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HomeMy WebLinkAboutPermit Electrical 2005-11-8 ,,"' \O~O 0 " . .;,.0 ~,',,, ~ . O~ '" ~~0 ,,0 ~'O c;,v . FAX: (54 J )n6.368~0" "00.,)\,0 . '...0" :\ ~ ~'(O, ~o 8 ,^o 0" ,- *'\.... cP I ( - - 0 J ,,s..-O ,,0 0' '" ~~.,,~" ,~ .,;'1,"....,' I 3, ~!1J." ,.., ( . .;, ns FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726,3753 ELECTlUCAl.. PERMIT APPLICATION CIC,' Jobt'umber CouA~-ot57'Date I, ,'.L(),C;;jj6,".;:8R.:W~~i9.~~l\tWim\'JI " ....~.",...ll~.a~I~~ ""~ l{O 7 S- rrA",- ~,.... 'J1(tI~ c:G.~,L DESCRIPTION I 7013. l{1.{ 3. o C; zoo :08 D!:SCRIPTION A).~ 2.. C-.t~c..,^~~ ParnilS 'He non-rransferable and explre if work is nOI ",,,,d \l'irhin J 80 days of Issuance or if work is Suspended for 180 days, :'Col\iTi8t~}.~~"}_~(p~1fr;)~ ". ,':~":":"';:'J::t.:'1\t~trl' K.{fq~N~ ::ie-:,!ric',:1 ConrraclOr ':'.dcrc:ij surrell Bros, Electric 401'59 Booth Kelly Road Springfield, Oregon 97478 ""-.-""'~-l_,-"'L-"'-. c ~ r~ ~'-';J-:!"\I~or License Number ~~J '- S--- ::"~,,,""on D,,, \c::> \~:"\ ,.... Con;" CalllL Number v~::i'_~~\..o !:.\"''''!IDn Dale \C:l \ t'l', . ~t;:'""~~'0- .! __ I." 0"',,,,., ."'111' Por....-vl...... t-Y ~ LC " ^V~ ,',ocr", Z 51 " c,,> 6.'-7 b"\ C L, (.., f Phone (JII'.\EI< i,'\ST,-U.LATION r,:c: l."!sl.:dlauon is being made on propeny r own which lj !'lot Intended for sale, lease,or rent. O',,'ners Sign2fure: ~' ~ #\~~ ~\)' Illsp,,,ion Request: 726,3769 A, Service Included 1000 sq, ft, or less Each additional 500 sq, ft, or pOl1ion thereof Each Manufact'd Home or 'Modulo,. Dwelling Service or Feeder $106,00 $ 1900 $50,00 $ 63,00 $ 75,00 $i25,OO SI6J,OO S375,OO S 50,00 Installallon, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Voils see "B" above, D, if~:[t~!.~;1;~,;:~':S':7: .... ~{f...r...,.......,..,....,... $ 50,00 $ 69,00 '$ I 00,00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit I 7% Stare Surcharge 10% Administrative Fee TOTAL snoo $ 3,00 l{3 ;l & I , Va.'Il OleQO - \ \O~ , 200J~Sl6pre&l \\\e ~ S 3-le S~?,ClCl\- :I:\~~~'?f~PS'I~~ )H0'Jil?~; O~?- ~ ;,:.IBS 'O'i ~ 'O'll 'lllljl't'\:P's,qO' ~ ~\~iii'pbQ s 0\ \\\ ('",o\\e \O~, .."'\\ <;\r\ nOle \e\er ~ 0" .\\\CcOVl ,A,(Ifil'l10 l,OJ!,\),II(mps. \\\e .-,Iie'" I ~O- o.<-;t; ,,'0- .... n\6' ~O' . O~W~er \~QOj,,:rI)~~ils \,)\\iI\'J t\ 1\\ 9()~eC6~~I(j!l~X le90\\ 3?'??,A. ClO 1\ \\Q ~ . \\.;1 0 \J\J,?j e, I \\' I./b :3~-z. '160 S3B"l.... Shared on....e{T:yauiJdirlg Forms/Elecmcal Pennil ApplicalioD I-OJ.doc . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-01579 ISSUED: 11/08/2005' APPLIED: 11/08/2005 EXPIRES: 05/08/2006 VALUE: Status: Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 4075 FRANKLIN BLVD ASSESSOR'S PARCEL NO.: 1703344309200 Eugene TYPE OF Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add two circuits for exit lights Owner: NORMAN FRANK Address: 2511 LILY AVE EUGENE OR 97408 Phone Number: 541- .",' Contractor Tvpe Electrical I CONTRACTOR INFORMATION I ATTENflON: Oregon law r"n"ir,,~ YOb' 'A. . Contractor follow rules ador't d b ["cense .. EXPll'atIon Date BURRELL BROS ~;r~,~RI~~~~~ eT,-_~~Iit'3~~~6g0n UtI!lIy 08/20/2009 . - ~---- _u_ ~."r;,~~rcr, 1'1' BUlLp,ING.INFeRMkl1I0NIIAR 9p~-OO1: uu"u. TlJU may Obtain copies of the r!)IJM;I!><Y call,#,!!~Sto~J:s"er, {Note: the teleph_ Lot Size: numfu1ilibt ~(e Oregon Utility NotifiCa.ljm,Sq Ft Ist Floor: TYel!l"!.~~!lt, -800'332-2344), - Sq Ft 2nd Floor: Water Type: ' ' Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Patb: Sq Ft Other: Sprinkled nla Occupant Load: Phone 541-747-2724 # of Units: Primary Occupancy Group: Secondary Occupancy , Primary Construction Type : Secondary Construction , # of Bedrooms: 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: Notes: Description Type of Construction SPerSqFt or muItip6er Square Footage or Bid Amount Value Date Calculated 1 of 2 . . CITYOFSPRlNGFIELD- Building/Combination Permi( PERMIT NO: COM2005-01579 ISSUED: 11108/2005 APPLIED: 11/08/2005 EXPIRES: 05/08/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paitll Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ , Add, Alter, Extend Clrc Ea Add Amount Paid Date Paid $4.60 $3.22 $43.00 $3.00 11/8/05 11/8/05 11/8/05 11/8/05 Receipt Number 1200500000000001693 1200500000000001693 1200500000000001693 1200500000000001693 Total Amount $53.82 I Plan Reviews I To Request an inspection caD 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. wiD be made the following work day. Rough Electric: Prior to Cover 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 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 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 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 wiD reDialn on the site at all times during construction. Owner or Contractors Signature Date 2 of 2 225 Fifth Street Sprfngfleld, Oregon 97477 541-726-3759 Phone . ~l ~ '- JoblJournal Number COM2005-0 1579 COM2005-01579 COM2005-0 1579 COM2005-0 1579 Payments: Type of Payment CreditCard ',~ '- 0' ;; , :~ ': \ " .':'1 , 1118/2005 RECEIPT #: " ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000001693 Date: 11/08/2005' Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By JOSHUA BURRELL Received By djb I of I Item Total: l.:heck Number Authorization Batch Number Number How ReceIved 01710B In Person Payment Total: II :45:30AM Amount Due 3,22 4,60 43,00 3,00 $53.82 Amount Paid $53,82 $53.82