HomeMy WebLinkAboutPermit Electrical 2005-7-20
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. CITY OJ. ",PRINGFIELD, OREGON '
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225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3~9,/'o/,< ,
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ELECTRICAL PERMIT APPliCATION ~ 0 'o~~;~? ""19
CityJobNumberCOlM.z.cOr-oo W1 Date 7/20 C> ~ "9 ~?~ ~'O'OO:'g.~ '
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1000 sq. ft. Of less ,00
Each additional 500 sq. ft. or ~
portion thereof $ 1 00
Each Manufact'd Home or
Modular Dwelling Service Of
Feeder
LEGAL DESCRIPTION
J f?O')DZZO
JOB DESeRIPJION /l!.
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Permits are non-transferable Jm& expire if work is '
not started within 180 days of issuance or If work is
Suspended for 180 days.
02 ?'OO
J
$50.00
00
SO-
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2. .;t" ....4r,'i_"i'.~....";,:J.,-t..'""'i~~r~;,!-dr-, <'J;~:,~_:oilf:~..~~t ":~4.l:1~
Electrical Contractor It~ p:; .e.d1-,,;[;he
Address {'51 f 3 J!v.JLf if f So uI4
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City GLl..aUJ fJ Phone 71/ D V1 (
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B. ~~:rF~~f;~~~~rtnIl6il,~~t:{it~~$fii~~~:R~I~t:f~h~;'~:J~'
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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 Amps/Volts ,'._ $375.00
Reconnect Only n laW fequ\relllvJ-:,,~tJ $ 50,00 _
A~~~:..J~~J~~lJ!w~;I'-~e<tIaw,'.m~I
lii\~t:;~l1~Il!~i1! ~~,,~,',,~"l~
NoV~~at\on 1l0AtQ,~1~ thrOUg~&1.ltl~Ju\es bV
In ~Ri1.WiD , \I obta\W'MIi~ he telep\'1one
o@!l.A'Jiipfil~f"f^ter, tNote..t. .... J,,_~.;n{$ 50,00
1,9j.\~ ~l&~on Ut\\\W \~';:'... $ 69.00
wr0lIRPs1ffi 1 \l1,Am""JO.332-23~"" $100.00
cen'tJY I'<>-r<'"
Over 600 Amps or 1000 Volts see "B" above.
D ~B;~/:';Il"!!;;':!~" '1 !;f~'!;':::tl~J!If:e~~i~1 Z;t'.:~~'tl'~~4it~
. ing Electrician . t:.,~ !'1!n..'!~LS~.l~~jPJ~~r-,:.l~~ .;:-~ ':t~-';t.;:'~ Ft
(' >f New Alteration or Extension Per Panel
_ _.; One Circuit $ 43,00
~ ,/ ,each, Additional Circuit or with
Owners Name 2WL-.ur..i'dt:'" Jt/ ~ rf t:! /(l.vtf:'c;=rnce or Feeder Permit $ 3,00
Z. 0-0 S+- E. tt~~i(S~E"7rlr', d~~tr-"\!i~d~,;'r,,;E~tiifn~fulliitlth"J
Address I e:r CI'~}-"bQ. ~~<"'.""""'"'''~'w''' ,_,~,,,J,j!!!..'''<''~.M <"'","~~<_H~.j
City t-u.Cr~e Phone 7V6 -60(1.( Pump or irrigation $50,00
Sign/Ontline Lighting $ 50,00
OWNER INSTALLATION Limited Energy/Residential $ 25,00
The installation is being made on property I own which Limited Energy/Commercial $ 45.-00
. , ded~ I I ...,,,1(
IS not mten lor sa e, ease or rent. .,-u't.!\firiliiinm Electric Permit Inspection Fee Is $45.00 + Surcharges
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COMi\\\:.G\~Di\i I'I'.\'IIUU, ~ J' 10% Administrative Fee 500
. f\\o.l'/ \B \. '\ .1.n.. "t:>
InspectlonRequest: 726-3769 .. WTAL S13 5_
~ ~ Shared DrivdT: VBuiIdin. FormsIEIecttica1 Permit ADDlication 1-ll3.doc
Supervisor License Number
<13(" %S
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,9 o-lo3c'
1/; jOt?
Expiration Date
Constr. Contr. Number
Expiration Date
.
.
CITY OF SPRINGFIELD '
Building/Combination Permit
Status: Issued
225 F1ftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
. PERMIT NO: COM2005-00947
ISSUED: 07/20/2005
APPLIED: 07/20/2005
EXPIRES: 0112012006
VALUE:
SITE ADDRESS: 4795 FRANKLIN BLVD SPACE 3 Eugene
ASSESSOR'S PARCEL NO.: 1803022002900
TYPE OF
Ellectrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Manufactured home service replacement
Owner: RIVERSIDE MOBILE HOME COURT LLC
Address: 2100 STONE CREST DR
EUGENE OR 97401
Phone Number: 541-746-6014
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
ARC ELECTRIC
License
115113
I BUILDING INFORMA nON,
Expiration Date
07129/2006
Phone
541-741-0494
, Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Units: # of Stories:
Primary Occupancy Group: R-3 Height of
Secondary Occupancy ATTENTION: Oregon lIlyp~youto
Primary Construction Typ~How rulVNadopted b)\!iUeJOI'fp'\l:n Utility
Secondary Construction Notification Center. Th083~y.pt; set forth
# of Bedrooms: in OAR 952.001-001 0 thJj)J1~ID\Y,l!~952-001-
0090:You may obtain c~/!li'!~<<!he rules by.
......."'I.~ ...... VO""'~'J 'J'''''- ,.,... 't';".~,.....t':."1_ _.
number for thE1 DEV-EL<;)PMENTJNEOKMATION I
Center is 1.800-332.2344).
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Lot iiize:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occnpant Load:
nla
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street
I "";. IPUBLICIMPROVEMENTSI
1\. '_ ~..........
h.lS H:R,\:IT SHALL EXPiRE IF THE WORK
Aul MLkiLED UNDER THIS PERMIT is NOT
CU"':\ItNCElJ OR IS AHANDONED FOR
l,i~Y 1 bU OfN PERIOD,
Sidewalk Typ,e:
Downspouts/Ilrains
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descrintion I
Description
Tvpe of Construction
$ Per Sq Ft
or muItipUer
Square Footage
or Bid Amount
Va:tue
Date Calculated
1 of 2
.
.
CITY OF SPRINGFIELD
Building/Combination Permit
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
PERMIT NO: COM2005-00947
ISSUED: 07/20/2005
APPLIED: 07/20/2005
EXPIRES: 01/2012006
VALUE:
Total Value of Project
F~s Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Manufactured Home Service
Amount Paid
Date Paid
Rec"ipt Number
$5.00
$3.50
$50.00
7120/05
7120/05
7120/05
12B0500000000001046
l2-B0500000000001046
121B0500000000001046
Total Amount
$58.50
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. win be made the following
work day.
MH Service: Approval required prior to utility company energizing service.
By signature, I state and agree, tbat I have carefully examined the completed application and d) hereby certify that all
information hereon is true and correct, and I further certify tbat any and all work performed sllall be done in accordance
witb the Ordinances of tbe City of Springfield and the Laws of tbe State of Oregon pertaining 10 tbe work described herein,
and tbat NO OCCUPANCY wiD be made ofany structure witbout permission of the Communily Services Division,
Building Safety. I further certify tbat only contractors and employees who are in compliance witb ORS 701.005 will be used
on this project.
I further agree to ensure tbat all required inspections are requested at the proper time, tbat each address is readable from
the street, that the permit card.. located at tbe front of the property, and tbe approved set of plans wiD remain on the site
at all times during construction.
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
~1'pringneld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00947
, COM2005-00947
. COM2005-00947
Payments:
Type of Payment
f,,- ~reditCard
1-
,
(..
'j,
4
,
'I
7/20/2005
RECEIPT #:
.
~.
.ity of Springfield Official Receipt
Development Services Department
Public Works Department
1200500000000001046
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Manufactured Home Service
Paid By
ARC ELECTRIC
Received By
djb
I of 1
Date: 07/20/2005
Item Total:
L:heck Number Authorization
Batch Number Number How Received
025838 In Person
Payment Total:
10:46:40AM
Amou nt Due
3.50
5,00
50,00
$58.5U
Amount Paid
$58.50
$58.50 .