HomeMy WebLinkAboutPermit Electrical 2006-9-12
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225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ~ _
ELECI'RICAL PERMIT APPLICATION " /~
City Job Number ...(DVVI "ZOo 6 ~ 0 1171.( Date fh.y0b
I. i WCATION OF INSTALLATION 1 3. I COMPLETE FEE SCHEDULE BEWW
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2, I CONTRACTOR INSTALLATION ONLY I B. I Services or Feeders -Installation, Alterations or Relocation:
Electrical Contractor ,tJ-oc:; tilt! ~-h-, 'v'I:bc. 200 Amps or less1es '10\.\ \0 $ 63.00
. 201 AmPsltCf400'Al!\PSU\I\I\'1 $ 75 00
.f) 0 I.? ) 1/] -:00 0 n,,(jl' ' ( \1<;,,- \ \0\1\1 .
;, ,0 (J)( &>"-~ .--\Ol't '4q!.A'!lI1s:fuo600sAJNlS,e ()()\_ $125.00
"'1'", tJ'to I AC"'\.vu f:\ P 1\B f"\~:/)#
. f1y'1-1 p..", 'oS au 601 Amps to 1000.Amps" '0'1 $163.00
City ,-j f f-fj ,IJR Phone 1 W le.y'fZ~ cef\qr~~ooor"';~.\Y.Olts') l\.\\e~a $375.00
, t-\0\I\lV~'S5'2--()()\Reg~1!1lect;oIlIY~\,e le\e?\'\O liol\ $ 50.00
Il\ 0"'''' IDa'l o. INO\e. .. ...\()III\IJ"l:
Supervisor License Number L/.~ L, SI S ()()90:.""Og\.\ \\1 C"~(T~WP~oiit;$'~,4i~""ll1r Feeders
co"ll\ 101 \\ ,,, - o()().",,~'
'Oel '0"\.0
(\\.IID celliistaUatIon, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Ainps or 1000 Volts see "B" above.
D. I Branch Circuits
LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire If work is
not started within 180 days of issuance or If work Is
Suspended for 180 days.
Address
Expimtion Date
ddress
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ity
OWNER INST ALLA TlON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
~speeC:t&es:~ 7iis6j I j
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A. I New Residential- Single or Multi-Family per dwelling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
~o
(
$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit $ 3.00
. 'f\II?-'lo- ".
E. I Misccllaneous (Service/feeder not incl~~;)dj'-~ach:lnstallation I
. . , , \.. 'c.1--\ ,. 't.'i\\W llI'i\
Pump or,\rri~~tio~', \\\ ",\\,,~ 'i\ ,\\\\'0 I' n'1t5.O:OO
SignlOutline:Lighti~." '0'i!\D\ ,1l.i\.1"vv $ 50.00
~\'\\" -o.'l\:.'-' 0 ,,,.
Limited EnergylResiilential'i)D ,," $ 25.00
i\V ,\-H\.i\.-~ "'I:.'i\\\'"
Limited Energy!<30mrnerciill' $ 45.00
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Minimum Electrl~~Permlt Inspection Fee Is 545,00 + Surcharges
$ 43.00
4.1 SUBTOTAL OF ABOVE
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2S0
8% State Surcharge
10% Administrative Fee
'5 % "-att f'~
TOtAL
Shared Drivc:(T:)lBuilding F
. CITY OF SPRIl'il:d'II'.LD
Building/Combination Permit
PERMIT NO: COM2006-01174
ISSUED: 09/12/2006
APPLIED: 09/12/2006
EXPIRES: 03/1212007
VALUE:
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4795 FRANKLIN BLVD SPACE 17 Eugene
ASSESSOR'S PARCEL NO.: 1803022002900
TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Replace service
TYPE OF USE: Repair
Residential
t"~
Sidewalk Type: \-y..~ ~ ~~\
DownspontslD{'I-.\"~~ ~~\'\ \~~
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I Valuation Descriotion II:,(J~ \ 'Oil '0P;
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$ Per Sq Ft Square Footage
or mnUiplier or Bid Amount
Owner: RIVERSIDE MOBILE HOME COURT LLC
Address: 2100 STONE CREST DR
EUGENE OR 97401
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
License
115113
BUILDING INFORMA:IION I
\~es 'lv--.)\\\\\'l
# ~~~t~rii!S;p.C\OI' _~\ \O~~
R-3 ,,~eJght;~'Str~c,t~re' ",O':JV
. Ole"'T '-;; lif Heat:" ?,<:).. '0'1
..\o'(li. ~,.yp c,~' - o[>.'?- ',>'"
~\NI '3-009 W~ter Typ'e: \,\\e 10' 1'''>
[>.'\'\ ... 10\eSrel'\eIRange~Type:, 0\ "e\e9'\'O "\01'
~\O" I' v c'''~ r.,,'~ , '2-'
\0 . ,d..\O ,Oa\' ~IU,!gy'r~~!.h.:0'\e ,\-\Oi)"C
~O\\\ 9-- ?,"'~ '3-'1 'Spri,~k!ed B0'!ldin.g~o.,. n/a
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"oa?,a'~'i:I~-DEVELOPMENiI"INFORMATION I
C2- ':oe'" \el ,-
1'0~ eel'
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Contractor
ARC ELECTRIC
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
Frontyard Setb~ck:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEl\ou"" I '" I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Paee I of2
Expiration Date
07/29/2008
Phone
541-741-0494
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-01174
ISSUED: 09/12/2006
APPLIED: 09/12/2006
EXPIRES: 03112/2007
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 I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Manufactured Home Service
Amount Paid
Date Paid
Receipt Number
$5.00
$2.50
$4.00
$50.00
9/12/06
9/12/06
9/12/06
9/12/06
2200600000000001263
2200600000000001263
2200600000000001263
2200600000000001263
Total Amount Paid
$61.50
I Plan Reyiews 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.Reouired In'ir~ctionsl
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 trne 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, Bnilding Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed 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
Pa~e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-0 1174
COM2006-0 1174
COM2006-0 1174
COM2006-0 1174
Payments:
Type of Payment
Cred itCard
cReceinl1
.
RECEIPT #:
Description
Manufactured Home Service
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ARC ELECTRIC
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<& of Springfield Official Receipt
_Iopment Services Department
Public Works Department
2200600000000001263
Date: 09/12/2006
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 022987 In Person
Payment Total:
Pa~e I of I
10:18:16AM
Amount Due
50.00
2.50
4.00
5.00
$61.50
Amount Paid
$61.50
$61.50
9/12/2006