HomeMy WebLinkAboutPermit Electrical 2003-9-25
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, submitted has the following
225 FIFTH STREET . SPRlNCFIELD, OR 97477 . PH:(541)726-3753 . ~~,~~~cg9 ~equ" s~eclflc land use'
ELECTRICAL PERMIT APPliCATION
City Job Number (OlMLOO;S - 00 ? &"1
1. 1F:LocrrTIONCEL&sn;rT'!~0M1i~l<<c%',;
~~...t;""",;l:~:,,'::...'J..;""":'.;:'~"'-~Ol'.~.J.."W.~.::4~;oio6:71""i' -"'~~:::oii~i1;3
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LEG~p ~~O.N,'-'--___~,L .___
, '70333~'t _0'2.'=00 I
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JOB DESCRIPTION 1000 sq. ft. or less
~ 0{XVirt tD UMS1Y\AcJiU\(l ;:':0~::~~~5oosq"ft.or
fermitS are non-transferable and expire if work is IT AI ~~ch Manufacr'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. . - . ' Feeder
2. 'll~~~~~~~m~J-,~ B. t~~~~~~El~f~I~~~m~ll~~~~i~i~zr~~
Ele~tr.!.~o~~~ro~tl:3CrVV) CAtv) 8\BLiI r '0 200 Amps or less I $63.00 Jt'3-
I 'SIlIIlY,Y7,11Ir--1fIL2-. ,20lAmpst0400Amps I $75.00 "1J:j-
Address I ~\V~k!?:2Y.:.\I"L.::?.l ov. 401 Amp. to 600 Amps l.I.n $125.00
.,. , I r;:J'\ /.I . I : '"-. 601 Amps toJ~~\te~~~\i\i\'l $163.00
City 5,. t ~,.v l! ~ tl!&'Pone !Jug 9..Q'V S~ 00 Nl~u.o~~l~y..o1Qte9 e se\tott $375.00
., I' ~"E li~~~usetl.lleS~95?.oO' S50.00 .
1((j:HJ/ ~ \o\lOW~~~Gf.f\\!l~.li mi~\:I:P~u~~,L~"~.,.=",~,.,.,,,"'f'l!TO""'_"
S -....-U"".- 0- N''':'''''~ :.,...,. "!- J""\ 1-" '\\ce.~-;'~if~~":1 .,s.. .. . .,' "-~"-'''''?""'''~6RF:e'€(l~eJ' ."....~-, .~~~1:~~~-.5l;1~~~~~.:., ""<<~~~..1-'''I~iJ;~~i!'t'::~:'':'':L~
upervlsor eense mue ,(\' oJ '-/ '10\1 S' "" ",I1",!., ".;:k="'t"I"':"c."'.'~' ,.""~~,"""""'j,,,. ..1..~'''''''I'' . .,
, . . ' , f\ 9 " _....,....~..". V'."'....""~"~:IT.."" ". -,.~....""",,,,-,_..,,,,,.,,,.,,.... ,
I 0 0 I OJ I \ O/'. . f{\a'j 0'0 . INO\e'. \he , ilica\IOn
Expiration Date '-t" nl'l90. '(OilJtl1Ila.!i<MtA1ter~tb'.J.,I.lltf 'ii~~c3tion ". .'
,. /1 ca\lit\~%.~ Qt~~1 .33'2..'2.344). S 50.00
Constr. Contr. Number b\ Itpl#'t> nl.llt\'o'2~~p!i'lO lId3\JZ"ps S 69.00
. ' 1!..-'JO 1M::.. 40 l' Amp. to 600 Amps . S 1 00.00
ExplT3tlon Date '- Ii'~
Over 600 Amps or 1000 VOllS see "B" above.
, I D r;;'"B~;:~~:~~lli~~';:'::'./;i~~l:.~4i;f"Ii:tl:~?'~':;"'~~:'1j("'~"if:lilMf~~~~f.t;';I;r1~~r.l!II~~~,~"l:!':-m;~b;i;~~'lj' ' :'9~
S,o-n.ture of SlI"ervlSlDg ElectnC1~" . r..aDC ...~C:;\UUf.1iII~,"',,;!:.:~ 4:"" ' ~.:""-""~.;.j~.~1ili'~'i!!I4,\:&'",'~N""ll:;.l>:.'il.t i{lj'~ \~-\..
'0-- -t'" , ' ....... . ~"i;,;."ol~~::.'.-::.c.;r:N.~,~"';:~.Ji~~,,':!)t;..: _"ii.}~~""~.~",_':"'~..:J'""",~",,,'..I~~~;..,:_, iit~
09/25/03 THU 12:57 FAX
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Owners Name
Address
~.,..
City
OWNER INSTALLATION "
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The installation is being made on. ,......l""'..)' I own which
is not intended for sale, lease or rent.
Owners Signature:
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Inspection Req uest: 726-3769
CITY OF
~002
Date
.?\ 1-5 (J3 n",~ 5'1~ - D -oct -0 ~ .
3. ~Eg!E~~i~~!;g:?~i!flk~~~~~
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A.. ~1::NewLResidentfa('Jf;Sm<.'!;"c;!0l[.MU1~~ffiV";~}a:,~t~fi~l1Jiit~~.r;~
;{;~.:..~ .,~~~;:'..,::~::,j.;i;;'..",:>':."-:,~'.,,-:.':~/. -,'- --~-..\.~~.~-;:~,;;::.-:.; ::~'\.;..::.J.::~,P.w..~J"L-i::;':~l::":'::~';';~'.:._"";;:'!~-:::
Scrvice Included
S I 06.00
$ 19.00
$50.00
New Alteration or Extension Per Panel
, One Circuit ,,. \~I(\?\<.$ 43.00
. E~~.1-dditiona1 Circei~l9\'twtlf: il '" 15 NO\ 3'-.
~\J~er:viCe or Fes#'Pet'triitI5 \l'C.RW.\ S 3.00
, HI\',':"". ~f..I;)\~~.]i~n'.' .~.,: ..ii1."J.'~' Q,.i~"""",""",.",,,,,,,,,~,,",,,,,,,,,,,""'''''',"
E. i'\1fic'dta'rle6W.-E!:i,,;'," , . ~~iit.'iRd\i'did~:aar'l'ii~r;tillii$
~~~\e1rJ\QO~'""""'''-':"'.<'~;~~~:.'''~'''"-'~''.''<
isil!hiQ'?;tline Lighting $ 50.00
Limited EnergylResidential S 25.00,
Limited Energy/Commercial S 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surch';:_g~
.1~~"'-('"i1~:;;~2i!.:Iu:~~t~I~~~''''::'1.''~::-l'm':cli'::'!lU'C'.li.!r.~,-'!'.w\r-;'~~\1I.'!o'll;;'''
4,'~';D;';~M;{OFilfir(jld:1':"~'~lo;t:.T~~;.1~.1'fi: " I \. ;.;:
ti.:;~i-f1t~;;~~;'~~~~~SB:~g41fJ.~~\~~~~~~-~ ""1'
t'.9D
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lt7Lj..~
7% State Sun:barge
10% Administrative Fee
TOTAL
Slu:1rai Drive(T:)l8uilding FonnslElectrie:l1 Penrut .A.pplic::lrlon ~ ..Q,3.doe
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PAID IN FULL
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CHERRY CITY ELECTRIC
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Status
Issued
Building/Combination Permit
PERMIT NO: COM2003-00984
ISSUED: 10/0312003
APPLIED: 09/30/2003
EXPIRES: 04/03/2004
VALUE:
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3001 Franklin Blvd
ASSESSOR'S PARCEL NO.: 1703334402600
Eugene
TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Service to construction trailer
Owner: OREGON DEPT OF TRANS HWY COMMISSION
Address: 355 CAPITOL ST RM 119 SALEM OR 97310
Owner, STATE LAND BOARD
Address: 355 CAPITOL ST RM 119 SALEM OR 97310
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
SETBACKS
Contractor License E.\wration Date
MORROW MEADOWS CORP 91668 ."'S 'l0~.\~\{lf/2012005
BUILDING INFORMAp~lb~aC60~ ;e\\~'
aQ,u" \'(\'" s e\a 1O'l..IJ"
# of St fil'$:'P\ ~aO 'O'l sa \\)\a O~ g Wt18Iz\:
~~tit\1~trt~re-<;'(\0 ~o\)~'(\ 0' \'(\0~'fI~~t Floor:
1'-':t:h!f'Or'Hett;;~~O'\ 0 \~ o~\a'" a \e\'S:l!l~\l Floor:
,tWfltCJ,\~';bO'\' 'X)\1,).fI C o\a'. \~ ~cSli'Ft Basement:
NcJ\i>>l~ 'l)yPe~e'l 0 ~a\' ~ ~ u\\\\1~'Ft Garage/Carport
\~~Y-!biih: e cafl O\a~O .'?J'?Jrz.' Sq Ft Other:
009 .~\~~ \~ ~ \'(\a ,\,'000 Impervious Surface Area:
..a: _.\0 _~\'"
-)'- -,\~'"
I DEVELOPMENT INFORMATION .
REQUI~D PARKING
, '~\IJ?\
Overlay Dist: \'i' \\'I'lltll :N.IJ\
# Street Trees Rqd: 'i:.'/..?\~'i:. ~~tf\ll.'iticaPPed:
Paved Drive Rq<<!:.~., <;\\~\.\. ,,<\\\S?t: 'c~ij1p'il'tt:
,,\('i\ \"" ~\'" f:J'i:.~ \ ""f:JIJ~'c .
% of Lot Coverl!g~:I:.\\ "I;) \J~ S ~'O~\~
\\\\... . (;)\\\1':t. IJ~ ~
.,\\~ ...,r.'C.\l jO\('l'i).
I PUBLIC IMPROVE~EN;;&.~ ~\>.~ \ .:
""~ '
.... Sidewalk Type:
Phone
503-399-7609
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
DownspoutslDrains:
Notes:
Pa2e 1 on
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Type of Construction
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
Perm Serv/Fdr 201 to 400 amps
Total Amount Paid
.
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
. CITY OF ~t'K11~GFIELD
Building/Combination Permit
PERMIT NO: COM2003-00984
ISSUED: 10/03/2003
APPLIED: 09/30/2003
EXPIRES: 04/03/2004
VALUE:
Value
Date Calculated
Total Value of Project
l.Fee~ Pfclid .
Amount Paid Date Paid Receipt Number
$14.10 10/3/03 1200200000000002267
$9.87 10/3/03 1200200000000002267
$3.00 10/3/03 1200200000000002267
$63.00 10/3/03 1200200000000002267
$75.00 10/3/03 1200200000000002267
$164.97
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.
l.Renuired In~nection~ I
1 Rough Electric: Prior to Cover
'2 Final Electric: When all electrical work is complete.
3 Electric Service: Approval required prior to utility company energizing service.
By signature, 1 state and agree, tbat I have carefully examined the completed application and do hereby certify that all
information bereon 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
tbat NO OCCUPANCY will be made of any structure witbout permission of the Community Services Division, Building Safety.
,I furtber certify that only contractors and employees who are in compliance with ORS 701.005 will be used on tbis project.
I further agree to ensure that all required inspections are requested at the proper time, tbat 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
Paee 2 00
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
COM2003-00984
COM2003-00984
COM2003-00984
COM2003-00984
COM2003-00984
Payments:
Type of Payment
Check
_~. Cl!"1lLD "
Ui!"."""".'.."'=.._,.....,,.i
,- . ..... "
'>.," 'r :1
'- 1_1
".;.~=""".,"",........_' "'""-.-
Receipt #: 1200200000000002267
Description
Perm ServlFdr 200 amps or less
Perm ServlFdr 201 to 400 amps
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
MORROW MEADOWS
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department"
Public Works Department.
Date: 10/03/2003
l1:21:12AM
Amount Paid
Item Total:
63.00
75.00
3.00
9.87
14.10
$164.97
How Received
In Person
Payment Total:
Amount Paid
$164.97
$164.97
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