HomeMy WebLinkAboutPermit Electrical 2006-1-23
SPRIN
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~" ~,' ~~ " ~
ELECTRICAL PERMIT APPLICATION , ~"'~
City Job Number Cc::.u-t 2.006. - 000 8'} Date l-;o(,~<Gj-
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A. [' New Resi;{e~tial :':singr~or M~Iv-falJijt?~er dwellingu,;it:
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1. ItOCA110'NOF LNSi'ALLATION 'I
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LEGAL DESCRIPTION
e>c>OO~ c:::>~ c:::.c:::. c::. Service Included
JOB DESCRIPTION 1000 sq. ft. or less
/ I _ (\ '\?.... Each additional 500 sq, ft, or
SeY!..vl<.E:f" ~ C.lol"'--.:" ~ (-wt. p u...:> portion thereof
Permits are non-tra~sferable and expire if work is si-.? ~ach Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. Feeder
$106,00
$ 19.00
$50.00
2. 190mlfACioRIN.ST.4.r.i:4.TION Ol>lLy.1 B.I'S~rvice~, \'~f~e~~'~~;i~stall~tion, Alterations ~~:R~ii>~~ti~n:
r i . ~) ~ _~i~ ~" '~,' ':. .. - ~ Oregon UtI\\1Y /" ""7
Electrical Contractor (l Mp (fU.x. Ek.l-:.w,lC. a200'Amps)(jrtl~gsl ale set forth / $ 63,00 t::>;>
, L-. ,- , ii"l0C,p'rlleS
PD I . \ ~'\ Ce20ll'AmpS'lo 400,Amps~ 952-001- $ 75.00
f"l ./ .110. N oJ '. ~- - :\r.;H\ H"}rQ"flll v."
Address , 'OOk. "t -, ')' ";,, 952-0C401/Amps 10 600 Amp'sle rules by $125.00
". .... . _ .....t~rlin cOOle~ VI ~,
~ Q .I om.jO, You ma601 f'i'PM00W?9,~ll)ps~phone $163.00
City ~ 1140'1 Phone /4Lo-14 -;},ling the ~~~9JW(~f"Jl!&(?ltSotifieatlOn $375.00
number for Rec.onnectoOrUY.32_2344), $ 50,00
Center IS 1-ll u v
Supervisor License Number SO..1 3. S C, I Temporary S~..~ices orFeeders :
Expiration Date \ 0 ( 0 \ \ 0 I Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D. l'_!lranch Circuits
'I
Constr. Contr, Number
!loll <61/
tJ\o I lJl1I 'L-()[)'1
$ 50.00
$ 69.00
$100.00
Expiration Date
Signature of Supervising Electrician
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NotiCE: New AItera~~~~'f."'RW~lI1\IneI I
11115 PERMtlnSl:lm n1~I~J~~~,M\11S NOT $ 43,00
AU1HOR\Zro<\!l,t!!aMl.~d"i!hR I z... $ 3.00
r.OMMENdU'$~.
707 aNY 180Jl{'tKs~'aneous (Service/feeder not iflcI~ded) ..,Each Installation I
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Address ? C> t!:: 0 X'
City bJ-~e- Phone
Owners Name
brat- blOC>
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25,00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
4,1 S!JBTOTAL OF ABOVE I -JilZ
11 S-b
_Lif... ZO
/ 67_~ s6
~ State Surcharge
10% Administrative Fee
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FonnsIElcctrical Permit Application ~-03.doc
.
. CITY OF ~rKlNGFIELD -
Building/Combination Permit
PERMIT NO: COM2006-00089
ISSUED: 01123/2006
APPLIED: 01123/2006
EXPIRES: 07/23/2006
VALUE:
Status
Issued
,225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4301 Franklin Blvd
ASSESSOR'S PARCEL NO.: 0000000000000
Eugene
TYPE OF WORK: Electrical Work Only
TYPE OF USE: New Commercial
PROJECT DESCRIPTION: Electrical Service and 13 circuit to bus stops at west end of bridge intersection of
Franklin and Old Franklin
Owner:
Address:
LANE TRANSIT DISTRICT
PO BOX 7070
EUGENE OR 97401
ATTENTION: Oregon law~~~I!..~r~~,?81irlb 541-682-6100
follow rules adopted by the Oregon Utility
Notification Center, Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
I CONTRACTOR,INFORMAUON'Il copies of the rules by
calling the center, (Note: the telephone
Contractor b frLicense, l<'xpiration Date Phone
num er ,-" .. ''-' .....,.....gOna""""".".y ,..v.",C:::\.l.uv,1
LONNIE LEROY JENKINS cE1~~~~~ 1-800<~32,l!.~Q6/~007 541-746-6441
BUILDING INFORMATION I
Contractor Type
Electrical
"
. # of Units:
Primary Occupancy Group:
O' 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:
nla
, DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: Total:
# Street Tr;e'01. Rqd: Handicapped:
PavN1Q)t.l~qd: CQJDpact:
% oTJj18e~M~:SHALL EXPIRE IF THE WOKI\
AUTHORIZED UNDER THIS PERMIT IS NOT
~"--f - l~ \""II"m,[ncno
nt:n\rnC.j .. . .:,. ....... Ci._.. - - .
I PUBLIC I 100.
Sidewalk Type:
Frontyard Setback:
: Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
- Street Improvements:
Storm Sewer Available:
Special Instruction:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of2
.
. CITY OF SPRINGFIELD '
Building/Combination Permif
PERMIT NO: COM2006-00089
ISSUED: 01/23/2006
APPLIED: 01123/2006
EXPIRES: 07/23/2006
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
~
Fee Description Amount Paid Date Paid Receipt Number
+ 100/0 Administrative Fee $14.20 1123'06 3200600000000000025
+ 8% State Surcharge $11.36 1/23/06 3200600000000000025
Add, Alter, Extend Circ $43,00 1/23/06 3200600000000000025 .
, Add, Alter, Extend Circ Ea Add $36,00 1/23/06 3200600000000000025
Perm ServlFdr 200 amps or less $63.00 1/23/06 3200600000000000025
Total Amount Paid $167.56
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.
I Rf'l1uirf'rl In'?f'''t~
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 he 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
Pal!e 2 of2
2~5, Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
"
J~b/Journal Number ,
COM2006-00089
COM2006-00089
COM2006-00089
COM2006-00089
COM2006-00089
RECEIPT #:
~
Mty of Springfield Official Receipt
.velopment Services Department .-
Public Works Department
3200600000000000025
Description
Perm Scrv/Fdr 200 amps or less
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 8% Slate Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment Paid By
CreditCard CAMP CREEK ELECTRIC
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1/23/2006
Received By
djb
Page I ofl
Date: 01123/2006
Item Total:
Check Number Authorizatlou
Batch Number Number How Received
279927 In Person
Payment Total:
11:47:03AM
Amount Due
63,00
43,00
36.00
11.36
14.20
$167.56
Amount Paid
$167.56
$167.56