HomeMy WebLinkAboutPermit Electrical 2004-6-3
--.
Ii':::"", f,-:i25.FfFTH.~!REET :.~ , ,\ 1'.) ;:'1 ~- Ii.: , .... \ E94J~ALPERMI:r NPLiC~Tioli'k~
t.;,;'.. ,hSPRINGFIEIJD,OREGON9747'71 , i\l . II i I, .' !. ........ '\01l0'fl
:\ "~~'I! .~INS,PEC~lq~ REQUf~f: 7~6,~769~ I j C:;!! 'c~y Joh ~~~heI'COO\z.OO~~~$~~
'< i, 9J,:F\CE: 7?-6-37,5.9\..' i!', L ! h. Ji. ~ Ii: I ;'; l: " \~sSIlO~~eS\lev
\ ,\ r . (" I J.' ,/I i i I (" ., L_ 'l,~_COMPLETE FEE s~~dIll~h' .
,.<' ;i h L%;CAT~IONO. F\iN~'TAL,'LA+,IO.' N~'1 . '11' :f.. i '\0110 DD06. .
. ~.' ~~ . ,} U "T . . 1\ .'y' "'~.. e.{\.. .
'-" -' J' Z .~ r:..e-(... ',/$ 'v . ._.,~ A~ Ne""Residentll\'t~le or" -'.
f Multll-~1milyp\!~I*relr
LEGAL DESCRIPTION Sen'ice Include . 6
1703. "Z 74 I 0300'0 06\6 SI\l,f\6W'
.X\0,1'/.6D
p..1l'
1000 sq.ft. or less
Each additional 500
sq. ft or portiou
thereof
Each ManuI'd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Sel'yicesol'Feeders /: ',',', .;'
Electrical~Oilt;actiC ~ S ~ ffifvlG ~~~~~~I:::::~' Alte7iiOns or .' : }':\ i:,,,
Address f'V:'b _ t?;h~1482..- /~',., 200 amps or le/','.-- ~$ 6'3':0;' :"':-
Cit),' $n~!'~'_~hone 7/Qt-9J,St.. ">~)~: :~:~~~~ :;:~~~:~~ . <,to .':1~~:~~":';
d' \ \ ." 1'1(-/'" . . 601 amps to 1000 amps . $163.00.'
Sup~rvisor License~Numbi:r /'''"171Q.ss.. o;'er) 000 amps/volts ~~ $375.00 . .. :
I' " \J 'I D/: I Ii . ',:' ^' , . Reconnlct9nly ~ =;"\\\r' $ ,50.00 ..;-0
Expiration Date . .1 0.,. ", . : ' . " rl'w.~t. ~'l\~~ "," .':
(, [': ~ " c.~em) \~'~~''\l.1~~~eled't1.~''': '
" Constr.<;:o~::.Number u~4~-,; po;,', '~'Y~~~~m [~~~""" .:
r:.,. >" ----- ctt loJ .,' '. ~\O'8 ~~ :\O~ o\~..ho(\e' '.'
r'<'" ':ExpirationDote -- J. T '. " .\0 ~~~Ml~~A,,~es~~""~.\~50.00 ,_,
, ,~~, . . . . _________~.~o o~~iI~~:' . ~~~'$69.00"""::-
~,.:~}<~:. 'f.. "Slgnatnre or,~~,,,erYlSmg Electncllln \(le~ ~n U~""~~ $100.00 ....:...-:
[~.':,:'.~: ._"~~"~f2{; . 00 :t~~::\&\ -,~-~'. ' ::' .'
\.,', ,. ,:' . ,,':-~ I D. Branch CirCUIts r
,:-.: '. Owners Name ~V-.C;' '{,Jd (~ New!Alteration or'Extension Pe/P;nel'
;, ~d~re~s Z 7' s-O . L 'y'G-/ev on:;~ircuit \ /. ~ . $4,300
" . " l, ' j fi . .", i
Citt&t.(-&V~ Phone 73b-Lfl(/4 iajh'Addition~I'Circuit or with Service
. . orY~~nnit " $ 3.00
OWNER INSTALLATION " :.. :t.\~,\\"i;. ~\j',' . :,-, ~
The IIlstallation IS bemg made on ' 't.'/-.?IR\Qt~~tP\.~'i!'8'S (Sen';celfeeller not incloll~d) '.'
property I 0\\'11 winch is not ~\~~il ~\\~\.\. ,\\\~? ",'C.~Jtfj}'l1s~al.lation ,
for sale, lease or :ent. ~~ ?'t.?-~\' \J~\J't.?- ~~~\Ja''jI'lImp or irngation _ $50.00
, . ,\\\~ ~\1..'t.\J \j?- \~ Il' SignJOlllhne Lighting $50.00
Owners Signatnre. ~\J'\\~...'t.~C't.\J ?'t.?-\\j\J. LImited Ener!''Y/Res , $25.00
C\jW<\'- !:l \)~ . Limited Energy/Comm $45.00
~\'i \'0 '. . .
f-i.. I\linimum ,~I~Ct.-ic Permit Inspection Fce is $45.00 + S~Il'chargcs
~ ,\~', .
j' .
G,[;"".'~ ,
I'" '.
,
"c ..
"
Cost
Sum
JOB DESCRll'TION
\26fL~ 'E,t.>-/!.Nr IMton~fL 1~rtt:tZIt.Vl.
$106.00
, '0.:',-
, .,
! - -I. ~
,
Permits are 11on-transferable and expire
if work is not \startcd within 180 days
of issuance ,br'if work is suspended "for
180 days.
; "., -t
$ 19.00
~
/.. "
,.
,I
"
. ,
.\
", '
$ 50.00
~
',:-
r.t
, .
/. .
, .'
,
4. SUBTOTAL OF ABOVE
7% State SUl'charge
80/0 Administrai'h'c Fcc ~
50.
~)'-'
~'-'
S-8~
TOTAL
"...~
. Lu i' OF ~rtOl'\jul'lJ!.LD
Building/Combination Permit
PERMIT NO: COM2004-00653
ISSUED: 06/03/2004
APPLIED: 06/0312004
EXPIRES: 12/03/2004
VALUE:
e
.\
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1629 KELLY BLVD
ASSESSOR'S PARCEL NO.: 1703274103000
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
PROJECT DESCRIPTION: Replace burnt meter interior
Owner: WILLIS ROBERT E & JUDY K
Address: 2950 IVY GLEN DR EUGENE OR 97402
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
C & SELECTRIC
License
3849
I BUILDING INFORMATION I
# of Units: # of Stories: to
Primary Occupancy Group.;.....ENTlo~~regon ,a~'m~'l\Ye
Secondary Occupancy Grlltlp, S,1t90 ted by tJ\l!pQriJlIA!atYti
Primary Construction Ty15ll10W ~ule Cll'rt~ ThostWu.te~l1:1file';et fO~
Secondary Construction~atlon ~~_0010thr&lg\xEJll#llQ52'()().
# of Bedrooms: in OAR 952-0 bt'n CO!}f!S'a1 RuJlfl.IleS by
0090. You may 0 al ~n~tfAt\Jl'lIarng: nla
_.:.~"-: ."" "Anter, ~~~ . .:,... .H_::~:!l::""'''
number for theJq,~ iNFORMATION I
Center 1:.1"" J.
,
Frontyard Setback:
Side I Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Paved Driye Rqd:
% of Lot Coverage:
Repair
Residential
Expiration Date
09/0112004
Phone
541-741-2236
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
. I PUBLIC IMPROVEMENTS I
NOTICE: Sidewalk Type:
THIS PERMIT SHALL EXPIRE IF THE WOl1MwnspoutslDrains:
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Street Improyements:
Storm Sewer A yailable:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
'.
Total Value of Project
Pal!e 1 of2
Value
Date Calculated
e
. CITY (JI< ~.rKl1~uN~LD~
Building/Combination Permit
PERMIT NO: COM2004-00653
ISSUED: 06/03/2004
APPLIED: 06/03/2004
EXPIRES: 12/03/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I Fp.p.s Paid I
Fee Description
+ 10% Administratiye Fee
+ 7% State Surcharge
Service Reconnect
Amount Paid
Date Paid
Receipt Number
$5.00
$3.50
$50.00
6/3/04
6/3/04
6/3/04
1200400000000000843
1200400000000000843
1200400000000000843
Total Amount Paid
$58.50
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 Reouirp.d I~p.ctions I
1 Electric Service: Approval required prior to utility company energizing service.
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 of the 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
Springfie\d, Oregon 97477
541-726-3759 Phone
e
Job/Journal Number
COM2004-00653
COM2004-00653
COM2004-00653
Payments:
Type of Payment
CreditCard
i.
...
\..
6/312004
RECEIPT #:
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Service Reconnect
Paid By
C&S ELECTRIC
~
av of Springfield Official Receipt
.elopment Services Department
Public Works Department
1200400000000000843
Date: 06/03/2004
Item Total:
l:heck Number Authorization
Received By Batch Numher Numher How Received
djb 000401 003340 In Person
Payment Total:
Page 1 of 1
IO:28:26AM
Amount Due
3.50
5.00
50.00
$58.50
Amount Paid
$58.50
$58.50