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Home My WebLink AboutPermit Electrical 2006-10-3 LDL IO~ -U:so>- /V:S 2:15 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO""'" 2.00b - 0 t Z b S- 1. :....WCA.TIONOF'J1.isT;tr.lf~fiONJ$1~ 3. ffcoMPiErErEEsCHEiiuiJiBirijlv:~'.';f~"'i:!:\i.'Jt'1? ,'~>r.f -' ,; 3~3bO,"",,-"-'~C:::;'i::jj11i~~\ l<--. .,=~, '.,:", < ,"-,___~"~,,,,,=,_<<,:;,'''if \i.",y.t.1.~':.:.: Each Manufacl'd Home or Modular Dwelling Service or Feeder I" ~ B. ~~AAi~~~ft~~~fitY:i~~6lli:30ri~~t~:il~~T~tirl6::~:~J tJl '-7;;S~~'f~~o~~:.rJ~'. ~"il~~ ~u:lj~'lf",,,~,~.N't.~tU ~"'''.~2n 200 t-mps.or'P4.s>. q" 0'0.0;: 'uv. / $ 63.00 bJ 2al,~'1<<P:sJ~(4jl-2 ~?/(i1~ 90'6 '1",'1. $ 75.00 401 A~ps t~~.A:19Jqo,O ~Q "'II.>. r&%. $125.00 601 Al1j~f?ci~~~s~ ~'O~&1.;O..~ '''l!$;i~.00 Over I o06'~?qo[S(1/t "0.0,..; r.pA .~ ^ .vO~ ~.l2 Reconnect OnlY" 6100 0;'$. 90S' \';4":'6,,$ tAl.!? <9n....,.,y.~ -rl>i 'eo ,jilt;.;'~ ,~ '0" u' -~n,2l~~ ,iii.... ~ .~.?;92~1'A-"".-.."- .', ,., ~ A. C. hTemporary Servic~;q>> rs~"~.l:': .",,'I:1i,~>l/., ~''./ _ :,',1 'er~ ~-...._---- - -.... m__ ----o~4J~:~ .... y':;"",*' ~.--~ --'-4"- ~~~~ Installation, Alteration or ~~Ii'~~O is' 6.J 1, vA ~ "~ Cl O';,-y, (C'~ .2'00 Amps or less ." $ 50.00 Constr. Contr. Number /500 7J? ><It 04rk (?~ ~AlI Amps to 400 Amps $ 69.00 . '}-;:' (<"~ ~~'(Q9>1tmps to 600 Amps $100.00 0'" <-': V~O {~~6~ Amps or I 000 v~~ se; "~" .abo~e. '~. .. . . '-1,'- 12,.,(,l:<~.&.~ . ,..~. ~w''''." '. "<JI!""~" .,-.. .',.1 rA W '.tir I~~ CUlts, '~l': '.'1!f,'f{l.\...;-." ~- ,,',l.. 'H1', ;,~"..; '~, . (C'~i~:~-.~~~ it:~s;::';;r'~~;:1 ': ::~:: u.'" .... ..', ,,-I Each Ad' oitt)rc~~); with / D :r D OwoersName ~cZ..G4N' L64.A-,r;J.( Utl.~Se,,:iceor ~~f/1>.f $ 3.00 . f:- ':--'::-'~',t"T'<- ~-"'n~!l\"I!t-~.<;~;f'<s.,...~~-_ .._ :":"",~--' --...... Address -Z '6'''1 ~ ~ fi;J I (ti... E. ~lil,C'1-t!i~ousJ~;~vj~~/f~~'L'\U~:~!~dtdj;;;~;~~:lii~1."J1..~~nj City t::-.-u.6-GtI C~one J C{Z - S"3 SO Pump or irrigation $ 50.00 . Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 LEGAL DESCRIPTION 170 J Z.'Z1 Z. o ZC'C'o JOB DESCRIPTION 2C>O~f s.~o'C... ~ /0 ctrrc.....(/~ Permits are non-transferai and expire If work Is not started within 180 days of issuance or If work Is Suspeoded for 180 days. f;r~r,n"'t<;,)"l.':.~ ,-" 1:"- "~~~""~'''-,\,,''-,1 ~J.':~~~'i,,,,.. """"''''I 2. Bi~~fT!?~~:n'ft,.,]!~1;E~~~~'fi Electrical Conttactor A 6:s -E/I"'clr/c :z;.;c Address "J/() ,&) '" dU'd / City h/ael7e '-' Phone 6!'6 -5'/(/</ Supervisor License Number <y'7~0S Expiration Date //J -/ zJ7 Expiration Date ,.f'-/'/-c?7 Signature of Supervising Electrician c:4~ ~. OWNER INSTALL The installation is eing made on property I own which is not intended ~ sale, lease or rent. Owners Sign Inspection Request: 726-3769 Date aIL: *' /0 -:J -of, .".t't "'~l -;,' -,. '.';:;r;;.- tr~:-( .,~.. , . ". <"C':"r.~'_.:r\..-.:: :,:.: :-t,; ,.y_ A. ~~sL4:~tl~~!~,grLLlr!!~'ft~~;P~!L~~~.I;~~~~(~:)"~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $19.00 $50.00 Minimum Electric Permit Inspection Fee Is 545.00 + Surcharges :~~,'. -. .:.: .' " ';~'~'r": ..:.:... -, 4. ~''SUBTOtAL OF ABOVEi7~,,: .'" ::;'c~i':; t<' ;~;., t.; ., . _ .,' '" '."}', '~.', .' " .' ,,,,p t' \' .. ~~._L_.L _ ..-l. .L.~_Iit1L....... ~ .~__ ..,..~,:t~.-f' 8% Slale Surchurgt: 10% Administrative Fee l>- % Tt::al- Pet: TOTAL ?J 7 'II( '73<> lI~ i JJl/ ~ Shllrt:U Drivt:(T:}JBuilding Forms/Electrical Permit Application 1-06.doc -iiC~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line . ecITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01265 ISSUED: 10/04/2006 APPLIED: 10/03/2006 EXPIRES: 04/04/2007 VALUE: Springfield TYPE OF WORK: Electrical Work Only SITE ADDRESS: 3360 GAME FARM RD ASSESSOR'S PARCEL NO.: 1703221202000 TYPE OF USE: Repair PROJECT DESCRIPTION: Replace 200amp service and add 10 circuits Residential Phone Numher: 541-342-5350 Owner: KOREAN CENTRAL COVENANT CHURCH Address: 28325 W 11TH EUGENE OR 97402 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor ROBS ELECTRIC INC License 156678 Expiration Date 08/14/2007 Phone 541-686-5444 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Sethack: Side I Set hack: Side 2 Setback: Rearyard Setback: Solar Sethacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I BUILDING INFORMATION I ,'\1 I t::.j~ I i\J,~;ul~ot} law requires you 10 follow ruiN aIM/)AA1II'A:lhe 0 . . 'JtHfIlcalion 'CeM'ilr.h~p,r~tructurr.egon Utility n OAR 952'OO11.:r-!?f1J!i'?M:ru1es are set fort~ )OMN \Vllfer,~gh OAR 952.001 liIv. .YOU maYJllPnI~JIT"ii'r:I9S of the rules b . calling the c('E'Jr~~rJ'ii'th':: the telephone \ lumber for thlSprnlOedIRlt....IiiJli40tlflcatlOl/t'a r:AntAr 10 1_0"" ~~~ 2€: :t . I DEVELOPMENT iNFORMATION I 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: NOTICE' % of Lot Coverage: THIS PER~/T' n, . ~~ H~P.mp.f'ctj~mfMf;l'I1ffftE Wo ANY ~~'~~ED DR IS~BA~~~ERMIT IS J9,\alk Type: Y PERIOD, NED FOR Downspouts/Drains: I Valuation DescriDtion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Description Tvpe of Construction Value Date Calculated Paee I of 2 -~ . .ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-0I265 ISSUED: 10/04/2006 APPLIED: 10/03/2006 EXPIRES: 04/04/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fees P~id I Fee Description + 100/0 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 Receipt Number $9.30 $4.65 $7.44 $30.00 $63.00 10/4/06 10/4/06 10/4/06 10/4/06 10/4/06 2200600000000001386 2200600000000001386 2200600000000001386 2200600000000001386 2200600000000001386 Total Amount Paid $114.39 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. l..ReolJired Jnso~ 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 1 further certify that any and all work performed shall be done in accordance with the Ordin:lDces 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 nnly contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure tbat all required inspections are requested at the proper time, that each address is readable from lhe streel, that the permit card is located at the front of the property, and tbe approved sel of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 2 of 2 225 Fifth Street Springfield,-Oregon 97477 541-726-3759 Phone . aPAJNQPI_ ~ c.' f Springfield Official Receipt. D opment Services Department Public Works Department Job/Journal Number COM2006-0 1265 COM2006-0 1265 COM2006-0 1265 COM2006-0 1265 COM2006-0 1265 Payments: Type of Payment CreditCard cReceinl1 RECEIPT #: Description Perm Serv/Fdr 200 amps or less Add, Alter. Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DA VID LAWLER r 2200600000000001386 Date: 10/04/2006 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 036978 In Person Payment Total: Page I of I 8:15:44AM Amount Due 63.00 30.00 4.65 7.44 9.30 $114.39 Amount Paid $114.39 $114.39 10/4/2006