HomeMy WebLinkAboutPermit Electrical 2003-12-18
CITY OF S' lNGFIELD, OREGON ,
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115...... 1 n STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54Im6=J"RlI
ELECTRICAL PERMIT APPliCATION
City Job Number COwtZOo:> -6 (267 Date
One Circui'f. . $ 43.00
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Pump or inigation $ 50,00
Sign/Outline Lighting $ 50.00
OWNER INSTALLATION Limited EnergylResidential $ 15.00
The installation is being made on .. ..;, I own which Limited Energy/Commercial $ 45,06
. 11f._YIJ"'\.I/J-U"eo I .. .
is not intended for sale.I'fE'e orren~~..' I. ~on 8>v j'MbiliiiilnllEleclrlc Permit Inspeetilln Fee is $45.00 + Surcharges
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Owners Signature: ~ li'~ ," ,I L: .,.(. ,hll'.J fd:...4. "~' Jj" ~~.t~O::~P" .;~'; .".::tf![f'
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. '. .. ': .:.:,'1 C ,.-. "",7%StatcSurcharge
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Inspection Request: 726-3769 '. '. . . _, ~:,; _:.'~.y 1\1-'I!fOTAIJ1
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LEGAL DESCRIPTION
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JOB DESCRIPTION
W~~tt~e.. S~HJ1(Q. ,a.JJ It<ta.-t-
Permits are non-transferable and expire If wlIrk Is
nllt started within 180 days of issuance lIr If work is
Snspended fllr 180 days.
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Electrical Contractor Arc.. pi ~ rh-tt- .InG.
Address q ~ 11.i JM.y-1-.'1DbU.tI;
City bjpjje.. Phone _? tJ/, 0 tffy
Supervisor License Number q' 3 C::, )7 S
10/ D 1/..:z.tJO <{
Expiration Date
Expiration Date
;20 ,to 36
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Constr, Contr. Number
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OwnersName LrnfL<+, Q,1 ~
Address 2C;/~ /1~~. SeW.
City .8.p.ll.oj~ 1! Phone 7 t/ c/.. 0 ;1S3
17/;8/03
3 !"c()MP.i!Jtrn.FEits€ii:itiitJi3E7fiill6wt,,!j,;~:", "j';}'::; """,.j..l.'
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Service Included
1000 sq, fl or less
Each additional 500 sq, fl or
portion thereof
$106,00
$19.00
Eacb Manufact'd Home or
Modular Dwelling Service or
Feeder
)...
00
$50.00 100-
B. t~;s~lt:?i'~~~,~'fililid~Ai~;:;;tlO''''icl~" ~i~mr;t:"~
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200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375,00
$ 50.00
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Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or I 000 Volts see "B" above.
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D. .;;Jlran. ~~q,I!S.UJt8. .,~.t~'., '~r..:'i.;..1,,,,,,".!~i?d'J,;,.tr~.$~~\ t;,:~",-\\r-}ie -', '",'
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$ 50.00
$ 69.00
$100,00
New Alteration or Extension Per Panel
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Shared DrivcIT:VBuiIdin. FormsII!Icctrical Permit ADnlication l-03.dnc
Status
Issued
'.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01267
ISSUED: 12/18/2003
APPLIED: 12/18/2003
EXPIRES: 06/18/2004
VALUE:
SITE ADDRESS: 4660 FRANKLIN BLVD SPACE I Eugene
ASSESSOR'S PARCEL NO.: 1803031102100
TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Upgrade service add heat
Owner: OGG ERNEST
Address: PO BOX 186 ATIN EUG MOBILE VILLAGE SPRINGFIELD OR 97477
Contractor Type
Electrical
, CONTRACTOR INFORMATION I
Contrl\ctor
ARC ELECTRIC
Phone
541-741-0494
A!U, a'l.iu,,::(J,DPC,\ la" i.3qulies you to
fe'low "d~~ u"uplc[) uy ttoe OI:Jgon Ulility
.'oLriei,(IL,., ,;8. ,'.sr. i1,;):'~. rul;.,.o are set fort
.01\1-1 CJ:,)-(jIJi-n01:: t:'i'lW.,l, OAf] 952-00
0090. You ~l 'V '.ll"'~,~::l ,......,~i2- nf th':} nIlE'S l
calling".: Hm. .. ...... ...."
nU'Il~)ar~.', td'Viiltilitiiin-n'escrlpti6n1Ion
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# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
...
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
License
115113
BUILDING INFORMATION I
Expiration Date
07/11/2004
# of Stories: Lot Size:
R-3 Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
VN Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
NOTICE: Impervious Surface Area:
~,,,..... ,...",-,....l..T C'tJ^1 I CVDIQC u: Tl..U: WORK
I DEVELOPMENT INFOIWATioN;liE.O UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABtmtQJjJug;PrnlRKING
Overlay Dist: ANY 180 DAY PERIOD. Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDrains:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
."
Value
Date Calculated
Total Value of Project
Paee 1 of2
...
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CITY VI< IH'KlNGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2003-01267
ISSUED: 12/18/2003
APPLIED: 12/18/2003
EXPIRES: 06/18/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fpps~
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Manufactured Home Feeder
Manufactured Home Service
Amount Paid
Date Paid
$11.80
$8.26
$18,00
$50.00
$50.00
12/18/03
12118103
12/18/03
12/18/03
12/18/03
Receipt Numher
1200200000000002629
1200200000000002629
1200200000000002629
1200200000000002629
1200200000000002629
Total Amount Paid
$138.06
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.
~ Renuirpd Insopctions I
1 Rough Electric: Prior to Cover
2 Final Electric: When aU electrical work is complete.
3 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to
the panel.
4 MH Service: Approval required prior to utility company energizing service.
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 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 tbe 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
Pa!!e 2 of2
225 }<'ifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01267
COM2003-01267
COM2003-0 1267
COM2003-01267
COM2003-01267
Payments:
Type of Payment
Check
~.'.'.".'.."
~1
Receipt #: 1200200000000002629
Description
Manufactured Home Feeder
Manufactured Home Service
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
ESTATE OF ARC ELECTRIC
Received By
djb
l.:heck Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Departlllfnt
Date: 12/18/2003 2:42:34PM' .
Amount Paid
Item Total:
50.00
50,00
18.00
8.26
11,80
$138.06
How Received
In Person
Payment Total:
Amount Paid
$138.06
$138.06
.
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