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Home My WebLink AboutPermit Electrical 2006-5-19 ~ 04/28/06 FRI l6:40 FAX CITY OF SPRINGFIELD I4l 001 225 FIFTH STREET' SPRINGFIELD. OR 97477 . PH:(54])726-3753 . FAX: (54])726-3689 ELECTRICAL PERMIT APPliCATION City Job Number c..o m 7.-CJO(;. DO S b S- ~..: . :!.o.,,~:~:,-.1 ,i;"'''~ ",..'On".;.' ",',,"::. ~,C', ,....:., ;.,~] ':';:':i.;I~;.~;:"'"::'i:';~"'~'''''"-'',';':;:'''';','''', -':it';;: I -r. ',- .\ -,~, , , .,...., - ... '.' ~H"' ~ -,~~, 'r,.....'''.,' _ .'~ ,,,.,.. .. -. -~ ~ ,- -." '... J 1. ;ir;OCATIONOF.'INST~TiOi\r:,~'::;'}5:,5:;"i 3. COMPLETE'FEESCHEDULE,BELOW;,.,';i ~;.' f 1,~:'L"'.-t.:...;:;"'i:~:~r:",::::.';;,;.:::,::;'i:,L'.'i.t_:;'-,-:ii.":\.;,::::""';':';:;'::;i;;:',j:.';~::::;j1.J~1=::,;;!~2.':;;ii:..~:..;,,, !.::... ...l.. .,,! I:L~. ).'-1 ~ ~.~=.......\:;.,-__' u~,\'" f,...~>,. '_<;:- . o.f'. ~J""~: ~'" ~1',H ,~'" 3DZ.t;2, -:\u.A.UY\q" fLA, s...',-\t., \ LEGAL DESCRIPTION ~ o'(L A. W&;l~'~~~il!:~~{~ii~!K~t.~r~g~i~i~~l ;~\~~~;~~j::j.)ffi1J~ \"1n,< 3< 4 C'\l/1f\O ' JOB DESCRIPTION (<:>nll ~ + 6 lq.....(I/OV) -t-o e'f~ f:.-fh'1 fA...e ( ...... --. Permits are non-transferable and expire if work is not slarted within 180 days of issuance or if work is Suspended for 180 days. 2. ~t~~fi)![!1&7g~~~laI:r~?Ig~~lltlf~~ ~Ar" Iv........ r:= Ie<.--+- Address los;o J...~#e.. A v-<- City (VJ~fVt~""'t/;/k <;'fo'ne 5Cf!''t72.-Zi{(f- Electrical Contractor Supervisor License Number , 51-" - S Expiration Date 10/;/'0 +- , Conslr, Contr, Number D I 7.1--;j. / 'l. / 7- /O!~ " , Expiration Date a171>>;;j; .-J OwnersName~ C.o.~ Address ~~C1S Cohlk1\ M,~ IO"'V City (i. 10.QryJU PhonS'H -&1 g 7 - (Jf1V q~'f~ 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 ZON L.rnI INlTlA LS N 1'\/\ DATE ~p:>-/q;~ " SOURCE fYV't -rs.~ Date5-Jq- t.(nJ<O Service Included 1000 sq, ft, or less Each additional 500 sq, ft or portion Ihereo f $106,00 $19,00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50,00 B, ~:~fht$j~:[l~~~A~~~l~l~if~~:~ffi\~f! ;~~f~A~~1:~~:~~~'!~~~}l~~~ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 63,00 $ 75,00 $125,00 $163.00 $375,00 $ 50,00 c. ~i~~~~~~!rL$:~~~~;~~Mt1W~~ t~~~~~~iTI~I~i~~~\1 Installation, Alleration or Relocation 200 Amps or less 201 Amps to 400 Amps '401 Amps to 600 Amps $ 50,00 $ 69,00 $100.00 Over 600 Amps or 1000 VollS see "B" abe ve, D. rnt~X~i~~FK~it~li~I~:~tl~~1~1!~~f~~r~~1~~ ~~~2~:;ilif~~~~If;!~~~~!~1~fJ&~~lt!~ New Alleration or Extension Per Panel One Circuit Each Additional Circuil or with Service or Feeder Pennit $ 43,00 $ 3,00 'f3~ E_' ~~~r~~~~11JI~~::~g~~1L~~~~~~~~~~~~~ :[~1~~rEiR~~1!i~~~~~K~~~~~~ Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45,00 Minimum Electric Permitlnspeclion Fee is $ 15,00 + Surcharges JtIT~ :~:Wi,j'1''i<!/'crOO .~*~~rr ?,i~~f/;~S3:J ~ , ~d,O~ I-/;~I)~ 15'3.'D~ 4. f~~:'f~al~~~i:i?:" 8% State Surcharge 10% Administrative Fec TOTAL Shared Drive(T:yBuilwng Fonns/Electrica Pennit Application I-06.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00565 ISSUED: 05/19/2006 APPLIED: 05/15/2006 EXPIRES: 11/19/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3028 JUDKINS RD ASSESSOR'S PARCEL NO.: 1703334400600 Eugene TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Connect sign 10 existing panel TYPE OF USE: Addition au to Commercial ATTENTION: Oregon law "'4U"as y " follow rules adopte~, by th~,~~e~.~n~~;I;~~h NotlTlCaUUl1 VC;ll~""l. .,.~-- - ....... ~....... ~.....1 in OAR 952-001-0010 t~1.\h_o.n~rNumber:)2541-687-9445 0090, You may obtain caples of the rules by r~llinn thp. center, (Note: the telephone ..., .rt"lhor fnr thp. Oregon UlIlIlY l"'UlllluU~'''''''' I CONTRACTOR INFORMA:r.ION"ls 1_800-332.2344). Owner: Address: CHAMBERS CONSTRUCTION 2295 CO BURG ROAD #100 EUGENE OR 97401 Contractor Type Electrical Contractor FARNHAM ELECTRIC CO License 1217 Expiration Date 12/07/2006 Phone 503-472-2186 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Build&!l'lC~. .,,. ~~~\, I'.frcIW.!'~!i~?d;~,~~ I DEVELOPMENT INFORMATioN \ Iml'.R lH\~ ~~~~~'r\)R 'cOMMeNCt.D OR \S i\Bi\N 'RlfQUIRED PARKING Overlay Dist: I\N'I150 Di\Y PeRIOD, Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compacl: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Slorm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I on . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00565 ISSUED: 05/19/2006 APPLIED: 05/15/2006 EXPIRES: 11/19/2006 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 Ff'f'S Paid. Fee Description + 100/0 Administrative Fee + 8% State Snrcharge Add, Alter, Extend Circ Minimum/Adjustmenl Electrical Amount Paid Date Paid $4.50 $3.60 $43.00 $2.00 5/19/06 5/19/06 5/19/06 5/19/06 Receipt Number 2200600000000000632 2200600000000000632 2200600000000000632 2200600000000000632 Total Amount Paid $53.10 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. I Rf'ouirf'd Insnections. Rough Electric: Prior to Cover Final Electric: When all electrical work is complele. 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 struclure 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 thai 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 Pa~e 2 of2 2251ifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00565 COM2006-00565 COM2006-00565 COM2006-00565 Payments: Type of Payment CreditCard cReceint I RECEIPT #: . ~ ~ <;iii& of Springfield Official Receipt .elopment Services Department Public Works Department 2200600000000000632 Date: 05/19/2006 Description + 8% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Paid By MELIA ABRAMS Item Total: Check Number Authorization Received By Batch Number Number How Received njm 019534 In Person Payment Total: Page I of I 2:30:15PM Amount Due 3,60 4.50 43,00 2,00 $53.10 Amount Paid $53,10 $53.10 5/1 9/2006