HomeMy WebLinkAboutPermit Electrical 2006-1-11
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number (.O.......-Z'OOb -Dc>04'{ Date
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LEGAL DESCRIPTION
170'15 Y"32.
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JOS DESCRIPTION
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C (fc..Vl-:+-s
3. ~tQMPif1rtH"F;r{s.C#E.putE BELQW'
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A. f:;N;~<<i~i,d;~~jaF~ ~i'I~gie:QF 1\'i,u)t!~-faJri.ih~per-id'ye)!ii1g I,~.',i!t';',~:d
Service lucluded
1000 sq. I\. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwellirg Se,!i.c,~,\'.'in law reqUires Y'$5li.00
Suspended for 180 days. Peeder, d b
'_u~.e Y tne uregon Utility
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Electrical Contractor ~ CU"f...O (yt;(Jl.. fJt"cl:r\c.1 200CAi%~stFi~~'SIaY obtain copies of the $163WO)Y
\ . LLc.... 201 AinplJIRf'400?Ani'p'Ster. (Note: the telel$115~00
Address %. fux. L..\ 1'1l'lO. 401 A'llij;'2Ii\fiioo'x!rippregon utility Notifin:isfOO
601 Amps to f608t,.(:;,Ws 1.800-30<::-<::J44j. $163.00
Ci~(v1t ~qlt.\D~hone I L\ lD-It11\ Over 1000 AmpsIVolts $375.00
I Reconnect Only $ 50.00
Supervisor License Number '30.,,;) ~ S
Expiration Date I'D I Cll I 01
ConSlT. Contr: Number \ \:0 1.\ ~ II
Expiration Date \)\0\ CA \ 'L.DO 1-
Signature of Supervising Electrician
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Address
LTh
?o IS o~ 7070
t:-VJ.rtrNt! Phone b '62-&:,(00
Owners Name
City
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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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 1000 Volts see "S" above.
D. ~~~~~a~~~h_-:(:'ii.~_~its~.fi~f~i:~;~:~;',:;:~:.'~;.::h:1:;,I~,':~f~\" ~i~~<:' ;." l~L,
$ 50.00
$ 69.00
$100.00
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New Alteration or Extension Per Panel '13
0001tlMtt ,_ _~' .. $,43...00 .
m51 ... i ill SII\iIIiJkn9Ui1IRE Ir I JVUHl\
~_~~R THIS p!:QMI IS$>I(j).ClO I Z
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. E. ~~Ays~~"def;i!~t..illcl~ded),:;:E.:i~h In'stJillatiOJi.
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited EnergylCommercial $ 45.00
Minimum Electric Permit Inspectio'n Fee is $45.00 + Surcharges
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4. 'SUBTOTAL OFABOVE..'.... ~ '>
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7% State Surcharge
10% Administrative Pee
TOTAL
Shi.red Drive(T:)lBuilding FormsfElectricnl Permit Application ~.o3.doc
.
. CITYOFSPRIr\iut<IELD
Building/Combination Permit
PERMIT NO: COM2006-00044
ISSUED: 01/11/2006
APPLIED: 01/11/2006
EXPIRES: 07/Il/2006
VALUE:
Status: Issued
'. 225 Flfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
._ 541-726-3769 Inspection Line
SITE ADDRESS: 3550 Franklin Blvd Bus Stop Eugene TYPE OF
ASSESSOR'S PARCEL NO.: 1703343200101
f.TTENTION: Oregon law requirEtypE'OF USE:
PROJECT DESCRIPTION: Electrical\Servicel!'nd,One.Ciri:uit:t6' BliS'Stop Utility
"'~t:l~;~;i~'n C~nt~r. Those rules are set lorth
. ~ ^ 9 952-001-0010 tnrOu9" UMn ""~'VV .
~;:::s: :O~~~~SIT DIS~~~ You may obtain copies 01 the rules by
EUGENE OR 97401 calling the center. (Note: tile telephone
. ,_ ~I-.~ Il..,.....,..m I Itilihl NotifIcation
Electrical Work Only
New
Commercial
Phone Number: 541-682-6100
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I CONTRACTOR INFORMATION I
,.
Contractor Type
, Electrical
Contractor
LANTZ ELECTRIC
License
84679
Expiration Date
07/14/2006
Phone
541-726-0659
I BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P"rlmary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
SIde 2 Setback:
Rearyard Setback:
, Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
,
Street
Storm Sewer Available:
Special Instruction:
IPUBLIC IMPROVEMENTS I
E~~~~~~'6 ~~~~~ ~~~~~~~~i,~~~~
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Sidewalk Type:
DownspoutsIDrains
Notes:
I VaIuat1]oo Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multipUer
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
1 Fee Description
.., + 10% Administrative Fee
" + 8% State Surcharge
Add, Alter, Extend Clrc Ea Add
Perm ServlFdr 200 amps or less
+ 10% Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Clrc
Add, Alter, Extend Circ Ea Add
Total Amount
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERl\fiT NO: COM2006-00044
ISSUED: 01/11/2006
APPLIED: 01111/2006
EXPIRES: 07/11/2006
VALUE:
Total Value of Project
~
Amount Paid Date Paid Receipt Number
56.60 11Il106 2200600000000000047
$5.28 1Ill/06 2200600000000000047
$3.00 1Ill/06 2200600000000000047
$63.00 1Ill/06 2200600000000000047
$5.50 2/3/06 1200600000000000108
$4.40 2/3/06 1200600000000000108
$43.00 2/3/06 1200600000000000108
$12.00 2/3/06 1200600000000000108
$142.78
I Plan Reviews I
To Request an inspection caD the 24 hour recording at 726-3769. AIl inspection requested before 7:00
:. a.m. will be made the same working day, inspections requested after 7:00 a.m. wiD be made the following
. work day.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work Is complete.
, 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 shan 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 wiD 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 . I further agree to ensure that an 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 wiD remain on the site
: at an times during constructiolL
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541..726-3759 Phone
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Jility of Springfield Official Receipt
.veIopment Services Department
Public Works Department
JOb/Journal Number
COM2006-00044
COM2006-00044
C\)M2006-00044
COM2006-00044
Payments:
T)l'e of Payment
CreditCard
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2/3/2006
RECEIPT #:
1200600000000000108
Date: 02103/2006
Description
+ 8% Stale Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Paid By
CAMP CREEK EKECTRlC
Received By
djb
1 of I
Item Total:
Lheck Number AuUlor1zaUon
Batch Number Number How Received
596048 In Person
Payment Total:
1I:41:59AM
Amount Due.
4.40
5.50
43.00
12.00
$64.90
Amount Paid
$64.90
$64.90