HomeMy WebLinkAboutPermit Electrical 2004-3-24
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH;(541)726-3753 . FAX: (54~8f1prOjef~~UE~!!)inedJl!is5t\Ei.iolloWlng
ELECTRICAL PERMIT APPUCATION , . /" ~~~'r~~'B~,nd does nOl"enUlr~pe:Gillg~anaruse
City Job Number(DyYflQDl..(_oOO Z''i Date 5:/z-,-!/Ol( Zoning (l ~
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LEGAL DESCRIPTION
170s'3 L(flZ~,
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JOB DESCRIPTION
SP-Vc... i 7 c... i o/Z.c..."'~\ K
Permits are non-transferable and expire if work is
not started within 180 days nf issuance or if work is
Suspended for 180 days.
2. ~~~c#.!g:~~i!~liQ&dl~m
Electrical Contractor ~T/'l1'~fl),J G vt;;c;n'U f/
Address '2-1 '70 I7V {.1L- <?1
City I:: tJ (;DJ/Z
Phone S;-i{ 1- '1'6<1-12- -rg
Supervisor License Number '2--11---'7'7
Expiration Date I tJ - ?1 - 0 '-/-
Constr, Contr, Number If J ? 1 I
Expiration Date 2- - rf - 0 '"
Signature of Supervising Electrician
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Owners Name ;7-Il?I r::[ ~
Address 4c?OI", ~}tAfi,.J l~jJ
A. ~~~~. ~J~;;f;~r%r~fif';;~r.-~~fi!iit~li~. i~~~~~n~~~~
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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
$50,00
ft":'I''ih_f: .,.'f.ji:' -1i '$'::'~':~~~: ';"~""l':,,~.~., .'I..:;:.',t"'~-'iP~.a..\,r-.;,-""~' ~?i'.J:.~":"'{)i'_1l. ~'"
B. ~~~xj;~f2.t~];~~~~UP_~A~}~~n.f11~r~.U;~s.t.~tlt~!Rc~,!~~~~.:~~ ~I
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
.Reconnect Only
I $ 63,00
$ 75,00
$125,00
$163,00
$375.00
$ 50,00
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Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps .
Over 600 Amps or 1000 Volts see "B" above,
1"~-""''''''''''"~~!XJl''\!:>:'''m., {'-" ".:!l1i ':I1"T.;.!Y'~~~~"'J~.,~}"'6I'W""J
D. ~~r~~~h;~g~~,g;~Hi:.~~~,.:~"ij~t\~",~..:~~i'tr":,vd..,~~~,.~ .~<<3.~
New Alteration or Extension Per Panel
One Circuit " $ 43,00
Each Additional Circuit or with ..., ,
Service or Feeder Permit '" $ 3,00
$ 50,00
$ 69.00
$100.00
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E. ~~f,~it~~J-~~~~ft~~W~~b~li~~~~~~~I~~~~~~i~~~ti~it~;
City 5 PJ?v,j) Phone Pump or irrigation $ 50,00
Sign/Outline Lighting $ 50,00
OWNER INSTALLATION . Limited EnergY/Re~dential . $ 25.00
The installation is being made on plbJ;'eAA~m~h!ffit\LL tXPffi\!>~d~;~~fmerCtal $ 45,00
IS not mtended for sale, lease or ren\\-\\S PER \ UNOE\I\f\qUlluRa:t~\1~rmit Inspection Fee is $45.00 + Surcharges
, t\U1\-\ORIIEO OR IS ~B'~~eO~~P.';k(f"""Y~'''''''-'i~T'i':~".",..'>:r'.~~"'1
Owners S,gnature: cot,^MENC~~ PER\0~.I~V!!.J;rl:;'1HH!J1J}f}Y!Jf,J;,~,~:{".;',/~!\~~~. 8-'1
t\N'i 180 0 7% State Surcharge . 58.):1
10% Administrative Fee g'f <)
q8_?%
Inspection Request: 726-3769 TOTAL f
Shared Drive(T:)IBuilding FonnslElectiical Pennit Application 1-Q3.doc
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s
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00084
ISSUED: 03/05/2004
APPLIED: 01/21/2004
EXPIRES: 09/24/2004
VALUE: $ 23,040.00
SITE ADDRESS: 4006 FRANKLIN BLVD
ASSESSOR'S PARCEL NO.: 1703344201600
Eugene
TYPE OF WORK: Office
TYPE OF USE:
Addition
Commercial
PROJECT DESCRIPTION: Camp Putt Sales office
'\,
Owner: CAMP PUTT
Address: % ROTH STEPHEN 4006 FRANKLIN BLVD EUGENE OR 97403
Phone Number: 541-741-9828
Contractor Type
General
I CONTRACTOR INFORMATION I
Contractor
CHARLES L POVEY
OREGON LOG HOME CO.
ALEXANDERJSTAPLETON
ALEXANDERJSTAPLETON
CHAPIN ENTERPRISES INC
Electrical
Mechanical
Plumbing
\,
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
.~ Notes:
License
33293
Expiration Date
04/14/2004
Phone
541-913-0808
541-549-9354
541-484-7278
541-484-7278
541-485-1146
41371
41371
81994
02/05/2006
02/05/2006
05/06/2004
BUILDING INFORMATION'
B
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement~ ou to
ATTENTION:oreglSq ~~SgiP/'JI.\Iity
folloW rules adoPte~=fVIb\\i~.w{Uiel)O':i'
"~';Ii,."ti~~ ~~~e~ .':' ;\..: ---1' nAR 9'5~!O~
I DEVELOPMENT 1NF.@QMl\I'R(')J'ri\rbtliih,coPies of the ruleS I
UU::lU. ru~( Y Note:JUi'.Ci!UliREbQl)fuKING
. calling the center. ( UtUihll\lotiflcatlon
Overlay D.st: lor the Oregon 'l'Olal:"
# Street Trees Rq'p'umber~ ,_.__;~ 1_pnrV~~a~d;t~~'ped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
NOTICE: ' Sidewalk Type:
THIS PERMIT SHALL EXPIRE IF THE WORK Downspouts/Drains:
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Page lof4
ATTENTION:Oregon law requires y( u to
follow rules adopted by the Oregon l tility
~otification Center. Those rules are 51 t for
In OAR 952-001-9019, ,~qHl1r OA~ 95 !-oO
0090. You may obtain~coples'O' the rL as l
calling the center. (Note: the telephl Ine
number for the Oregon Utility Notiflcl tion
-. ., ......... .....,....-: ::~\..1.-1:.
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~
\,
I Valuation Descriution I
Description
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
23,040.00
Estimate
Tvpe of Construction
Estimate
Total Value of Project
!..Fpp< P~\lU
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00084
ISSUED: 03/05/2004
APPLIED: 01/21/2004
EXPIRES: 09/24/2004
VALUE: $ 23,040.00
Value
Date Calculated
$23,040.00
$23,040.00
01/2112004
Fee Description Amount Paid Date Paid Receipt Number
Plan Review CommlIndlPublic $140.79 1/21104 2200400000000000049
+ 10% Administrative Fee $28.96 3/5/04 2200400000000000211
+ 7% State Surcharge $20.27 3/5/04 2200400000000000211
Building Permit $216.60 3/5/04 2200400000000000211
Fixture $28.00 3/5/04 2200400000000000211
'" Planning Final Occy Inspection $118.00 3/5/04 2200400000000000211
SDC Sanitary/Storm Admin $13.71 3/5/04 2200400000000000211
SDC Transpo Admin $11.83 3/5/04 2200400000000000211
SDC Transpo Improvement $192.81 3/5/04 2200400000000000211
SDC Transpo Reimbursement $43.71 3/5/04 2200400000000000211
Storm Drainage Impervious Area $274.22 3/5/04 2200400000000000211
Storm Sewer - 1st 50 Feet $45.00 3/5/04 2200400000000000211
+ 10% Administrative Fee $8.40 3/24/04 1200400000000000375
+ 7% State Surcharge $5.88 3/24/04 1200400000000000375
Add, Alter, Extend Circ Ea Add $21.00 3/24/04 1200400000000000375
Perm Serv/Fdr 200 amps or less $63.00 3/24/04 1200400000000000375
Total Amount Paid $1,232.18
I Plan Reviews I
~,
Paee 2 of 4
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00084
ISSUED: 03/05/2004
APPLIED: 01/21/2004
EXPIRES: 09/24/2004
VALUE: $ 23,040.00
"t
.,
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Review
01/28/2004
03/02/2004
OK
GRG
"~,.,
Initial Review
Plan nine: Review
01/22/2004
02/23/2004
LLH
EMM
01/22/2004
02/24/2004
APP
APP
Plan nine: Review
01/28/2004
WE
EMM
"J,
Public Works Review
01/28/2004
03/01/2004
APP
SB
Structural Review
SUB Review
01/22/2004
01/28/2004
02/02/2004
02/06/2004
OK
APP
TCM
JF
Plan Review-Camp Pull Miniature
Golf Course (same address as RRP):
construct sales office. Job
#2004-00084. Occupancy
Classification: B. Construction type:
V-No 256 square foot office with 812
sq. ft roof.
Provide or maintain address
numbers in contrasting color from
the background positioned plainly
visible and legible from the street or
road fronting the property (Oregon
Structural Specialty Code 502 and
Springfield Uniform Fire Code
901.4.4).
Provide public works lock on man
gate at Concord Street.
Obtained Plumbing permit on
2/2/04. Steve to inspect stub. No
connection allowed at this time.
Waiting for contractor to obtain
plumbing permit for stubbed up
sink not to be connected until sewer
is available. Kitti Gale Planner
Minor Site Plan Review
2002-02-0046
Corrected SDCs to remove
connection to sewer (septic until new
Franklin Blvd Trunk Line is
complete)
Received 1/28/2004.
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.
I R'prnirp,i Tnsnections I
6 Footing: After trenches are excavated.
7 Foundation: After forms are erected but prior to concrete placement.
8 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
3 Drywall: Prior to taping.
4 Final Building: After all Conditions have been completed as required on Development Agreement.
15 SUB Final: After all required energy'inspections have been requested and approved.
10 Rough Plumbing: Prior to cover and including required testing.
11 Storm Sewer Line: Prior to f1Iling trench.
.
in
Pae:e 3 of 4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00084
ISSUED: 03/05/2004
APPLIED: 01/21/2004
EXPIRES: 09/24/2004
VALUE: $ 23,040.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'~
2 Final Plumbing: When all plumbing work is complete.
18 Underground Plumbing: Prior to filling the trench and including required testing.
17 Underground Electric: Prior to cover
9 Rough Electric: Prior to Cover
1 Final Electric: When all electrical work is complete.
5 Final Fire Department. After all requirements of the Fire Departmcnt have heen met.
16 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
12 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
13 SUB Ceiling Grid: Interior Lighting
14 SUB Exterior Lighting
19 Rough Electric: Prior to Cover
20 Electric Service: Approval required prior to utility company energizing service.
21 Final Electric: When all electrical work is complete.
I,
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 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, 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 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
~,
Pal1e 4 of 4
225 Fifth Street cP
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00084
COM2004-00084
COM2004-00084
COM2004-00084
Payments:
Type of Payment
Check
-1A!-[Ji~:4ill
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Receipt #: 1200400000000000375
Description
Penn ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
STAPLETON ELECTRIC
2287
Q::ity of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 03/24/2004 lO:13:19AM
.,
Amount Paid
Item Total:
63,00
21.00
5,88
8.40
$98.28
How Received
In Person
Payment Total:
Amount Paid
$98.28
$98.28
.
.