CITY OF S:'iNGFIELD, OREGON .; <: . .. ~ 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 'ELECTRICAL PERMIT APPLICATION City Job Number C.Ovlll "Z-C> 0 b - 0 /4 0 I 1. I LoCATIONOFiNSTALLATION, sZ.,O MM~ ~ LEGAL DESCRIPTION I 7D:3 "Z '"Z.l L.. JOB DESCRIPTION D 4Y.OO i,,", "3 l..,,;i{ ~ e-U:::L-~lL Permits are non-transferable and expire irwork is not started within 180 days of issuance or if work is Suspended for 180 days. 2. fcdN;l1i4qroRjJV$~,4iJi'1.:r7PNlrfNI;VI 3. I COMPLETEFEESCHEDuLEBELOW A. I New Resldentlal- Sl~gle or Mnlti-Family Per dwelling nnlt. 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'Servlceso~.Feeder8~ 'nstollatlon; Alterations or Rel~cation: I $ 63.00 $ 75.00 $]25.00 $163.00 $375.00 $ 50.00 Electrical Contractor BEACON ELF'C'l'R.:rr~ 200 Amps or less 201 Amps to 400 Amps I \\'J iVII~A"\''''' J Address 2 'ill 'i ROOSEVEI;T,ilBI,VQ,r,"\)OIl < t'.. ot'!9I(.J\mps;to600 Amps . ., d plea uy lie ,. , ~. follow rules a 0 TIJ se rUle~OJrAmpsto;lOOO Amps City EUGENE .. ~f.~!!!,~l;5 4 f.P4'61r,- 0 i'9rbUgn <9,veF.lOoih\',Q~sNolts ... 0 ^R 952-001-UU · v u' . es ,Reconnect 0nl~y \ In ,.. . cop' ~. ...- 0090. You may obtaIn te: Iher":,Ionhnne Supervisor License Numher ~,,1I3 4'8 5Scenler. (No Ul'IC'V[tTemporBr.Y,Services or Feeders ., ;)n IlL] lJllmberfOr tne.v''''" _332-?344). Expiration Date 1 0/0 1 ~ 0 7 Center IS 1-800 . Installation, Alteration or Relocation 200 Amps or less Constr. Contr. Number 38497 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. Signature of Supervisi Electwifh C E: D. P;?~,~:tl\~~~~tSY,>;, '. '. r TUIc:. PFRMIT SHALL EXPIR~f!W ~Iteration or Extension Per Panel / .t. ~ -- i{;[n THIS \O~'\O.f;J.ir"\,UiiJ NO! $43.00 AU1HUtiILl:U Ul... " .~.~ddltiRnaICircuitorwith '3 L,tA.JJ-Lto~~i~~\S ~BAN[Ml~cUrFeederpennit .... $ 3.00 Add s 7/ ~ 50V\.-I-LN:J", ~Jt "BLV~ E.IMlscelIan"!'us (Servicelfeedeqlot,jnc!udC\l)...Each l'1stalIatlon I City $G\#/~ r.JA- Phone r OWNER INSTALLATION Expiration Datc 01/10/08 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 $ 50.00 $ 69.00 $100.00 l if] ~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidcntial $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Pennit Inspection Fee is $45.00 + Surcharges 4.lsr;;~u~AV6F!l'BB-vE-' 52 8% State Surcharge I..{I " 10% Administrativc Fee ~ b-1,?b S"ZD "5% na~ f'4' ;; /" '"7&,0 TOTAL ~ O~ c.- Shared Dnve(T.)lBUlldmg Fom~1~Ie;:~Ical Permit Application 1-06 doc -=ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01407 ISSUED: 11102/2006 APPLIED: 11102/2006 EXPIRES: 05102/2007 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3290 GAME FARM RD ASSESSOR'S PARCEL NO.: 1703221204400 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Add 4 circuits TYPE OF USE: New Resideutial Owner: Address: =F.:"TION'Urf"gUII te,," Iv',~.. "- J--'. LA WLESS LINDALIfW~YNE d' ted by the Oregon Utility 715 SOUTHCENTERfBIliMDrules a op set fof SEATTLE WA 98~~lbtification Center. Those rUhleosAaRre952_00', _ ___ ...,.,.. I'\n-t"thrnlln III v"',, t ..,...- - - - ~ L.L_:_ ........nice: nf the rules 0 0090. You 'I"CONTRAC:rOR INFORMA;rION I calling hlv -_P.- . on Utilit Notific.ation Contractor.nber~~~~~~:?r~gOO_332_~344). LIcense JOHNSEN ELEC'JlRI€'INC 1 8 38497 Contractor Type Electrical BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: R-3 Height of Structure NnTICE' Type of Heat: VB . Water Type: THIS PERMIT ~~agJ:F;;~!RE IF THE WORK AUTHORIZED ~mS\P,Mh;; PERMIT IS t,OJ COMMENCED ~rfi~~~~Hi.'JI9l&:D FOR n/a ANY 1 ~tb\HJ~LeHfENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Expiration Date 01/10/2008 Phone 541-461-0291 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslOrains: Notes: I Valuation Descrintion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Paee I of2 Value Date Calculated . &-11 t: (JI< ~n~H\iuJ1lJ!.LD Status Issued Building/Combination Permit PERMIT NO: COM2006-01407 ISSUED: 11102/2006 APPLIED: 11102/2006 EXPIRES: 05/02/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Numher $5.20 11/2106 1200600000000001599 $2.60 11/2106 1200600000000001599 $4.16 11/2106 1200600000000001599 $43.00 11/2106 1200600000000001599 $9.00 11/2106 1200600000000001599 Total Amount Paid $63.96 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, IRp.ol~ Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I 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 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 Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726~3759 Phone "'~AlNQ""'" . ....<.-.- : ~ . ! ~..'..0.. c.' f Springfield Official Receipt D opment Services Department Public Works Department Job/Journal Number COM2006-0 1407 COM2006-0 1407 COM2006-0 1407 COM2006-01407 COM2006-0 1407 Payments: Type of Payment CreditCard cReceint 1 RECEIPT #: 1200600000000001599 Date: 11/02/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By GARY JOHNSEN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 044328 In Person Payment Total: Page I of I 3:06:56PM Amount Due 43.00 9.00 2.60 4.16 5.20 $63.96 Amount Paid $63.96 $63.96 11/2/2006