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Home My WebLink AboutPermit Electrical 2004-2-12 G · 225 FIFTH STREET. SPRINGFIELD OR 97477 . PH:(541)726-3753 . FhX:"tB~fY'lQ~ll'dI"U~.,..\tt!~~~sth9!0:iOWlnli , i..:,.ill1\j and does not require specific land u~e ELECTRICAL PERMIT APPLICATION ;:> I ~"",".al . L.brL City Job Number COwl Z,CO'-( - OQ I b 7 Date 'I (2./0 L-I '. ~6ning. .R -Jr;-o ;j.' 1. 'i1!ooo'701J'lOF';!'NsTA 7T;4.1j'oN~~~ 3. r;:cOMPI1/ffi1f:ElkSCiiEjjrJi.E'JfELOWts~l<8~~ ~~~~I"'''''''''__'''' ,"-,~~.....:::::,H.<'f..... .,.~i .\ ~23 ".~,,",;~\lf&~.u1.(~r,jl\>:'~:u'G::SI\JrtatLlI':' c -- :, ,. 'B Ivd. , /33 Ke/l'1 LEGAL DESCRIPTION 1'7()s,. :s S-Z Z 123,60 JOB DESCRIPTION i?emokP i Rewl~ I/"L of. l)""ky PermitS are non-transferable and expire if work is not started within 180 days of i.ssuance or if work is Suspended for 180 days; I!iCO.'NTRA.cro'RHNSTALf1A:T.:iON70Nhy:1 2. lh.:1~~~-\,,~;;.."",).'l~."\\~;' ~"'~'0:~.:zU::'~li'tt"'i-i".J Electrical Contractor ])m H t:.leatU'c.. Address 7 f30 s' . 57 U City Sonna/ri!jj__ Phone 5i7-3059 I I Supervisor License Number 4!: 5"'1 S 10/ OJ /0'-/ I ' .. Constr. Contr. Number 1...0- 4S"8L 10101/0C( Expiration Date Expiration Date , , Signature of Supervising Electrician C\l , ,f" """"'- ~ LtL Owners Name LOf'" k y..c:')e. Address 31?"zO S?rz..f'/~ J5L..;'h tf!::"-"U" ":~~<~~'7.li)'l' ''''~,w..~ti.~'!\!= A.. "Ntf~iR~fiiential~Sii{~I~:;'tMuTIi'Familv'p.tr'dweilm"t~ .~~~~"'~~,-.~ ,-- "-':1,,~~,....,,--."'. ...,". ..,_,.~_...",.:..b,,1'5.A . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or p<?nion thereof. Each Manufact'd Home or Modular Dwelling Service or Feeder t $106.00 /00 $ 19.00 $50.00 B. ~-s:~~;i~'~t~t;);Fe~d~;~~~n~~t';.il~H;~;~rf:i;~'iJ~~ri~:R~fo~~ffil~':'~~; t1~~~ ...~..."'..1~".:.) .t.~" ."""v : ,,-":"J:'''~..:;~:i~....'Ll..llZ!/~..fi'_~J.~ '.~~ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 . $ 75.00 . $125.00 $163.00 $375.00 $ 50.00 c. [r1riiP.~7tf~ryJ.S~r.~:i~..cr.yF:etder~t- ~~~< - :.i_G~~-~{'~~t~:~:~ ~~X;it%~ i,d. . ~;;'>I.:..'" ......-.., . "'~'lio","n,,-- . "'....--".rll"~.)y_a..~~4;I'.:l'""n~;..'''-'~ . ..-(~m Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 40 I Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. . D. ~~wef;tlii~t.~~-\J~.~'n~-~' "'$" :~'~:~.1;:,_,;j~~~,,~"'~'''.~~j'\*(it...t~ ~~"'.- '. ""':"'NOlIC ;""'-'.... . f,. .,,~.... .' . " New Alteration or Ef~~ion~'M 'T"nel One Circuit A I /"tR ,_ SHALL nrb'OE IF THE WORK Each Additional Circ)l.t~Jttafi\IZEu UIVUtH THIS PERMIT IS NOT Service or Feeder pe~vl.MENCFn OR ,~ A'sAPfuOI\G3 mil . "",,,.,.,.,~ ,,,,,,,~..,,~;f.t~g-QAY~fi9.810D.,,".. ,<./.,.<~>~,-m E. f~i~~I),~h!9~~'.(~eQ~t~~!!f.,e-9~;~~~~!J~~~lli~f~)~~1~!lJn~t.~fl-~~ City E:v...~e:F Phone Pump or irrigation $ 50.00 . . . ~n law requires y~igq(Outline Lighting $ 50.00 OWNER INSTALLATI0NlTION.Oretg d by the Oregon Ulili~ EnergylResidential $ 25.00 follow rules adop e . fn~' . The installation is b~i~madP.on Io~Wllicliles are SISlm.ted Energy/CommercIal $ 45.00 .. 0 1""UUn .:>,.m'J, 1\1'1952-00 IS not mtended for s l~~ ea!i'1:,'!5z~BlJ1-001 0 through o Mihimum' Electric Permit Inspection Fee is $45.00 + Surcharges n vAH. . pies of the rUles I 0090 You may obtain co ~~"""'." _""~" ~...~., <,..n / OwnerS Signature: '. th center. (Note: the taifl.A".!:!~.J.9l4L;,qt~Q~~ Jt. '~t1; l~\~ ;0 b calling e UtTty Notlftcattor: .~..d_",~.,,-~ number for the.o~e2~~..~8~~2344). 7% State Surcharge' 742- 10% Administrative Fee lObO /2 L( 02 Inspection Request: 726-3769 TOTAL Shared Drive{T:)IBuilding Fonns/Electricn! Permit Application I-03.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00167 ISSUED: 02/1212004 APPLIED: 02/12/2004 EXPIRES: 08/12/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~ SITE ADDRESS: 733 KELLY BLVD ASSESSOR'S PARCEL NO.: 1703352212300. Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Rewire Owner: LOYD KRUSE Address: 3820 SPRING BLVD EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DONALD MARVIN HORTON License 116021 Expiration Date 07/2512005 Phone 541-937-1452 BUILDING INFORMATION I '. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS Front yard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFOR~pON I T - ....... REQUIRED PARKING HIS PERM Overlay Dist: A/IT IT SHALL EXP .T9tal: # Street Trees RtJO;M HORIZED UNDER THJ~RCfifndlt@I1JWJHK Paved Drive R'I)t~ MENCED OR IS AS PcR~,C/S NOT % of Lot Coverage; 180 DAY PERIOD. ANDONED FOR Street Improvements: Storm Sewer Available: Special Instruction: . I PUBLIC IMPROVEMEJ'IlS.1 ATTENTION:U'''llv" .~." -',' '. . follow rules adopted by the Oregon Utility -Jotification Center. Those rules are set for' OAR 952-001-0010 through OAR 952-00 ~090. You may'cibtain'copies of the rules I calling the center. (Note: the tele.~ho~e . _ _ .~_ ,",.~nnn I IIl1itv Notification Sidewalk Type: Downspoutsffirains: Notes: IIU'lU....... ...... - ("~n.n'li~ ~-8{)1I:~"'<:-'<:"":1'. I ValuatIon DescrmtIon Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00I67 ISSUED: 02/1212004 APPLIED: 02/1212004 EXPIRES: 08112/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlon Line I Fpp~ tiLilU Fee Description + 10% Administrative Fee + 7% State Surcharge Residence Wiring 1000 Sq Ft Amount Paid Date Paid Receipt Number $10.60 $7.42 $106.00 2/12/04 2/12/04 2/12/04 1200400000000000198 1200400000000000198 1200400000000000198 Total Amount Paid $124.D2 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 RPnuired Insnections I .1 Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 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 descrihed 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 ofthe property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pal!e 2 of2 225 Fifth Street .,,' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00 167 C0M2004-00167 COM2004-00 167 Payments: Type of Payment Check ~.,~....'..... ~l ~,.".."..,.. Receipt #: 1200400000000000198 Description + 7% State Surcharge + 10% Administrative Fee Residence Wiring 1000 Sq Ft Paid By DMH ELECTRIC Received By djb Check Number Batch Number Authorization Number 907 City of Springfield Official Receipt Development Services Department Public Works Department Date: 02/12/2004 8:21:47AM Amount Paid Item Total: 7.42 10.60 106.00 $124.02 How Received In Person Payment Total: Amount Paid $124.02 $124.02 . .