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Home My WebLink AboutPermit Electrical 2004-5-12 rl I1IO}eol at sub . O' doas liOl ra mlttedhasthefolJo' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541mg$S9 ,qUire Specific land us:,ng ELECTRICAL PERMIT APPLICATION '. Zoning~~ ....J Ute. ' . / . URt(:j City Job Nurnber(h.+1 ZOC4-o0 563 Date t; '/2.-,0 'i - ' "f-I3~ . ,-....u'vtlzt:a S' ~ ~"",(~.~,~."iO:;~I.o;?!1tt.."I'::,}~~~~.r:t....~n;-~""':t,,jgQ~4Ife$,.t*, ',J':"J1Ji._~,""''-~~~''l'':t'r,f",j 3. ~;COMPI]ETE:FEE;SCHEDULEBELO W,. ": ' .:.,;;:.'_l%';;~iJ,I.' .<t ~~..~-;;;'~l:l!i.\MMt~~...lOIo.'f~...:r~.~~,.",_",.,~.,.-~~~.'t-..':a~.'i~... Jf;+-'''_'r,17i.lj4J1~,''', ~::''1"~, ~',':"""Xltf'F~,'" '~\~~',-,' .~,q~~" - ..., .~~, 1. ~1,P.fi1-JlBi.y;~Q1)!NS.!t!::!:~~;I.QtfJ,.~~J.;;~ '1iQ$ 1n.\1UI~ ]lvJ! Sr6--<-e.. 3/ 029-00 LEGAL DESCRIPTION /&>3 DZZ() JOB DESCRIPTION" ~.e~ I [G ('.1M ~ PermitS are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~, .....y.""'''.,.....r,.f.~,;;..,m.;;'\il.....N''''''"'''~;j:;_<t>'....~-<t~.......,',.~ 2. ~~qw~~!l~R8~~~ Electrical Contractor n h Li '; f ~ S n ~ L<.- Be~ hI^- Supervisor License Number ~ I c:'1 '5 loJI/oc( , .;)..Io3'-{ C /6/ I I (j L/ , I Over 600 Amps or 1000 Volts see "B" above. D l1I'8"~"'li~';:,r,is'" -, S~' gna re o~ sUPrerv\isQing Ele, ctrician . it"li~'!S:.: Irc~1 . New Alteration or Extension Per Panel ~ One Circuit , ( i1rV( y,;, j2., y'lA.I>.I. tPv-<1 ) Each Additional Circuit or with Owners Name f.vl1A Vl-1DVl Jp.aJ J.1...., ~.Jll8.h.4, Service or FeederPennit '-Ncl<* $ 3.00 Address :JODI ~,'I.J. ~1~'~~lt~ E. .@i!~~~t~~~~~ifi~i~ City' PIiJ,"&>uP Phone ~,/", /"D 1 '-1_ \),\\\7~P\\<l['U\'1g~~~\~~ ~~..'0\j\\~ $ 50.00 , c.:- ~ S ~~irl~~I~~til>~~ $ 50.00 . OWNER INSTALLATION ' ,,' \~~\\I,\il'fu\ee.~e~~'iliential $ 25.00 The installation is being made on property I own which ~c,\)~~~r~~commercial $ 45.00 is not intended for sale, lease or rent. Mi#'h~'~:Iectric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: 4.'t?~W~~~~~, 1'12 DO V. if / Co. 3> 0 73.7J Address ,J'ri-q ~ City f AkJhLL-- Expiration Date Constr. Contr. Number Expiration Date Phone ~ S-~ -f, J)-I ..",_'>;"i\i"",,,,,,,,,,,,.___"'.";lS;;'."',,"'><""~-""-',,,,",='l'i<"'."~;'-'- t;;'~ :l"',~ .... a4"'-r.'".?tP':::'\:;.":~.~,;...'w . - . ". ,_~.rl. '....__~".l.."'l'>~;ry,~-:..':'(ffl";~ . ';f{ A. !S~;l'f:!t.!,~t~I?t~J.~,mgt~J<9!~~~tt,~~~Jlr !1e.L~~~~~.~~J~ ,'1~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ~~liJt~J~'~f~2W;;l;;:t.>f,':):~ir~''''~,~>~"'~~;i~~~.lt~~~~ B. vSer,Vlces1oriFeeders -:>i!!!"",-,sta"llatlon;:rAlteratlO~Reloca,liori,: :({,m "',,1 1.~~~~~lf4:<<!~;,v~~Il:"_'.l'Il(-~~'-"':3:~~:~.,u;(( -,- ~;- '~~~ ( $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 &200 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps \; 60 I Amps to 1000 An.!.~'\)\t~ 'l~'J"" Over I 000 AlWl~moleCdOl\ . \01\\' Rec~~d'O~ ~e ~~ ale l>~ nn'- ~~~o?\e ~ ~ p.\\9';'" ~ . f>-\\ r: lmri;~~~~~.~', ; ,o\\O"~ "'~~~~ ~';_. ~O\\\\C~~tO~\ py{if.~ cO~~.~1~ \(\ 0'" >lnU (\\~ ~el. ~ U\\\<<!"A4)- 009(2qlr~~'il~eele~~~:v' ' C;2\i'f'~~~~- . ~'O~m.%Uo Amps' $ 50.00 $ 69.00 $100.00 $ 43.00 7% State Surcharge ~~ ~ 10% Administrative Fee \!jh:J ~OTAL ~~~ Shared Drive(T:)lBuilding Fonns/Electrical Permit Application 1-03.doe Inspection Request: 726-3769 . . CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2004-00563 ISSUED: 05/12/2004 APPLIED: 05/12/2004 EXPIRES: 11112/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4795 FRANKLIN BLVD SPACE 3 Eugene ASSESSOR'S PARCEL NO.: 1803022002900 TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Service change Owner: RIVERSIDE MOBILE HOME COURT LLC Address: 2100 STONE CREST DR EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor CHRISTENSON ELECTRIC INC License 458 Expiration Date 05/0112007 Phone 541-688-6121 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type, # of Bedrooms: VN # of Stories: Lot Size: 'Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor, NO!iJType, Sq Ft Basement: THI e 1):I'e: Sq Ft Garage/Carport Ph!'hHAll EXPIRE IF THE w~t Other: AUT~~ llMl\!~7H'S PEFmflr IS N upant Load: ('()U"'::~:f:El::__!,_~ T , D~l\IE~~~ATI.ON~r FOR REQUIRED PARKING R-3 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ATTENTION: Oregon law fnlln", ,..1M _ ~ . 1 ,. requIres YOu fn No IPUBlJlroMi~~ti9wr.gon Utility 'in J,.,n ""<<'UUl 0010 are setfortn 0090 Yi -. through OAR 9~~tj'~,!k Type, . ou may obtam co i calling the center (N p .es of the rID8Itt'njpoutslDrains: number for the Or~go~tuet"lthtyeNtele~hone C. II otiflcation enter IS 1-800-332-2344). Total: Handicapped: Compact' Street Improvements: Storm Sewer A vaHable: Special Instruction: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee I of2 . . CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO:' COM2004-00563 ISSUED: 05/12/2004 APPLIED: 05/12/2004 EXPIRES: 1111212004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F~~~ Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 5/12/04 5/12/04 5/12/04 Receipt Number 1200400000000000726 1200400000000000726 1200400000000000726 Total Amount Paid $73.71 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection rfquested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be Dlade the following work day. I Reouir~d T nsn~rtions , I Electric 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 h'lreby certify that all information hereon is true and correct, and I further certify that any and all work performed shaU: 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 Servkes Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 wiU 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 . Wir8r~'~I_~'!!'_!!!'!?' --, ..- ,!,I -'. ' - .. , .' i', ..........,_;M..~. , .y of Splringfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 1200400000000000726 Date: 05/1212004 lO:06:40AM Job/Journal Number COM2004-00563 COM2004-00563 COM2004-00563 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 63.00 4.41 6.30 $73.71 Amount Paid Check CHRISTENSON ELECTRICAL djb 1002 In Person Payment Total: $73.71 $73.71 5112/2004 Page 1 of I