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HomeMy WebLinkAboutPermit Electrical 2005-8-1 '" .1 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54~X7r~68 ELECTRICALPEKMIT APPLICATION 0 /Y'i~tf " '::ityJobNumberCo-I1Z00.f"-O/C3Z Date ()-I-c.oa--5 Date~,!<Ii . "."'ir.~~z:;r,~~-::;':;s~."\~i;~'.:'~~r"'.t.~:"'H': "e,.;,.,:, ",,")ir..~,.:t'~~j,m:.:., .,,';H"'~"'><' ' ffl" ';l)C:\"i"'~" et.~.l4:~.~,' ~""'~;"dfiOJIZeo;,:s"g!lHtu~..:. .,.....""'.'...;..', -~-[8~, ,r;,470~.~~.q'~-i;.'~ 1"'LOCA.'I'10MOE1NSTA.IJE:A.TION~',' ",,"'i;.. 3.' COllffiEETE"FEE SCHEDUEE'8EEOJ1/J:~~~;"".,\'i;~~i~1l'*" 4~ f5"~~;',,"':rr:~~"\:J=:sr~:::":';~ f (. :tr~':7~.;::t\:-"-'-"~;~=;~="~'d""~""< LEGAL DESCRIPTION A. ~iN~~~R'~1r~i~,C;~~gj*Nf~i~t~ffi~liiifl~ITfl2~~ ~fi;:::.~1(~~/iI,'o,;.<;;;;~~>.l;:,';<:;~...A;rx":':4<~~""~tt~,""'-_ll":AJ"tJ,',~~}';~~","",".~~.m.1::<tlt no 3"5 LPI t.{ 0 "3 (eYO Service Included 200 Amps or less $ 63,00 201 Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps $163,00 Over 1000 AmpsNolts $375,00 Reconnect Only Q\1." $ 50,00 ~~es'f '~~ .".:s.r.!~~~ \o\\o'll1a\l.~R~itJ;\"IO~~s 0\ \":e?"one $ 50,00 ~o\i\\C~49j~s~@O'~Ja', \"e~o\i,\...a\iOl\ $ 69,00 ' \~~. ~,~I~6le.~~,~1!=~:~,'~0_~~,~ ,,~. " {JJ "tsr !\\~;~~e","",,"~ New Alteration or Extension Per Pa~el One Circuit Each Additional Circuit or with O "() \ Service or Feeder Permit Owners Name U ~ \ Q ':> U \ f\ ~~~'~.",~~1P'..::,'?f> '#~~:i?!~~~~~~':r~'~~*~ Address \ <- Cl ~ \ ~ .... d Q r.<" '"' 1\ ~ ~ E. ill.~~J!!i~2R-il(~~lY~'i.~'it!lott~<l\}~)p~~~WJ$ City~O<;t>.,..~ ~1~ Phon.(s41)6'86-770tJ pumporirrigatio!tt\~~~~Ci\ $50,00 ...s",\' \\'- o.~\\\ \l ..~' Sign(O!'tline I::igllting'r\ tCl'i\ $ 50,00 no;'\'v~' ,of c.I:'T'~ - ,\\\o.l ,,"':c.v OWNER INSTALLATION \tv \ \ cn~~' q::imite<!\EnergY.lResidential $ 25,00 -"''01',-,, \i\.l\~~e" t>,'O""- , The installation is being made on property I own whicli 1G'i\\1.t: \un0!f.d,Energy/Commerclal $ 45,00 , , ded' I 1 ,,\J\I:' ,.,('X;) -9.\()IJ, IS not mten lor sa e, ease or rent. f' t\Minimum;Electric Permit Inspection Fee is $45.00 + SurcharO"es r-G\W" \\1'-' " v...,,, \'OQ "'"<""I}",~_~,,,-,^-,, 1/ 92- \\\~' 4. STffB'liQ'1ljffi,01i!A:BOYE \:) \) . , JOB DESCRIPTION ~~ ~ \~C ~ -rr.-t{; c S: ~",J SPn/ ~(.~ 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 rff~R:?€XOR!1NSTAEE4if.fON.:ONLX,.,.# .--. >;:~,"",~w~~'!">.'~~o_;:~~-"'~~'~ Electrical Contractor eke,(:) C-:TJ E\o~L..;c Address \6 ~6<z."d STr-DP\' 0f_ CityS;I \<2_ '113<:)(.Phone(s03)J"I'1-nlJ'1 :upervisor License Number \ 3 CZS ~ -.$ Expiration Date \ a - \ - 0 7 Constr, Contr, Number ~ I G 6 B "7 - cO - 07 Expiration Date Signature of Supervising Electrician 'i\~ w\4~ Owners SIgnature: Inspection Request: 726-3769 1000 sq, ft, or less Each additicinal500 sq, ft, or portion thereof Each Manufac!' d Home or Modular Dwelling Service or Feeder $106,00 $ 19,00 $50,00 . , ~"))_'r"';>,,, l'l.o\,%",;,:t-y:;.,!m'~J"'>""':l"(Y_;(1Yfci' ~~r"';~~;'..~~,-*",&1<.\'"'V\"~.;')~o;~~ B "Ql;;.pr-~'~" ;1'U:.,-n,--:wd' .~~~~:~'JM.:."t' II'" t.<t~i'~.?..I.'lt'-"'_"'at..iif;f^'~~5R"'hl"!Kffiti"'-l\l>'I>'-;~ ." .:;,..,.~n"Ic;.es~or~!l,ee et::Sr;:!.nS 2 2 1~"U ..eJ; lOnswr" e OC3 on.~,.~~ ~~'l?--:-,r;::;;~M'_.",.j;:;;n~'fp.'~";"L~~.t'):, - -"-1E..,.~..:.;~~~y;:.z...-~-""""~b>'';'',t'r''';'.1:I~'fliS f.:,:j~ $ 43,00 \ OJ' 3'- $ 3,00 7% State Surcharge 10% Administrative Fee 4~ ~~ 77~J~ TOTAL ,... Shared Drive(T:)/Building FonnslElectrical Pennit Application 1-03.doc ""IlIIII . . CITY OF SPRINGFIELD ' Building/Combination Permit PERMIT NO: COM2005-01032 ISSUED: 08/0112005 APPLIED: 08/0112005 EXPIRES: 02/0112006 VALUE: Status: Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4215 FRANKLIN BLVD ASSESSOR'S PARCEL NO.: 1703344403100 Eugene TYPE OF Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Replace traffic signal service Owner: ODOT Address: 355 CAPITOL ST NE SALEM OR 97301 Phone Number: 503-726-2552 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MORROW MEADOWS CORP License 91668 Expiration Date 07/20/2007 Phone 503-399-7609 I BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy , Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback:, Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Lot Size: Height of Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: mNi!'Clf~!l~ law requires you to Sq Ft Basement: tnow r . ~~ by the Oregon Utility Sq Ft Garage/Carport No 'f! f ~OOllr!1tlj1nose rules are set forth Sq Ft Otber: In O~~c: ~~00f~a1 0 through OAR ~~~~~ ~ Occupant Load: OI-DE~M~lflNFciRMA~IDN~~e ... U{,{"lJ,,l. !. i ' 'I' t'on , number for the Oregon Utility NOti lea I ~~Mlwl:PI~00-332,2344). If Street Trees Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: IPUBLIC IMPROVEMENTS I Street Storm Sewer Available: Special Instruction: Description Tvpe of Construction Sidewalk Type: DownspoutslDrabtsO t\ ~ . . ,WI- \ ~C)l .,:.\'\\\\.\\~\\ \'0. \\Cl~\C~\V\\\ ~'\~\\\\\\S~~~~t.\)~??-> \ _, "c. Pt.\\ .d"' \\~ ,~, r,,\\;>: . ..;.' '" ~....- \)i"- I' ~\\\\,W' ,,(,C\) n\\}\)' Valuation Descri)ltiiin\ -" I't.". _ ' v,,:,'1 \'O\l tl1', " .. $ Per Sq Ft ~Square Footage or multipUer or Bid Amount Value Date Calculated Notes: 1 of 2 ""lIIIIIl . . CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2005-01032 ISSUED: 08/0112005 APPLIED: 08/01/2005 EXPIRES: 02/01/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid' Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid $6,60 $4,62 $3,00 $63,00 8/1105 8/1105 8/1105 8/1105 Receipt Nwnber 1200500000000001125 1200500000000001125 1200500000000001125 1200500000000001125 Total Amount $77.22 I Plan Reviews I To Request an inspection caD 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. wiD be made the following work day. IRp(l~ 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 wiD be made ofany structure without permission of the Community ServlcesDivision, 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 wiD remain on the site at all times during constructiolL Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfi~ld, Oregon 97477 541-726-3759 Phone . "!'RIH~__""'._ ~ __ .,' It:i ---- . T ,..." . _..,,_..~.,. . Job/Journal Number C,oM2005-0 I 032 COM2005-0 I 032 COM2005,O 1032 COM2005-0 1032 Payments: TWe of Payment Check Change Job/Journal Number COM2005-01032 COM2005-0 I 032 COM2005-01032 COM2005-01032 ,,' ~ayments: TWe of Payment Check Change , :Jj " ;;) " 8'112005 RECEIPT #: ;lIIll ,J,i,i.ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000001125 Date: 08/01/2005 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By MORROW MEADOWS CORP MORROW MEADOWS CORP Received By djb djb Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By MORROW MEADOWS CORP MORROW MEADOWS CORP Received By djb djb 1 of I Item Total: Lbeck Number Authorization Batch N umber Number How Received 18812 In Person In Person Payment Total: Item Total: (;beck Number Authorization Batch Number Number How Received 18812 In Person In Person Payment Total: 2:50:52PM AmlXlnt Due 63.00 3.00 4.62 6,60 $77.22 Amount Paid $77.68 ($0.46) $77.22 AmlXlnt Due 63.00 3.00 4.62 ' 6.60 $77.22 Amount Paid $77,68 ($0.46) $77.22